Transcript sucking breast

Breastfeeding Education for
Home Visiting Programs Toolkit
Copyright © Ann & Robert H. Lurie Children’s Hospital of Chicago. All rights reserved.
What’s In This Toolkit
Page 3………………………...……….……....................Introduction
Page 4……….…………………….......……How This Toolkit Works
Page 5……….…………………...……Talking About Breastfeeding
Page 6…………………………….…………..Motivational Interviewing
Page 16…………..………….....Resources: Motivational Interviewing
Page 18……………………..…….....How to Introduce Breastfeeding
Page 22………….……………......Resources: Baby Behavior Basics
Page 31……………………………….......The Choice to Breastfeed
Page 34…..………….……......Resources: The Choice to Breastfeed
Page 45…………………….................Preparing for Breastfeeding
Page 46………………………...................Planning for Breastfeeding
Page 49………………...........Resources: Planning for Breastfeeding
Page 55………………………......................Maternity Leave Planning
Page 56…………..…………….Resources: Maternity Leave Planning
Page 68……………………………..…..………...Educating Employers
Page 77…………………………....…..………..…...How to Breastfeed
Page 78…………………………...……Resources: How to Breastfeed
Page 81…………………………………Is Baby Getting Enough Milk?
Page 82……..……………Resources: Is Baby Getting Enough Milk?
Page 88……..………………..……………………...……Bottle-Feeding
Page 89…………………………..…………Resources: Bottle-Feeding
Page 94……………………….Overcoming Breastfeeding Barriers
Page 95………….…..Resources: Common Breastfeeding Problems
Page 101………………………..…………Resources: Family Support
Page 105..……………..…………Resources: Breastfeeding in Public
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Introduction
Breastfeeding in early childhood has many health benefits. It has been shown
to reduce the risk of ear infections, asthma, eczema, childhood leukemia,
necrotizing enterocolitis (an intestinal disease usually seen in preemies),
diarrhea, severe lower respiratory tract infections (i.e. pneumonia), sudden
infant death syndrome (SIDS) and type 1 and 2 diabetes. Additionally, not
breastfeeding is associated with a 32% higher risk of childhood obesity.
The Consortium to Lower Obesity in Chicago Children (CLOCC) has made a
commitment to breastfeeding work through its support of the Baby-Friendly
Hospital Initiative (BFHI) in Chicago. Under this initiative, hospitals and
birthing centers are awarded a Baby-Friendly designation if they successfully
implement the Ten Steps to Successful Breastfeeding and take actions to
restrict the marketing of baby formula. However, there have been calls to build
upon BFHI by offering additional breastfeeding support in the community to
help mothers continue breastfeeding once they have been discharged from
the hospital.
Community breastfeeding support is an important
piece of the fight against childhood obesity.
Home visiting programs represent an important community-based service
through which health professionals and home visiting workers may provide
additional breastfeeding education and support. Yet many home visiting
models approved by the United States government do not emphasize
breastfeeding support. We recognize the unique position you, as a home
visitor, are in to support mothers in their breastfeeding journey. This toolkit’s
goal is to arm you with the resources you need to effectively educate families
about breastfeeding.
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How This Toolkit Works
We want this toolkit to be as useful as possible for you. All of the pages are
for your reference, but some are designed to be shown to your participants
and others are not. Any page with a green header is designed so that you
can show it to a mother or other family member, if you’d like:
Any page with a blue header is designed for your reference:
Additionally, there are “resource” sections throughout this toolkit. Generally, all
handouts in those sections are designed to be used with your participants
unless they have blue headers. Typically, these pages include links to videos
that we recommend you share with participants on your computer.
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Talking About Breastfeeding
You may have experienced conflict around breastfeeding in the past, and
you’re likely not alone; the decision to breastfeed (or not) is a personal one
that people sometimes feel strongly about. We understand the personal
nature of this choice and recognize that the ability to breastfeed depends
upon much more than scientific evidence and health benefits.
The goal of this toolkit is not to judge anyone for how they choose to feed their
babies or to tell you how to do your job. We realize that you are the expert on
your program and participants, and we recommend you incorporate the
information and resources in this toolkit into your curriculum as you see fit. All
of the information in this toolkit is supported by science, and we hope you find
it useful. In this section, we review some techniques and information you
can use to approach breastfeeding in a non-confrontational way:
• Motivational Interviewing
• Baby Behavior
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Section 1: Motivational Interviewing
Motivational interviewing (MI) is a method of communication that may make it
easier for you to introduce and discuss breastfeeding. It’s based on the idea that
people get defensive when they’re given advice they didn’t ask for and may be
described as “giving advice with permission.” The communication style is nonauthoritarian, supportive and emphasizes reflective listening and why to change
rather than how. A more formal definition is below.
“Motivational interviewing is a person-centered, directive method of
communication for enhancing motivation to change by exploring and
resolving ambivalence.”
Motivational interviewing is also based on the Stages of Change Model. This model
assumes there is a natural process to change – depicted by the illustration below –
and you can use this technique to facilitate the process by recognizing which stage
your participants are in and responding appropriately.
On the following pages, we’ve included a variety of MI tip sheets to help you
learn this communication style.
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HowInterviewing
to Introduce
Breastfeeding
Motivational
Tip Sheet
for Home Visitors
•
Five General Principles of Motivational
Interviewing:
1. Express empathy
2. Develop discrepancy (between participant’s
behavior and ideals/goals)
3. Avoid arguing
4. Roll with resistance
5. Support self-efficacy
What’s reflective
listening?
When you repeat or
paraphrase what a
person shares with
you; you understand
the underlying
feeling in their
statement and
repeat that to them.
This encourages
them to share more!
•
Specific Motivational Interviewing Strategies:
1. Ask open-ended questions
2. Use reflective listening
3. Affirm what you hear
4. Summarize
5. Elicit self-motivational statements
•
Assumptions to Avoid in Motivational Interviewing:
1. This person OUGHT to change
2. This person WANTS to change
3. This person’s health (or their baby’s health) is
the main motivating factor for him/her
4. If he or she does not decide to change, the
consultation has failed
5. Individuals are either motivated to change or
they’re not
6. Now is the right time to consider change (see the
Stages of Change on page 9!)
