Infant feeding

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Infant feeding


Infant feeding

All THS hospitals are Baby Friendly Accredited  providing a supportive environment for women  regardless of their feeding choice.

Our policies support the establishment and maintenance of breastfeeding. Should you wish to see a copy of the complete breastfeeding policy, ask your midwife.

If you are unsure about how to feed your baby, feel free to discuss with  your midwife or doctor  so an informed decision can be made. We also have further literature we can give you to support your decision.

If you did not breastfeed last time or had issues it can be good to talk this over with your midwife, attend a breastfeeding class or see a lactation consultant.

Breastfeeding

Antenatal education

Research indicates the importance of learning about breastfeeding during your pregnancy. We suggest you include your partner  in your  education  as they then understand better what to expect in regards to labour and breastfeeding. The hospital runs breastfeeding education opportunities regularly. To fnd out more information, ask your  midwife.  You need to book  early as these sessions are very popular. If you have any specific breastfeeding concerns you can also book an antenatal appointment  with one of our accredited lactation consultants through your midwife.

Please cancel if you are unable to attend as sometimes there is a waiting list.

There  is no special preparation  required for breastfeeding however  it can be helpful to learn a little more before the baby comes. Mums do best if they have read all the available information  about feeding, watched  a baby being breastfed, gone to a breastfeeding class or sorted out any concerns before baby comes. Doing these things can help you be more prepared and you may find the establishment of breastfeeding easier.

Usually your breasts will increase in size during your pregnancy due to hormonal infuences, with most of the growth occurring in the first 20 weeks or in the last few weeks.

Avoid using soaps and perfumed creams or body lotions on your breasts, especially in the last few weeks of pregnancy. This helps preserve the action of the natural lubricant secreted by pores on the areola.

Exclusive breastfeeding

  • Breastmilk alone is the only food or drink a baby needs for the first 6 months of life.
  • Breastfeeding continues to be important after 6 months when other food is introduced.
  • The World Health Organisation (WHO) recommends  breastfeeding for 2 years and beyond.
  • Offering your baby bottles or a dummy can lead to less frequent breastfeeds and you may not make enough milk.

Breastfeeding is a learnt skill and like many other  skills, it takes time, patience and practice.

Why is breastfeeding better for your baby?

  • A healthier baby - helps protect  against gastroenteritis (tummy upsets), ear infections, allergies, chest and urinary tract infections and juvenile diabetes.
  • Longer term, breastfeeding helps protect  against childhood cancers, obesity and heart disease.
  • Perfect food - helps baby grow, develop and learn.
  • Breastfed babies have improved  speech, sight, muscle development,  reduced tooth decay and gum disease.
  • Perfect way to bond and feel close to mother.

Breastfeeding is best for you because:

  • Saves money – bottle feeding with infant formula can cost up to $3000 per year;
  • With fewer trips to the doctor, medical expenses will be less;
  • Saves time  – breastfeeding  is quick, efficient and hygienic - more time to relax and enjoy your baby;
  • Helps you return to your pre pregnant weight more quickly;
  • Helps protect against against breast and ovarian cancer and osteoporosis;
  • It is also VERY good for the environment - no packaging, transport or factory costs; and
  • One important aspect for prevention of SIDS.

Baby’s behaviour before the first breastfeed

If left skin to skin on your abdomen after birth your baby will gradually crawl toward your breast.

Your baby will start mouthing; hand to mouth movements; licking fingers and touching your nipple which makes it erect and easier to attach to.

As your breast brushes baby’s cheek, baby will turn his/her head towards your breast: open the mouth wide and protrude his/her tongue over the bottom lip to lick your nipple.

When ready, baby will attach to your breast and begin to suck. This usually occurs within the first hour of birth.

Babies breastfeed they don’t nipple feed.

It is essential baby takes a good mouthful  of your breast not just your nipple. Encourage your baby to self attach for the first feed.

If possible, baby should be kept skin to skin with you for an hour even if they feed earlier.

