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l.f Conner - you're my sunshine

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The Village Maternity Services P.O. Box 972906 Miami, FL 33197 www.villagematernityservices.com write: info@villagematernityservices.com ring: (305) 482-1649

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Table of Contents
PREFACE RISK OF NOT BREASTFEEDING THE BASICS SKIN TO SKIN FEEDING ON DEMAND LATCH ADDITIONAL TIPS APPENDIX BIRTH PLAN WORKSHEET 7 9 11 13 15 18 19 20 21

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Preface
on taking the first steps necessary towards creating a positive breastfeeding experience for you and your baby. Ive heard many lactation professionals say, breastfeeding is not only a science, but an art. This is so profoundly true. My breastfeeding journey isn't unlike that of many other women. I had some good days, some triumphs, disappointments and regrets. In retrospect, I realize I didn't do my due diligence as an expecting mother. I knew I WANTED to breastfeed and that was it. I thought it was something that would come automatically. After all, isn't breastfeeding natural?

Breastfeeding is not only a science, but an art!

Boy was I in for a surprise. Although I breastfed my son until he was about 9 months; I weaned after returning to work and starting nursing school; I was unable to produce enough milk to exclusively breastfeed. When faced with some of the challenges that may come with breastfeeding, I didnt know where to go for help. I became frustrated! Possessing the knowledge I have now would have
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made a world of difference for my son and myself. You see, London, my son, suffers from asthma, a myriad of allergies, and eczema. It pains me to know that my chose to not exclusively breastfeed may have been the contributing factor. That is why I am so happy to be able to take the information I have gathered as healthcare professional and mother and share with you. Breastfeeding is making headlines around the world. Although I am excited to see this push, we must also support each others decisions. Women in our society have so many obstacles and face a myriad of booby traps. Think about it for a moment: If you were returning to work, would you be able to pump every 2-3 hours, in a stress free, clean room (cannot be a bathroom)? At the hospital, did your nurses encourage formula? Did you leave the hospital with a gift bag filled with formula? Did you leave the hospital confident in your ability to breastfeed? Do you give women who breastfeed in public strange looks? Do you have a support system? We should support each others decisions. We dont know what difficulties someone is facing until we walk in their shoes. My lactation instructor Gini Baker, would always say You did the best you could, with what you knew. Lets adopt this philosophy for ourselves and others. Be a positive vessel for change. Furthermore, I hope what you find within these pages gets you one step closer to reaching your definition of breastfeeding success. Thank you for allowing me to be a part of your village.
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RISK OF NOT BREASTFEEDING

If you are like most women, then you are well aware of the BENEFITS associated with breastfeeding. Here are just a few:

Benefits of breastfeeding

Decrease risk of SIDS Decrease risk of childhood obesity Preventing allergies

Not to mention, there is absolutely nothing in the world, that anyone can manufacture, that can ever be as easily digestible and homogenous to your babys digestive system as human breastmilk. But did you know that by not breastfeeding you and your baby are at a higher risk of developing certain diseases? Risks for your baby Ear infections Gastroenteritis Pneumonia Atopic Dermatitis Childhood cancer Risk for you Menopausal breast cancer Ovarian cancer Postpartum depression

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On a larger scale, Author of The Politics of Breastfeeding, Gabrielle Palmer credits women for producing "the most ecological food product in the world." Breastmilk is a natural, renewable resource! According to the U.S. Department of Agriculture, $3.6 BILLION would be saved if we increased the number of breastfeeding women 10%. So see, the benefits of breastfeeding dont stop at your front door. Breastfeeding can have a major positive economic effect nationwide. Key points: Breastfeeding is good for baby, mommy, and our economy American Academy of Pediatrics recommends breastfeeding for 1 year (only breastmilk for the first 6 months)

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The Basics
One of the biggest mistakes I made during my nursing process was that I did not understand the means by which my body would produce milk. This along with skin-to-skin and latch, which we will discuss later, are the building blocks for successful breastfeeding. Our bodies are uniquely designed to produce the amount of milk necessary to feed our baby. Click here to watch a video that helps illustrate this point.

At about 14 weeks into your pregnancy, your body will begin making colostrum. Once you give birth, you dont need to wait for you milk to come in. Nature makes sure its already there. In the first few days of breastfeeding, your baby may want to suck a lot. This is important. Let your baby suck on demand. Whenever he wants; even if it is only for 5 minutes. During this time, your baby is getting use to the motions of sucking, swallowing, and breathing. Establishing good techniques now will help when your milk increases in volume. During this time you are bonding and releasing feel good hormones that aide in breastmilk production.