7. A tough approach is always best
8. I’m the expert – he or she must follow my advice
9. A negotiation approach is always best
Adapted from: http://www.motivationalinterview.org/Documents/Skills%20Tip%20Sheet.pdf
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HowInterviewing
to Introduce
Breastfeeding
Motivational
Tip Sheet
for Home Visitors
•
•
Signs of Resistance
1. Arguing
• Challenging
• Discounting
• Hostility
2. Interrupting
• Talking over
• Cutting off
3. Ignoring
• Inattention
• Non-answer
• No response
• Sidetracking
4. Denying
• Blaming
• Disagreeing
• Excusing
• Claiming the rules
don’t apply to them
• Minimizing
• Pessimism
• Reluctance
• Unwilling to
change
Strategies for Handling Resistance:
1.
Simple Reflection: simple acknowledgement of the
participant’s disagreement, emotion or perception
2.
Double-sided Reflection: acknowledge what the participant
has said and add to it the other side of the participant’s
ambivalence
3.
Clarification: verify your understanding matches the
participant’s perspective
4.
Shifting Focus: shift the participant’s attention away from
what seems to be a stumbling block
5.
Emphasizing Personal Choice and Control: assure the
participant that in the end, it is he or she who determines
what happens
Adapted from: http://www.motivationalinterview.org/Documents/Skills%20Tip%20Sheet.pdf
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MI Procedure and Stages of Change
Use the Stages of Change to help move your participants through the change process.
Stage of Change
Characteristics
Techniques
Pre-contemplation Not currently considering change: Validate lack of readiness
Clarify: decision is theirs
"Ignorance is bliss"
Encourage re-evaluation of current behavior
Encourage self-exploration, not action
Explain and personalize the risk
Contemplation
Ambivalent about change: "Sitting
on the fence"
Not considering change within the
next month
Validate lack of readiness
Clarify: decision is theirs
Encourage evaluation of pros and cons of
behavior change
Identify and promote new, positive outcome
expectations
Preparation
Some experience with change and
are trying to change: "Testing the
waters"
Planning to act within 1 month
Identify and assist in problem solving with
obstacles
Help participant identify social support
Verify that participant has underlying skills
for behavior change
Encourage small initial steps
Action
Practicing new behavior for 3-6
months
Focus on restructuring cues and social
support
Bolster self-efficacy for dealing with
obstacles
Combat feelings of loss and reiterate longterm benefits
Maintenance
Continued commitment to
sustaining new behavior
Post-6 months to 5 years
Plan for follow-up support
Reinforce internal rewards
Discuss how to handle relapse
Relapse
Continuation of old behaviors:
"Fall from grace"
Evaluate trigger for relapse
Reassess motivation and barriers and plan
stronger coping strategies
Adapted from: http://www.motivationalinterview.org/Documents/Skills%20Tip%20Sheet.pdf
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MI Techniques
O.A.R.S.
•
Open-Ended Questions
•
•
Affirmations
•
•
Nodding, looking in the eye  encourages person to
continue talking
Reflections
•
•
Invite person to talk freely versus answering with a “yes”
or “no”
Use reflective or active listening: repeat or paraphrase
what the person shares, understand the underlying feeling
in their statement and repeat that to them  encourages
them to share more
Summarization
•
Gather the person’s statements from the conversation and
present them back to the person in a “bouquet”
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MI Techniques
Elicit-Provide-Elicit
•
•
•
Elicit: ask what the participant knows, would like to know or if
it’s okay if you offer them information
•
“Could you tell me what you know about breastfeeding?”
•
“Would you be interested in hearing what I know about
breastfeeding?”
Provide: share information in a neutral, nonjudgmental fashion
•
“What we know is that formula can actually put your baby
at risk for a variety of diseases.”
•
“Research shows that breastfeeding can reduce the risk
for illnesses like ear infections and pneumonia.”
Elicit: ask about the participant’s interpretation of the
information you shared
•
“What do you think about what I just said?”
•
“What do you think your next step should be?”
•
“How can I help?”
• Use neutral language as much as possible: “Folks have
found…” “What we know is…” “Others have benefited from…”
E-P-E
Tips!
• Avoid sentences starting with “I” or “You”
• Use conditional words rather than concrete words: “might”
“perhaps” “consider” vs. “should” “must”
• When “instructing” is necessary, recognize what stage of
change your participant is at and only provide relevant
advice/information.
Tips adapted from: http://www.motivationalinterview.org/Documents/Skills%20Tip%20Sheet.pdf
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How to Introduce Breastfeeding
Case Study:
E-P-E and
Breastfeeding
•
Mother who says she thinks she wants to formula-feed her
baby when she is born
•
ELICIT
•
•
Could you tell me what you know about breastfeeding?
How about formula-feeding?
•
INSTEAD OF:
•
If I fed my daughter formula, I’d be scared she would get
sick all the time.
PROVIDE
•
•
What we know is that formula can cause children to get
sick more often and make them gassy or constipated.
ELICIT
•
What do you think about that information I shared?
•
INSTEAD OF:
•
It’s obvious from this information that you need to
breastfeed your child.
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MI Techniques
Recognize Change Talk
•
Change talk is an important step in encouraging healthy
behavior and signals a participant may consider the positive
behavior at hand
•
Desire: statements participants make about preference for
change
•
•
Ability: statements participants make about self-capability
•
•
“Breastfeeding helps make my baby healthy”
Need: statements participants make about feeling an obligation
to change
•
•
“I think I could breastfeed”
Reasons: statements participants make that are specific
arguments for change
•
•
“I would like to breastfeed”
“I should breastfeed”
Commitment: statements participants make about the action(s)
they will take to change
•
“I’m going to breastfeed”
Encourage and strengthen these statements – this is where
summarization or “bouquet” skills should be used!
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Adapted from: http://www.motivationalinterview.org/Documents/handout.pdf
MI Techniques
Strategies for Eliciting Change Talk
1.
Use Open-Ended Questions
•
•
•
•
•
Why would you want to make this change? (Desire)
How might you go about it, in order to succeed? (Ability)
What are the three best reasons for you to do it? (Reasons)
How important is it for you to make this change? (Need)
So what do you think you’ll do? (Commitment)
2.
Ask for Elaboration
•
When a change talk theme emerges, ask for more detail:
•
In what ways?
•
How do you see this happening?
•
What have you changed in the past that you can relate to this
issue?
3.
Ask for Examples
•
When a change talk theme emerges, ask for specific examples:
•
When was the last time that happened?
•
Describe a specific example of when this happens.
•
What else?
4.
Looking Back
•
Ask about a time before the current concern emerged:
•
How have things been better in the past?
•
What past events can you recall when things were different?
5.
Look Forward
•
Ask about how the future is viewed:
•
What may happen if things continue as they are?
