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Nutrition for New Moms

Thanks to Brooke Bulloch, the Registered Dietitian behind Food To Fit Nutrition Inc., for writing this guest post.

 

Congratulations on your new baby!

Or perhaps you are a supportive friend or family member. Regardless, this is an exciting time for everyone. A new mom requires appropriate support, rest, and a nutrient dense diet in order to maintain her energy for a recovering body and caring for a new baby.

Postpartum Nutrient Needs

Most women can meet their postpartum nutrient needs from food. A general recommendation is to continue taking a prenatal supplement for 6 weeks after birth. If you are anemic, gave birth to twins, or follow a vegan diet, you should consult a dietitian or health care provider about supplementation.

Vitamin D is a nutrient that helps the body to build and maintain strong bones and teeth. Not enough can lead to soft, brittle bones. Health Canada recommends that adults up to 70 years of age (including during pregnancy and lactation) receive 600 IU vitamin D daily, but not more than 4000IU daily. There are few food sources that contain enough vitamin D to meet this requirement and Canadians may not produce enough in the skin due to reduced sun exposure during the winter months (and the use of sunscreen in summer months). Although most prenatal supplements will contain at least 600IU vitamin D, as soon as you stop taking prenatal supplements, ensure you continue to take a vitamin D supplement daily.

Lactation is an energy expensive process! A breastfeeding woman requires roughly 500 additional calories (slightly more than your 3rd trimester) just to keep up with lactation. To put this into perspective, 500 additional calories may look like: 1 slice of whole grain toast with 1 egg, ½ cup 2% yogurt, ¼ cup nuts, and ½ cup fresh fruit throughout your day. Breastfeeding women have higher recommended dietary intakes for vitamin A, C, B12, and zinc. But the additional calories from a variety of food groups will make up for these increased needs. Iron needs are lower than non-breastfeeding women due to the difference in blood loss from menstruation. However, iron-rich foods provide energy and keep the blood healthy so it’s important for everyone.

Postpartum Weight Loss – Nurturing your Body

For the first 6+ weeks, just rest! Ignore the pressure (wherever it may be coming from) to get out and work off that “baby weight”.  You just spent 9 months gradually putting the weight on, it’s realistic to expect 9 or more months adjusting towards your natural size. Birth can change so many things about your body, including your new “normal” postpartum weight status. A woman’s body weight after pregnancy may very well remain above her pre-pregnancy weight. This does not mean she is less healthful, less beautiful, or less valuable. This may be very normal.

Restricting calories too much and too quickly can affect milk supply and consequently infant growth. Early studies looking at the impact of energy restriction and exercise on lactation suggest that:

  1. Lactation must be well-established prior to reducing calories or incorporating exercise;
  2. Exercising women tended to have higher milk production and volume (that is when their energy intake was also higher and meeting energy output needs);
  3. Weight loss of 0.5 kg/week did not negatively affect the growth of the baby nor the composition of breast milk in women who were “overweight” prior to conception. We do not know a lot about the effect of weight loss on women who were not classified as “overweight” prior to conception.

As a dietitian who has supported many women with perceived weight issues and weight loss goals, I have seen the negative effects that dieting can have on a woman’s self esteem, body image, long term health, and issues with weight cycling (i.e. losing and re-gaining). Be kind and nurture your body. Do not actively try losing weight for the first 6 or more weeks postpartum. Let your body recover and focus on nourishing your body and soul with both healthful and comfort foods. After that point, allow the body to naturally transition its weight status. Weight loss of about 2 kg (~4.5 pounds) per month is considered safe and healthy.

Putting it altogether – Practical Nutrition Tips

Stock your cupboards, fridge, and freezer with nutrient-dense, but convenient foods. Have a friend or family member help with the shopping and prepping:

Healthy fats

  • Use vegetable oils such as extra virgin olive oil, canola oil, or avocado oil with cooking
  • Use butter or coconut oil in smaller portions and less often
  • Frozen avocado pieces can be easily added to a smoothie or thawed and mashed into a guacamole dip
  • Keep nuts on hand for quick snacking options, such as almonds, cashews, pecans, walnuts, or peanuts

Fish (fresh or canned)

  • Eating a small portion of fish twice per week will provide the essential omega 3 fats called EPA and DHA. If you do not eat fish, you might consider a fish oil supplement containing 500-1000 mg of combined EPA + DHA daily
  • Keep canned tuna or salmon in the cupboard for easy lunches like tuna melts

Iron-rich foods

  • Meat, fish, poultry, egg yolks, nuts, pumpkin/sunflower seeds, tofu, tempeh, dried fruits, spinach, kale, potato with skin, lentils, chick peas, beans, oats, quinoa, and enriched flours (e.g. pasta, breakfast cereals) are all good sources of iron
  • Have a batch of bean and veggie soup or chili in the freezer and packed into smaller containers that are easy to re-heat (hello guests – bring food!)

Quick, low maintenance snacks to keep you going

  • Individual yogurt containers
  • Individual cheese packs or cheese strings
  • Trail mix made with dried cereal, dried fruit & nuts
  • Washed, peeled, and cut carrot and celery sticks, peppers or cucumbers
  • Washed cherry tomatoes, snap peas, fresh green beans, and radishes stored in a Tupperware container
  • Hummus or tzatziki dip to go along with fresh veggies
  • Strawberries, grapes, cherries, bananas, mandarin oranges, or apples
  • Frozen berries and mango
  • Hard-boiled eggs
  • Peanut butter or almond butter
  • Whole rice, corn, wheat, or rye crackers
  • Fruit smoothie packs: ½ cup frozen fruit + handful of spinach + 1 tbsp of hemp seeds (make into Ziploc bags, stored in the freezer, then add yogurt and milk to make a smoothie)

You may not always have the time or energy to plan and eat 3 square meals. With assistance from family and friends, stock your home with nutrient-dense foods that are easy to prepare or “grab-and-go” when time and energy are limited. Have something to eat every 2-4 hours in order to maintain mental and physical energy, energy requirements for lactation, and nutrient needs for recovery. Don’t worry about the “baby weight” and trust your body to adjust naturally. Exercise when the doctor gives you the go-ahead but ease into it and listen to your body. Rest up and enjoy your new babe!

