Question

describe how you would educate a new mother about the benefits of breastfeeding. In addition to this, you will describe the different nutritional needs for premature newborns versus newborns born at its correct gestational age

Answer 1

Greetings of the day!

Answer:

Health Education for a new mother about the benefits of breastfeeding :

Introduction

Breast milk is the perfect food for your baby. Breastfeeding provides many nutritional and health benefits. The American Academy of Pediatrics endorses breastfeeding exclusively for the first six months; the Academy also supports continued breastfeeding along with complementary foods for the first year and beyond as long as mutually desired by mother and child.

Although breastfeeding is natural, it is a learned skill for both mother and baby. Be prepared to practice and have patience. A breastfeeding class will help you learn the basics and avoid many common problems. After the first 2-3 weeks, you will find that breastfeeding will become easier.

Benefits of Breastfeeding

Benefits for baby:

Most health professionals are familiar with the benefits of breastfeeding. There are researches available to support the unequivocal evidence that breastfeeding protects against a variety of diseases and conditions in the infant such as:

• bacteremia
• diarrhea
• respiratory tract infection
• necrotizing enterocolitis
• otitis media
• urinary tract infection
• late-onset sepsis in preterm infants
• type 1 and type 2 diabetes
• lymphoma, leukemia, and Hodgkins disease
• childhood overweight and obesity

Saves Lives

• Currently there are 9 million infant deaths a year. Breastfeeding saves an estimated 6 million additional deaths from infectious disease alone.

Provides Perfect Nutrition

• Breast milk is a perfect food that cannot be duplicated. Mother's milk is tailor-made for your baby. In fact, it actually matches 50% of your baby's genetic material.
  
• Breast milk provides the right balance of nutrients. It is the most natural and nutritious way to encourage your baby's development.
  
  
  
  
  
• To date, we have identified over 200 components in breast milk, and each plays a role not only in the baby's nutrition, but also in general development and growth as well as the development of the immune and nervous systems.
  
• Breast milk provides all of the calories your baby needs in the first 6 months. It has the perfect combination of proteins, fats, carbohydrate, and fluids that new-born babies require.
  
• Breast milk composition is very stable, even when the mother has a poor diet or is ill.
  
• Mother's milk contributes significantly to the growth and maturation of the baby's digestive system, which is not complete until around 6 months of age.
  
• The sugar (carbohydrate) and protein in breast milk are also designed to be used easily and more completely by the human baby.
  
• Breast milk prevents a shortage of vitamin A between 12 and 36 months.
  
  
  
  
  
• With less salt and less protein, breast milk is easier on a baby's kidneys.
  
• Breast milk decreases the risk for vitamin E and Iron deficiency anemia.
  
• Breast milk is a dynamic fluid that changes in composition throughout the day and throughout the course of lactation. It provides for the baby the specific nutrients that are needed at each age and in each situation. The varying composition of breast milk keeps pace with the infant's individual growth and changing nutritional needs.
  
• Breast milk tastes different from feeding to feeding, Subtle changes in the taste of breast milk prepare babies to accept a variety of solid foods,
• Children receive the most complete and optimal mix of nutrients and antibodies.
  
• Breast milk provides adequate water for hydration.
  
  
  
  

• All types of immunoglobulins are found in breast milk. The highest concentration is found in colostrum, the pre-milk that is only available from the breast the first three to five days of the baby's life.
  
  
  
  
  
• Colostrum: Even before your baby is born, your breasts are making colostrum
• Colostrum is a Thick Milk That is Clear and Colorless or Yellowish.
  • Is high in protein, which is exactly what your baby needs in the first few days
  • Contains antibodies that protect baby from infections
  • Helps baby pass the dark, tarry stools he has in the first day or two.

Nurse your baby often in the first few days so he'll get plenty of colostrum. It will also help your breastmilk supply to come in.

• When your baby is 2 to 5 days old, your milk will become thinner and bluish-white in color, like skim milk. Your breasts will also feel fuller. Congratulations, your milk has come in! When this happens, it is very important to nurse your baby frequently to keep your breasts from becoming too full or engorged.
  
  Your milk changes as your baby feeds. When your baby first begins a nursing session, he gets foremilk. Foremilk is lower in fat and higher in lactose, a milk sugar that is important for development. The foremilk quenches your baby's thirst. As the feeding progresses, your milk transitions to hindmilk. Hindmilk is higher in fat, so it helps your baby feel full longer. During a feeding, it's important not to switch breasts until your baby has had a chance to get the hindmilk from the first breast. Some people think of hindmilk as the baby's dessert.
  
