Tuesday, August 21, 2012

Breastfeeding, A Collection of Tips from Several Years (okay, A Decade) of Nursing

"Breastfeeding is not a destination...it is the Journey, it is the Process" - Me

When you hear that to successfully breastfeeding you need to "get a good latch," what does that look like? Or have you heard of using "breast compression" to help encourage milk flow - how do you do it and how to know the breast is compressed in the right shape?  While the information in this blog cannot replace a good lactation consultant or the advice of someone who's successfully breastfed, this blog is a collection of tips, video links, perspectives, and clarity on advice NOT commonly found everywhere else. You won't find this compilation of tips anywhere else. They are Breastfeeding Tips from several years of nursing three kids. Let's jump into these easy to remember tips and reminders on what breastfeeding looks, sounds, and feels like.

Breastfeeding, A Collection of Tips from Several Years (okay, A Decade) of Nursing


Overtime, I was a nursing mom who struggled with all three kids, for one reason or another. But I breastfed all my kids as long as possible. The good news is once you get the swing of things, and that takes time, breastfeeding can be a truly wonderful experience between mom and baby.  And then some days you just feel overwhelmed and you don't want to nurse. All of these feelings are normal.

Now that your baby is born, you will see that they know how to suck at the breast and they will eventually want to constantly suck, but baby doesn't always know how to latch on properly. And mom might not recognize a proper latch, look, and feel either. Mom and baby will learn to breastfeed over the first several weeks (up to 8 weeks or more).

What a lot of women don't say - for whatever reason - is that Breastfeeding is hard in the very beginning, when we (mom and baby) are learning to breastfeed. Then add in the sleep deprevation, exhaustion, and if you have other kids - phew!! I think knowing that breastfeeding requires some effort for a few women, to a lot of effort for others, makes expectations for new moms more realistic and manageable. If you are persistent and continue to nurse, you can experience success.

Starter Websites:

During every problem I encountered while nursing over 7 years and 3 kids, I read out of print books, researched websites and anything I could get my hands on. There are many great reputable "starter websites" that can teach you how to breastfeed and resolve common issues.

-- I strongly recommend Dr. Jack Newman who's the only doctor who has committed his entire practice to study breastfeeding!!

-- Kellymom is a lactation consultants website with great details.

-- And most recently the Stanford University website with new information from recent breastfeeding studies, including how hand expressing milk in the first few days after birth, helps increase milk production.

Here is some of the BEST reassuring advice I have ever read about nursing:

If you breastfeed your baby even for a few weeks, you have a nursing relationship.
If you nurse your baby at night, you have a nursing relationship.
If you have enough milk to offer your baby "snacks," you have a nursing relationship.
If you breastfeed your baby in any way, you have a nursing relationship.

2013-05-07 165

How Breastfeeding Starts:

How do I start breastfeeding?

-- Put the baby near your breast, some babies latch on to your breast on their own! Some babies can "smell" the breast milk and "sniff around" looking for the breast.

--latch baby on the breast right after birth if possible. Insist on this at delivery! Make your desire to breastfeed known - tell every doctor and every nurse you see. At shift change sometimes the medical caregivers might not exchange notes on what your wishes are. So tell all medical people who walk in your hospital room that you are breastfeeding. No formula in these first few weeks.

-- In the first few days you produce only drops of colestrum. Then drops of milk. These drops is all the baby needs, not more.

--Babies tummy is the size of a marble at birth... So drops of milk are the perfect amount of milk!!! (you tube video).

-- and since babies stomach is so small they will nurse frequently, some times every 20 minutes - as baby grows over the first few days there will be more time in between feedings (30 minutes, 40 minutes...etc. and longer space between as baby grows up into 3, 4, months old).

---Babies love to suck, let them suck all they want on the breast. Dont unattach baby. Let them drink until they are full.

-- by day 3 the baby may be eating every 15 minutes to nearly every hour. There's no schedule, just determined if baby is hungry.