 

Brooke Bulloch, Registered Dietitian (BSc)

Food to Fit Nutrition Inc.

www.foodtofit.ca

Works Cited

1) http://www.vitamindcouncil.org/further-topics/vitamin-d-during-pregnancy-and-breastfeeding/

2)http://lpi.oregonstate.edu/infocenter/lifestages/pregnancyandlactation/

3) Health Canada

4) Lovelady, C. et al. (2011). Balancing exercise and food intake with lactation to promote postpartum weight loss. Proc Nutr Soc 24:1-4

5) Dewey, KG. et al. (1998). Effects of maternal caloric restriction and exercise during lactation. Journal of Nutrition. 386S-389S


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Brooke Bulloch is a Registered Dietitian (BSc) from Saskatoon, SK. Brooke shares her thoughts and yummy recipes on her website Food To Fit.

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Top 10 Things That Can Freak You Out When You Have a Newborn Baby

Caring for a newborn baby can be a bit overwhelming at first. Some things can be downright alarming! Many times, however, they are actually normal. Here are the top 10 alarming (but normal) things you may notice in your newborn baby.

 

1. “Blood” in diaper

 

It can be alarming to discover a reddish tinge in your newborn baby’s diaper. You may assume it is blood. But is it?

In baby’s first few days, the urine can be so concentrated that uric acid crystals show up as a color. We call this ‘brick dust’. It is pinky orange (almost salmon-like) in color and can be easily be mistaken for for blood.

poop-1-e1472585693600-150x150Although alarming, brick dust is temporary and will go away once baby is drinking larger volumes of milk. If the brick dust is still present after baby is 5 days old, contact your healthcare provider to make sure baby is drinking enough.

If your baby is a girl, a  second possibility is ‘pseudomenstruation’. Babies are continuously exposed to mom’s hormones in the womb. The sudden withdrawal of the hormones at birth can cause baby girls to have a mini period (also known as pseudo menses). This is not a cause for concern; it will go away within a week or so.

When to consult your healthcare provider:

– If baby has brick dust after 5 days old

– If brick dust or pseudomenses doesn’t seem to fit with what you are seeing, particularly if your baby seems unwell.

2. Bumps on baby’s skin

Your beautiful newborn baby can develop bumps on the skin that can look rather alarming. Here are 2 conditions that are completely normal.

– A common newborn rash that can resemble teenage acne or bug bites. Newborn-rashYou will see small white dots surrounded by a reddened area. It can come and go on all parts of baby’s body.

– Small white bumps on a newborn’s nose, chin or forehead. These skin bumps, called milia, are caused by small flakes of skin getting trapped just below the surface of the skin.

The best treatment for both of these skin conditions is to do nothing! They will disappear on their own within a few weeks.

When to consult your healthcare provider:

– If baby seems unwell in addition to having a rash

3. Voracious appetite

Newborn babies eat often! 10, 12, 14, 16 or more times a day is normal. You may think “Surely my baby can’t be hungry, he just ate!” Well guess what? He is probably hungry.

Breast milk is so easy to digest that half of it can be gone after only 45 minutes. Breastfeeding mamas will spend 10 ½ – 12 hours a day feeding. Ask for help with other household tasks to free you to do this important job.


Are you ready for breastfeeding? Learn 5 things you can do now that will make breastfeeding easier. Download our FREE ebook: 5 Crucial Ways to Prepare for Breastfeeding.


When to consult your healthcare provider:

4. Frequent Sneezing

Newborn babies sneeze often. This can be alarming and you may wonder if your baby has developed a cold or allergies.

Sneezing is simply baby’s way of clearing his nose. Nasal passages are tiny and can easily be clogged with mucous. If your baby was born by caesarian section, he may have a bit more mucous as it was not “squeezed out” as he came through the birth canal.

When to consult your healthcare provider:

– If sneezing is accompanied by wheezing or other signs of illness such as a fever.

5. Bleeding Umbilical cord

After birth, your newborn baby’s umbilical cord will be clamped and cut, leaving a small stump at the base. As this piece of the cord dries, it begins to shrivel and darken.

As the cord starts to separate from the skin, you may notice a tiny stain of blood on baby’s sleeper or diaper. (The amount of blood should be similar to what is present when a scab falls off.) A little bleeding from the base of the cord is an indication that the cord is beginning to fall off. Learn more about caring for your baby’s cord in this post.

When to consult your healthcare provider:

– If the bleeding reappears as soon as you wipe it.

– If there is thick greenish foul smelling ‘pus’.

– If the skin near the umbilicus is reddened and warm-to-touch.

– If baby seems ill.

6. Whites of baby’s eyes appear yellow

Jaundice is a common newborn condition that causes baby’s skin and the white parts of the eyes to appear yellow. Most babies will have at least some jaundice in the first week after birth.

The first place jaundice is noticeable is on the baby’s nose; as jaundice increases, the yellow color becomes noticeable further down the body. Jaundice typically peaks on the third or fourth day of baby’s life and then begins to fade. The whites of the eyes are often the last to return to normal color. Read more about jaundice here.

When to consult your healthcare provider:

– If your newborn baby appears yellow in the first 24 hours of life.

– If baby is too sleepy to feed, despite using wake up techniques.

– Is baby is not having an adequate number of wet and dirty diapers. (Warning! There are photos of baby poop. Scroll down to see a chart of the number of diapers we would expect.)