•
If you were 100% successful in making the changes you want,
what would be different?
•
How would you like your life to be in the future?
Adapted from: http://www.motivationalinterview.org/clinicians/Side_bar/skills_maintenence.html
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MI Techniques
Strategies for Eliciting Change Talk
6.
Talk About Extremes
•
Ask about the best and worst case scenarios to elicit additional information:
•
What are the worst things that might happen if you don't make this
change?
•
What are the best things that might happen if you do make this
change?
7.
Use Change Rulers
•
Ask open-ended questions about where the participant sees himself or
herself on a scale from 1 – 10.
•
On a scale where one is not at all important, and ten is extremely
important, how important is it to you to change _______? (need)
•
Follow up: Explain why are you at a ___ and not [lower number]?
•
What might happen that could move you from ____ to a [higher
number]?
•
How much do you want _________? (desire)
•
How confident you are that you could _________? (ability)
•
How committed are you to ______? (commitment)
8.
Explore Goals and Values
•
Ask what the person's guiding values are.
•
What do you want in life?
•
What values are most important to you?
•
How does this behavior fit into your value system?
•
What ways does [the behavior] conflict with your value system?
9.
Come Alongside
•
Explicitly side with the negative side of the person’s ambivalence.
•
Perhaps ____________ is so important to you that you won't give it
up, no matter what the cost.
•
This may not be the main area that you need to focus on in our work
together.
Adapted from: http://www.motivationalinterview.org/clinicians/Side_bar/skills_maintenence.html
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Resources: Motivational Interviewing
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Change Ruler Worksheet
On the scale below, mark how important it is for you to:
_____________________________________________________________.
1
2
3
4
5
6
7
8
Not
important
9
10
Most
important
Adapted from: http://www.motivationalinterview.org/Documents/handout.pdf
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Section 2: How to Introduce Breastfeeding
Recommendations
• Educate families about baby behavior and infant cues to ease
into infant feeding discussions.
• If you have more than one prenatal visit, discuss general baby
behavior and infant cues during your first visit.
• On your second visit, briefly review infant cues related to
breastfeeding, then introduce breastfeeding using motivational
interviewing techniques.
• If you only have one prenatal visit, consider using the baby
behavior discussion to transition into infant feeding topics later
in your conversation.
• Ask: “What have you heard about infant feeding?” or “What
have you heard about breastfeeding?”
•
Note: Starred topics on the following three pages are closely
related to infant feeding; consider reviewing these to transition
into breastfeeding discussions.
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How to
Introduce
Breastfeeding
Baby
Behavior
Basics
•
Taking care of a new baby can be confusing
•
Newborns are uncoordinated and may accidentally send confusing cues! Take
the 1-2 hours after birth when they are alert to get to know each other and
practice feeding.
•
Babies use “engagement cues” when they want to interact
•
Babies are born knowing how to use these cues to speak to their parents.
Babies who want to engage with you will look at what they’re interested in, relax
their face or smile or, when they’re older, try to touch and taste things they’re
interested in.
•
Babies use “disengagement cues” when they need a break
•
New babies are easily over-stimulated, and disengagement cues mean that
something is bothering your baby. She may close her eyes, turn her face away
from you, arch or twist her body away, get tense or frown. It won’t always be
obvious what’s bothering her, but begin reducing stimulation to figure out what
the problem is.
•
Babies “cluster” cues to convey important messages
•
Sometimes, the message is, “I’m hungry!” Your baby will move her head to and
fro, pull her hands and knees towards her face, making sucking noises, open
her mouth and increase her movement. She will also cluster cues when she’s
full: she’ll relax, slow her eating, let her hands fall from her face and sometimes
fall asleep.
•
Crying doesn’t always mean babies are hungry
•
Sometimes babies cry when they’re hungry, but usually when they’ve already
used other feeding cues and no one has fed them. If baby isn’t using feeding
cues, crying also may mean she could be: tired, frustrated, bored, lonely, overstimulated, startled, scared, sick, in pain or have a dirty diaper.
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How to
Introduce
Breastfeeding
Baby
Behavior
Basics
•
Crying increases dramatically on the second day
•
On the second day, babies become more alert and work harder to give
cues, but – again – newborns are uncoordinated and may not express
themselves well! Often their cues mean they’re hungry. Don’t be shocked;
it’s healthy and normal for baby to feed often and it stimulates your milk
supply. Feed frequently and hold your baby skin-to-skin to soothe her.
•
Paying close attention to babies can mean less crying
•
To prevent crying, try to anticipate things around you that may upset your
baby and then limit them. You should also pay close attention to your
baby’s cues and address them early. Finally, remember that no one is
perfect! Babies can be hard to understand, so just try to learn from your
mistakes. The two of you will get better at communicating with time!
•
Babies are soothed by repetition
•
Sometimes, even when you fix what’s upsetting your baby, she won’t stop
crying. And sometimes you won’t be able to figure out what’s upsetting her!
You can still calm her using repetition: rocking, singing or even riding in the
car. Choose one action and do it for a few minutes. If nothing changes,
switch to another action. Doing more than one at a time may upset her
more.
•
It may take a lot of practice to master feeding
•
Sometimes babies have a hard time learning to eat at first – coordinating
breathing and sucking can be difficult! That said, babies usually learn very
quickly and can feed well after a few days. This is why it’s important to
practice feeding your baby whenever she gives feeding cues. New babies
also have very small tummies and can only consume about a small amount
of milk each feeding, so this helps make sure they don’t get hungry.
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How to
Introduce
Breastfeeding
Baby
Behavior
Basics
•
Young babies are not supposed to sleep through the night
•
Unfortunately, new babies wake up every few hours – but for good
reasons! Since their new brains, muscles and lungs aren’t quite in sync
yet, sleeping too deeply could mean they get too hot or too cold or that
they don’t wake up when they need more air. Additionally, new babies have
tiny tummies and need to eat often.
•
Dreaming helps babies’ brains develop
•
Babies dream for half of the time they’re asleep – this is when their brain
develops and grows! Dreaming is a light stage of sleep, and unlike adults,
babies fall into dream sleep right away, then move into deeper sleep. This
is why babies wake up so easily. To keep your baby from waking up when
you lay her down to sleep, look for signs she’s moved from light sleep to
deep sleep: her eyelids will stop fluttering and she’ll stop twitching.