--many women say at this point (the first few days) they don't make enough milk. It's true. Because baby doesn't need that much right now. And the more often baby sucks your breast/drinks your milk, the more milk our body makes.

--At birth babies drink drops of colestrum, not ounces.

--Not until Slowly, by 3 weeks, baby will take 1-2 ounces total per feeding. There stomachs are tiny and don't stretch.

--sometimes shortly after nursing the baby will want to have the breast again. This is normal, baby might want to suckle, have a snack, or comfort nurse.

- baby stomach size is only a small marble at birth, so drops of cestrum is more then enuogh mik. By 5 days it's a large marble. Not even a few ml, or a 1/4 oz per feeding - that's only drops of your milk that will fit. By 10 days baby stomach is the size of a golfball - roughly 10ml or a 1/2 oz.

-- By 6 weeks babies tummy is the size of a golf ball - so 1-2 ounces of milk is also sufficient, baby may just eat more often then other babies.
You tube video on baby tummy size.

-- Babies should suck swallow the first 5-7 mins of feeding. This suck-swallow is how you know baby IS eating and not just keeping the breast in their mouth. Unless the baby is feeding for a snack, or comfort nursing. (link Dr jack video on suck swallow)

-- a nice latch technique is to roll the breast down along babies lower lip with bottom of your aereola to get a wider mouth and a better latch. (you tube video n minute)
http://www.youtube.com/watch?v=XMPpQULNG0w&feature=youtube_gdata_player

- unlatch - my baby didn't start falling off after breastfeeding or "unlatch" on her own until almost 6 weeks. So expect that baby will fall asleep at the breast and stay asleep unless you wake them. There's another school of thought. It to wake baby. But in my case I didn't wake baby and she wasn't actively eating enough, milk wasn't removed, more milk wasn't made, etc., so I needed to wake baby by unlatching, burping her and then offering the second breast.

- when you wait for the open mouth, my lactation consultant taught me that you need to firmly push baby onto the breast. It'll feel strange to first time moms/nursing because we are used to being overly gentle with baby. But when you hold babies neck and push her on the aereola as seen in many latching videos... It's a firm push, not slow because if your too slow you will loose the "open mouth" on baby!

-- Newborn Babies want the breast often - every 1 hour or less and will stay on for 20 mins to an hour, first eating, then sleeping and sometimes just comfort sucking.

--Babies know to sux but they don't know to take enough aereola in. Practice practice practice. Relatch and relatch as needed. Thats why it's said to not give up breastfeeding because it takes time for mom and baby to learn!! And time can mean several weeks!

--Thats why it's said to not give up breastfeeding because it takes time for mom and baby to learn!! And time can mean several weeks!

-- if you feel you need to supplement with formula, then consider a supplemental nursing system. SNS is a great way to supplement AND experience breastfeeding. See below.

-- ask someone to show you how to co-sleep with the baby. And learn to nurse laying down in the "sideline" position. These two tactics saved my nursing relationships with my babies.

-- keeping up even a limited milk supply so you can nurse at nighttime is wonderful so you can save yourself from making a bottle or supplementing at night.

-- gassy baby. After feeding on one side, burp and put back on same breast. Baby may not be getting enough hind milk which is filling and fatty and will aid in gas Relief.

-- if baby starts to spit up it might not be acid reflux. Consider that baby is possibly over eating? Babies will spit out the breast and bottle with their tongue. Do not make the baby finish a bottle. Why do they "have to" drink 2 ounces or 4 ounces? Is it because of your schedule? Baby's won't overeat on their own. So if your being told to consider acid reflux medication for your baby, pay closer attention to how s/he is eating.

-- what to expect in the early weeks of breastfeeding http://life.familyeducation.com/breastfeeding/36046.html?page=1


How does Breastfeeding Feel?
Does breastfeeding hurt?

-- at first it may hurt a little, or a lot. Depending on your latch, and pain tolerance/ irritation tolerance. But if you can last a day or two, it does get easier.