• Secretory IGA, a type of immunoglobulin that protects the ears, nose, throat, and the GI tract, is found in high amounts in breast milk throughout the first year. Secretory IGA does its work before it is digested in the stomach. Secretory IGA attaches to the lining of the nose, mouth, and throat and fights the attachment of specific infecting agents. Breast milk levels of IGA against specific viruses and bacteria increase in response to a maternal exposure to these organisms.
  
• Lactoferrin is an iron-binding protein that is found in breast milk, but is not available in formulas. It limits the availability of iron to bacteria in the intestines, and alters which healthy bacteria will thrive in the gut. Again, it is found in the highest concentrations in colostrum, but persists throughout the entire first year. It has a direct antibiotic effect on bacteria such as staphylococci and E. coli.
  
• Breast milk contains lysozyme (a potent digestive ingredient) at a level thirty times higher than in any formula. Interestingly, while other contents of breast milk vary widely between well nourished and poorly nourished mothers, the amount of lysozyme is conserved, suggesting that it is very important. It has a strong influence on the type of bacteria that inhabit the intestinal tract.
  
• Breast milk specifically encourages the growth of Lactobacillaceae, which are helpful bacteria that can inhibit many of the disease-causing gram-negative bacteria and parasites. In fact, there is a striking difference between the bacteria found in the guts of breast- and formula-fed infants. Breast-fed infants have a level of lactobacillus that is typically 10 times greater than that of formula-fed infants. Both the presence of the lactobacilli and the action of the lactoferrins and lysosomes help protect the infant by limiting the growth of unhealthy bacteria in the gut.

Toddler Health

• Mothers of 67 infants were questioned about the types and duration of illness episodes requiring medical care between 16 and 30 months of age. Breastfeeding was noted to decrease the number of infant illnesses and indirectly improve toddler health.

Bonds Mother and Child

• Breastfeeding is a gentle way for newborns to transition to the world outside the womb.
  
• Breastfeeding provides physiological and psychological benefits for both mother and child. It creates emotional bonds, and has been known to reduce rates of infant abandonment.

• The skin-to-skin contact encouraged by breastfeeding offers babies greater emotional security and enhances bonding.

Protects Against Infection

• Human milk has been called environmentally specific milk -- the mother provides it for her infant to protect specifically against the organisms that her infant is most likely to be exposed to.
  
• Breast milk helps your child fight germs and reduces the risk of developing infections. Research shows that breastfed infants have fewer and shorter episodes of illness.
  
• Illness and death are lower in children who are breastfeed until age 2 or 3.
  
• Breastfed babies cry less and have less digestive troubles, such as colic.
  
• Anti-infective properties
  Only breast milk is alive with many different kinds of disease-fighting factors that help prevent mild to severe infections. Babies who are fully or almost-fully breastfed, or breast milk-fed babies, have significantly fewer gastrointestinal, respiratory, ear, and urinary infections.
  
• Antibodies in breast milk directly protect against infection. Other anti-infective factors create an environment that is friendly to good bacteria, referred to as normal flora and unfriendly to bad bacteria, viruses, or parasites.
  
• On average, breastfed babies have fewer infections in their early life. In particular, they have less diarrhoea and vomiting, chest infections, and ear infections compared to babies who are not breast fed. The main reason for this is that antibodies and other proteins are passed in the breast milk from mother to baby. These help to protect against infection.
  
• Breast milk also appears to have properties that help a baby's own immune system work best. If your baby does become ill when breastfeeding and receiving your milk, the infection is likely to be less severe.
  
• In developed countries such as the UK the reduction in the risk of infection is significant. In developing countries such as certain countries in Africa the reduction in the risk of infection is dramatic. For example, a review in 42 developing countries estimated that exclusive breastfeeding for six months, with partial breastfeeding continuing to 12 months, could prevent 1.3 million deaths each year in children under five years.

Protects Against Illnesses

• Compared with formula-fed children, those who are breastfed are healthier and have fewer symptoms and shorter illnesses when they do get sick.
  
• Protection against ear infections, respiratory illnesses, pneumonia, bronchitis, kidney infections, septicemia (blood poisoning),
  
• Increased resistance to infections. Baby is less likely to be hospitalized due to serious illness.
  
