Breastfeeding Part 4

Length of Feeding

Mothers used to be told to time their babies at the breast. We now know that babies will tell us when to change breasts. They are much smarter than a clock. If you let your baby feed at the first breast for as long as the feeding pattern is going well, the baby will get that high fat milk.

Babies may not feed for as long at the second breast. That’s fine—you can start at that breast at the next feed.  Babies are all different. Some feed quickly, some slowly.  As you learn to understand what your baby is telling you, you will fell more confident that the both of you know what you are doing.

newbron breastfeeding

Frequency of Feeding

Breastmilk is esily digested and new babies have small stomachs. They may ask to feed every hour and a half to every 3 hours during the day, perhaps every 3 to 4 hours a night. This pattern changes as the weeks go by. As the infant grows and as your breast become better at what they are doing, your baby will take more milk and last longer between feeds.

Signs that tell you that you Baby is Feeding Well

  • you feel no pain when your baby latches
  • you see the big jaw movement and you hear swallowing
  • baby is really soaking 6-8 diapers daily by the second week.
  • baby is having lots of stools, at least one big one day
  • baby appears content between feeds
  • baby’s clothes start to get too small

When Should You Get Help?

  • if you are feeling pain or discomfort in your breasts or nipples
  • if your baby wants to feed all the time or within an hour of the last feed
  • if feeds are lasting longer than an hour
  • if you are not getting many really wet diapers or stools
  • if baby is fussy at the breast or between feeds
  • if you have so much milk your baby can’t cope with the amount
  • if you aren’t enjoying the experience yet feel you’re doing everything right.

It is important that you reach out for help when you need it as you are learning the skills of breastfeeding. Some mothers wait too long because they are afraid of looking foolish. Most problems can be solved with help and support. The first few weeks are a time to pull in all of your support people.

Breastfeeding Part 3 (Burping)

Is Baby Feeding Well?

Once latched on, you will see little jaw movements. These are telling your brain that it’s feeding time. As the milk lets down, you will see the jaw rhythm change to big open and close movements. The movement can be seen right up to the tip of the ears. As baby swallows the milk you can hear swallowing noises. At first, it may be a small sound, like a soft “k” in the back of the throat. Later, as the milk has more volume, you can hear swallowing much more easily. Babies have a pattern of suckling movements when they are feeding. They suck, swallow,suck,swallow…..and pause. Then the pattern will start all over again.  This pattern continues throughout the feed. Infants will slow down as the begin to feel full ot perhaps get an air bubble. This is a good time to take your baby off the first breast, offer a burp, and move on to the second breast.

Burping

Burping is done in between feedings. If you are breastfeeding, then the best time to burp the baby is before he starts on your second breast.

Burping Positions:

There are three easy to do burping positions

  • Over the Shoulder: This is the most commonly used position when burping since it’s the easiest to do. Put your baby in an upright position then pat his back gently. Make sure to support his head and neck. It would also be good to have a burping towel over your shoulder just in case he spits up.
  • Sitting: As the name implies, you put your baby in a sitting position then gently rub his back until he burps.
  • Over the Lap: Position your baby in a lying position with his back towards you. Lay him on your lap and gently tap his back until he burps. It would be more comfortable for baby if you place a pillow on your lap.

If you have done any of these positions and the baby still doesn’t burp after a few minutes, maybe he doesn’t need to burp so you need not worry.

Burping the Baby

Positions in Burping your baby

PHOTO SOURCE HERE

Breastfeeding Part 2 (Latching)

It is important for your baby to latch well. An infant’s mouth has to be filled with breast tissue so that there is no space left in the mouth and your nipple is places as far at the back of the baby’s mouth as possible. When that happens your baby will be able to reach the part of your breast where the milk is, behind your areola (the brown part which surrounds your nipple). It is necessary to understand that the baby is breastfeeding– not nipple feeding.

Your nipple is out of the way of the strong little jaws and should be free from pain and damage. The tongue will be lying under your breast tissue and reach baby’s gum line. This is what is meant by breastfeeding and not nipple feeding.