The first few days

This is a good time to learn and practice getting your baby on the breast (attachment). All midwives on the Maternity Unit are able to assist you  to achieve good attachment. Babies need to take a good amount of breast tissue into their mouth for this to occur and to try and ensure feeding is comfortable for you. Getting it right in the first few days can make the transition at home easier.

Your breasts are soft in the first few days before your breastmilk changes from the highly nutritious colostrum to mature milk. It is important  during these days that your baby is offered breastfeeds frequently.

A baby that appears sleepy may need stimulating to feed more often after the initial settling in period (around the first 24 hours).

Hints to achieve and recognise good positioning and attachment

  • Have baby’s body facing you and held close to your body, with their mouth next to your nipple.
  • Point your nipple towards baby’s nose and tickle their bottom lip with the edge of the areola until their mouth is wide open, then bring baby into your breast with your hand behind their shoulders.
  • When attached well, baby’s lips should be turned outwards and their chin should be well into your breast, leaving their nose clear.
  • It is normal  to feel some tenderness for the first 6-8 sucks while baby stretches your nipple to the back of their mouth, then the feed should feel comfortable – not painful.
  • Your baby should have rhythmic sucking with well rounded cheeks and you should hear swallowing.
  • Your nipple may be elongated at the end of a feed but will still be a good shape and colour.
  • Any problem with this – ask your midwife to review  a feed with you.

Demand feeding

  • Is feeding your baby according to their needs – the more often you feed the more milk you will make. This is called supply = demand.
  • In the early days it is normal for your baby to feed a minimum of 6-8 times and up to 12 times in 24 hours to help your breastmilk supply to establish.
  • Rooming in (keeping your baby in your room) allows you to recognise hunger cues and provides the right environment for demand feeding.

The only time a newborn needs fluids other  than breastmilk is when there is a medical reason.

Expressing and storage of breastmilk

Some mothers find it necessary to express milk from the breast to give to the baby later. If you plan to express on a long term basis, you need good skills to keep your milk supply. You should talk about this with your midwife or lactation consultant before the birth.

You will find information on how to store breastmilk in your baby’s Personal Health Record book (given to you after your birth). Support from your Child Health & Parenting Service (CHAPS) and the Australian Breastfeeding Association (ABA) is invaluable  1800 MUM 2 MUM or 1800 686 268

Thaw breastmilk in cold water or it can be thawed in the fridge overnight. Warm in a jug of hot water when ready to use. Microwaves should not be used. Once heated it cannot be reheated and used again so only thaw what you need to feed baby.

Avoiding teats, dummies and complementary  feeds

  • Your new baby is learning to breastfeed and can become confused if offered a teat or dummy  before he has learnt to breastfeed well.
  • Offering fluid other than breastmilk will decrease the time he breastfeeds, and reduce your milk supply.
  • Frequent unrestricted  sucking at the breast will satisfy your  baby.

Feeding cues (signs that your baby is ready to feed)

  • Hands up to mouth.
  • Sucking movements.
  • Soft cooing, sighing sounds.
  • Head movements and stretching.
  • Crying is a late sign of hunger – don’t wait until then!

10 Steps to successful Breastfeeding

The following  10 Steps to Successful breastfeeding have been established by the World Health Organisation and the United Nation’s Children’s Fund for all facilities providing maternal and newborn care. The THS has adopted these steps as a summary  of their Breastfeeding Policy - the full policy may be viewed on request.

  1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
  2. Train all health care staff in the skills necessary to implement the policy.
  3. Inform all pregnant women about the benefits and management of breastfeeding.
  4. Place babies in skin-to-skin contact with their mothers immediately following birth for at least an hour and encourage mothers to recognise when their babies are ready to breastfeed offering help when needed.
  5. Show mothers how to breastfeed, and how to maintain lactation even if they are separated from their infants.
  6. Give newborn infants no food or drink other than breast milk, unless medically indicated.
  7. Practise rooming-in - allow mothers and babies to remain together 24 hours a day.
  8. Encourage breastfeeding on demand.
  9. Give no artificial teats or dummies to breastfeeding infants.
  10. Foster the establishment of breastfeeding support and refer mothers on discharge from the facility.