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Key points Milk production begins 14 weeks into pregnancy Milk does not come in at birth. It is already there. It will, however, increase in volume later Sucking is a stimulus that signals your body to produce more milk

Brain

Oxytocin

Sucking stimulus

Milk productiion & letdown

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SKIN TO SKIN
There may be reasons a womans body is not producing enough milk to feed a growing baby. Tongue-ties Breast augmentation Severe maternal stress Milk Stasis Engorgement

Some complication may arise weeks and months after initiating breastfeeding. This book by no means, serves to state that your breastfeeding experience will be as easy as 1-2-3. However, the first few days are pivotal in getting your body on the right track. These steps outlined in these chapters will get you on your way.

Skin-to-skin, also called kangaroo care, is a crucial first step in creating a bond between you and your baby that will promote the release of oxytocin and promote let-down. Skin to skin regulates the babys temperature, blood sugar, breathing, heart rate, and calms a fussy baby. Immediately following birth, place baby on your bare chest between y our breast. Baby will lay there for a while and begin to familiarize himself with the new surroundings. It may take some time (12 hours), but a newborn can actually find, crawl to, latch, and breastfeed on their

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own! All around the world, women are experiencing the breast crawl phenomenon. Heres a link. If would like to do skin-to-skin immediately after birth, discuss your wishes with your healthcare provider. A good way to begin this conversation is by developing a birth plan. A birth plan outlines your wishes for your birth experience. Please visit our website for a list of printable worksheets. Key points: Skin-to-skin helps baby acclimate themselves with their new world Promotes release of feel good lactation hormones Skin-to-skin immediately after birth and as often as possible Create and discuss your birth plan with healthcare provider

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FEEDING ON DEMAND
Its important to understand that newborns feed frequently. It may be every 1-2 hours, or in 45 minute time spans. Understand early hunger cues and it will be easier to feed baby. Early hunger cues: Smacking or licking lips Opening and closing mouth Sucking on tongue, lips, hands, etc Rooting (turning head to the side searching for nipple) Late hunger cues: Moving head frantically from side to side Fussing and breathing fast Crying

Since the proteins in breastmilk are small, it is a lot easier to digest. A breastfed baby will feed more often than a formula fed baby. Also, a newborns stomach is very small. At this time you will be producing about 30 mL of colostrum per day; more than enough to feed your baby. 3-5 days after birth, your milk will increase in volume. Since your baby has retained fluid at birth water is not necessary. Even after baby has lost the extra fluid, your breastmilk is designed to hydrate your baby. Your foremilk is thinner and will quench his thirst. The hindmilk is denser and calorie rich providing baby all the nutrients he needs for the first 6 months of life.
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Also, for the first 6 weeks resist the urge to use bottles or pacifiers. This is especially important for mothers that want to exclusively breastfeed. By using a pacifier, you are satisfying your babies sucking need and decreasing the stimulation to your nipples needed to increase milk volume. The use of bottles will create a preference; not confusion. Babies are not confused. Its much easier to get milk out of a bottle . He has to work harder to massage milk from the breast and may begin to prefer the bottle over your breast. At about 6 weeks, a good breastfeeding regimen should be established, and introducing any of these items at this point should not interfere with breastfeeding.

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Key points: Breastfed babies feed often Breastmilk is the only thing your baby needs in the first 6 months of life Dont substitute baby to breast for anything else (pacifiers or bottles) for the first 6 weeks of life.

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Latch
Since you are breast feeding, and not nipple feeding, you want to ensure baby has a deep latch on your breast. Baby needs to take in the nipple and large portion of the areola; especially on the bottom. The bottom jaw does the majority of the work when it comes to sucking. You want to present the breast and rub your nipple against the babys top lip. He will instinctively put his head back and open his mouth to feed. You will then bring the baby to the breast; chin first; while his mouth is wide open. Always bring the baby to the breast, never your breast to the baby. You will know he has a good latch because his lips will be pursed out like a fish. An improper latch that is not deep is the main reason women experience soar and cracked nipples; some tenderness in normal. Youve never had this amount of stimulation and pressure applied to your nipples. However, the nipples shouldnt crack and feeding shouldnt be painful. If he isnt latched properly, insert a clean pinky into his mouth, and pull outward on his check breaking the seal. Attempt to re-latch. Key point: Breastfeed. Dont nipple feed Lips should appear pursed out like a fish during feeding Break the seal and re-latch if breastfeeding is painful or latch isnt deep

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I hope you find this information useful as you begin your breastfeeding journey. If you encounter difficulty, seek the assistance of a lactation educator/counselor or a lactation consultant. La Leche League offers free support groups in many communities. Together, we can raise happier healthier babies.