10-Freaky-But-Normal-Things-About-A-Newborn-Baby

 

7. Diarrhea

Breast milk poop is watery and can even be explosive! You may worry your newborn baby has diarrhea. Loose poop, however, is normal for breastfed babies. It can range in color from yellow to brown to orange and will have some milk curds or ‘seeds’. Some babies will have a bowel movement with every feed.

We get a lot of questions about what is normal for baby’s poops. To answer, we wrote an entire post of the subject. Check it out here.

When to consult your healthcare provider:

  • If you notice blood in baby’s poop
  • Baby has green liquid poop that completely soaks into the diaper

8. Swollen Breasts

Newborn babies, both girls and boys, can have swollen breast tissue at birth. If you touch the area, you may feel a lump.

The swelling occurs because baby was exposed to mother’s hormones in the womb. The same hormones that prepare mom’s breasts for breastfeeding can cause baby’s breasts to swell as well. This is not a cause for alarm; the swelling will disappear on its own over the next few weeks.

When to consult your healthcare provider:

  • If the swollen breast tissue is reddened or baby has a fever.

9. Swollen Genitals

You may notice that your baby boy’s scrotum or your baby girl’s labia are quite a bit larger than you would expect for the first few days after birth. This is largely due to exposure to mom’s hormones while in the womb. The swelling goes away on its own within the first few days.

When to consult your healthcare provider:

– If your baby’s scrotum continues to be swollen beyond the first couple of weeks or if baby seems in pain.

10. Crossed eyes

It is normal for newborn babies to have brief periods when their eyes appear to “cross”. The muscles around their eyes are not yet strong. This should resolve by the time baby is about 3 months old.

When to consult your healthcare provider:

– If your baby’s eyes seem to be crossed all the time.

– If it persists beyond 6 months old.

Looking for more answers to your newborn questions? We would love to help you during this special time of your life.

– Answers for New Parents is an easy place to find answers to all sorts of questions about caring for your newborn, breastfeeding and your own recovery from birth.

– Our Simply Breastfeeding course will increase your confidence by answering questions such as “Is it normal for breastfeeding to hurt?” and “How can I know baby is getting enough?”

We want to help you relax and enjoy your baby instead of worrying!

 

References:

  1. O’Connor, Nina R., MD, Maura R. McLaughlin, MD, and Peter Ham, MD. “Newborn Skin: Part I. Common Rashes.” – American Family Physician. AAFP, 1 Jan. 2008. Web. 30 Aug. 2016.
  2. “Strabismus.” KidsHealth – the Web’s Most Visited Site about Children’s Health. The Nemours Foundation, Oct. 2013. Web.

 


thumbnail-cindy-and-janaCindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.



 

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How to Prepare for a New Baby on a Budget

Expecting a new baby soon? Bewildered by the vast array of products to buy? 

 

Here are 10 Baby Items You Don’t Need to Purchase

 

1. Change Table

Change tables are expensive and take up a lot of space. If you don’t have space for one, just gather a basket of changing supplies. Together with a change pad, you will be ready to do diaper changes on any flat surface!

Having supplies on each level of your home will prevent having to walk up and down the stairs. You will appreciate that in the early postpartum period!

 

2. Baby Bathtub

A baby bathtub is costly and will only be used for a short time. Save your money. Line your sink with a towel or put a couple of inches of water in your own bathtub and lean over the edge to do the bath.

 

3. Crib Bedding Set

Although they are adorable, you should pass on bumper pad and quilt sets. Bumper pads are not recommended, as they are a risk factor for Sudden Infant Death Syndrome (SIDS). The quilts, while beautiful, are rarely soft enough to use to wrap your baby.

 

4. Baby Laundry Soap

Most laundry soaps marketed for baby are more expensive than similar household products. Select a dye and fragrance-free, hypoallergenic laundry soap that you can use for your entire family.

 

5. Stuffed Animals

It can be tempting to buy soft teddy bears or other stuffed animals for your nursery. Babies, however, are not really interested in them for the first few months of life. In addition, safe sleep guidelines would caution against having these in your baby’s crib.

 

6. Fancy Baby Clothes

Babies grow quickly. It is not uncommon for babies to outgrow clothing before you have had a chance to dress them in it! Borrowing or purchasing second hand clothing is much more economical. Save your money for when your child is a teen and they really care about their clothing!

 

7. Baby Shoes

Baby shoes are so adorable but so unnecessary! They are probably not comfortable for baby either. There is no need to purchase baby shoes until your little one is walking.

 

8. Breastfeeding Products

Breastfeeding is a fantastic way to save about $3,000 in baby’s first year! There are many products marketed for breastfeeding women but most of them you will not need.

 

Some people like to use a breastfeeding pillow but bedroom pillows can be easily substituted if needed. Once you and your baby have had a bit of practice, you will find that no pillows will be needed at all!

 

Women have the right to breastfeed anytime, anywhere. Nursing covers have become popular but you do not need to use one! Do whatever works to make yourself comfortable; we support you either way!

 

If you are considering purchasing a breast pump, this article will help you to decide what type of pump to purchase, or whether you really need one at all!

 

Sign up for our FREE email series “Getting Ready to Breastfeed.” We will increase your confidence by sending you what you need to know before your baby arrives.

 

9. Fancy Garbage Can

Fancy nursery garbage cans are marketed for odor control. Simply taking out the trash often can easily substitute for making this purchase.

 

10. Wipes Warmer

This is a luxury item and by no means a nursery necessity. To warm a wipe, simply hold it in the palm of your hand for a few seconds. Consider using a washcloth and warm water as a way to save even more!

 

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Worth Spending Money On

 

There are 2 items we think you should purchase before baby’s arrival.

1. Car Seat

Car seats have expiry dates as plastic will break down over time. We do not recommend purchasing a car seat second hand as it is important to know the car seat’s history. Even if there is no visible damage, the plastic may have been weakened by being dropped or having been in an accident. The instruction booklet for the car seat is invaluable as you learn to adjust it to fit your baby.

