Michelle Cangiano, MD is a third-year family medicine resident at the UVM Medical Center.

Editor’s Note:  August 1-7 marks the World Health Organization’s 20th annual recognition of World Breastfeeding Week.  For more information or support regarding breastfeeding, please contact the UVM Medical Group Obstetrics and Midwifery service at the UVM Medical Center or your physician.

Breast milk is the most nutritionally complete food for babies.  The American Academy of Pediatrics, the World Health Organization, and the American Association of Family Physicians all recommend exclusive breastfeeding for the first six months of baby’s life, to be continued as long as desired.   Here is some advice, information, and resources to help you and your new baby achieve your breastfeeding goals.

How will I know when my baby is hungry?

Cues baby is hungry include stretching, yawning, lip smacking, putting hands near mouth, looking around, making sucking motions or pulling up arms and legs toward tummy. Crying is the last sign of hunger.

Basic Steps for Positioning for Nursing:

  1. Position yourself comfortably with back support, pillows supporting your arms and in your lap and feet supported comfortably.
  2. Position baby close to you with hips bent. His or her mouth and nose should be facing your nipple.
  3. Support your breast; be sure your fingers are well behind the areola (darker colored portion of the breast).
  4. Attach or latch baby onto your breast. Encourage baby to open mouth wide and pull baby close by supporting the back and shoulders rather than the back of the head.
  5. Enjoy! If you are feeling pain, detach baby gently by placing a clean finger in the corner of baby’s mouth to break the seal and then try again.

What are the signs that my baby is getting enough milk?

  • Weight gain: it is normal for a baby to lose 5-10% of body weight in the first few days after birth. The baby should regain its birth weight by 10-14 days after birth. After the first week the baby should gain 4-8oz/week. Weight will be checked by your doctor at your visits so it is important that your baby is seen within a few days of discharge.
  • Wet diapers: Expect one wet diaper on day one, two on day two, three on day three, increasing to 5-6/day by one week. Urine should be pale and mild smelling.
  • Stool: the stool will start off dark and transition, so by day 4 the baby should have 4 yellow stools about the size of a quarter.
  • Breastfeeding: baby should have 8-12 breast feeds in a 24 hour period. A breast feed could be one or both breasts. Baby should latch well, have visible or audible swallows, and finish at one breast before moving to the other. Watch for clues that the baby is full, and not the clock, to determine when a feeding is finished. Cluster feedings are times when baby wants to eat frequently for a period of time. This is normal and can happen many times in a row. For the first few days your baby may be too sleepy to eat and you may have to wake baby every 3-4 hours to try and feed.
  • Baby: after a meal the baby is content. The baby is also alert and active. The baby should not be unusually sleepy or fussy.
  • If you have any concerns that your baby is not feeding well, please call your doctor.

More Resources for Breastfeeding

Lactation Help:

  • UVM Medical Group Obstetrics and Midwifery Breastfeeding Clinic in Williston: 847-2237 (office appointments)
  • VNA of Chittenden County: 658-1900 (ask for IBCLC)
  • There are lactation consultants that do home visits; ask your doctor or hospital lactation consultant for a list.

Helpful websites and books:

  • www.kellymom.com (lots of helpful information, created by moms)
  • www.drjacknewman.com (videos on breastfeeding and latching)
  • www.llli.org (La Leche League information on breastfeeding and meetings in the area)
  • Breastfeeding: A Parent’s Guide (by Amy Spangler)
  • The Ultimate Breastfeeding Book of Answers (by Dr. Jack Newman)

Places to buy or rent a breast pump:

  • Directly from the UVM Medical Center’s Nurse-Midwifery program
  • Local WIC (Women, Infants and Children) offices
  • Medical supply stores (Keene Medical, The Medical Store, etc.)
  • Local specialty stores (Mothers Care Breast Pump Products, Natural Beginnings, etc.)
  • From on-line suppliers (www.medela.com, www.hygeia.com, etc.)
  • Local breastfeeding clinics (Obstetrics-Midwifery Breastfeeding Clinic, Lactation resources of Vermont, etc.)

Michelle Cangiano, MD is a third-year family medicine resident at the UVM Medical Center.

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