• Breastfed infants, and those who are fed expressed breast milk, have fewer deaths during the first year and experience fewer illnesses than babies fed ormula.
  
• Among the studies showing that breastfed infants have a lower risk of infection than non-breastfed infants are:
  
• In a 1993 University of Texas Medical Branch study, a longer period of breastfeeding was associated with a shorter duration of some middle ear infections (otitis media with effusion) in the first two years of life.
  
• A 1995 study of 87 infants found that breastfed babies had half the incidence of diarrheal illness, 19% fewer cases of any otitis media infection, and 80% fewer prolonged cases of otitis media than formula fed babies in the first twelve months of life.
  
• Breastfeeding appeared to reduce symptoms of upper respiratory tract infections in premature infants up to seven months after release from hospital in a 2002 study of 39 infants.
  
• A 2004 case-control study found that breastfeeding reduced the risk of acquiring urinary tract infections in infants up to seven months of age, with the protection strongest immediately after birth.
  
• The 2007 review for AHRQ found that breastfeeding reduced the risk of acute otitis media, non-specific gastroenteritis, and severe lower respiratory tract infections.
  
• Bowels. Less constipation. Stools of breastfed babies have a less-offensive odor.

Prevents Diarrhoea

• Diarrhoea is the leading cause of death among infants in developing countries. Infants under two months of age who are not breastfed are 25 times as likely to die of diarrhoea than infants exclusively breastfed. Continued breastfeeding during diarrhoea reduces dehydration, severity, duration, and negative nutritional consequences of diarrhoea.
• Babies will breastfeed when they have diarrhoea and a fever even when they refuse other foods. This keeps fluids levels high, prevents dehydration and helps them get better faster.
• Diarrhoeal disease is three to four times more likely to occur in infants fed formula than those fed breast milk.
• Children less than 12 months of age had a lower incidence of acute diarrhoeal disease during the months they were being breastfed than children that were fed with formula during the same period.
• Digestive system. Less diarrhea, fewer gastrointestinal infections in babies who are breastfeeding. Six months or more of exclusive breastfeeding reduces risk of food allergies. Also, less risk of Crohn's disease and ulcerative colitis in adulthood.

Reduces Risk of Respiratory Infections

• Short duration of breastfeeding involved another significant risk of recurrent respiratory infections and otitis media.
  
• Respiratory system. Evidence shows that breastfed babies have fewer and less severe upper respiratory infections, less wheezing, less pneumonia and less influenza.

• Breastfeeding provides a nutritious, easily digestible food when a sick child loses appetite for other foods. When a child is ill or has diarrhea, breastfeeding helps prevent dehydration. Frequent breastfeeding also diminishes the risk of malnutrition and fosters catch-up growth following illness.

Promotes the Recovery of the Sick Child

• General
  Infants of a middle class and well-educated populations benefit from the breastfeeding practice and its protective effect, more so if they are exclusively breastfed and for a longer period.
  
• In developing countries, differences in infection rates can seriously affect an infant's chances for survival. For example, in Brazil, a formula-fed baby is 14 times more likely to die than an exclusively breast-fed baby.
  
• Immunologic Development
  Enhanced fecal SIgA in breastfed infants is not cause solely by the presence of IgA in breast milk; it represents a stimulatory effect of breast milk on the gastrointestinal humeral immunologic development.

General Morbidity

• There is an inverse relationship to breastfeeding and morbidity. This was most prominent in the first year of life, but it was also present in the first three years.

Infant Survival

• There is an association between breastfeeding up to 6 months of age and survival of infants throughout the first year of life. The younger the infant and the longer the breastfeeding, the greater the estimated benefits in terms of death averted.

• Breast milk, especially the first milk (colostrum), contains anti-bacterial and anti-viral agents that protect the infant against disease. The colostrum coats the GI tract, preventing harmful bacteria and allergy -triggering protein molecules from crossing into baby's blood. Breast milk also aids the development of the infant's own immune system.
• During breastfeeding antibodies pass to the baby. This is one of the most important features of colostrum, the breast milk created for newborns. Breast milk contains several anti-infective factors such as bile salt stimulated lipase (protecting against amoebic infections), lactoferrin (which binds to iron and inhibits the growth of intestinal bacteria) and immunoglobulin A protecting against microorganisms.