2. Breastfeeding Class

Statistics show that families who learn about breastfeeding before their baby arrives feel more confident and less stressed. Knowing a little about how breastfeeding works and how newborns behave will go a long way to giving you the newborn experience you are longing for. We’ve created an online class to teach you what you need to know, Simply Breastfeeding. Sign up here.

 

We would love to know what baby items you felt were essential and which ones you wished you had not purchased. Please comment below!

 

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Continue learning by reading this post: Preparing to Breastfeed During Pregnancy or check out Cindy &Jana’s Prenatal Breastfeeding Classes.

 


 

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Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

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Preparing to Breastfeed during Pregnancy

When you are expecting, it is easy to focus on labor and delivery and forget to prepare for what comes next. You are already ahead of the game by reading this post! Women who prepare before their baby arrives feel significantly more confident and encounter less problems breastfeeding their newborn. Check out our breastfeeding classes here.

Nipple preparation?

Good news! You don’t have to do anything physically to prepare to breastfeed. Your body is already doing the work for you, developing ducts and milk making tissue.

You also don’t need to prepare your nipples for breastfeeding. Years ago, friction with a rough towel was recommended prenatally but it was actually found to do damage.

Women’s nipples come in many different shapes and sizes. A breastfeeding baby latches to the breast, not to the nipple. Unusually shaped nipples are rarely an issue. If you have concerns about the shape of your nipples for breastfeeding, speak to your doctor, your midwife or an International Board Certified Lactation Consultant.

Have a birth plan

Limiting medications and interventions during labor and birth (whenever possible) is a great first step in helping your newborn learn to breastfeed.

Talk to your healthcare provider about having your baby skin to skin immediately after birth. (Learn why it is important here.) Breastfeed as soon as possible, ideally within the first hour.

Parents delivering in a hospital have found it helpful to create a card for baby’s bassinet saying: “I am a breastfed baby… no formula or pacifiers please!”

Keep your newborn near you so that you can respond quickly to baby’s earliest hunger cues.

Learn about normal newborn feeding behavior

Newborns feed often! It is easy to misinterpret frequent feeding as a sign of not enough milk. Feeding 10, 12, 14, 16 times or more a day is not unusual. Learn more by reading our post How often will my Newborn feed?.

Make a plan for the first 2 weeks after baby’s birth

Breastfeeding is time consuming. Newborns feed often. Both you and your baby will be learning. Having the time and privacy to learn is essential.

New parents frequently tell us they had too much company in baby’s first few weeks. Take some time now to make a plan for handling visitors. We explore this further in video #3 of our free course Getting Ready to Breastfeed. Watch it now and download the PDF worksheet to get started.

Planning ahead will help to save your time and energy for the important task of breastfeeding.

Surround yourself with supports

Begin surrounding yourself with other moms who have had positive experiences with breastfeeding. Ask them to be your support team once baby arrives You may want to attend a La Leche League meeting (mother-to-mother support) prenatally.

If you prefer online mom-to-mom support, join our Simply Breastfeeding Moms Facebook group.

Take a class

There is an overwhelming amount of information available both online and in print. Unfortunately, not all of it is good information supported by evidence.

Sign up for our free online email series, Getting Ready to Breastfeed. We’ll discuss “Is Breastfeeding going to hurt?”, why skin to skin is important, the best ways to prevent breastfeeding problems and more.

If you’d like a more in depth class, we’ve put together a 12 video course, Simply Breastfeeding. Check it out here. (Note: you can preview the breastfeeding positions lesson for free. Simply scroll to the bottom of this page.)

Prefer to learn through books?

These are some of our favorites.

5 Crucial Ways to Prepare for Breastfeeding a FREE ebook by Cindy Leclerc and Jana Stockham.

Dr Jack Newman’s Guide to Breastfeeding by Dr. Jack Newman and Teresa Pitman. Written in a readable, no nonsense style.

Breastfeeding Made Simple: 7 Natural Laws for Nursing Mothers by Nancy Mohrbacher and Kathleen Kendall-Tackett.  How to avoid and overcome breastfeeding challenges.

The Womanly Art of Breastfeeding by Diane Wiessinger. La Leche League’s wonderful guide to breastfeeding.

 

Equipment for breastfeeding

There are many products on the market for breastfeeding women. Fortunately, all you really need is your breast and the baby!

Here’s our take on 5 common breastfeeding products:

  1. Nursing bras: You do not need a nursing bra to breastfeed however many women purchase one for the convenience. If you choose to buy a nursing bra, wait until you you are at least 36 weeks pregnant to judge the size you will need.
  2. Nursing Pads:  Not all moms leak milk. Those who do may only leak for a short time. Begin with a limited supply of nursing pads and purchase more if you need them.
  3. Breast pumps:  Not every breastfeeding mother needs a breast pump. Many moms find they prefer to hand express for occasional  bottles or to establish a “stash”. To learn more about hand expression, see this post.
  4. Breastfeeding pillows:  Some moms find that a breastfeeding pillow is convenient but it is not necessary. You could use bedroom pillows instead. If you choose to purchase a breastfeeding pillow, remember that all bodies are shaped differently so you may need to shop around for one that best fits your body.
  5. Formula samples:  You do not need to have formula samples “just in case”. Not having formula in the house has been shown to increase breastfeeding success. Be wary of signing up for “free products” as you will often receive formula. If you receive free samples, consider donating them to your local food bank to avoid the temptation of using it during a long or fussy night.

Believe in yourself

A woman’s body is an amazing! Believe in your ability to provide the right food at the right time and at the right temperature for your baby.

Best wishes as you prepare for your breastfeeding journey.