-- video link is below; with suck on finger to first knuckle, then second to learn difference in nipple feel. Put your finger in your mouth so your teeth touch to the first knuckle. Suck like That tickle of tongue on tip of your finger tells you baby is "tuckling the tip of the nipple". That means the latch is too shallow. Now put your finger in gour mouth to your 2nd knuckle. When you suck like threw a straw you feel the tongue rub the bottom of the finger- that's correct sensation.
http://www.youtube.com/watch?v=SUHLDu4HrM&feature=youtube_gdata_player

-- listen for swallowing, similar sound to when y swallow after sipping thru a straw.

-- video link
-- -Sucking feels like a tugging. But the tug starts at the niplple and feels can feel like a pull or small tug throughout the interior of the breast all the way thru to the chest wall. General description, varies baby to baby.

--you should feel something, basically that baby isn't just holding the nipple in their mouth.

-- breast compression feels like a gentle push on the breast tissue and helps the flow of milk, but squeezing and holdin the squeeze too long stop the flow of milk - see Dr Jack Newman video on proper compressions.

--As baby get older - 5+weeks you may feel / see the top of the aereola move and get tugged as baby sucks. This is normal, and shows she's sucking strongly. But it shouldn't hurt your nipple or breast - tugging is okay but no pain.

--If baby is not sucking well or has a high pallette or a low suck, read this link with ways to improve baby's suck.
http://www.llli.org/nb/nbsepoct04p169.html

-- babies as they get to be 2 weeks old or so will "hug" the breast, wrapping their arms around it. Then as try gain more control of their arms, baby will "kneed" the breast to encourage milk flow. These pushes from baby are similar to breast compressions mentioned by Dr. Jack Newman. Baby might also Di these things to encourage the Milk flow at the breast: push it, press on it, or squeeze it. Sometimes a squeeze feels
Like pinching. You can tell baby gently NO and move their hand, or start breast compressions. Don't be rough and swat or push babies hand away, this is natures way of encouraging milk production.


How does Breastfeeding Look?
How do I know if baby is latched right?
How does a good breastfeeding latch look? :

-- guide to basic setup where baby is tummy to tummy with mom for cradle position. Link

-- Nipple to nose means the flat/top part of the nipple is pointing to babys nostrils and NOT near the top/tip of babies nose.

--when latching your actually focused on getting the aereola in babies mouth and the nipple "tags along" and flips in at the last Moment. Baby is NOT nipple feeding, their aereola (the brown part all around the nipple) sucking. This "flip in" is a good strategy to get plenty of aereola in the mouth.

-- babies neck will be extended, long, and seem like baby is looking up. Their chin shouldn't be touching their chest wall.

--Lips larger then "L" shape

-- Baby should look like they have "fish lips." Their lips are flipped out and you can see the pink interior.

-- Baby is actually taking in only 1/2 of the aereola, the Nipple is the top interior of their mouth and the bottom of aereola is resting on babys tongue. The top part of the (above the nipple) will not be in babys mouth- jack Newman drawing.

-- When latching your not approaching the aereola straight on. Baby is taking in 1/4 of the breast. Do not approach straight on but on an angle. From the top view of a cradle or cross cradle hold, If the nipple is at babys nose then babies mouth is at the all the way right or left of the nipple. More then 1/2 the nipple stays exposed especially in the early weeks when baby's mouth is small.

-- a nice latch strategy is to make a "nipple sandwich" and Squeeze the areola (behind the nipple), release once a good suction is started, a few seconds, this way baby gets plenty of areola in their mouth.

-- a Nipple sandwich should be a "U" shaped compression for the cradle hold: have your fingers parrallel to babies lips. If you football hold or lay down to nurse your fingers, parallel to babies lips will look like a letter "c" - link; Standford and Dr Newman.

-- bring the Nipple to the babies Nose. I know this sounds weird, but baby will "smell" the nipple and tilt their head back and latch on every time.

-- baby Has their lips "flipped out" for a good latch.

-- at the end of Nursing, some babies will have a little "lip blister" on the center of their upper lip - its not painful.