•
Over time, new babies do sleep longer
•
New babies develop quickly, so by the time they’re 6-8 weeks old, they can
sleep for longer periods of time (with fewer nighttime feedings). By the time
she reaches 4 months of age, your baby will start sleeping like you – falling
into a deeper sleep right away and staying asleep for even longer at night.
By 6 months your baby will begin sleeping through the night completely!
•
But, sometimes new babies sleep too much
•
Sometimes, newborns sleep for long stretches, and this can be a sign of
trouble. If your baby does this, you’ll need to wake her for feedings. You
can do this by using a variety of actions: undress your baby, change her
diaper or position, or talk or sing in different voices. If your baby isn’t
interested in feeding, sucks weakly or doesn’t have dirty diapers often, you
should go to the doctor.
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Resources: Baby Behavior Basics
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Source: http://www.nal.usda.gov/wicworks/Sharing_Center/CA/Training1/Infant_States.pdf
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Source: http://www.nal.usda.gov/wicworks/Sharing_Center/gallery/FitWICBaby.htm
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Source: http://www.nal.usda.gov/wicworks/Sharing_Center/gallery/FitWICBaby.htm
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Source: http://www.nal.usda.gov/wicworks/Sharing_Center/gallery/FitWICBaby.htm
The Choice to Breastfeed
The American Academy of Pediatrics recommends mothers only feed their
babies breast milk (nothing else, not even water or infant cereal!) for the first 6
months of life and to continue for at least 12 months as they introduce the
baby to new foods. They make this recommendation for good reason: formulafeeding is associated with a higher risk for a variety of illnesses in mothers
and babies.
In this section we provide you with resources to help you educate
families about breastfeeding and to help families decide how to feed
their infants.
31
Concerns with Formula-Feeding
For Infants
•
Higher risk of…
•
Ear infections
•
Diarrhea
•
Severe lower respiratory tract infections (like pneumonia)
•
Eczema (a skin condition)
•
Asthma
•
Obesity
•
Type 1 and 2 diabetes
•
Childhood leukemia
•
Sudden Infant Death Syndrome (SIDS)
•
Necrotizing enterocolitis (a condition usually seen in
premature babies that causes the death of tissue in the
intestines)
•
Breast milk passes antibodies onto babies to protect their
underdeveloped immune systems – formula-fed babies don’t get
this immunity!
•
Formula can cause gas and constipation in babies
DID YOU KNOW?
The American Academy of
Pediatrics recommends
mothers feed their babies only
breast milk for the first 6 months
of life.
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Concerns with Formula-Feeding
For Mothers
•
DID YOU KNOW?
Higher risk of…
•
Type 2 diabetes
•
Breast cancer
•
Ovarian cancer
No babies – breastfed or
formula-fed – should drink
water for the first 6 months.
•
Stopping breastfeeding early can cause a higher risk for
postpartum depression
•
Breastfeeding can help you lose baby weight
•
Formula will cost you about $1,500 per year
•
•
Cleanliness and preparation hazards
•
•
Breastfeeding saves you money – it’s free!
Formula can be complicated to prepare!
•
All equipment must be sterilized before each feeding
to kill germs
•
Measurements must be exact to avoid watering
down, which can cause seizures in babies
•
Water needs to be boiled and cooled to kill any
germs
Manufacturing errors
•
Formula is processed and can be contaminated, or
mislabeled, just like any other store-bought products
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Resources: The Choice to Breastfeed
34
Breast Milk versus Formula
Consider sharing this video with mothers and family members to show how
breastfeeding has made a difference in the lives of their peers. Available at:
http://womenshealth.gov/itsonlynatural/planning-ahead/making-the-decisionto-breastfeed.html.
There are also many other videos about breastfeeding – including secrets to
success, “what breastfeeding means to me” and breastfeeding benefits –
available at:
http://womenshealth.gov/itsonlynatural/planning-ahead/index.html.
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Source: http://www.unicef.org.uk/Documents/Baby_Friendly/Leaflets/otbs_leaflet.pdf
Source: Ready Set Baby Patient Booklet (version 1e), Carolina Global Breastfeeding Institute, July 2014. Available at: breastfeeding.unc.edu.
Source: Ready Set Baby Patient Booklet (version 1e), Carolina Global Breastfeeding Institute, July 2014. Available at: breastfeeding.unc.edu.
Source: Ready Set Baby Patient Booklet (version 1e), Carolina Global Breastfeeding Institute, July 2014. Available at: breastfeeding.unc.edu.
Source: Ready Set Baby Patient Booklet (version 1e), Carolina Global Breastfeeding Institute, July 2014. Available at: breastfeeding.unc.edu.
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Breast Milk versus Formula
Consider playing the “Does Formula Stack Up?” game with your participants
to show them the differences between breast milk and formula. The game
available at: http://www.breastmilkcounts.com/educational-activities/game.swf
Remind parents that use of formula can be a concern because:
• Formula use is associated with higher risk for many diseases
• No immunologic benefits for baby’s underdeveloped immune system
• Gas and constipation
• Cleanliness and preparation hazards
• Manufacturing errors
• Economic burden
However, remind them there are legitimate reasons that parents
sometimes need to use formula and that they should be proud of any
breastfeeding they can do!
43
Breastfeeding Decision Worksheet
When we make a decision, most of us don’t really consider all “sides” in a
complete way. Instead, we often do what we think we “should” do, avoid doing
things we don’t feel like doing or just feel confused or overwhelmed and give
up thinking about it at all. Thinking through the pros and cons of all options is
one way to help us make sure we have made the best decision possible. This
can help us stick to our plan in times of stress or temptation. Below, write in all
of the reasons that you can think of in each of the boxes. This will help you
make the best feeding decisions for you and your baby!
Costs/Cons
Formula-Feeding
Breastfeeding
Benefits/Pros
Adapted from: http://www.motivationalinterviewing.org/sites/default/files/decisionalbalance.pdf
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Preparing for Breastfeeding
So your participant has decided to breastfeed – great! Mothers often have a
lot to learn about breastfeeding and making it work for them. There are some
adjustments to make, and despite the fact that breastfeeding is natural, it is a
learned task that they may need help with.
In this section we provide you with resources to help mothers prepare
for breastfeeding and to educate them about the following topics:
• Planning for Breastfeeding
• Maternity Leave Planning
• How to Breastfeed
• Is Baby Eating Enough?
• Bottle-Feeding
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Section 1: Planning for Breastfeeding
Birth Plan
The first time a women breastfeeds, she will likely be at a hospital or
maternity center. But, hospital policies, medical procedures and
medications can all affect how easy it is for a woman to breastfeed after
birth. So, it makes sense that birth is the first step women should think
about when they’re planning for breastfeeding!