Provides Initial Immunization

• Breast milk, especially the first milk (colostrum), contains anti-bacterial and anti-viral agents that protect the infant against disease. The colostrum coats the GI tract, preventing harmful bacteria and allergy -triggering protein molecules from crossing into baby's blood. Breast milk also aids the development of the infant's own immune system.
  
• During breastfeeding antibodies pass to the baby. This is one of the most important features of colostrum, the breast milk created for newborns. Breast milk contains several anti-infective factors such as bile salt stimulated lipase (protecting against amoebic infections), lactoferrin (which binds to iron and inhibits the growth of intestinal bacteria) and immunoglobulin A protecting against microorganisms.

Enhances Vaccine Response

• Breastfed babies respond better to vaccinations. Breastfeeding helps the baby's immune system mature, protecting the baby in the meantime from viral, bacteria, and parasitic infections.
  
• Breastfeeding promotes earlier development of the infant immune system and increases the effectiveness of immunizations, increasing the protection against polio, tetanus, and diptheria vaccines.
  
• Breast milk can transfer specific or nonspecific immunities to the external mucosal surface of the intestine and possibly to the respiratory tract of the newborn. The acquisition of such passive immunity is particularly important in the early neonatal period when the immune system is immature.
  
• Many studies show that breastfeeding strengthens the immune system. During nursing, the mother passes antibodies to the child, which help the child resist diseases and help improve the normal immune response to certain vaccines.
  
• The antibody levels of immunized infants were significantly higher in the breastfed than the formula-fed group. These findings are strong evidence that breastfeeding enhances the active humoral immune response in the first year of life.
  
• The breastfed group had significantly higher antibody levels than two formula-fed groups together. Breastfed infants thus showed better serum and secretory responses to perioral and parenteral vaccines than the formula-fed, whether with a conventional or low-protein content.

Premature and Low Birthweight Infants

• Breastfeeding provides benefits not just for full-term infants but also for premature and low birthweight infants.
  
• Compared with premature infants who receive breast milk, those who receive formula have future IQs that are 8–15 points lower.
  
• Less necrotizing enterocolitis in premature infants
  
• Breastfeeding may protect preemies from infections and high blood pressure later in life
  
• For premature infants, breast milk:
  • significantly shortens length of hospital stay
  • reduces hospital costs
  • hastens brainstem maturation
  • reduces the risk of life-threatening disease of the gastrointestinal system and other infectious diseases
    
• Breastfeeding releases endorphins, which creates a feeling of relaxation and well being in mother and baby, and is even an ideal pain reliever for the baby.

Availability

• Breast milk is always available, never spoiled and totally free.
  
• Breast milk availability works on a supply and demand basis. Maintaining a good milk supply depends on the regular stimulation provided by baby or by pumping. Double pumping helps increase your prolactin levels, which helps maintain milk supply. This benefit is important to working mothers who might have difficulty maintaining their milk supply because baby isn't always available for breast stimulation.
• No mistakes in mixing.

Easily Digested

• Since nature designed human milk for human babies, breast milk is the most nutritious and easily digested food your baby can receive. A nutritious, yet easily digested first food is important for a baby's immature digestive tract. Babies uses less energy, yet break breast milk down more completely into its basic ingredients, so the nutrients, anti-infective factors, and all the other ingredients in your milk are more available to fuel the baby's body functions and to promote the baby's growth and development.
• Mother's milk is easier to digest and almost completely assimilated by the baby. This is why breastfed babies feed more frequently than formula-fed babies. Breastfed babies also make liquid stools that contain almost no solid matter (and do not smell offensive).

Bio-Avalibility

• Bio-availability is a fancy way of referring to how well the body can use the nutrients in a food. The high bio-availability of nutrients in breast milk means your baby gets more benefits from the nutrients it contains even for nutrients that appear in lower levels in breast milk when compared to infant formulas (because your baby's body can absorb and use them most effectively). It also means your baby saves the energy that would be needed to eliminate any nutrients he/she had difficulty digesting or using.
  
• While carnitine is present in both breast milk and formula, the carnitine in breast milk has higher bioavailability. Breast-fed babies have significantly higher carnitine levels than their counterparts. Carnitine is necessary to make use of fatty acids as an energy source. Other functions of carnitine have been hypothesized, but have not yet been proven.

