Parkwest Medical Center Breastfeeding Guidebook

Skin-to-skin, or Kangaroo Mother Care, coined by Dr. Nils Bergman, enhances the hormones needed for breastfeeding and helps to stabilize the baby’s body temperature, heart rate, respiratory rate, and blood sugar. It also helps to make the baby’s transition from the uterus to the real world easier.

To use this practice, with the help of a nurse, as soon as possible after delivery:

• Place your baby skin-to-skin (undressed with just a diaper and hat) on your bare chest.
• You may be reclined but not flat.
• Position the baby above your breasts with his head turned to one side so his face can be easily seen.
• Your baby’s shoulders should be flat against your chest.
• Baby’s head is tilted up off his chest and his neck is straight, not bent, for ease of breathing.
• Cover the back of the baby with a blanket for warmth, making sure that the nose and mouth are not
• covered.
• Allow the baby to nurse within the first hour.
• If the baby doesn’t nurse, then leave him/her skin-to-skin until the first breastfeeding is established.

Moms need to stay well-rested and have uninterrupted skin-to-skin time with their babies.

Oxytocin, a hormone that releases colostrum and milk, is very high after delivery. If your baby nurses during this time, he/she can get a moderate amount of colostrum to help sustain him/her during the sleepy period which occurs a few hours after delivery. The oxytocin surge also helps decrease your own bleeding post-delivery.

Prolactin is another hormone that is high after delivery and for the first week following delivery. When the baby nurses, surges of this hormone help you make more milk and also help you feel relaxed and sleepy.

Normal frequency, in the beginning, is eight to twelve times in a 24-hour period because your baby’s stomach capacity is small. (It starts out being about the size of a marble.)

The baby may nurse for 10-20 minutes on both breasts or at least on one breast per feeding every 1 ½ to 3 hours. Always offer both breasts, and switch breasts if the baby wants to nurse longer than 25 minutes.

These are a series of frequent mini-feedings, which are common especially at night when the prolactin hormone (milk-making hormone) is high. If your baby sleeps a lot during the day, she may want to be awake more through the night to eat.

Feeding cues are a baby’s signal that she is ready to eat. These cues can include:

• Hand-to-mouth movements
• Sucking motions
• Tongue thrusting
• Becoming more alert
• A succession of short whimpers.

Crying is a late sign of hunger. If your baby cries, calm her down before starting to feed.

Methods for calming your baby include:

• Swaddling
• Allowing the baby to suck on your clean finger
• Swaying side-to-side
• Rocking and making shushing noises close to your baby’s ear
• Changing a diaper if it’s messy
• Burping the baby
• Placing him skin-to-skin

Newborns are often sleepy. If your baby does not wake to feed or show any feeding cues, then wake him every two to three hours by trying things like:

• Changing the diaper
• Removing the blanket and/or t-shirt
• Burping him
• Sitting the baby up
• Rolling the baby gently from side-to-side
• Massaging his back, legs, and feet
• Placing him skin-to-skin for 20 minutes.

Writing down feedings and diapers allows you to keep a careful record of your baby’s feedings, urine output, and bowel movements. This is important because the baby’s output can help us determine whether or not she is getting enough to eat.

Keep the log for the first seven to 14 days and take it to your pediatrician’s visits.

A good latch and your baby’s ability to breastfeed frequently with good milk removal are the keys to successful breastfeeding. Read more about breastfeeding positions here.

If you are unsure about how to help your baby latch well or concerned that he may not be getting enough milk, please contact Parkwest Lactation Services at 865-373-4081. We want to help you achieve success in feeding your little one.

Babies should have at least one wet diaper for each day of age until day five, at which time they should have six to eight wet diapers per day. Tear open diapers to avoid missing wet diapers. If your baby urinates while his/her diaper is off, that counts too! Don’t forget to check bowel movement diapers for urine also.

Newborns should have one to two stools every day for the first three or four days and then at least three to four per day after that. Some babies will have a stool with every feeding. Initially, the stools will be black, tarry meconium, then greenish-black by day three, then should be soft, yellow, and seedy by day five.

If your baby is not having appropriate output, try:

• Waking her to try to feed more frequently.
• Listen and look for swallowing.
• Use breast compression techniques to maximize what the baby can drink at the breast.

If you are still concerned about your baby’s output, please call your baby’s doctor or a Parkwest lactation consultant at 865-373-4081.