Photo Source: www.thenewparentsguide.com/breastfeeding

When you are holding your baby in a firm hold, you are in control. Baby is facing your breast with mouth facing your nipple. Now you have to have patience and wait for a big mouth–as big as a yawn. A baby will do this if hungry.

Sometimes, touching baby’s lips gently with your nipple may tease the mouth open. When you see that big mouth, very quickly pull the baby on to your breast. Do not try to push your nipple into the mouth, it will just get stuck at the front of the mouth which will be painful. If you feel pain it means the jaws are coming together on your nipple. If this keeps happening, your nipple will get ver sore and may bleed.

It is hard for you to see what the latch looks like, but you can feel it. You should not feel pain. Your baby’s nose will be touching your breast and the lower jaw will be under your areola. Some mothers become concerned that their baby won’t be able to breath. Don’t worry– if an infant is having trouble breathing it will come off the breast on its own.

If there is any space between baby’s nose and your breast, the baby isn’t on your breast enough or its head may be tilted too far back. If the nose is buried in your breast tissue, baby is too high up. Noses make good direction signals. If you can feel or see any of the above or feel pain, take your baby off and try again. When the baby is latched on well with a big mouth, the lower lip will be curled down and will be well under your breast. To take the baby off the breast, insert your finger in baby’s mouth to break the suction.

Breastfeeding Skills Part 1

Unfortunately, breastfeeding is something that only mommies can do. The most that we can expect from daddy is support. If you are a father, support during breastfeeding time has a tremendous effect on its success!
Although breastfeeding is a natural process, it is also a learned skill for both mother and her baby. You need to learn how to put your baby to your breast, know when the baby is feeding well, how to know when your baby is full and how to know if you are running into problems. Be patient. It can be frustrating, it would be so much easier to just buy milk formula then feed your baby with it. However, breastfeeding is a natural alternative to feeding. Aside from the bonding time that you get during breastfeeding, you will be giving your baby Colostrum. This is what you will give your baby for the first 2-3 days. Colostrum is rich in vitamins, protein, and substances which will protect infants from germs. Colostrum is thicker than milk formula and somewhat yellow tinged in color. Do not be alarmed if the color of your milk is not pure white. This is Colostrum. it contains immunoglobulins that help in providing immunity to your newborn child. Breast milk also contains fat. This is an important ingredient as it helps baby to gain weight and feel full and sleepy at the end of a feed and increases with the length of time baby spends on one breast.
The Basics
  • Your baby’s face should be facing your breast (not the ceiling) and the body should be in line. If you look down, the ears,tip of the shoulder and hip bone will be in a straight line. That way, the baby’s head will not be twisted to the side.
  • Baby’s mouth should be across from your nipple or even slightly below.
  • You can support your baby in different ways with your arms and pillows.
Different Breastfeeding Positions:
  • The Football Hold: This works well for mothers who had a C-section, mothers with flat nipples and for small babies. Sit upright with pillows at your side. Support the back of baby’s neck with your hand, allowing baby’s head to tilt back a little.

Football Hold for Breastfeeding
  • Cradle Hold: Hold where baby is positioned across the abdomen so that the baby’s whole body faces the mother’s body and the baby’s head is supported by the mother’s arm. The baby’s lower arm is tucked around the mother’s waist. The baby’s ear, shoulder and hip should be in a straight line.

Cradle Hold
  • Lying Down Cradle Hold: Mother is lying on her side, stomach to stomach with baby. Mother can cradle the baby with her arm, resting on the side supporting her breast properly with the other hand. using the arm holding the baby, she moves baby close enough to guide the breast to the mouth.

Lying Down Cradle Hold
  • Transverse Hold/Cross Cradle: Sit upright with good back support and a pillow in front of you. Lie baby across yor body facing you. Hold breast with hand on same side while supporting back of baby’s neck and shoulders with your other hand. When baby is feeding well, try taking hand from breast and put around baby for support.