(Banner photo courtesy of Flickr: Frank de Kleine)

Learn more about breastfeeding: Bras to Breast Pumps: What do you really need for breastfeeding? and Positions for Breastfeeding.


thumbnail-cindy-and-janaCindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.



 

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How to Bottle Breast Milk: Answers to the Top 9 Questions

Women choose to bottle feed expressed breast milk for a variety of reasons.The health benefits of breast milk for babies is well documented. Expressing milk is extra work and takes time and dedication.  If you are expressing your milk, feel proud of the hard work you are doing to give this gift to your baby!

Please don’t be discouraged if you are unable to express enough milk to meet 100% of your baby’s needs. Any amount of breast milk is beneficial! If you have questions about how to build your milk supply, see the tips in this post.

 

1. What is the best type of nipple to use?

 

There are a wide variety of nipples and bottles available. It can be confusing to read the bottle packaging. You may have to experiment to find a bottle and nipple your baby likes.

Bottle nipples come in a variety of flow rates. For healthy, newborns, choose a slow flow nipple. Each brand’s slow flow may be labeled differently e.g. “newborn”, “stage 1”, “0+ months”, “slow flow”.

Milk should drip from the nipple at a rate of about 1 drip per second. If it drips faster, your baby may have trouble keeping up with the flow of milk.

Some brands of nipples claim to be closest to breastfeeding and others claim to reduce gas. Please know that there is no research to say that any bottle or nipple resembles or is most like the breast. But, it is a good marketing strategy!

 

2. Do I need to sterilize the bottles and nipples?

Sources vary as to the recommended cleaning method for bottles and nipples. This is confusing for both parents and health care workers!  Due to this difference of opinion, we recommend boiling all feeding equipment for 5 minutes until your baby is 4 month old. This will ensure you have met the highest standard.

 

3. How do I sterilize bottles and nipples?

1. Before you begin, wash your hands with soap and warm water.

2. Wash your preparation surface well.

3. Put a large pot of water on the stove to boil.

4. Separate the bottles, nipples, lids, and rings. Wash them in hot soapy water and

rinse them well. A bottle brush may help to clean residue from the bottles. Take care

to ensure the nipple holes are not plugged.

5. When the water is at a rolling boil, completely submerge all the bottles and other

feeding equipment in the water.

6. Boil for 5 minutes.

7. When the water is cool, remove the items with the clean tongs and place them on a rack or clean towel to dry.

8. Once they are dry, and store them in a clean, covered area until use.

 

4. How long will expressed breast milk last in the fridge?

Freshly expressed breast milk can be stored in a refrigerator for up to 4-8 days (4 degrees C / 39 degrees F). Milk that has been previously frozen may be kept in the refrigerator for 24 hours.

See this post for more information about storage of expressed breast milk.

 

5. How do I warm the bottle?

Simply place the bottle of breast milk in a container of warm water. Be sure to keep the nipple out of the water.

Never use a microwave to heat a bottle as it can create hot spots that can burn your baby’s mouth.

 

6. What if my baby doesn’t finish the bottle? Do I need to throw out the remaining milk?

When a baby feeds from a bottle, bacteria from baby’s mouth can enter the milk. Breast milk contains cells that hamper the growth of bacteria. There are no conclusive recommendations for when to discard an unfinished bottle of breast milk, however based on related evidence, 1-2 hours seems reasonable.

Kellymom.com has an in depth post about this issue.

 

baby-229645_6407. Do I need to hold my baby to feed the bottle?

Newborns need to be held to feed. Never prop a bottle in your baby’s mouth, as it is a choking hazard.

Choose a comfortable chair and use pillows if needed. Hold your baby close during feeds with his head higher than his body. Newborns love to be bottle fed skin to skin (baby in a diaper only, against your bare chest).

See this KellyMom post for a description of how to make bottle feeding more closely resemble breastfeeding.

 

8. Will it upset my baby’s stomach to use both breast milk and formula?

Our first choice for babies is always breast milk. If breast milk is not available, however, by all means, you may use both. We suggest bottling the breast milk first rather than mixing breast milk and formula in the same bottle. This will prevent wasting any of the precious breast milk!

Burp your baby mid-feeding and at the end of the feed to help expel air.

 

9. How do I take my bottle of breast milk with me when I go out?

Put your bottle of expressed milk in a cooler bag with an ice pack. Some mothers take a thermos of warm water and an empty container to warm the bottle just before feeding.

 

References:

  1. Mohrbacher, N., Stock, J. & Newton, E. (2012 Update). The Breastfeeding Answer Book Schaumburg IL: La Leche League Intl.
  2. International Lactation Consultant Association (2014). Clinical Guidelines for the Establishment of Exclusive Breastfeeding. Raleigh: International Lactation Consultant Association
  3. Jones F.(2011) Best Practice for Expressing, Storing and Handling Human Milk in Hospital, Homes, and Child Care Settings. Fort Worth, TX: Human Milk Banking Association of North America Inc.

 

To learn more, see this post about hand expression and this post about pumping breast milk.

 


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Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

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Before Baby’s First Word: How Baby Communicates

Even though babies do not usually say their first words until they are close to 1 year of age, they begin to communicate with us much earlier.

How do babies communicate before they start to talk?

By 2 months of age, most babies will:

  •       Look at you and make eye contact when you talk to them
  •       Laugh and coo
  •       Show interest in people
  •       Have different cries for different reasons

By 4 months of age, most babies will:

  •       Babble to themselves and others
  •       Make a variety of sounds such as coos, gurgles, and cries
  •       Copy sounds
  •       Laugh and smile in response to your laughs and smiles

By 6 months, most babies will:

  •       Make sounds to express pleasure and displeasure
  •       Make sounds back to you when you talk to them
  •       Respond to their own name
  •       Play with sounds when alone and with others
  •       Try to interact with others

At 6-12 months of age, most babies will:

  •       Make sounds, babble often, and try singing with you
  •       Copy your actions such as clapping and banging toys
  •       Copy your sounds such as coughing, kissing, and clicking your tongue
  •       Communicate with you by pointing, reaching, and making sounds
  •       Have fun repeating the sounds they make
  •       Shout or make noises to gain attention
  •       Shake their head for “no” (around 9 months of age)
  •       Wave hello/good-bye (around 11 months of age)

How can you help your baby to communicate?

