Breast-feeding is a dynamic relationship. This means that breast-feeding changes as the needs of either the baby or the mother change. You will find that you and the baby do best by being flexible. Scheduled feedings are a product of bottle-feeding. Keeping track of how often, how long, and how much doesn't really apply to breast-feeding. Although general patterns do emerge, there are no strict times to nurse and no time limits to a feeding. When your baby is hungry, nurse him/her for as long as the baby wants to.

After your baby is born, bring him/her up to your breast and begin the first feeding. This is a special time for you and your newborn. The urge to suck peaks at about 20-30 minutes of age. If the infant is not put to breast at this time, your baby's sucking reflex may not be as strong for another 24-36 hours. The baby is (usually) quiet and alert during the first hour of life. Looking around soaking in the sights, sounds, and smells. Feeling your touch and warmth. Drinking drops of colostrum or foremilk from your breast. Getting used to a new world. Try to keep this as a private time with your labor coach - so you can explore the new person you've worked so hard to meet. Phone calls, visitors, weighing and bathing baby can wait until after the first hour has passed.

Many people don't know it, but exclusive breast-feeding is the easiest and most complete way to protect your baby from common childhood illnesses. An internationally recognized study conducted in Cooperstown compared rates of illness in breast-fed and bottle-fed infants. Here are some of the results:

+Episodes per 1000 patient hours.

Data from Cunningham AS: Breast-feeding and morbidity in industrialized countries: an update. In Jellife DB and Jellife EFP, editors: Advances in international maternal and child health, vol. 1, Oxford University Press.

Other studies have discovered that bottle-fed infants are at an increased risk for more serious illnesses. Although the cause of Sudden Infant Death Syndrome (Crib Death) is unknown, it occurs at a higher rate for bottle-fed babies than for breast-fed infants. And bottle-feeding was associated with a six-fold risk of developing lymphoma which is a cancer that can occur in childhood. Juvenile diabetes is also higher in bottle-fed infants.

There is a large quantity of material on the health benefits of breastfeeding. On the surface breast-feeding seems so simple, but actually it is a complex dialog between mothers and their babies. As we learn more about breast-feeding, one fact seems clear: human babies grow bets on human milk. Breast-milk is not just good food, it's good medicine.

Don't be discouraged if things don't go well at first. Give yourself and your baby a minimum of 2-3 weeks to learn how to work together. La Leche League is a network of nursing mothers who help each other over the rough spots and who share the joys of nursing. Information on local LLL chapters is listed on the Breast-feeding Resource Guide in this binder.

Beware of well-meaning friends and relatives who doubt the adequacy of your milk supply. Breast milk can be slightly yellowish or blue tinged -- this is normal. If you don't think you have enough milk, nurse more frequently. The more often you nurse, the more milk you will produce.

Your baby is getting enough milk if he/she is...

• nursing 8-12 times/day
• wetting at least 6-8 diapers a day
• is gaining weight

Did you know that the most important factor in a woman's success or failure in breast-feeding her baby is the attitude of the people around her? Well, it's true. And you thought she never listens to you! if you feel positive about her decision to breast-feed and support her through the ups and downs, she'll feel better about her ability to feed her baby. Very few women are physically unable to breast-feed, however, many women worry about "the baby not getting enough" or "having the wrong kind of nipples" or "being too small to breast-feed" or "being too nervous to breast-feed." So, this is where you come in. Learn about breast-feeding along with her. Read the other pages in this binder or watch a video with her. The more you know, the more confident you'll be.

Fathers: Sometimes fathers feel "left out" of breast-feeding. Of course, not much can be done about sharing the actual act of breast-feeding, but you are sharing raising the child. Knowing that your baby is getting the best food available anywhere should make both of you feel good. Fathers can help give a tired mother a break by taking over other parts of the baby's care.

Grandmothers: Chances are you weren't able to breast-feed your children. This is because in the '50s and '60s the number of breast-feeding women hit an all-time low in the United States. At that time, young mothers were encouraged to bottle-feed, because we didn't fully understand the true value of breast-feeding. We placed more confidence in the science of formula, than we did in nature. Over the past 20 years, the benefits of breast-feeding have been "rediscovered." So today, you can help your children get off to a good healthy start with your grandchild by helping them through the adjustments of parenting.