Cross Cradle Hold

These are the 4 most common breastfeeding position. Whatever is most comfortable to the mother is the one usually used. Make breastfeeding an enjoyable moment both for you as the mother and your baby.
Part 2 of this post will be about:
  1. Latching
  2. Length of feeding
  3. Ways of burping the baby
  4. Breast Pain and Engorgement

The decision to circumcise your baby

You just gave birth to an adorable baby boy and family members are visiting you and the baby in the hospital. Your mother says it would be best not to circumcise the baby but your mother in law says otherwise. Your husband is silent and would rather not discuss it because the impact of him being a first time father is too much at the moment.— Sounds familiar? Oh if only your baby boy could talk and answer for himself!

Circumcision- surgical removal of the foreskin of the penis.

Procedure:

1. The doctor uses a plastibell which squeezes the foreskin between a plastic ring and a tight string so that this rim of foreskin dries, shrivels and later falls away.

plastibell

OR

2. The doctor uses a metal clamp (gomco). It takes about 15 minutes and then the penis is wrapped in gauze covered with petroleum jelly. It will be sore for a few days and the tip of the penis will look dark and scratched with perhaps a bit of yellow mucus appearing. In a few days, the baby will be back to normal.

used for circumcision

Main Advantages:

  • Improved cleanliness
  • Less risk of cancer of the penis
  • Less risk of phimosis (inability to retract the foreskin)
  • Less risk of balanoposthitis (inflammation of penis and foreskin)
  • Less risk urinary tract infections
  • Possibly less risk of transmitting sexual transmitted diseases (including HIV and cervical cancer)
  • Looks like father (if dad is circumcised)
  • Religious requirements (e.g. Jews, Muslims)

Disadvantages:

  • Surgical risks (bleeding, infection, damage to penis)
  • Pain
  • Not really medically necessary
  • Possibly diminished sexual sensation

Personally, due to cultural influence my sons are circumcised or will still be circumcised. Circumcision in the Philippines is part of an adoloscent’s coming of age. As a nurse, I believe that circumcision on a whole scale level would benefit the child until he becomes an adult. Since you are the parent/s, it is your decision either to have your baby circumcised or not. Either way, the child is still this precious little being that God gave to you… circumcised or not.

Safest Way in Bathing a Newborn

There are a 101 ways of bathing a baby. There has never been a standard to bathing a baby. However, when I was teaching, I always told the students that no matter what way you bathed a baby, SAFETY should always be a priority.

Newborn Infants still have to adjust to outside world, and this may also mean adjusting to external temperature. Unlike when he was still in his mother’s womb, the external temperature is much lower. I have made a checklist so when my students had to do practical exams in bathing a baby, all I had to do was check. I am sharing it to you.

