KM-NICU-Breastfeeding-Book-English-Final

Parents Guide For Pumping And Breastfeeding

Helping You Supply Breastmilk The Best Nutrition For Your Baby

Helping You Supply Breastmilk - The Best Nutrition For Your Baby

Your baby has been admitted to the hospital. Providing breastmilk for your baby lets you participate in your baby’s healthcare in a very crucial way. Breastmilk will give your baby the very best start in life because it is the best nutrition. Babies need their mother’s milk to helpprotect themfromdisease, help them grow and develop, and help with digestion. Providing breastmilk is one of the most important things you can do to help your baby.

Breastmilk contains special nutrients that help prevent infections and help shorten your baby’s time in the hospital. It is specially designed for the baby’s needs. Even a few drops of the first milk you produce, called colostrum, contains important infection-fighting cells. You may need help in learning how to provide breastmilk for your baby. This booklet will give you the information you need to get started. Here at Kern Medical, we also offer 24-hour lactation support.

Pumping Basics

Establishing Your Milk Supply • The best way to establish and maintain a good milk supply is to pump as often as you would nurse a newborn baby. • You should begin pumping as soon as possible after delivery, ideally within 6 hours. The hospital will provide a pump for use during your stay. • It is best to pump with a hospital-grade breast pump and a double pumping kit, so you will be able to pump both breasts at the same time. These breast pumps are available in stores for purchase and can also be rented. Plan to rent a hospital-grade electric breast pump at least until your due date plus one month if your baby was born prematurely. If you participate in WIC, you may be eligible to be supplied a pump for use while your baby is in the hospital. Ask your baby’s nurse for details.

Preparing to Pump Your Milk • Wash your hands before pumping to keep germs from getting into your milk. • You may want to apply a warm, moist towel over your breasts and/or massage your breasts gently from the chest wall toward the nipples before pumping, covering all areas of both breasts. Warmth and massage will help with your milk flow and supply.

Pumping Your Milk • Plan to pump 8-12 times in a 24- hour period. Pump every 2-3 hours during the day and every 3-4 hours through the night. This is how often your baby would breastfeed. • Write each session in a feeding log to ensure you are pumping enough times to start and maintain milk production. • Pump each breast for 10- 15 minutes, preferably at the same time if you have a double pump. Massaging the breast will increase milk volume. • In the beginning you may not see any milk or only get a few drops of milk at each pumping. That is normal. Your baby only needs

small amounts of milk in the first few days. Any amount will be beneficial for your baby. Continue to pump. • As you produce more milk, pump until about 2 minutes after the milk stops dripping. • The more you pump in the first days after birth, themoremilk you will produce. By the 7th day, milk production should approach 500ml/24 hours (about 16oz).

TIPS • Allow 20-30 minutes of quiet time for pumping. • RELAX - The most common causes of low milk supply are fatigue and infrequent pumping (the more you pump, the more milk you produce). To help you relax, keep a picture of your baby nearby during pumping, or think of your baby and visualize him or her nursing at your breast. Pump at your baby’s bedside or after holding your baby. • Keep a log of how long you pump and how much milk was obtained. A written record will help you to determine if you have a drop in the number of sessions, in actual time spent pumping, or in the volume of pumped milk. You can then make changes before a real problem develops.

Using a Breast Pump

Electric Pump Read the instruction manual first, but you may have to experiment with different techniques and settings on the breast pump before you find the one that works best for you. You may want to moisten the rim of the breast flange with water before pumping to create a better seal on the breast. You can either center the breast flanges on the nipple and areola first and then turn the pump on, or turn the pump on first and then place the flanges over the breasts. Start the pump at the low/minimal suction setting and gradually turn up the suction so that you feel a deep, pulling sensation. Set the level as high as comfort allows; the highest level may not be needed. Pumping should not hurt. Decrease the suction if it causes discomfort. Suction cannot be maintained if the seal of the

flange on the breast is broken, so check the seal of the flange periodically. Also watch for the rhythmic pull and release of the nipple and areola in the flange. When you are finished pumping, you must break the seal between your breast tissue and the breast flange. To do so, use a clean finger and press in on your breast, just above the breast flange. If milk has pooled in the flange, tilt it so that milk can drain into the collection bottle as you remove the flange. Then turn off the breast pump (You may prefer to turn the breast pump off first, and then break the seal between the flange and the breast).