Mothers should be encouraged to speak with doctors and other hospital
staff about their wishes for their birth. A birthing plan is a helpful tool to
gather all of a mother’s wishes on one piece of paper (see page 50) so
she can quickly and easily share it with hospital staff. Birthing plans
typically address the following topics:
•
•
•
•
Breastfeeding – mom can state that she does not want her baby to
be fed any formula, only breast milk, and that they would like help
breastfeeding within the first hour, when baby’s sucking reflexes are
strongest.
No bottles or pacifiers – artificial nipples should be avoided when
babies are learning to breastfeed. Artificial nipples work differently
than breasts, so this can be confusing for baby!
Skin-to-skin – baby should be placed onto mother’s bare chest
immediately after birth, even before any medical tests or cleaning.
This helps baby breastfeed and bond with mom right away and
regulates baby’s temperature, breathing, heart rate and blood sugar.
Emergency C-Sections – mothers who need surgery can request
skin-to-skin as soon as possible afterwards to help them breastfeed
right away.
Continued on next page…
46
Section 1: Planning for Breastfeeding
•
•
•
•
Rooming in – mom can tell hospital staff that she would like baby to
stay in her room 24 hours a day and never be taken to a nursery.
This helps mom learn baby’s feeding cues, to feed baby whenever
he is hungry (which helps her produce milk and prevents crying) and
bond with her baby.
Breastfeeding assistance – moms can request support from
hospital staff, such as lactation consultants, on how to position and
latch her baby for breastfeeding. She can also ask for contact
information for a breastfeeding support worker for when she leaves
the hospital.
Breast pumps – mom can ask for access to a breast pump in the
event she needs to be separated from her baby. Pumping milk can
help mom produce milk to be fed to the baby wherever she is.
No discharge bags – mom can request she not be given any
formula marketing materials or free formula.
DID YOU KNOW?
Non-medicated vaginal birth with
immediate skin-to-skin contact
makes breastfeeding easiest. This
is because medications used
during birth and c-sections can
make mom and baby less alert. So,
elective c-sections should be
avoided.
47
Section 1: Planning for Breastfeeding
The Two-Week Plan
Breastfeeding for 6 months to a year may seem daunting when a mom
is first learning how to do it. This is normal – she’s also recovering from
pregnancy and childbirth! Because of this, moms may find it more
manageable to make a two-week commitment to breastfeeding. See
page 53 for a template for mom’s two-week plan. Encourage mothers
to seek help if they have trouble breastfeeding and tell them not to be
too hard on themselves!
The Six-Week Plan
It usually takes about six weeks for moms to get into a breastfeeding
“groove.” By then, she and her baby have gotten to know each other,
her milk has matured and she’s had several well-baby visits to show her
how breastfeeding is helping her baby develop and grow. After two
weeks, work with mom to make a new goal of six weeks – and
reevaluate what was written in her two-week plan – to encourage her to
keep going. See page 54 for the plan.
48
Resources: Planning for Breastfeeding
49
My Birthing Plan
Source: http://www.breastfeedingpartners.org/images/Hospital%20Infant%20Feeding%20Plan%20Document.pdf
51
Source: Ready Set Baby Patient Booklet (version 1e), Carolina Global Breastfeeding Institute, July 2014. Available at: breastfeeding.unc.edu.
Source: Ready Set Baby Patient Booklet (version 1e), Carolina Global Breastfeeding Institute, July 2014. Available at: breastfeeding.unc.edu.
Two-Week Breastfeeding Plan
The reasons I want to breastfeed for at least two weeks are:
The steps I plan to take to breastfeed for two weeks are:
The ways other people can help me are:
I will know my plan is working if:
Some things that could interfere with my plan are:
What I will do if my plan isn’t working or if breastfeeding is difficult:
Adapted from: http://www.motivationalinterviewing.org/sites/default/files/changeplan.pdf
53
Six-Week Breastfeeding Plan
The reasons I want to breastfeed for at least six weeks are:
The steps I plan to take to breastfeed for six weeks are (remember to include things
that worked from your two-week plan!):
The ways other people can help me are:
I will know my plan is working if:
Some things that could interfere with my plan are:
What I will do if my plan isn’t working or if breastfeeding is difficult:
Adapted from: http://www.motivationalinterviewing.org/sites/default/files/changeplan.pdf
54
Section 2: Maternity Leave Planning
Maternity leave and combining breastfeeding with work or school is a
particularly important part of planning for breastfeeding because usually
mom cannot take breaks to go breastfeed her child. You should
encourage mothers to:
• Tell employers they plan to breastfeed
• Take 6 weeks maternity leave, breastfeed exclusively and return to
work gradually, if possible
• Seek support from a lactation consultant or counselor if they need to
go back to work before 6 weeks
• Learn to pump and remind them it takes practice
• Complete a breastfeeding and work plan (see pages 58-60)
• Find breastfeeding-friendly child care in advance
• Be proud of any breastfeeding they can do!
This section is composed of resources from a variety of sources
that you can use to help moms and families:
• Communicate with employers about their breastfeeding plans
• Prepare themselves and their babies for a return to work or
school
• How to pump milk and store it safely
• Educate employers about how to create a breastfeeding-friendly
workplace
55
Resources: Maternity Leave Planning
56
Working Mom Videos
Consider sharing this video with mothers and family members to show how
their peers have combined work and breastfeeding. Available at:
http://womenshealth.gov/itsonlynatural/planning-ahead/making-the-decisionto-breastfeed.html.
Another helpful video discusses how to handle stress of being a new mom:
http://womenshealth.gov/itsonlynatural/fitting-it-into-your-life/handlingstress.html.
57
58
59
Source: http://www.breastfeedingpartners.org/images/pdf/My%20Breastfeeding%20Plan.pdf
Illinois.
60
Source: http://www.breastfeedingpartners.org/images/pdf/ForMomsFINAL.pdf
How to Talk with Your Supervisor
•
•
•
•
Don’t be afraid! Most supervisors are happy to support you and
it’s the law!
Let your supervisor know you want to breastfeed before you
have your baby so she has time to prepare a place for you to
pump while you’re away.
Share “My Lactation and Work Plan” with your supervisor to
help you both agree on pumping locations and times.