-- As baby get older - 5+weeks you may see / feel the top of the aereola move and get tugged as baby sucks. This is normal, and shows she's sucking strongly. But it shouldn't hurt your nipple or breast - tugging is okay but no pain.

- Dr. Jack Newman latch - great video (which starts with an exposed breast) showing a baby latched on properly.

-- have a special activity/books for toddler to only get to play with during nursing. It's great book reading time too.

-- no pacifiers bottles or anything other then breast for first 3 months or until supply is well established

--At 4/5 weeks I can put baby down for 15-20 mins to make lunch, potty, get my water bottle filled etc. then she will want to nurse again. We started to nurse every 1 - 1 1/2 hours at about 6-8 weeks.

-- she still doesn't unattach when done feeding - she just falls asleep. Then I unattach her after a few minutes and put her to bed for a nap.

-- how a good breastfeeding latch should feel? discovered a roll down the lower lip method to attach baby and get a full mouth of aereola. Also a video on how the nipple should feel by babys tongue.

-- sometimes I unattach and relatch her 5-7xs until we get it right. I let her suck a little and swallow 2-3 xs before I unattach and start again. Baby can get frustrated after so much unlatching and refuse to nurse - use caution.

-- unlatch - my baby didn't start falling off after breastfeeding or "unlatch" on her own until almost 6 weeks. So expect that baby will fall asleep at the breast and stay asleep unless you wake them.

-- when you wait for the open mouth, my lactation consultant taught me that you need to firmly push baby onto the breast. It'll feel strange to first time moms/nursing because we are used to being overly gentle with baby. But when you hold babies neck and push her on the aereola as seen in many latching videos... It's a firm push, not slow because if your too slow you will loose the "open mouth" on baby!

-- a deep latch instructions and pictures
http://www.pumpstation.com/pumpstation/dept.asp?dept_id=3228


How does Breastfeeding Sound?
Do babies make noise breastfeeding? :

-- you should NOT hear loud sucking sounds, or slurping noises. There may be one noise at first, but after one minute or two, baby should only sound like the sounds listed below. That would mean Baby is taking in to much air as s/he sucks. It could also mean baby is sucking their cheeks in, or sucking on his lips, and is also not a correct latch. Unlatch baby and start again. Use the roll down technique mentioned above.

-- it sounds like occasional swallows. Just like when you swallow.

-- it sounds like little releases of air from the nose.

-- it sounds like the swallowing sound you make when drinking through a straw.

Breastfeeding Facts for mom:

How much water should I drink when breastfeeding?
(common tips demystified)

--drink plenty of liquids means:
- you are not thirsty
- you drink mostly water or non- caffine drinks.
- you drink about 64 ounces a day, that's 8 oz or 1 Cup of water every hour
- you are urinating every hour during the day.

-- a good way to stay hydrated is drink drink 8 ounces of water before each nursing session. And if you are still parched, then drink another cup after nursing.


How does breast pumping look and feel?
How does it look when you pump  Breastmilk?
What's a good nursing and pumping schedule?

-- understand just for yourself, what are your reasons for pumping? Is it So someone else can give baby a bottle? Because you work? If you primarily breast feed and baby is always in your care, do you really need to pump?

-- pumping looks like nothing at first. On the first few attempts It could take several minutes (2-7 minutes) before you even get a drop of milk to come out. Many moms need to walk away from the machine, take a few minutes break and then come back and try again in the first attempts at pumping.

-- a lot of advice says look at a picture of baby, or sniff their clothes. But if you are constantly thinking about that email from work, or that website you had to read.... Do it! Once you learn how to pump you can read email instead of looking at baby's picture.

-- Realize also that you won't pump 8 ounces probably ever, or even 1 oz until many, many weeks to months down the road. Droplets are great in the first few days!! Then a half ounce (from both breasts) is excellent. Anything more is not the norm.

-- breastmilk looks like a skim milk with a slight light blue color. It turns from watery drops to a thicker Looking whole milk.