ADDITIONAL TIPS
Dont wait. Ask for help right away if you experience difficulty. Problems are easier to fix the sooner they are addressed Dont watch the clock. Let your baby set the pace Consider a co-sleeper or rooming in Develop your support team Consider a to-do-list for friends and family that want to help out. You should be resting during this time, not entertaining guest Have family & friends signup to deliver meals Drink plenty of fluids If you cant sleep when baby sleeps, at least try to get rest. Put your feet up. Read a magazine.. REST The world can wait, so can the dishes and the laundry Give yourself time Dont measure your success against anyone else

Enjoy your baby

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APPENDIX
Colostrum This is the first milk. It is usually yellow in color compared to mature milk. Also known as the foremilk. Newborns have very immature digestive systems, and colostrum delivers its nutrients in a very concentrated low-volume form. It has a mild laxative effect, encouraging the passing of the baby's first stool, which is called meconium. This clears excess bilirubin, a waste-product of dead red blood cells, which is produced in large quantities at birth due to blood volume reduction, from the infant's body and helps prevent jaundice. milk (typically lower in fat) available at the beginning of a feeding hindmilk is milk at the end of a feeding, which has a higher fat content than the foremilk at that feeding This let down reflex usually happens after your baby has been sucking the breast for about two minutes. Some women feel this let-down reflex as a tingling or a warmth. Other women dont feel their let down at all. Even if you dont feel your let down, you will see a change in babys swallowing patterns and hear your baby swallowing Causes the cells around the alveoli to contract and eject your milk down the milk ducts

Foremilk

Hindmilk

Letdown

Oxytocin

Diaper chart

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Birth Plan Worksheet

Basic Information Name: __________________________________________ Partners Name: ___________________________________ Doctor/Midwifes Name(s): __________________________ Other Birth Attendants (doula, friends, etc.): ________________________________________________ _____________________________________________________________________________________ Children and Helpers, if attending: ________________________________________________________ _____________________________________________________________________________________ Babys pediatrician, if known: _________________________________ Delivery location: ______________________________________ Estimated Due Date: ___________________________________ Pre-Birth Preferences Induction: ___ I prefer to be induced on _____________ (date) ___ I will discuss induction after _____________ (date) ___ I prefer not to be induced unless it becomes medically necessary ___I am having a scheduled c-section on _____________ (date) Arriving at the Birth Location ___ I will be birthing at home ___ I prefer to arrive as soon as contractions begin or my water breaks ___ I prefer to arrive once my labor is well established ___ I prefer to arrive only once I am advanced in labor; I want to labor at home as long as possible Paperwork ___ We will pre-register ___ We will do the paperwork at our earliest convenience; please do not separate me from my support person ___ We will do the paperwork immediately; please make an y separation as brief as possible Comfort Measures I would like to use the following comfort measures: ___Pain medication (see below) ___Massage ___Birthing ball ___Birthing tub ___Music ___Essential oils ___Other: _____________________________ 21 | P a g e Need more help? Sign up today for a class. Click here.

Pain Medication ___Please dont offer it; I will ask if I want it ___Please offer me pain medication immediately upon arrival (explain my options) ___Please offer me pain medication only if I seem to need it IV ___I do not want an IV or Hep lock at all ___I am okay with a Hep lock, but do not want an IV ___I would like an IV Water ___I would like my water broken upon arriving at the hospital, to speed things along ___I would like my water broken only if my labor is slow and I am exhausted ___I would like my water broken only if my babys arrival is imminent and it hasnt broken on its own ___I would not like my water broken under any circumstances Food/Drink ___Please offer me ice chips or popsicles and nothing else ___Please offer me drinks but not food ___Please offer me food and drink as I need it ___Please do not offer me anything; I will ask or have an IV Labor Augmentation ___If it becomes necessary, I would like to try natural methods first, including: ___Nipple stimulation ___Walking ___Herbs ___Other ___Please offer me Pitocin ___I would like to try to avoid augmentation if at all possible; my baby will come when s/he is ready Fetal Monitoring ___I prefer an external continuous monitor ___I prefer a continuous internal monitor ___Please use an external monitor for a few minutes per hour to check on my baby ___Please use a Doppler to check on my baby occasionally ___Please do not use any devices to monitor my baby; use a fetoscope or palpations only Labor Positions I would like to labor: ___While walking ___Lying down ___Sitting on a birthing ball ___In the tub/shower ___Let me decide at the time

