Positioning Your Baby
It is important that you alternate the position used for nursing so you drain all the milk sinuses regularly. Properly distribute pressure on the areola and nipple to avoid soreness.
The Madonna: Traditional sitting position. Sit with the baby’s body across your abdomen, supporting her with the same arm as your breast.
Cross-Cradle: Holding your baby across your lap, using the opposite arm to the breast she is feeding from to support her.
Football Hold: With pillows positioned along the side of your body, hold your baby under your arm; much in the same way a football player holds the football.
Lying Down: Lie on your side with knees bent. Lay baby on his/her side facing you, bringing his/her face toward your breast. Use pillows for comfort or support, if needed.
- Laid-back: Semi-reclined, with your baby lying across your stomach or shoulder.
Offering the Breast
During the first few weeks, it is important to provide some support for the breasts during feeding. The preferred method of supporting the breast is the C-hold. You cup your free hand to form the letter C with your thumb on top and your fingers curved below the breast. You can then gently guide the breast so that the nipple is centered in the baby’s mouth. This technique helps keep the breasts from obstructing the baby’s breathing, and is especially useful for large breasted women.
Removing the Baby From the Breast
If the baby is allowed to determine the length of the feeding, his/her mouth will gently release the nipple when he/she is finished. If you wish to remove your baby from the nipple before this occurs, you will need to break the suction. Insert your finger gently into the corner of your infant’s mouth and press your finger against your breast near the corner of your baby’s mouth. The nipple should then slip easily out of the baby’s mouth.
Ensuring Equal Breast Stimulation
In order for you to produce equal amounts of milk in each breast, you want to ensure that both breasts receive the same amount of stimulation. They must also be emptied regularly in order to avoid problems with plugged ducts, engorgement, or breast infections. Routinely offer both breasts at every nursing. Alternate the breast you begin with at each feeding. Encourage your baby to take the second breast. Burp him/her and stimulate him/her after he/she has finished nursing on the first side. He/she can then have unlimited nursing time on the second breast. If you end with the left breast at a nursing, you will begin the next nursing with the left breast.
After nursing, let your nipples air-dry. Moisture can lead to tender and sore nipples. You can pat the nipples dry with a soft cloth or leave the bra flap down a few minutes. Air-drying is especially important if you plan to apply a lubricant, such as lanolin, to the nipples since this lubricant can trap moisture.
The supply of breast milk is determined by the amount of nipple stimulation that you receive from your baby. When the baby nurses frequently, there is greater nipple stimulation and greater milk production. Nursing makes milk. To ensure that you have enough breast milk, nurse your baby frequently offering both breasts at each feeding. This will ensure that more milk will be produced.
During the first month, nursing frequency for your healthy baby may range from 8 to 14 feedings per day, with most babies requiring 10 to 12. Some breastfed babies nurse as often as every two hours for part of the day with some other feedings spaced four to five hours apart. Generally, you should nurse your baby around every two to three hours during the day. Try not to allow more than three hours to lapse between feedings during the day. You do not need to wake your baby at night for feedings unless your baby has not nursed enough during the day or unless he/she has poor weight gain. Don’t be alarmed if your baby wants to nurse as often as every hour or hour-and a half during the day and several times during the night. Every baby’s needs are different and you should remain flexible to meet your baby’s requirements. By about six weeks of age, your baby usually will have developed a pattern of nursing every two to three hours with a longer stretch at night. As your baby matures and becomes a more efficient nurser, he/she will obtain more milk in a shorter period of time and will begin to space his/her feedings further apart.
Effects of Medication While Breastfeeding
Burping helps to remove swallowed air. Both breast and bottle-fed babies swallow air. Sit him/her in your lap with his/her head supported, hold him/her upright over your shoulder, or place him/her face down over your lap, and pat his/her back. Burp your baby frequently during the feeding as well as at the end.
Feed on demand – that is, whenever your baby seems hungry. This usually is between 2-4 hours. In general, the baby will have more knowledge as to his/her hunger than anyone else. Begin by placing 2-3 oz. of formula in the bottle. If this is not finished, discard remainder immediately. When your baby finishes the amount of milk offered, begin to increase the amount placed in the bottle by ½ to 1 oz. In general, have a little more milk in the bottle than is ordinarily taken. Remember, if the baby is sucking his/her fingers and smacking, and it has not been 2 hours since the last feeding, he/she may be suckling for comfort and a pacifier may be tried.
Sucking comforts babies. Even when not hungry, babies often suckle the fingers and thumb for comfort. You will learn the difference in your baby’s hungry behavior and “I need comfort” behavior in time. For formula-fed babies, a pacifier is fine. Breastfeeding moms may want to limit pacifiers until your milk supply is well established, as mentioned earlier. Allowing frequent nursing will meet your baby’s comfort needs.
At bedtime and naptime, prepare your baby by being sure he/she is warm, dry, and not hungry. It is fine to rock for comfort, and then place him/her in his/her bed to go to sleep. Babies should sleep on their backs with no pillows or soft bedding. Babies who are put in bed awake, sleepy and satisfied, and allowed to go to sleep on their own are better sleepers in the long run.
A warm room
Table or countertop of comfortable height
A soft washcloth
Cotton balls and Q-tips
Gently wash the penis with a cotton ball and mild soap, rinse, and pat dry. Apply Vaseline until healed.
Care for the Uncircumcised Penis
Don’t try to pull the foreskin back over the head of the penis. As your child grows, the foreskin will gradually loosen and they will be able to gradually retract it more and more.
Dressing and Diapering
Babies need very basic clothing for the first month of life. They should be dressed comfortably for their environment. A cotton gown and diaper will be sufficient for several weeks. A light blanket for sleeping will be needed. Do not overdress. Either cloth or disposable diapers may be used.
Fever in the First 2 Months
When taking a rectal temperature, first shake down the thermometer below the 96 degree mark. Lubricate the tip with Vaseline or other lubricant for easy insertion. Lay the baby on his/her stomach in your lap (with a diaper underneath for protection), holding the baby firmly. Spread the buttocks with one hand. Carefully insert the thermometer into the rectum ½ to ¾ of an inch. Do not let go of the baby or the thermometer. Hold the thermometer in place for 2-3 minutes. Remove the thermometer and read results where the mercury stops. Cleanse the bulb with soap and cool water. Rectal temperature records the baby’s internal temperature. A normal rectal temperature can be 97.0 to 100.0 degrees. If the temperature is above 100.5 degrees, do not give fever-reducing medication and please call your pediatrician.
Illness and/or Problems
If, during the first three months of life, the baby’s rectal temperature is over 100.5 degrees, he/she is extremely fussy or lethargic, has difficulty breathing, or has excessive vomiting or diarrhea, notify your physician. In this age group, we don’t recommend giving Tylenol without talking to a doctor. Your pediatrician will instruct you further with any special care or treatment.
Squeeze the bulb syringe. Insert into each nostril or the sides of his/her mouth. Release syringe compression and suction mucous out of the baby’s nose or mouth. Cleanse bulb often with soap and water.