Hand Expression Every mom needs to learn how to hand express their milk. Even if you have a pump, it may stop working or

1. Make a “C” with your thumb and index finger, then place them 2-3 inches apart on the breast-centering the nipple between your fingers (resting position). 2. Push into the breast and back toward your chest wall. 3. Bring your fingers together without sliding them along the skin. This should release milk. 4. Return to resting position and repeat. It may take several minutes to begin milk flow. 5. Rotate the placement of your fingers and thumb around your breast, repeating steps 1-4. This will help empty all areas of the breast. When milk flow slows down, switch to your other breast. Expressing your milk gets easier with practice. Don’t be discouraged if you can only express a small amount the first few times. The more comfortable you become doing this, the more milk you will be able to express. Remember, for your baby, every drop counts.

you may forget a part of the pump at home. Use a clean container with a wide opening to collect your milk. Wash your hands. Place a warm washcloth on your breast to help your milk flow. Massage your breast to help increase the amount of milk you express. Do this by placing one hand under your breast for support. Apply gentle pressure, using a circular motion with your other hand. Massage from several starting points, always working from the chest toward the nipple. Repeat on the other breast. Hold the clean container near your breast.

Collecting and Storing Your Breastmilk

Collecting Your Breastmilk Obtain containers and labels from your baby’s nurse. Wash your hands before handling your breast pump and storage containers. Pump directly into the storage containers supplied to you. Use new containers at the next pumping session. Do not add milk from different pumping sessions to the same container. Write the date and time the milk was collected on the label supplied and place it on each container of milk obtained. Breastmilk that is not labeled will not be accepted. Place the collected milk in the refrigerator if you plan to be at the hospital within 2-4 hours. If not, put it in the freezer. Always store the milk in the back of the freezer or refrigerator (this is where the temperature is the coldest).

Transporting Your Breastmilk Use frozen cold packs in a cooler to transport the breastmilk to the hospital. By fillingempty spaces in thecooler withcrumpled paper or towels, the milk will stay cold longer. Frozen milk must be kept frozen and cold milk from the refrigerator must be kept cold during transportation.

Cleaning the Pump Parts 1. Always clean the parts after each pumping session. 2. Separate the parts that come in contact with the milk. If using the Medela® attachment kit, separate the yellow valve and white membrane. 3. Rinse the parts in cool water to remove the milk protein. 4. Wash in warm, soapy water with a mild liquid detergent. Do not use anti-bacterial soap. 5. Rinse in clear water. 6. Allow the parts to air-dry on a clean towel or paper towels. 7. Do not wash the tubing. If you notice moisture in the tube, run the pump with the tubing attached for 1-2 minutes or until dry.

How long milk is usable depends on where you store it. Breastmilk cannot be refrozen once thawed. Milk Stored Here: Is Safe For: Refrigerator 96 hours (or 4 days, if fresh) 24 hours (if thawed) Frost-free freezer which 4 months is part of your refrigerator (around 24° F) Deep Freezer at 0° F up to one yea r

Skin- To- Skin Care

Holding Your Baby Close Skin-to-skin or kangaroo care is the practice of holding your baby dressed only in a diaper and cap on your bare chest with a blanket placed over your baby’s back. This skin-to-skin contact benefits both you and your baby. Youmay be a little nervous about trying kangaroo care. If your baby is very small or sick, you may be afraid you’ll hurt him/her. Your nurse will help you to get more comfortable in touching and positioning your baby. Your baby knows your scent, touch and the rhythms of your speech, heartbeat and breathing, and he/she will enjoy feeling that closeness with you. Kangaroo care can help: • Calm your baby • Help him/her to gain weight • Maintain his/her body warmth • Regulate his/her heart rate and breathing

Skin-to-skin has emotional benefits for you too. It builds your confidence as you provide this closeness that can improve your baby’s health and well-being. You are giving something special to your baby that only you can give. By holding your baby skin-to-skin, you will feel the experience of new parenthood and closeness to your baby. Ask the hospital staff if you can provide skin-to- skin care with your baby when visiting him/her. Kangaroo care is safe and beneficial. Take your pump kit with you when you are planning to do skin-to-skin and pump right after. This will help your milk supply.

PUMPING LOG

DATE _________ SKIN-TO-SKIN ______________

TOTALS

TIME MINUTES AMOUNT IN ML

DATE _________ SKIN-TO-SKIN ______________

TOTALS

TIME MINUTES AMOUNT IN ML REMEMBER • Wash hands before pumping • Pump each breast 10-15 minutes each session or at least 100 minutes a day (per baby)

• Pump 8-12 times a day (every 2-3 hours during the day with one 4-5 hour break at night) • Wash all pump parts after every use