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Environment ___Please keep the lights dimmed ___Please keep noise levels low ___Please play music. I would like a particular collection: _________________ ___Please do this: _______________________________________ Internal Exams ___Please examine me as soon as I arrive and hourly after to check my progress ___Please examine me only if I ask ___Please keep examinations to a minimum Pushing Preferences ___I would like to push on my back ___I would like to push on my hands and knees ___I would like to push on my side ___I would like to push on a birthing stool ___I would like to push _____________________ ___Let me the decide at the time Episiotomy ___Please cut an episiotomy if my baby is large and having difficulty ___Please do not cut an episiotomy; I would rather risk a tear ___Please allow me to try different pushing positions to avoid a tear ___Please use perineal support, massage and hot compresses to help avoid a tear Vacuum/Forceps If I need an assisted delivery, I would prefer: ___Vacuum ___Forceps ___I trust my doctor to decide whats best C-section ___Please help me to avoid a c-section unless an emergency arises ___Please offer me a c-section in my labor is not progressing after ___ hours ___I would prefer a c-section ___Other: ___________________________ Emergency Procedures ___Please explain to me what my options are so I can choose ___Please use your own discretion and choose what is best for me Moment of Birth ___Please place my baby immediately onto my chest and leave him/her there ___Please allow me to hold my baby briefly before taking him/her to be cleaned and weighed ___Please take my baby to be cleaned/weighed immediately

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Cord Cutting ___Please cut my babys cord immediately ___Please allow my husband/partner to cut the cord ___Please have a doctor cut the cord ___Please wait until the cord stops pulsing before cutting ___Please wait at least an hour to cut my babys cord ___Please do not cut my babys cord (lotus birth) Initial Bonding ___Please leave us alone for an hour after birth to bond ___Please clean and dress my baby, complete our medical exams, and then allow us bonding time ___Please do this: _______________________________________________ Newborn procedures: We give consent for: ___Eye ointment ___Hep B vaccine ___Vitamin K shot ___PKU test ___Hearing test We do NOT give consent for (please bring us any waivers we need to sign): ___Eye ointment ___Hep B vaccine ___Vitamin K shot ___PKU test ___Hearing test Feeding ___My baby is exclusively breastfed, please do not offer: ___Formula ___Sugar water ___Pacifiers ___My baby is formula fed, please help us choose a formula Rooming In ___I wish for my baby to remain in my room 24/7 ___Please take my baby to the nursery only at my request ___Please take my baby to the nursery at night so I can sleep (bringing him/her for feedings) ___Please take my baby to the nursery except when s/he needs fed Visitors: ___I am open to any visitors during visiting hours ___Please allow only the following people: __________________________________________ ___Please do NOT allow the following people: _______________________________________ ___Please, no visitors during these times: ___________________________________________

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Medications Post-Birth ___Please offer me OTC-strength medications to cope with pain (acetaminophen, ibuprofen) ___Please offer me stronger medications to cope with pain (as prescribed) ___Please offer me arnica or another natural pain reliever ___Please do not offer me pain medication ___Please offer me a stool softener ___Please do NOT offer me a stool softener Babys Exam ___Please perform my babys exam in my room ___Please perform my babys exam in the nursery with myself or my partner present ___Please perform my babys exam in the nursery, we do not need to be present Hospital/Birthing Center Stay: ___We prefer to leave 6 hours after birth ___We prefer to leave 24 hours after birth ___We prefer to stay 48 hours after birth ___Please give your recommendation on our length of stay Complications ___If my baby requires a hospital transfer, please allow my partner to accompany him/her ___If my baby requires a hospital transfer, please allow us to go together once I am released ___Please allow another family member to accompany my baby: ________________________ Other: _____________________________________________________________________________________ _____________________________________________________________________________________

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