-- when pumping the milk starts as little milk drops from on top of the nipple, then either a small drops drip Down or/a spray stream forms. "spray streams" is the milk coming out of the nipple. Some women have one or two spray streams start. Some women have many spray streams from their nipple. (I rarely get past this point and I'll pump 1-1/2 oz in 5-10 minutes.)

-- when your milk comes out of the nipple there is two types of simultaneous flow: one slow constant drip, and one spray of milk with every suction action. (The spray part comes out of the nipple in one hole or thru several holes - like a garden spray hose attachment/ or a shower nozzle with a few holes). It's worth watching a hand expression video (on you tube) to see this effect in action.

-- Occasionally I will have a "milk let down" while pumping and a large amount of spray holes open - looking like a spray valve with nearly 10 sprays of milk working simultaneously. Sometimes only the "drip" happens with 1 spray hole working. And sometimes it's 4 sprays... Everything depends on when you pump, before or after a feeding, is it morning, are you tired, etc.

-- how much you pump depends on so many factors. How full of milk your breast are, is it after a feeding, is it early morning, or evening, are you relaxed enough?

-- remember we are not designed to pump. The machine doesn't suction as well as a baby. You only pump approximately 70% of what your breasts produce.

-- most women see at least a few drops. Pumping many ounces (more then 1-2 ounces or so) is the exception.

--I could only pump 1/2 oz or less (total from both breasts) for the first several pumping sessions thru 5 weeks. More pumping experience = equals more milk per session. This happens slowly over several ( 3-5) days... Not hours!

-- when pumping it is helpful to try breast compressions to help drain the milk. See Dr. Jack Newman compression video. It really helps to gently push out the milk working with the pumps rhythm.

-- and add power pumping or every hour pumping.

-- this is a nice pumping and breastfeeding combination schedule. It is from an adoption website, but works for moms trying to build a milk supply while pumping. http://www.fourfriends.com/abrw/Boot%20Camp/bcr.htm


How to know if breastfeeding works?
Is Breastfeeding going well?
How big is newborn poop stools?
In general:

-- baby is actively sucking at the breast.

--Baby is satisfied after eating (not screaming or irritated).

-- watch baby, are they making drinking sounds?

--Baby is relaxed and not tense or tight fisted. But feeding is an intense experience for the baby. It is
Normal for baby to look and feel excited before nursing by cooing, babbling or crying. My babies would kick their legs or even shake with excitement.

-- there is enough in the diaper to count pee and poo. After 6 weeks Some breastfed babies poop once a week, but this is only true after 6 weeks or so. Otherwise breastfed babies poop at least once daily, some poop after every feeding.

-- baby stools and baby poop is small. The first day merconium amount is small, less then palm size. As babys continue to poop everyday, poop will vary, but I usually small in the first few weeks through 6 weeks. link here to what baby poop looks like.

-- Sometimes baby poo is only the size of a dime or a quarter. This is a stool and poop that equals a dirty diaper.

-- is my breastfed baby constipated? Or is baby just not pooping enough?

-- baby is gaining weight using the WHO world health organization guidelines (3.5-7 ounces a week). Breast fed baby weight growth chart link

-- don't be afraid to weigh baby yourself and own a scale. In Europe many women own their own scales and weigh baby daily. In the united states we would cause major congestion at the doctors offices just weighing our babies! This is a good way to feel at ease and know baby is gaining weight, and not wait too long between weight checks to uncover a possible problem!

-- early good weight gain turns into slow/no weight gain at 6 weeks or so. Read Dr. Jack Newman article about how newborns stay on the breast often falling asleep there and shorty after get a 2nd let down of milk. This adds calories an intake. Another good reason NOT to unlatch baby right as they fall asleep. When they are older babies get frustrated sooner or other reasons highlighted In This article.

-- Dr Jack Newmans BLOG is a great read thru and resource also.

-- if baby is gassy s/he may not be getting enough "hind milk." hind milk is more fatty and filling. After a feeding, and it's time to feed again, put baby back on the same breast as the last feeding so they can get more of the hind milk. Then When baby finishes the first breast offer the second breast. After a several feedings this should help ease the gas.

