As some of you know, I'm currently working on a new book for employed breastfeeding mothers that will be available through Praeclarus Press this coming spring. This is a sneak preview of a handout written for the breastfed baby's caregiver. My goal is to make it available in a format that's easy for mothers to share. Until I get it "prettied up," you can download a pdf of it here. --Nancy
Caregivers & Feeding
You already know that you make a difference to the breastfeeding baby in your care. But you may not know what a key role you play in helping baby’s mother meet her breastfeeding goals. Here are some of the many ways you can support her.
If baby takes too much milk while mother is away, baby will be less interested in breastfeeding when they are together. Less breastfeeding puts mother’s milk supply at risk. She may also need to provide more pumped milk. Anything you can do to reduce the amount of milk mother needs to pump makes her life easier. Here are more basics.
Know breastfeeding norms. Most breastfed babies take smaller feedings and feed more often than babies fed formula. At an average feeding, a breastfed baby older than 1 month takes 3 to 4 ounces (90 to 120 mL) of milk.
Feed when baby shows signs of hunger rather than on a schedule. Cues such as rooting and hand-to-mouth mean it’s time to feed. It is common for breastfed babies to feed more often during some parts of the day than others.
Feed slowly using paced bottle feeding. When fed slowly, baby feels full with less milk, reducing mother's need to pump. If baby is older than 6 to 7 months, she may be fed by cup. If bottle fed, expect feedings to take about 15 to 30 minutes. Here’s how paced bottle feeding works:
- Hold baby semi-upright or upright (see photos) and tap her lips with the nipple until she opens wide.
- Help baby latch far enough onto the nipple so her lips close on the nipple’s base rather than its shaft or tip. (Gagging means baby needs a shorter nipple.) If baby’s lips are pulled in, use your fingers to flange them out.
- During feedings, hold the bottle nearly horizontal, so the flow isn’t too fast.
- Build in pauses every few minutes by lowering the end of the bottle so milk runs out of the nipple. Or remove the nipple from baby’s mouth and rest it on her lower lip.
- Repeat throughout the feeding until baby is done. Switch sides halfway through.
- Stop when baby stops, even if there’s milk left.
- Burp baby after feeding to bring up any air.
One key way mother keeps her milk production steady is frequent breastfeeding. You can help by encouraging her to sit down and breastfeed just before leaving baby with you and as soon as she returns. To make this easier:
- Make comfortable seating available.
- Offer a private area for nursing, if desired.
- Make it clear that breastfeeding is welcome and encouraged.
- If mother is due to arrive soon and baby seems hungry, feed just a little milk until she can breastfeed.
The more times each day a mother breastfeeds, the less milk she must pump. Breastfed babies need on average about 25 to 30 oz. (750 to 900 mL) per day. The more milk baby gets directly from mother, the less pumped milk is needed.
Store & Handle Milk with Care
You can also support mother by handling her milk with care so that little milk is discarded.
- Let mother know if baby regularly takes less milk than is in her containers.
- Follow the milk storage guidelines she provides.
- Thaw and warm milk gently and gradually, keeping heat low. Swirl the milk to mix layers. Don't shake it.
Milk can be thawed in the refrigerator or overnight. You can also thaw or warm milk in other ways.
- Hold the container under warm running water for a few minutes.
- Hold the container in water previously heated on the stove. Do not heat the milk directly on the burner.
If you use water to thaw or warm milk, tilt or hold the container, so the water cannot seep under the lid. Feed thawed milk right away or refrigerate it.
Do not thaw or warm milk in a microwave, which changes the milk and heats it unevenly. Even if you swirl or shake the milk afterwards, hot spots remain that can burn baby’s throat.
By supporting breastfeeding in these ways, you can provide great quality of care for the breastfed baby. And at the same time you can make life easier for mother and the entire family.