  • Talk to your baby about what you are doing during the day even if it is something as simple as folding laundry, making lunch, or changing your baby’s diaper. Repetition and routine help babies attach meaning to what they see and do.
  • Copy the sounds, actions, and facial expressions that your baby makes. This will help them learn that what they say and do are important.
  • Give your baby time to copy your sounds and actions.  This teaches them simple turn-taking skills.
  • Play face-to-face.  Get down to your baby’s level and look into their eyes.  Look at what your child is looking at and talk about what they see and do.
  • Read with your baby. Do not worry about reading books word-for-word.  Instead, when your child is looking at or holding a book, talk about what they are doing and what they see on the pages.
  • Sing with your baby.  Singing helps with language development, memory and listening skills, imitation, and turn-taking.  It is okay if you do not know the words to songs – you can make them up or change them to be meaningful to your baby.

When should you be concerned?

Does your baby:

  • By 6 months, smile or show other warm, joyful expressions?
  • By 9 months, share sounds, smiles, or other facial expressions with you?
  • By 12 months, Babble and use gestures with an adult, such as pointing, showing, reaching, or waving?
  • By 16 months, say their first words?
  • By 24 months, combine two-words into phrases (e.g., “more milk”, “hi mom”)?

Contact your local *Speech-Language Pathologist if:

  •       You answered “no” to any of these questions
  •       You have concerns
  •       Your child shows any loss of speech, babbling, or social skills at any age
  •       Your child has a history of frequent ear infections
  •       You have questions or concerns about your baby’s feeding or communication skills
  •       You would like more ideas for interaction with your child

(*A Speech Language Pathologist, or SLP, works with people from all walks of life. SLPs help with all areas of communication including speech, language, voice, and fluency (or stuttering).   They can also help with feeding and swallowing difficulties in all age groups.)

Do you live in the Saskatoon, Saskatchewan area? In Saskatoon, Saskatchewan, phone 306-655-2434.  In rural areas near Saskatoon, phone 306-655-4700.

 

If you live outside the Saskatoon area or would like more information on feeding, communication, or finding an SLP in your area visit: www.sac-oac.ca or www.hanen.org.

 


 

This guest post is written by Bonnie Quiring Gallen, MSLP, S-LP (C) on behalf of Saskatoon Health Region Population Public Health. Bonnie is a Speech Language Pathologist, and mother to two children, ages 2 and 7 years old.

 

 


 

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Vitamin D and the Breastfed Baby

Vitamin D, the “sunshine vitamin”, is important for both moms and babies. It helps to make sure that bones and teeth are healthy. Our skin makes Vitamin D when we are in the sunshine; it is also found in some foods.

 

Vitamin D for Breastfeeding Moms and Babies

 

Vitamin D for Breastfeeding Moms

It can be difficult to get enough Vitamin D, even if you have a very healthy diet. Sun exposure on the hands and face, for at least 15 minutes a day, will help. You may need a Vitamin D supplement, especially in the winter months.

You are more at risk for low Vitamin D if:

  • you have immigrated to North America.
  • you have dark skin.
  • your pregnancies have been close together.
  • you do not drink milk.

Foods sources of Vitamin D include:

  • fish
  • egg yolks
  • milk
  • breakfast cereals

Ask your health care healthcare provider about having your Vitamin D level tested if you are concerned.

 

Vitamin D for Babies

Breast milk is naturally low in Vitamin D. In addition, babies are not usually exposed to sunlight. Giving breastfed babies at least 400 IU (International Units) of Vitamin D each day is therefore recommended for baby’s first year. You can purchase Vitamin D for babies at most drug stores.

 

baby-small-child-babiesVitamin D is available in different strengths. Be sure to read the instructions carefully. Many families prefer a concentrated form of Vitamin D (400 IU in a single drop.) The drop can simply be placed on the nipple prior to a feeding.

Other parents use a more diluted form of Vitamin D (400 IU contained in 1 ml). To give this larger volume, hold your baby in a slightly reclined position. Place the end of the dropper inside baby’s mouth, pointing it at baby’s cheek. Slowly squeeze the end of the dropper. Give half of the dose at a time, allowing baby to swallow in between.

Premature infants or those living in northern communities may need a different dose of Vitamin D. The American Academy of Pediatrics states that babies who are not breastfed need at least 32 ounces (1,000 ml) of formula with Vitamin D added in order to get enough Vitamin D. Please check with your healthcare provider to find out what is recommended for your baby.

 

Sources and more information:

  1. “Vitamin D & Iron Supplements for Babies: AAP Recommendations.” HealthyChildren.org, 27 May 2016,.
  2. Canada, Health. “Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months.” Canada.ca, 18 Aug. 2015.
  3. Kids, Caring for. “Vitamin D.” Vitamin D – Caring for Kids, Nov. 2012.

Other related posts: Nutrition Necessities for New Moms and Do I Need to Drink Milk to Make Milk?


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Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.

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Bras to Breast Pumps: What do you really need for breastfeeding?

There are many products on the market for breastfeeding women. In this post, we will help you wade through the available accessories and give you guidance on what you will need to purchase.

If your budget is tight, we have good news! There is nothing essential that you MUST purchase. All you truly need for breastfeeding is a mom and a baby.

Here is our take on 7 commonly purchased products:

 

  1. Nursing bra

Nursing bras are very convenient but they are not an essential for breastfeeding. If your budget is tight, you can wear a regular bra. Simply unfasten and lift the cup for feeds.