Once the milk comes in

Breastmilk, once established, looks a little like skim milk, whitish blue in colour, and thin. It is not “too weak”, it always has the right amount and type of nutrients, perfect for your baby.

Is my baby getting enough milk?

  • Baby will have some settled periods.
  • You will be reassured when you can hear swallowing sounds with feeds.
  • Baby’s wet nappies will increase in number after the milk comes in – at least 5 heavy disposable nappies in 24 hours.
  • During the first few days your baby’s bowel  actions change from black meconium to a soft mustard yellow in appearance. Most babies will have 1-3 bowel actions per day in the first 3 months of life.
  • Your baby starts to gain weight after an initial loss of 5-10 % and will regain birth weight by 10 days to 2 weeks. There  should be an average gain of 150 gms per week.

If breastmilk supply is a problem,  talk to a midwife, lactation consultant or CHAPS nurse about the many things you can do to improve your supply.

Breastfeeding and returning to work

  • It is possible  to work and breastfeed, many mothers express at work for their baby’s feeds.
  • Discuss with your midwife, lactation consultant or CHAPS nurse.

Support after birth

Lactation consultant telephone advice

Available from 8.30am-4.00 pm, Monday to Friday.

LGH: (03) 6777 8934
North West: 0409 973 547
RHH: (03) 6166 7929 (office - leave a message) or telephone RHH switchboard (03) 6166 8308 and ask to be put through to the Lactation Consultant.

Australian Breastfeeding Association (ABA)

Telephone 1800 686 268 (1800 MUM 2 MUM) for Breastfeeding Helpline, local group contacts and enquiries www.breastfeeding.asn.au

Child Health and Parenting Services (CHAPS): incorporates Parenting Centre

Telephone: 1300 064 544

Tasmanian Multiple Birth Association

Telephone 0420 588 805 or go to www.tasmba.org.au

Parent Helpline

24 hour telephone 1300 808 178 for advice and support for any stressful feeding or parenting issues that need immediate attention.

Your Doctor

Your family doctor or obstetrician  if the symptoms are not getting better in 8-12 hours, or immediately if you feel very unwell.

Formula feeding

Some mothers who plan to formula feed give their baby the frst feed at the breast, so the baby gets a very precious feed of colostrum (mothers first milk). If you don’t want to do that, you could consider expressing some and giving it to your baby.

If you have chosen to formula feed prior to your baby’s birth we strongly recommend skin to skin contact immediately following the birth for at least one hour. This first contact is important  for all babies regardless of method of feeding.

Remember to bring a tin of formula suitable for a newborn baby under 6 months to hospital with you. Your midwife will show you how to make up the formula and discuss how to sterilise the bottles, teats, and caps when you are in the maternity ward. You don’t need to bring your own teats or bottles  as these are provided.

Refer to the formula tin for appropriate amounts per feed. The amount will increase as baby grows. Ask the Child Health & Parenting Service for advice.

If you choose formula feeding remember  to offer skin to skin contact on a regular basis. As formula fed babies sleep heavily it is recommended by Red Nose (previously known as Sids and Kids) in accordance with the safe sleeping guidelines that your baby sleeps in the same room  as you in its own safe sleep environment.

When formula feeding always hold your baby during the feed as this offers your baby visual stimulation and close physical contact with you. It is not a recommended safe practice to prop feed your baby as there is a danger of choking.

Further literature to support your choice of feeding is available on request. Help after discharge with  bottle  feeding issues can be obtained from your midwife at home visits, child health nurse or doctor.

Infant tooth decay

The following may increase the risk of infant tooth decay:

  • Honey or sweetener on the dummy;
  • Infrequent tooth brushing or not cleaning after the first tooth appears;
  • Prolonged and frequent bottle feeding when teeth are present;
  • Adding any sweeteners to the bottle; and
  • If your baby has a bottle or dummy which has been in the mother’s  mouth bacteria will be transferred which may cause decay or infection in your baby’s mouth.