Suitability

• Your milk is best suited to, and so it is more gentle on, your baby's body systems. The suitability of your milk plays a role in your milk's digestibility, and it allows your baby's body to function most efficiently while spending a lot less energy on body functions. Suitability is also thought to be one reason that breastfed babies are less likely to develop allergic-related skin conditions and asthma.
• The composition digestibility, bio-availability, and suitability of your milk means that your baby's body is able to work less to receive more nourishment. Your baby also receives properties to help fight infections.
• Your milk is the perfect first food to help your baby achieve every aspect of ideal growth and development.

Supports Food Security

• Breast milk provides total food security for an infant's first six months. It maximizes food resources, both because it is naturally renewing, and because food that would otherwise be fed to an infant can be given to others. A mother's milk supply adjusts to demand; only extremely malnourished mothers have a reduced capacity to breastfeed.

Enhances Development and Intelligence

• Enhanced neurological development that may result in higher IQs.
• Human survival depends more on brain power than on strong muscles, rapid growth (rapid maturity), or body size, so your milk is rich in the nutrients that best promote brain growth and nervous system development.
  
  
  
  
• Breast milk is high in fat. fatty acids for brain development. Some recent NICHD-supported research also suggests that breast milk contains important and essential fatty acids, a key source of energy and building blocks that help an infant's brain develop. Two specific fatty acids, known as DHA and AA, may help increase infants' cognitive skills.
  
• Breastfed infants develop higher IQ's, and have improved brain and nervous system development; IQ advantage of 10-12 points studied at ages 8, 12, and 18. (Breastfeeding is considered the 4th trimester in brain growth and development...there are specific proteins in breast milk that promote brain development).

Higher IQ

• Research has found that breastfed babies perform better on different kinds of intelligence tests as they grow older.
  
• Children who had consumed mother's milk by tube in early weeks of life had a significantly higher IQ at 7.5 to 8 yr. than those who received no maternal milk, even after adjustment for differences between groups and mothers' educational and social class.
  
• Mother's milk contains the fatty acids essential to the development of the baby's nervous system and vision. This may be one of the reasons why breastfed babies' IQ are 8 to 10 points higher than that of formula-fed babies.

• Breastfed children scored score higher on cognitive and IQ tests at school age, and also on tests of visual acuity.
  
• Higher IQ in breastfed children. Cholesterol and other types of fat in breast milk support the growth of nerve tissue.

Cognitive Development

• Supplementary regression analysis examining the strength of relationship between duration of breastfeeding and cognitive development show a small but significant relationship between duration of breastfeeding and scores on the mental development index of the Bayley Scales at 1 and 2 years.
  
• In 771 low-birth-weight infants, babies whose mothers chose to provide breast milk had an 8-point advantage in mean Bayley's mental developmental index over infants of mothers choosing not to do so.

Social Development

• The psychomotor and social development of breastfed babies clearly differs from that of bottle-fed ones and leads at the age of 12 months to significant advantages of the psychomotor and social capabilities.
  
• Significant evidence suggests that breast-fed children develop fewer psychological, behavioral and learning problems as they grow older. Studies also indicate that cognitive development is increased among children whose mothers choose to breastfeed.
  
• In researching the psychological benefits of breast milk, one researcher found that breast-fed children were, on average, more mature, assertive and secure with themselves as they developed.
  
• Developmental and emotional factors
  
• One study reported that performance in childhood intelligence tests was better in children who had been breastfed compared to those who had been bottle fed. It is difficult to assess emotional factors, and no firm conclusions can be drawn. However, it is thought that breastfeeding enhances the 'bonding' process between baby and mother.

Psychological Factors

• You mentioned that these scientists suggest that the only difference between formula and breast milk is psychological. I strongly disagree that this is the only difference, but I agree that the psychological difference can have profound implications. Over the last decade-and-a-half, the developing field of psychoneuroimmunology has demonstrated repeatedly that an individual's psychological state has a direct effect on his or her immune function. Perhaps the nursing experience by itself does directly improve the immune status of infants.

Long Term Benefits for Infants

• Many studies have looked at the possible long-term health benefits of breastfeeding. There is now good evidence that, on average, the following health problems in later life are less common in those who had been breast fed compared to those who had not:
  
• Some benefits of breastfeeding become apparent as the child grows older.
  