Things you can say to your supervisor (Source: the New York
“Making it Work” Toolkit):
“I am planning to breastfeed my
baby because it so healthy for
both the baby and for me. After I
come back to work, I plan to
continue giving my milk to my
baby by expressing my milk every
2 or 3 hours while I am at work.
Lots of working women do this
every day.”
“Breastfeeding is so important
that there are laws that ask
employers to give time and space
for expressing milk at work. This
also benefits you because
companies save money when
babies are breastfed – they get
sick less often, so parents miss
work less and have fewer health
care costs!”
“I will plan to use my usual breaks and lunch period to express
milk. It will take around 20 minutes each time. If I need a little
more time while I’m first learning, would you be open to letting
me come in a little earlier or staying just a little later to make up
the time?
Adapted from: http://www.breastfeedingpartners.org/images/pdf/ForMomsFINAL.pdf
61
How to Talk with Your Co-Workers
•
•
•
•
Bring your baby to work so they can meet her and fall in love
with her just like you have.
If you need to ask co-workers to cover for you while you are
pumping, return the favor when they need your help.
Listen if your co-workers share stories about breastfeeding with
you, even if it did not work for them. Everyone wants to be
heard and to know that they’re good parents.
Things you can say to your co-workers (Source: the New York
“Making it Work” Toolkit):
“I’m expressing milk for
my baby because the
health benefits are so
amazing. Your support
will make pumping easier
for everyone!
“I’m going to be taking
my usual breaks to pump
milk for my baby and I’ll
be making up extra time
when I need to.”
“I’m breastfeeding because research shows that
breastfeeding moms miss less work in the long run, and
it saves companies money in the long run because
babies get sick less!”
Adapted from: http://www.breastfeedingpartners.org/images/pdf/ForMomsFINAL.pdf
62
Tips for Pumping and Storing Milk
•
Pump every time your baby would normally eat.
•
Double electric pumps (ones that express milk from both breasts
at the same time) can express your milk in 20-30 minutes, but
manual pumps or expressing by hand may take longer. Be patient
– you’ll get faster with time!
•
Pump during your regular breaks and meal period. If you need a
little extra time, talk to your supervisor about making up time
before or after your normal hours.
•
If you work in a restaurant or retail store, pump milk when
business is slower, or ask about working a “split shift,” which
means you work during the busiest periods (ex: lunch and dinner
at a restaurant) and go home in between.
•
If you work in a factory, you can see if “floaters” can be used to
cover your station while you are pumping.
•
If you don’t have co-workers to cover for you while you pump
milk, see if it’s all right to post an “I’ll be back later” sign while
you’re away.
•
In any of these situations, ask your supervisor if a family member
or your child care provider can bring your baby to you to
breastfeed in person.
•
Store your milk in an insulated lunch box, a cooler or a
refrigerator until you can take it home.
•
Make sure your containers and pump are sterilized before use.
Adapted from: http://www.breastfeedingpartners.org/images/pdf/ForMomsFINAL.pdf
63
Tips for Pumping and Storing Milk
Do’s
•
Do store milk in small amounts (1-4 ounces) so it doesn’t go to
waste
•
Do store milk at room temperature for 3-4 hours (65-80 degrees)
•
Do refrigerate milk for up to 3 days
•
Do freeze milk if you won’t use it within 3 days (for up to 6
months)
•
Do store milk in sterilized BPA-free milk storage bags or
glass/hard plastic containers
•
Do label milk with the date it was pumped
•
Do thaw frozen milk by running containers under warm water
•
Do use thawed milk right away and only for that feeding
Don’ts
•
Don’t place milk near freezer door (to keep it from thawing when
door opens)
•
Don’t microwave milk to thaw it
•
Don’t worry if frozen milk changes color – this is normal!
•
Don’t save milk left in a bottle after a feeding
•
Don’t refreeze milk that has been frozen
64
65
Source: http://www.breastfeedingpartners.org/images/pdf/ForMomsFINAL.pdf
Guide to Storing Fresh Breast Milk for Healthy Babies
Place
Countertop,
table
Temperature
How Long
Things to Know
Room temp (60°F
- 85°F)
Up to 3-4 hours
is best.
Containers should be covered
and kept as cool as possible;
covering the container with a
clean cool towel may keep milk
cooler. Throw out any leftover
milk within 1 to 2 hours after the
baby is finished feeding.
Up to 6-8 hours
is okay for very
clean expressed
milk.
Smaller cooler
with a blue-ice
pack.
59°F
24 hours
Keep ice packs in contact with
milk containers at all times; limit
opening cooler.
Refrigerator
39°F or colder
Up to 72 hours
is best.
Store milk in the back of the
main body of the refrigerator.
Up to 5-8 days
is okay for very
clean expressed
milk.
Freezer
0°F or colder
Up to 6 months
is best.
Up to 12 months
is okay.
Store milk toward the back of
the freezer where temperature
is most constant. Milk stored at
0°F or colder is safe for longer
durations, but the quality of the
milk might not be as high.
Guide to Storing Thawed Breast Milk
Room
temperature
(60°F to 85°F)
Thawed breast milk
Up to 1-2 hours is
best.
Refrigerator
(39°F or colder)
24 hours
Up to 3-4 hours is
okay.
Adapted from: http://womenshealth.gov/breastfeeding/pumping-and-milk-storage/index.html
Any freezers
Do not refreeze.
Thaw milk by
running under warm
water.
66
67
68
Source: http://www.breastfeedingpartners.org/images/pdf/ForMomsFINAL.pdf
Educating Employers
Hopefully, most mothers you work with will have employers that support
their decision to breastfeed. However, if employers insist on mothers
pumping in a bathroom (which is never acceptable) or don’t allow them
time to pump at all, they need to be educated about nursing mothers’
rights in the workplace – in Illinois, employers are required to give
mothers unpaid break time to pump and to provide a room other than a
bathroom to do so.
Mothers may also want to educate their employers if they do not
understand the benefits of breastfeeding for businesses (and babies!),
don’t have a workplace lactation policy or if they think their employers’
policy or pumping room could be improved.
The following pages are for mothers to share with their employers
to educate them about nursing mothers’ rights and how they can
support breastfeeding in their workplace.
If a mother you work with needs additional support, the United States
government has a “Business Case for Breastfeeding” website. It
includes additional resources beyond what is included in this toolkit; the
booklet entitled “The Business Case for Breastfeeding: Easy Steps to
Supporting Breastfeeding Employees” may be particularly helpful. The
website is accessible at:
http://mchb.hrsa.gov/pregnancyandbeyond/breastfeeding/.