Best Friends: You may or may not have breast-fed an infant, but your input is important to your friend's success in breast-feeding. If you have breast-fed, help her by letting her talk about her experience and share some of your insights with her. If you haven't nursed a baby, you may be the next breast-feeding mom in your circle of friends, so now's your chance to learn the ropes before your turn comes up.

Engorgement is overfullness in one or both breasts. It is caused by incomplete emptying of the breast. It can occur at any time when feedings are interrupted, delayed, or missed, but it is most dramatic the first 24-48 hours after birth. If you become engorged, call a lactation consultant, La Leche league leader, midwife, or nurse to discuss how to best manage the engorgement.

The best treatment for engorgement is nursing your baby. This is often complicated with initial engorgement, because the infant may not have had the chance to learn how to nurse yet and the overfullness of your breast may hinder the attempts the baby makes to suckle. This in turn will cause increased swelling. Your goal is to break this vicious circle by helping the baby latch on. Here are some suggestions:

When a breast-fed newborn is exposed to a pacifier or artificial nipple, nipple confusion can occur. Because suckling takes more coordination, it is best to give your baby a chance to get the basics of breast-feeding down before you introduce a pacifier or bottle. Wait at least three weeks. Symptoms of nipple confusion can be:

Often well-meaning individuals will offer you a pacifier to soothe your infant. Explain nipple confusion to them and ask them if they would rock or walk the baby instead.

Eventually you will want to give your infant a bottle of expressed breast milk. Allow your baby a couple of weeks to adjust to using a bottle along with breast-feeding and he/she will be able to do both.

Drawing milk from the breast is different than sucking on a pacifier or bottle. The positioning of the gums, lips, jaw, and especially the tongue is different.

Suckling is a well-coordinated process. When your baby nurses, he/she opens the mouth wide and with lips flanged pulls the areola (the dark area of your nipple) in. The tongue is slid over the bottom gum and draws the milk from your breast using a wave-like motion.

An infant sucking on a pacifier or bottle pinches the nipple between the upper and lower gums. The tongue is pushed back into the mouth and the lips are pursed.

Once an infant has mastered suckling (usually after three weeks) an artificial nipple can be introduced. Some babies refuse pacifiers, some such their thumbs, some don't use either. Let your infant tell you his/her preferences. By working with your baby you will be able to find a sucking pattern that meets both your needs.

Pumping and storing your breast milk gives you the opportunity to leave your infant with others. For lactating women who plan to return to work, it is an essential skill to learn.

There are several ways to express milk: manual expression, non-electric pumping, and electric pumping. Manual expression of breast milk can be an effective way to relieve engorgement when you are away from a pump; however, few women use it exclusively. A breast pump is a good, practical investment and it makes a great shower gift. Breast pumps are available through mail order catalogs, rental stations, pharmacies, some department stores, and the Birthing Center. For more information on pumping, contact your nurse, midwife, or lactation consultant.

Store your milk in small quantities. In the beginning, you will express only 1-2 ounces of milk at a time. This is because the infant's stomach is about the size of his/her fist. So when you are packaging your milk, store it in small individual feedings. This is best accomplished by using disposable feeding bags that come pre-sterilized. They should be available in the infant section of your grocery store. Collect the bags of milk and place them in a plastic container at the back of your freezer. Breast milk can also be stored in bottles - plastic is best.

Bestfeeding: Getting Breastfeeding Right for You by Mary Renfrew, Chloe Fisher, and Suzanne Arms.
Based on successful breast-feeding work with thousands of women around the world, the authors bring a blend of academic knowledge, clinical wisdom, and practical skills.
$12.94 - 228 pages

*The Womanly Art of Breastfeeding by La Leche League International.
This breast-feeding handbook has been the standard reference of breast-feeding mothers for years. Newly updated.
$9.95 - 447 pages

*Breastfeeding Your Baby by Sheila Kitzinger
Beautifully photographed. Makes good use of photos to save hundreds of words. Covers all aspects of breast-feeding and discusses some parenting issues.
$14.95 - 160 pages

Breastfeeding and the Working Mother by Diane Ingersoll and Diane Mason
Deals with the special needs of the working mom who breast-feeds. Discusses day care options, pumping, and storing milk.