• In one study, breastfeeding did not appear to offer protection against allergies.[41] However, another study showed breastfeeding to have lowered the risk of asthma, protect against allergies, and provide improved protection for babies against respiratory and intestinal infections.[42]
  
• A review of the association between breastfeeding and celiac disease (CD) concluded that breast feeding while introducing gluten to the diet reduced the risk of CD. The study was unable to determine if breastfeeding merely delayed symptoms or offered life-long protection.[43]
  
• An initial study at the University of Wisconsin found that women who were breast fed in infancy may have a lower risk of developing breast cancer than those who were not breast fed.[44]
  
• Breastfeeding may decrease the risk of cardiovascular disease in later life, as indicated by lower cholesterol and C-reactive protein levels in adult women who had been breastfed as infants.[15][45] Although a 2001 study suggested that adults who had been breastfed as infants had lower arterial distensibility than adults who had not been breastfed as infants[46], the 2007 review for the WHO concluded that breastfed infants "experienced lower mean blood pressure" later in life[15]. Nevertheless, the 2007 review for the AHRQ found that "the relationship between breastfeeding and cardiovascular diseases was unclear"[14].
  
• Breastfeeding protects against developing chronic diseases such as: celiac disease, inflammatory bowel disease, asthma, and childhood cancers.
  
• Mother's milk protects the baby from many diseases, both during breastfeeding and throughout life, first by conferring passive immunity and then by stimulating the baby's own immune system. These effects increase with breastfeeding duration

There are also maternal health benefits to breastfeeding such as:

• decreased postpartum bleeding and more rapid uterine involution and slimming process.
• decreased menstrual blood loss and increased child spacing (lactational amenorrhea)
• earlier return to prepregnancy weight
• decreased risk of breast and ovarian cancers

​Breastfeeding is also a great benefit to the environment and society. Breastfeeding families are sick less often and the parents miss less work. It does not require the use of energy for manufacturing or create waste or air pollution. There is no risk of contamination and it is always at the right temperature and ready to feed.

Contraindications to breastfeeding

The only true contraindications to breastfeeding are the following:

• infants with classic galactosemia (galactose 1-phosphate uridyltransferase deficiency)
• mothers, in the US, who are infected with human immunodeficiency virus (HIV).

​Refer to the policy statement​ for other conditions that may require further investigation.

Breastfeeding is NOT contraindicated with the following conditions:

• infants born to mothers who are hepatitis B surface antigen-positive
• mothers who are infected with hepatitis C virus (persons with hepatitis C virus antibody or hepatitis C virus-RNA-positive blood)
• mothers who are febrile (unless cause is a contraindication outlined in the previous section)
• mothers who have been exposed to low-level environmental chemical agents
• mothers who are seropositive carriers of cytomegalovirus (CMV) (not recent converters if the infant is term)
• mothers who smoke tobacco (though they should be encouraged to quit) or have an occasional celebratory drink
• the great majority of babies with jaundice or hyperbilirubinemia can continue to be breastfed without interruption

OTHER ADDITIONAL TEACHING REGARDING BREASTFEEDING

Feeding Patterns

During the first several weeks, it will seem as if your baby is feeding all the time. Breast milk is quickly digested in a baby’s stomach. Therefore, baby needs to breastfeed at least 8-12 times every 24 hours during the first few weeks. Frequent feedings are needed for baby to gain weight and to stimulate your body to produce plenty of milk.

Feed your baby at the first signs of hunger. Do not wait until baby cries. Crying is often a late sign of hunger; it can make latching on harder.

When the baby is Sleeping

Newborns can be drowsy. If your baby falls asleep after only a few minutes of active feeding, he or she may not be getting enough breast milk.

• Stroke the bottom of the baby’s foot with your finger
• Place baby in a sitting position for burping
• Loosen the baby’s clothing
• Change breastfeeding positions; baby may stay awake in a different position
• Gently squeeze and massage the breast to get the milk flowing

Baby is getting enough milk if:

• Baby is back to his or her birth weight by 10-14 days
• Baby gains weight steadily after the first week (4-7 ounces per week)
• Baby makes swallowing sounds while nursing
• Baby seems satisfied after being fed and burped
• Baby is nursing at least 8 times in 24 hours
• Your breasts feel softer after feeding
• You are changing six to eight wet diapers a day by the end of the first week
• By 5-7 days after birth, baby stools 3-6 times per day and may stool after each feeding for the first month of life

Breastfeeding Holds

You will spend many hours feeding and soothing your baby at the breast. Your baby’s success at latching onto the breast, as well as your comfort during feedings, are important for breastfeeding success. Try holding your baby in different positions to find what works best.