69
70
Source: http://www.illinoisbreastfeeding.org/media/951db617803effddffff8b01ffffe415.pdf
Source: http://www.breastfeedingpartners.org/images/pdf/ForEmployersFINAL.pdf
The Illinois Nursing Mothers in the Workplace Act
72
Source: http://www.illinoisbreastfeeding.org/media/c65e6fd0803efb61ffff89a5ffffe415.pdf
73
Source: http://www.illinoisbreastfeeding.org/media/c65e6fd0803efb61ffff89a5ffffe415.pdf
74
Source: http://www.illinoisbreastfeeding.org/media/c65e6fd0803efb61ffff89a5ffffe415.pdf
Lactation Support Program Components
From the Health Resources and Services Administration Website:
Privacy to Express Milk
If women do not work in a private office, a small, private space (as small
as 4’ x 5’) can be set up for a lactation room. Many companies also
provide a hospital-grade electric breast pump that makes pumping
quicker and more efficient. Employees should never be asked to
express milk or breastfeed in a restroom.
Flexible Breaks
Milk expression sessions usually take around 15 minutes, plus time to
get to and from the lactation room, and are needed about every 3 hours.
Breastfeeding employees typically need no more than an hour per work
day to express milk, which can easily be divided between usual paid
breaks and the meal period.
Education
Employees value information they receive during their pregnancy about
continuing to breastfeed upon returning to work. Pamphlets, resources,
lunchtime prenatal classes, and access to a lactation consultant can
help employees feel more prepared.
Support
Supportive policies and practices that enable women to successfully
return to work and breastfeed send a message to all employees that
breastfeeding is valued. Support is a temporary need for each
breastfeeding employee – once babies begin eating solid foods at 6
months, milk expression requirements gradually diminish.
75
76
Source: http://mchb.hrsa.gov/pregnancyandbeyond/breastfeeding/toolkit/policy.pdf
77
Source: http://mchb.hrsa.gov/pregnancyandbeyond/breastfeeding/toolkit/policy.pdf
Section 3: How to Breastfeed
In this section, we provide you with resources to share with mothers to
help them learn how to position (there are different ways!) and latch their
babies, as well as teach them about their breast milk.
Stage of Milk
Qualities
Colostrum – first few days after
birth
•
•
Infant’s “first immunization” – full of
antibodies to boost immature immune
system
Laxative effect to help clear infant
digestive tract
Transitional Milk – begins to
appear 2-5 days after birth
•
Combination of colostrum and mature
milk
Mature Milk – comes in around
2 weeks after birth
•
•
Thin, watery and bluish in color
Breasts will feel fuller, heavier and
more sensitive
Continues to change to meet baby’s
nutritional needs as she grows
•
DID YOU KNOW?
Breast milk changes from the
beginning of a feeding to the end. The
milk at the beginning – or foremilk – is
low in fat. The milk at the end – or
hindmilk – is high in fat. It’s important
to drain each breast at a feeding to
give baby that high-fat milk because it
helps her brain develop.
78
Resources: How to Breastfeed
79
Visit the following website for more detailed information:
http://womenshealth.gov/breastfeeding/learning-to-breastfeed/#b
80
81
Section 4: Is Baby Getting Enough Milk?
Many mothers worry that their babies aren’t getting enough milk,
particularly at the beginning. You can ease mom’s worries by assuring
her that:
• Her baby has a tiny tummy when she’s born – just the size of a
marble or almond!
• This is why feeding on demand is important – baby’s tummy
empties out quickly
• This is why colostrum is produced in such small amounts
• It’s normal for babies to lose weight the first few days
You can also teach mothers to track their babies’ diapers and feedings
to help reassure them their babies are getting enough food. Remind
them to feed on demand, but babies generally eat about 8-12 times a
day. See the following pages for these resources.
82
Resources: Is Baby Getting Enough Milk?
83
84
Dirty Diaper Facts
Baby’s Age
Number of Wet
Diapers
Number of Bowel
Movements
Color and
Texture of Bowel
Movements
Day 1 (first 24
hours after birth)
1
First usually
occurs within 8
hours
Thick, tarry and
black
Day 2
2
3
Thick, tarry and
black
Day 3
5-6
3
Looser greenish to
yellow
Day 4
6 or more
3
Yellow, soft and
watery
Day 5
6 or more
3
Loose seedy,
yellow color
Day 6
6 or more
3
Loose seedy,
yellow color
Day 7
6 or more
3
Larger amounts of
loose seedy,
yellow color
Adapted from: http://womenshealth.gov/publications/our-publications/diaper_checklist.pdf
85
Source: http://www.beststart.org/resources/breastfeeding/pdf/breastfdeskref09.pdf
86
87
Source: http://images.thenestbaby.com/tools/pdfs/breastfeeding_tracker.pdf
88
Source: http://www.womenshealth.gov/publications/our-publications/breastfeeding-guide/breastfeedingguide-general-english.pdf
Section 5: Bottle-Feeding
Key Fact: There are different
types of formula.
Key Fact: There are types of milk
you should not feed babies.
•
Ready-to-feed
•
Concentrated
•
•
•
•
•
•
•
•
Must be diluted with the
proper amount of water
Powdered
•
Must be measured and
mixed with water
according to package
instructions
Cow, sheep and goat milk
Soy, rice, almond and oat milk
Dried milk
Condensed milk
Evaporated milk
Your baby should only drink
breast milk or formula for the
first 6 months of life! No water!
Bottle-Feeding Do’s:
•
•
•
•
•
•
•
•
Do sterilize the bottle, formula container and all other equipment
before preparing
Do make sure the nipple hole is the right size
Do try different nipple shapes to see which the infant likes best
Do angle the bottle so the baby isn’t sucking in air
Do burp the baby a few times each feeding
Do encourage dad to feed using a bottle – it’s bonding time for him!
Do wipe milk from baby’s teeth before putting her to bed
Do listen to baby’s hunger cues!
Bottle-Feeding Don’ts
•
•
•
•
Don’t prop the bottle
Don’t warm a bottle in the microwave
Don’t let the baby fall asleep with a bottle in her mouth
Don’t ever put cereal in the baby’s bottle!
89
Resources: Bottle-Feeding
90
91
Source: http://www.unicef.org.uk/Documents/Baby_Friendly/Leaflets/guide_to_bottle_feeding.pdf
92
93
94
Overcoming Breastfeeding
Barriers
Despite the harms of formula feeding, there are legitimate reasons mothers
are not able to breastfeed. It’s important that we keep these in mind and
support moms as they overcome challenges for the health of their babies.