  • First, make sure you have closed the windows to prevent draft from coming in, if you have a heater, it is best you turn it on 2 hours prior to bathing a baby. There is no set temperature for the room, trust your instincts! Prepare all the necessary materials prior to bathing. This saves time.
  • Prepare baby clothing and diapers on the changing table or bed. It is always safer to have all your baby’s clothes ready by the time you’re done. This is also an efficient way of saving time and preventing your baby from having chills right after his bath.
  • Check the water temperature either by using your elbow,inside of your wrists or if you have a bath thermometer, you can use that. Recommended water temperature would be 90-100 F.
  • If you are new to bathing a baby, it is always safe to clean the face first while he is laying on the bathing table. Get a clean washcloth or cotton ball, dip it into the water then squeeze off excess water. Clean your baby’s eyes from thee inner eyelid to the outer eyelid. Remove the “sleep” from your baby’s eyes. Do this gently and as often as necessary. Always remember to pat dry afterwards
  • Get a padded tongue depressor, dip it into sterile water then gently clean your baby’s inner cheeks, roof of the mouth and tongue.
  • Clean the nose and ears gently with a clean or moist washcloth. Pat dry
  • Clean the face with a moist towelette then pat dry.
  • You can now undress your baby, but make sure you have a bath towel still wrapped around him to prevent chills. If your baby particularly cries a lot during bath time, it may be because of you haven’t wrapped him and he feels uncomfortable with the cold temperature.
  • Hold your baby using the football hold. Support the neck and head with your palms. If you’re baby is less than 2 months old, he still has no neck control. Supporting the neck and head would prevent injuries. Football Hold
  • Wet your baby’s head gently, it always helps that you talk to him soothingly while washing his head. Apply a little amount of shampoo then gently rub your baby’s head in a circular motion. Rinse off the water. Then remove the bath towel. And dip him gently into the baby tub. Support his head and neck with one hand while the other hand is supporting his lower body (preferably, it is best to hold him between the legs. Wet his body gently.
  • Put him back on the bathing table then soap your baby’s body while still on the bathing table. This is the safest way. Get the soap, wet it a little bit and gently soap your baby. Always soap the genitals and hands last. The genitals are the dirtiest part while soaping the hands last would prevent the baby from hurting his eyes if he suddenly decides to touch it while you are busy soaping his legs.
  • Now gently slip him back into the tub. Support his head and neck and his lower body. Rinse off all the soap in his body. Again rinsing off the soap in his genital last. Before turning him around, make sure the support on his head and neck is there. Make a V out of your hand and support his neck and head in front while rinsing off the soap on his back. It is best to have another tub for a second rinsing. Pay attention to the creases on your baby’s skin. This is where dirt is. Head and Neck Support
  • Lift him out gently. Then pat him dry. You are now ready to dress him!
IMPORTANT: You should NEVER leave the baby unattended even for a short period during bathing!
This bath alone, would take only 3-5 minutes if done correctly. This prevents the infant from getting chills and, if your baby cries a lot during bath time, this is a better alternative. Just make sure all the things you need have been prepared prior to the bath. You will find out that these steps would make bath time for you and your baby a pleasant experience!

The Healthy Baby

You’ve waited nine long months and sometimes wondered if your baby would ever arrive. Suddenly the infant is in your arms–and most mothers feel thats their organized life has become topsy turvey. You’ll start by examining your child carefully–and of course –satisfying yourself that everything is normal.

  • Appearance: Most babies weigh between 3200 to 3600 grams or 7 to 8 pounds. Some babies are quite small, either because they are premature or were underweight. On the other hand, some infants are quite huge (over4500 grams)–but may of these had mothers who had diabetes.
  • Body Position: When your baby is born, you will notice that the body is curled up, with bent knees and elbows. Even the feet are curved. Don’t be concerned — this is usual and the body will soon straighten out.
  • Body Movements: babies sleep most of the time, but you will notice movements, even during sleep — stretching, slight trembling and often showing some sucking and eye movement. When the baby is awake, arms and legs will move in various directions– and the baby will grasp hold of something places near a hand. (A detailed description of these movements or reflexes will be discussed in further detail on my next blog)
  • Skin: At birth most babies are very red. Hands and feet may look a little blue because blood circulation during this time is still sluggish. Your baby is still adjusting to the outside world. There may be some birthmarks, or somewhat that resembles a bruise specially on the lower back. This is evident to dark skinned babies and is caused by the pigment in the deep layers of the skin.
  • Head: You will notice the soft spot (fontanelle) on top of the baby’s head. This is covered by a tough inner skin, do not be scared to do regular activities like washing the baby’s scalp.
  • Eyes: A newborn’s eyes are closed most of the time. Young infants look cross eyed and this is normal.

These are basically signs of a normal, healthy baby. If you are a mother like me, I think you would know right away if there is something wrong with your new baby. Until I have given birth to my eldest son 12 years ago, I have never believed in a mother’s instinct, but I am telling you, it is quite true. In most of the years I have been a mother, I have thanked my instincts so many times because, trusting these instincts always told me how to handle things with my kids and prevent them from harm. Call me superstitious but it’s true!