-- baby should have 6 wet diapers a day. Wet means 1-2 ounces of pee, especially under 6 weeks. Take an empty diaper and fill it w a shot glass worth of water, that's one ounce. now hold the water filled diaper in the palm of your hand, and hold an empty diaper in your other hand. Compare the sensation (it's a subtle difference).

-- after a nursing session if baby won't stay asleep alone, without mom, this Does NOT mean baby is hungry. My daughter would take a full nursing and I would lay her down when she fell asleep and within 5 minutes she'd be awake. But if she fell asleep and i'd keep her in my arms or in a baby sling, she'd sleep for a full 20-30 minute nap.


Look at baby when they are nursing, it helps develop self esteem and awareness areyousureaboutthatblog


General breastfeeding advice and tips:

Links:
Stanford studies
Kelly mom
Dr. Jack Newman

-- if baby is spitting up, consider they are over eating or eating too fast. Slow the feeding by giving half the breast/ or bottle supplement. Stop and burp baby. Then give the rest of the feeding. If baby isn't hungry, and spitting out the bottle, then respect that.. do not force baby to eat more - their stomachs are small.

-- once your baby is regularly nursing in a rhythm (not a schedule) and baby is regularly finishing the breast, and then starting her next feeding sooner, this is how baby gets your breast to make more milk. Allow baby to eat sooner - it's not your time to eat doesn't help the nursing rhythm.

-- Do you always finish your lunch or dinner? Do you sometimes need a snack, or maybe your a Little extra thirsty today? Babies needs also vary, consider this when feeding your baby. Sometimes they are hungry sooner, or baby needs an extra drink.

-- When Breastfeeding / Nursing in public: do you like eating with your head covered? Having your dinner with a scarf over your head so you cannot see? I think covering up a nursing baby actually draws more attention to you -- people know your trying to cover something. I started nursing without a cover up and I find people pay less attention to us. If you nurse and see yourself in the mirror you will find that your baby covers a lot of the breast.

-- sometimes shortly after nursing the baby will want to have the breast again. This is normal, baby might want to suckle, have a snack, or comfort nurse

-- A friend who was still night nursing at 2 year old. I still want to nurse because this is my last baby. I'm Not having more kids and I want to last as long as possible! WHO recommends nursing until 2 years old, and it's not because of "lack of dietary" needs in poorer countries. It's because breast milk contains everything's babies need. Consider combination nursing and introducing foods.

How to produce the most breastmilk?
How to make more milk?

Induced Lactation Resource

-- I started using a SNS because baby wasn't gaining fast enough. I then kept the SNS the hospital gave me out of fear of him being hungry. Every whimper, every cry, in my mind it meant hunger. Insecurity is so dibilitating.

-- Nursing is fab. No bottle no water to shlep. Just some nappies and my body brings the milk. I love going on outing with my kids and I can nurse anywhere while they have fun and get there energy out.

-- I don't unlatch baby girl when she falls asleep. I find that after a little while, sometimes 10 mins of nibbling, sometimes 20, she will start gulping - alot - it is either a 2nd left down of milk or all those drops from nibbling build up in her mouth to several gulps worth.

-- Cluster feeding - babies sometimes build up there calories for a long night's sleep, so they "cluster feed" or take several feedings in a short period of time at night. Maybe every 20 minutes for 1-2 hours before bedtime.

-- Often I feel like a refridgerator constantly in use

-- cup feed supplement instead of a bottle, even with a newborn.

-- compress breast to get milk flow- pain free

-- link Breast Compression  Dr. Jack Newman
-- Dr Spock: excerpt diapers and breastfeeding paragraph so moms know wet / poop diapers standard for formula fed baby and breastmilk varies.

-- if you have a Gassy baby, After feeding on one side, burp and put the baby back on the same breast. Baby may not be getting enough hind milk which is filling and fatty and will aid in gas Relief.

-- Spock sleeping with baby excerpt

-- tongue tie - consult a pediatric dentist for good advise in additin to LC and pediatrician. See tongue tie questions.