Cradle Hold

The cradle hold is the most commonly used nursing position. Sit in a comfortable chair, with arm rests is possible. Place your baby on your abdomen, tummy-to-tummy. The baby’s head is in the crook of your arm and the face to your breast. The baby’s knees are underneath your other breast. The baby’s head, back and legs should all be in a straight line. If you feel your nipple starting to hurt during the feeding, check baby’s position.

Cross Cuddle Hold

Place a pillow on your lap and put the baby on top of the pillow. You will use the hand on the side as the breast to support the breast. Instead of holding the baby’s head in the bend of your elbow as in the cradle hold, hold him with the opposite arm so that your hand rests between the shoulder blades and supports the back of his neck and head. The baby lies chest to chest with the mother.

Football Hold

Cradle the back of your baby’s neck in your hand with the body under your breast and toward the elbow. Place a pillow under your elbow to support your baby’s bottom. Your other hand supports your breast. This position gives you control of the baby’s head and eases latch on positioning. This is a good position for mothers who have had cesareans.

Side-lying or Lying Cradle Hold

Lie on your side with one arm supporting your head. Your baby lies beside you with the head facing your breast. Pull the baby in snugly and place a pillow behind to support the baby. This is also a good position for mothers who have had a cesarean section because the baby does not put pressure on the mother’s stomach.

Breast Health

Establish a routine of checking your breasts and nipples regularly. Leaning how to identify, prevent, and treat conditions that can occur during breastfeeding can help you avoid problems and resolve discomfort faster.

Breast Care

• Wear a supportive bra, even at night. Make sure it fits well and is not too tight. Nursing bras are convenient for feeding.
• Avoid restrictive clothing and underwire bras, which can cause blocked milk ducts and increase the risk of breast infection.
• Change nursing pads whenever they become damp, wet, or soiled.
• Take a daily shower. Use only clear water on the nipples. Soap washes off the natural lubricant produced by the glands around your nipples; it can cause your nipples to become dry and cracked.

Sore Nipples

Breastfeeding should not be painful, but your nipples may feel tender for the first few days. If your nipples become sore, your baby may not be latching correctly.

Plugged Ducts and Mastitis

In a breastfeeding mother, a milk duct can become blocked and cause a hard, tender knot on the breast. Here are some tips to treat such an area:

• Apply a warm compress to the affected area before feeding.
• Allow your baby to nurse often. Offer the plugged side first if it is not too tender. If possible, position baby so that the chin or nose points to the plugged ducts. This will help drain the area more effectively.
• While nursing, massage the hardened area, moving your fingers from the chest toward the nipple.
• Use hand expression or a pump to express milk left in the plugged breast after feeding.
• Apply a cold compress after feeding to relieve pain and swelling.
• Spend more time resting, eat a healthy diet, and drink enough fluids

Pumping Breast Milk

At times, women who breastfeed need to use a pump to express their breast milk. Reasons for expressing breast milk vary. Women pump milk to relieve breast engorgement, permit another person (spouse, family member, caregiver) to feed the baby, or because they are returning to work.

Expressing milk can be done with a commercial pump or with your hands. Breast milk volume is regulated by supply and demand. Pumping is a way to keep your breasts regularly stimulated while you’re at work, on errands or if your baby is sick and has temporarily stopped feeding. It’s normal not to get milk the first few times your pump; keep trying.

Storing Breast Milk

Whether you plan to use your expressed milk the same day or later, you must store it safely. These guidelines are for healthy infants. Storage times may vary for premature or sick babies.

• Store milk in a clean bottle or disposable milk storage bag.
• Fill each bottle with enough milk for one feeding. Storing 2-4 ounces of milk per container should cut down on waste.
• Use a solid cap to create an airtight seal.
• Hold the bottle under warm running water, or place in a bowl of warm water for a few minutes, until milk reaches room temperature.
• Do not warm milk in the microwave or on a stove. Rapid heating destroys nutrients and causes hot spots that can burn baby’s mouth.

The different nutritional needs for premature newborns versus newborns born at its correct gestational age:

Postbirth Age WATER REQUIREMENT (ml/kg/day)

Preterm infant

Low birth weight - 80-140 ml/kg/day

Growing preterm infant - 150-180 ml/kg/day

Term infant

3 days - 80-100 ml/kg/day

10 days - 125-150 ml/kg/day

3 months - 140-160 ml/kg/day

6 months - 130-155 ml/kg/day

1 year -    120-135 ml/kg/day

Sources: Trahms and Pipes (1997) and Zerzan and O’Leary (1997).