If you plan to buy a nursing bra, we would suggest waiting until you are at least 36 weeks pregnant to better judge what size you will need. In the first few days after birth, your breasts will become larger as they fill with milk. This increase in size is temporary. Your breasts gradually adjust to the amount of milk your baby is taking. By 2 or 3 weeks after birth, your breast size will likely be close to the size at the end of your pregnancy.

Underwire nursing bras are not recommended for breastfeeding women. Pressure from the wire can prevent some of the milk ducts from emptying, increasing your risk for a breast infection.

 

  1. Nursing Pads

Nursing pads are pieces of absorbent material you can wear in your bra to soak up leaking breast milk. They help to keep your shirt from getting wet. There are both reusable and disposable breast pads available for purchase.

Some breastfeeding mothers will leak milk for a few days, others will leak for many weeks. Still others will leak very little or not at all. (Note: You can still have a great milk supply even if you do not leak.) Because you don’t know how many nursing pads you will need, we would suggest you limit the number of pads you purchase prenatally. You can always pick up more once baby arrives.

 

  1. Breast pump

There are many different breast pumps on the market. At prenatal breastfeeding classes, we are often asked what type to purchase. It is important to know that a breast pump is not a nursing essential. Maternity leaves vary in length and every family’s situation is different.

Even if you have to return to work soon after your baby’s birth, hand expression is a great option for your to explore. It is low cost, always available and for many moms, more effective than a pump.

If you are more comfortable using an electric breast pump, beware of purchasing used. Pumps designed for single use have an “open system”; there is potential for milk to accidentally enter the pump mechanism. Research has shown that some viruses and bacteria can be transmitted through breast milk. There is no way to disinfect these pumps between users, even if your purchase a new kit and tubing.

Note: Hospital-grade pumps available for rent are designed with a “closed system”. With a new kit and tubing, more than one woman can safely use them.

To learn more about breast pumps, read this post.

 

  1. Breastfeeding pillow

A breastfeeding pillow can be convenient when you are learning to breastfeed, but it is certainly not a necessity. Many women choose to use bedroom pillows instead.

If you plan to purchase a breastfeeding pillow, remember that all bodies are shaped differently. You may need to shop around for one that best fits your post-baby body. Women who are long-waisted may need a thicker pillow than those who are short-waisted or have larger breasts.


Learn some basics about breastfeeding BEFORE baby arrives with our FREE email series, Getting Ready to Breastfeed. Get started here.


 

  1. Nipple cream

Nipple creams are popular but recent research has shown that they are not effective and may even delay nipple healing! A recent study tested lanolin-based nipple cream along with 3 other products. They found that rubbing a few drops of breast milk onto your nipples (or using nothing at all!) was more beneficial than using a cream.

A second piece of good news from this study was that no matter what treatment was used, most nipple pain was reduced to a mild level by the time baby was 7 to 10 days old.

 

  1. Nursing cover

Nursing covers are popular and may be something you are considering for purchase. Before you do, we want you to know that you have the right to breastfeed anytime, anywhere, without covering up. Have a look at the billboards and magazine ads around you. You will see more flesh exposed than you would ever see with a woman nursing her baby.

Some mothers, however, tell us that a nursing cover made them feel more confident breastfeeding in public when they were first learning. If this is the case for you, go for it. But feel free to discard it once you are able to latch your baby with ease.

 

  1. Formula samples

If you are planning to breastfeed, we would not recommend purchasing formula to have on hand. Research has shown that breastfeeding women who do not have formula in the house are more likely to reach their breastfeeding goals.

If you receive formula samples in the mail, consider donating them to your local food bank before your baby arrives. This will help you avoid the temptation to give formula unnecessarily during a long or fussy night.

 

Learn more about preparing to breastfeed in these posts: Preparing to Breastfeed during Pregnancy and How to Prepare to Breastfeed When you Have Inverted Nipples.

 

**If you’d like to learn even more, sign up for our Prenatal Breastfeeding Class.**


 

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Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.


 

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Breastfeeding – Getting Started

 A great start to breastfeeding begins during pregnancy. Knowing what is normal can help to smooth out some of the bumps you may encounter.

Before baby is born

If your baby has not yet arrived, download our FREE ebook and learn 5 things you can do NOW to make getting started with breastfeeding easier and less stressful. 5 Crucial Ways to Prepare for Breastfeeding. Download it here.

Baby’s first 24 hours

Once baby arrives, snuggle in close skin to skin contact for at least an hour after birth if possible.

Breastfeeding can take a bit of practice. Both you and baby will be recovering from birth. Babies are often in a quiet alert state for the first hour after birth. This is a great time for a first feeding attempt.

Once baby latches, try to limit distractions. This is a special time and you have waited a long time for this first introduction! Most procedures, such as a baby bath, can wait.

The colostrum your baby receives in early breastfeeding is important for baby and has been referred to as “baby’s first immunization!”

After the first quiet alert stage, your newborn will enter a state of deep sleep and will be difficult to wake to feed. This may be a better time for mom and baby to get some rest. When baby wakes from this deep sleep, try breastfeeding again.

Rooming in is important as you start to learn your newborn’s feeding cues. Cues your baby may be ready to feed include:

  • stirring and stretching
  • turning the head with an open mouth (“rooting”)
  • bringing hands to his mouth
  • making sucking motions

Crying is a late sign of hunger. If your newborn is already crying, try to calm baby prior to offering the breast by holding close, talking quietly, or rocking gently.

If your baby has not latched by 6 hours of age, hand expression will stimulate your body to begin the milk production process. Drops of colostrum expressed can be fed to baby on a spoon.

Be patient. Most babies will eventually latch to the breast. It sometimes can take a bit of patience and practice!