-- surround urself with support - it's hard to find sometimes.

-- Get people to cook for u .


How to Breastfeed and Supplement?
How can I breastfeed and give formula to my baby?
How soon should I start supplementing?
How to supplement feeding a breast fed baby?

-- if supplementing consider buying breastmilk from a milk bank instead of formula. Or use your pumped milk.

-- Consider using a supplemental nursing system (SNS). It's a nice way to supplement while nursing!
one type of SNS sold by Medela, however I used a tube with a plunger and a baby bottle. Easy to Use! Areyousureaboutthatblog

-- when baby drinks from a bottle the milk flow is fast, and baby does not have to suck hard or work as hard to get the milk out. When using the tube feeding SNS the baby still has to suck to get the milk out. So at the same time baby practices breastfeeding.

-- you can also use a less expensive #8 French tube feeder with a small plunger. Use the tube in the corner of babies mouth as you would the SNS, and attach to the bottle as pictured. Cleaning the tube: Buy a catheter tipped syringe to push clean water through the tube. Amazon links here.

-- if baby is not gaining weight well and having less then 6 wet diapers a day, this is an indication of a problem with breastfeeding.

-- for example: My daughter was only gaining 1.5 ounces a week for 2 months. She was never satisfied after a feeding yet we nursed constantly. She had 3 wet diapers a day and very little poop, maybe one spot the size of a dime, every other day. In my case we started supplementing at 8 weeks, after truly giving breastfeeding it's due time to work.

-- I started supplementing at 2 months / 8 weeks with my 2nd son due to low weight gain. However knowing the information I have now, he didn't loose weight. I would have waited a little longer to supplement.

-- with my daughter I started supplementing at 8 weeks because she did loose weight.

-- when supplementing along with breastfeeding, first let baby breastfeed until they unlatch. If they fall asleep at the breast, burp baby, change their diaper, and then offer the same or the next breast. Then slide in the SnS into the corner of their mouth while latched to the breast. Or offer the bottle after baby breastfeeds.

-- if supplementing, start slow. Newborns tummies are so small they need only drops, not ounces!!

-- If you want breastfeeding to be successful then except that baby will eat with in 20 minutes to an hour, not longer between feedings. This allows for them to not over eat and be ready for the next breast feeding.

-- Baby's tummy is small. So "getting enough" it relative to babies age, and tummy size. Link to British you tube video stomach sizes:
Day 1-2 Baby's Tummy is the size of a marble
Day 3 about the size of a ping pong ball.
by Day 10 its the size of a large egg.

-- babies have been studied an found that they will take a full breastfeeding and Then can still take a full bottle!! Babies cannot "turn off" the sucking reflex. So add the supplement-- slowly, a few drops to a few tablespoons. Formula fed babies can go 3-4 hours between feedings. If you give formula your baby will not nurse and then you will "loose" that feeding of milk from your breasts.

-- If needed, add 1 tablespoon of supplement at a time. See if baby is content. Then build up over a day to 2 tablespoons, then the next day 3 tablespoons until you may or may not reach 1 ounce for easier weening later. You DO NOT have to feed one ounce to baby!! 1-2 tablespoons might be enough, just to take off the edge of hunger from baby..

-- formula keeps babies satisfied longer the. Breastmilk, eating every two hours is a Formula based feeding schedule. Remember to pump or hand express if you supplement with any milk.

-- weening from formula strategy and chart

Weening from supplement link: http://www.mother-2-mother.com/supplement.htm#wean

http://kellymom.com/bf/got-milk/basics/decrease-formula/http://kellymom.com/bf/got-milk/basics/decrease-formula/

-- or 8 week self weening

-- a nice article on the impacts of breastfeeding and formula feeding. If you breastfeed, your baby will be healthier,’ to ‘If you don’t breastfeed, your baby will be more prone to…,” http://drjaygordon.com/breastfeeding/milkyway.html

The days are long, but the years are short. - Chinese Proverb 


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