* These books are available for purchase in the Gift Shop in the old clinic building.

A Healthier Baby by Breastfeeding by Linda J. Smith, ACCE, IBCLC
A good look at the practical concerns of breast-feeding mothers. Shows multiple mother/infant pairs. Covers: How to Get Started, How to Make Enough Milk, Where to Get Help. Lists information sources for mothers seeking additional material on breast-feeding.
30 minutes

Breastfeeding: The Art of Mothering
A comprehensive guide to breast-feeding from delivery to going home to the first well-baby visit. Discusses involving family members in supporting the nursing mom. Features several breast-feeding mother/baby couples. Good coverage of manual expression of breast milk and breast anatomy. Approved by the American Academy of Pediatrics.
40 minutes

Breastfeeding Techniques that Work by Kittie Frantz, RN, CPNP
A close look at beginning breast-feeding. How to position the infant and breast in order to avoid nipple soreness.
10 minutes.

Ask for help if....

• you have questions about breast-feeding or need reassurance about your breast-feeding experience
• you are feeling overwhelmed or frustrated
• you are engorged (painful swelling of the breast)
• you experience any discomfort while nursing
• your baby is unusually fussy, irritable, or lethargic
• your baby isn't nursing at least eight times a day or isn't wetting at least six diapers a day
• your baby's stools are liquid green and frothy
• you need help finding a breast pump

Help is available from a variety of sources:

• family and friends who support your decision to breast-feed
• books, pamphlets, videos, and this handbook
• La Leche League which is an international support group for breast-feeding women and their children has several local chapters
• your nurse, midwife, doctor, or a lactation consultant

Consult the Bassett Birthing Center Breast-feeding Resource Guide
located in this binder and posted in the Birthing Center
for a detailed listing of breast-feeding support.

Here is some space to write out your own plan for breast-feeding before the baby is born. The Breast-Feeding Workshop offered by the Birthing Center will help you write a plan that fits your specific needs.

I plan to breast-feed my baby for:

I plan to give my baby solids at:

I plan to give my baby drinks other than breast milk at:

the father of the baby

my mother

my friend(s)

my other children

my health care provider

the baby's health care provider

my child care provider

my employer

I will be returning to work:

My child care provider will feed my baby:

I plan to pump milk until the baby is old.

The pump I'll be using is:

I will be away from my baby hours.

I will be able to pump times at work.

My Breast-Feeding Coach is:

My Breast-Feeding Book is:

Notwithstanding any other provision of law, a mother may breast-feed her baby in any location, public or private, where the mother is otherwise authorized to be, irrespective of whether or not the nipple of the mother's breast is covered during or incidental to the breast-feeding.

NYS Assembly bill #6403
1993-1994 Regular Sessions

The Surgeon General of the United States recommends that babies from birth to one year of age be breast-fed, unless medically contraindicated, in order to attain an optimal healthy start. Despite such recommendation, statistics reveal a declining percentage of mothers choosing to breast-feed their babies, and nearly half of all new mothers are now choosing formula over breast-feeding before they even leave the hospital, only twenty-six percent are still breast-feeding when their babies are six months old, and only six percent are still breast-feeding when their babies are one year old.

Breast milk offers better nutrition, immunity and digestion, and may raise a baby's IQ. In addition, other benefits such as improved mother-baby bonding, and its encouragement have been established as a major goal of this decade by the World Health Organization and UNICEF. The social constraints of modern society militate against the choice of breast-feeding and lead new mothers with demanding time schedules to opt for formula feeding for reasons such as embarrassment and fear of social ostracism or criminal prosecution.

The promotion of family values and infant health demand putting an end to the vicious cycle of embarrassment and ignorance that constricts women and men alike in the subject of breast-feeding and represents hostility to mothers and babies in our culture based on archaic and outdated moral taboos. Any genuine promotion of family values should encourage public acceptance of this most basic act of nurture between mother and baby, and no mother should be made to feel incriminated or socially ostracized for breast-feeding her baby.