24-48 hours after birth (Day 1-2)

During this stage you can expect your baby to have at least one wet and one dirty diaper. Baby will be passing black sticky stool called meconium (see photo here). You should start hearing the occasional swallow at the breast, a soft “cah” sound.

It is normal for nipples to feel “tender” as you get used to breastfeeding. If you would describe your nipples as “sore” or if you find yourself curling your toes with pain, please ask for help! The earlier you get help, the better for both you and baby.

48-72 hours after birth (Day 2-3)

adorable-22040_640On Day 2, baby’s feeding pattern changes and you may start to wonder if you have enough milk. Baby will want to be at the breast frequently, sometimes still rooting or chewing on hands after feeds. This may be tiring for you as you may feel like all you are doing is breastfeeding!

It is important to try to sleep when the baby does as baby may only have one longer stretch of sleep in 24 hours. The frequent feeding at this stage is a signal to your body to make more milk. When you express a drop of milk you may notice a change from the golden colostrum color to a whiter, watery appearance.

You may start to notice your breasts feeling heavier. As the breasts get heavier, your baby will begin to swallow more frequently during feeds. After a feed your baby will be content and relaxed and go to sleep. Your baby’s stools will enter the “transitional” stage (see photos here). You may notice a pinky orangy color resembling brick dust in the baby’s urine (see a photo here). It is normal at this stage. The urine should become colorless and free of brick dust in the next few days.

Day 3-5

During this time, your breasts may feel overly full and tender. This is normal. Your breasts will adjust to the amount your baby needs over the next few days. A few minutes of massage and warm compresses prior to feeding may help the milk to flow. Cool compresses after the feed may help with swelling.

If the areola (the brown area around the nipple) is too firm you may find your baby slips off the breast with latching attempts. Try moving the swelling away from the nipple and areola with counter pressure.

You will hear louder and more frequent swallows during this stage. After breastfeeding on the first side, burp baby and offer the second side. Do not be alarmed if your baby is not interested in the second side. Baby’s tummies can hold only a limited amount of milk. One side may be enough.

If your baby wants to eat an hour later, it does not mean that she did not get enough the first time. A full tummy of milk can be digested in 90 minutes or less!

Your baby’s weight will begin to increase. Newborns typically gain about 20-30 grams per day (almost 1 ounce). More than this is not a concern. A breastfed baby can never gain too much!

Baby’s stools will become watery, bright mustard yellow and curdy (see photo here).

If your breasts are heavier, the feeds are comfortable, and your baby is gaining, you are off to a great start! You have worked hard to get to this stage and are probably a bit sleep deprived. Sleep when the baby does, limit company and try to focus on caring for yourself.

If you are struggling with breastfeeding, seek help as soon as possible from a healthcare professional or International Board Certified Lactation Consultant.

Surrounding yourself with other breastfeeding mothers can be invaluable! Ask your community health nurse if there are mother’s groups that she can suggest.


Learn more about why breastfeeding is important in our free video course, Getting Ready to Breastfeed.

Learn even more in our online Simply Breastfeeding course (12 videos that teach you everything you need to know about breastfeeding).


How-To-Get-A-Great-Start-With-Breastfeeding

 

References and More Information:

  1. Average Weight Gain for Breastfed Babies.” KellyMom.com. 11 Apr. 2016. Web.
  2. Bonyata, Kelly. “Breastfeeding your newborn — what to expect in the early weeks.” KellyMom.com. 01 Mar. 2016. Web.
  3. Establishing Your Milk Supply.” lllc.ca, La Leche League Canada, 2010. Web.
  4. Holmes, Allison V., Angela Yerdon McLeod, and Maya Bunik. “ABM Clinical Protocol #5: Peripartum Breastfeeding Management for the Healthy Mother and Infant at Term, Revision 2013.” Breastfeeding Medicine 8.6 (2013): 469-73. Bfmed.org. Web.
  5. Newman, Jack, MD, FRCPC, and Edith Kernerman, IBCLC. “Breastfeeding – Starting Out Right”, 2009. Web.
  6. When will my milk come in?” KellyMom.com. 15 Mar. 2016. Web.
  7. Weight Gain and Knowing Baby Is Getting Enough Milk.” La Leche League Canada. N.p., n.d. Web.

 

Learn more about breastfeeding in these posts:


 

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Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.



 

 

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What Foods Increase Milk Supply?

Lactation cookies… oatmeal…  spinach… salmon… flaxseed… brewer’s yeast… garlic….

These foods have all been suggested to increase milk supply. But do they actually work? If only it was that easy! While trying different foods can have nutritional benefits, there is no evidence that any one food that will increase milk production.

Many women worry they don’t have enough milk. It is the number one reason women stop breastfeeding. Most of the time, they actually do have enough milk. Learn how to know your baby is getting enough in this post.

Normal newborn behaviours, such as frequent feeding, ‘cluster’ feeding and growth spurts can be misinterpreted as having a low milk supply. If extra milk is given by bottle, baby will breastfeed less often. This becomes a downward spiral as breast milk supply relies on baby feeding more frequently during these times, not less frequently.

 

LactationCookiesAndFoodsToIncreaseMilkSupply

 

Breastfeeding your baby often and on demand is the very best way to increase milk supply. Learn other tips for increasing milk supply here.

There is some evidence that herbs, such as fenugreek, blessed thistle or alfalfa can act as a galactogogue (a substance that increases milk supply). Caution is recommended when using any herb, just as you would be careful when taking a medication. Two respected IBCLC’s (breastfeeding specialists) that have written about herbal galactagogues are Kelly Bonyata and Dr. Jack Newman. Read what they have to say here and here.

So go ahead and enjoy whatever foods you have heard may increase your supply, lactation cookies included! While there is no research indicating their effectiveness, it certainly won’t do any harm. But be sure to relax and breastfeed often as well.

 

Related post: Foods to Avoid While Breastfeeding and How to Increase Your Supply of Breast Milk.


Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.



 

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