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Protecting Breastfeeding When Baby Can’t Nurse

ADVICE FROM THE EXPERT!

• Breast stimulation normally begins soon after birth. Babies may be sleepy the first day. From then on, newborns breastfeed 8-12 times a day. Breast stimulation on Day 2 is important to prevent delays in your milk coming in. If complications cause delays, protect your breastfeeding options by following 3 Rules:

Feed the baby (hand-expressed or pumped colostrum or donor milk)
Protect the Milk Supply (hand express and pump every 3 hours)
Protect breast focus (skin-to-skin holding, use breast as pacifier)

• Colostrum (the first milk) protects the baby from infection and prevents excess weight loss. Hand express and spoon feed it to help wake a sleepy baby so you can practice breastfeeding.

• Rent a hospital grade electric breast pump if there will be a delay in the baby being able to breastfeed. Double pump for 12-15 minutes at least 8 times during every 24 hours. Hand expressing increases milk supply in combination with pumping and skin-to-skin baby holding. Select the highest comfortable pump pressure setting. Make sure the pump flange is a good fit with your nipples. If your nipples swell and rub on the sides of the flange, get a larger flange. If the flange is too tight, milk cannot flow freely. Avoid prolonged engorgement because it causes the milk supply to decrease.

• Normal milk volumes:
Day 1 - 7 ml per feeding/pumping
Day 2 - 12-14 ml per feeding/pumping
Day 3 - the milk "comes in" and averages about 2 oz per feeding/pumping
Day 7-10- a normal milk supplies is about 24 ounces of milk each 24 hours period (about 3 ounces every 3 hours).

• Skin-to-skin contact at each feeding improves milk production. Offer the baby a little milk from a cup, spoon, feeding tube or bottle at the start of the feeding, and then put the baby to breast when they are not so hungry or frustrated. This makes the breast the reward and helps with an easier transition to full breastfeeding.

• It is a sign of good milk intake if the baby makes 4 or more loose, yellow poops (bigger than a quarter in size) every day from Day 4 on. After 3 months, some babies go longer without making a dirty diaper but constipation is rare in newborns. Lack of bowel movements is a warning sign in infants. Seek advice if your baby loses more than 7% of birth weight. Breastfed babies normally regain birth weight by Day 10, and during the next several months gain 1 ounce a day (7 oz per week, about 2 lbs per month).

• Stress, pain, and fatigue affect milk supply. Drink to thirst, and take naps. Eat 4 oz of protein at every meal (eggs, cottage cheese, beans, fish, meat, nuts). Treat anemia or low Vitamin D status, or thyroid conditions. Painful feeding is not normal. If it hurts to breastfeed, find someone to help you improve the latch and examine you for possible infection of the nipple or breast.

Barbara Wilson-Clay, BS, IBCLC, FILCA    © 2012

 Barbara Wilson-Clay is a world renowned Lactation Consultant and author of The Breastfeeding Atlas. She was a Founding Board Member of the Mothers' Milk Bank at Austin and served on the board for 11 years. Barbara resides in Austin where she continues to share advice with breastfeeding mothers while relishing in her new role as a grandmother to two adorable grandbabies!


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