Remind mom that breastfeeding is a learned skill and that she is not alone as
she works through any problems! Lactation consultants are a great resource.
Also encourage family support, as fathers and grandmothers are significant
influences in a mother’s choice to breastfeed. Finally, remind her that it’s her
right to breastfeed in public, and Illinois has laws in place to help her do so.
In this section we provide you with resources to help mothers overcome
the following barriers to breastfeeding:
• Common breastfeeding problems
• Lack of family support
• Breastfeeding in public
95
Resources: Common Breastfeeding Problems
96
Breastfeeding Troubleshooting
The Problem
What You Can Do
Sore nipples
1.
2.
3.
4.
5.
6.
7.
8.
9.
Make sure your latch is correct
See a lactation consultant
Try changing positions
Rub expressed milk on your nipples – it has natural
healing properties!
Don’t use creams, nipple shields or hydrogel pads without
talking to a health care professional first
Avoid tight clothing that puts pressure on your nipples
Change nursing pads often to avoid trapping moisture
Avoid putting soaps or ointments with chemicals on your
nipples
Ask your doctor about non-aspirin pain relievers if your
nipples are very sore
Low milk supply
1. Remember, usually your milk supply is just fine!
Babies eat more or less depending on whether they’re
having a growth spurt or not.
2. Make sure your baby’s latch and position are good
3. Feed on-demand
4. Offer both breasts at each feeding – keep baby on the first
breast until feeding slows, then offer the second
5. Avoid formula or cereal – this may make her less interested
in breast milk
6. Avoid pacifiers while doing any of the tips above
Oversupply of milk
1. Breastfeed on one side per feeding and continue to offer
the same breast for the next two hours until the next full
feeding.
2. If the other breast feels uncomfortable before you’re ready
to feed on it, hand express milk to relieve pressure or use a
cold compress or washcloth to reduce swelling.
3. Feed your baby before she get very hungry to avoid
aggressive suckling.
4. Try positions that don’t allow gravity to help with milk
ejection as much, like side-lying or football hold.
5. Burp baby frequently if she is gassy.
Adapted from: http://womenshealth.gov/breastfeeding/common-challenges/index.html
97
Breastfeeding Troubleshooting
The Problem
What You Can Do
Engorgement
1.
When your breasts feel
hard, swollen, tender,
throbbing or painful.
2.
3.
4.
5.
6.
7.
8.
9.
Plugged ducts
Feels like a tender, sore
lump in the breast.
Breast infection
(mastitis)
Soreness or lump in the
breast accompanied by
a fever and/or flu-like
symptoms.
Feed your baby often and on-demand. Wake her up to
feed if it’s been more than four hours.
Work with a lactation consultant to improve baby’s latch.
Breastfeed on the affected breast often to keep it from
getting too full.
Avoid using pacifiers or bottles to supplement feedings.
Hand express or pump milk to soften the breast before a
feeding.
Massage the breast or use a cold compress in between
feedings to ease the pain.
When returning to work, try to pump on the same
schedule your baby ate, or at least every 4 hours.
Get enough rest, proper nutrition and fluids.
Wear a properly-fitting, supportive bra that isn’t too tight.
1. Breastfeed on the affected side often to help loosen the
plug (as much as every two hours).
2. Massage the area starting behind the sore spot and moving
towards the nipple.
3. Use a warm compress on the sore area.
4. Get extra sleep or relax with your feet up to speed up
healing – plugged ducts are often a sign you’re doing too
much!
5. Wear a properly-fitting, supportive bra that isn’t too tight –
consider one without an underwire.
1. Breastfeed on the affected side often to keep the breast
from becoming too full (as much as every two hours).
2. Massage the area starting behind the sore spot and moving
towards the nipple.
3. Use a warm compress on the sore area.
4. Get extra sleep or relax with your feet up to speed up
healing – infection is often a sign you’re doing too much!
5. Wear a properly-fitting, supportive bra that isn’t too tight.
Adapted from: http://womenshealth.gov/breastfeeding/common-challenges/index.html
98
Breastfeeding Troubleshooting
The Problem
What You Can Do
Fungal infections
(yeast infection or
thrush)
1.
2.
Sore nipples that last
more than a few days,
even after checking
baby’s latch. Nipples
may also be achy, flaky
or blistered.
3.
4.
5.
Nursing strike
1. Try to express your milk on the same schedule baby used to
breastfeed to avoid engorgement.
2. Keep track of baby’s wet and dirty diapers to make sure
she’s getting enough milk.
3. Keep offering your breast to baby – try when she’s very
sleepy and stop when she’s frustrated.
4. Try various breastfeeding positions and skin-to-skin.
5. Focus all your attention on baby and give her extra cuddling
time.
6. Try breastfeeding while rocking in a quiet room free of
distractions.
When baby has been
breastfeeding well for
months and then
suddenly begins
refusing the breast
because she’s in pain,
stressed, sick or upset.
Inverted, flat or very
large nipples
May make it hard for
baby to attach
6.
7.
Change disposable nursing pads often.
Wash any towels or clothing that comes in contact with the
infection in very hot water.
Wear a clean bra every day.
Wash your and your baby’s hands very often.
Boil pacifiers, bottle nipples and toys baby puts in her
mouth daily, then discard after one week.
Boil all pump parts that touch milk daily.
Make sure other family members are thrush-free and get
them treated if they have symptoms!
1. Talk to a lactation consultant or your doctor if you’re
concerned about your nipples.
2. Use your fingers (or a special device) to try and pull your
nipples out.
3. If you have very large nipples your baby’s latch will improve
as she grows – it may take several weeks. But, if you have
a good milk supply, your baby should still get enough milk.
DID YOU KNOW?
LactMed is a website where you can check
whether it’s ok to take your medicine when you
breastfeed. Access the website at:
http://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm
Adapted from: http://womenshealth.gov/breastfeeding/common-challenges/index.html
100
Source: http://womenshealth.gov/publications/our-publications/breastfeeding-guide/BreastfeedingGuide-General-English.pdf
101
Source: http://womenshealth.gov/publications/our-publications/breastfeeding-guide/BreastfeedingGuide-General-English.pdf
Resources: Family Support
102
Videos: Breastfeeding and Family Support
Consider sharing the following videos with mothers and fathers to show how
dads can support breastfeeding moms. Available at:
1. http://womenshealth.gov/itsonlynatural/finding-support/daddy-duty.html.
2. http://womenshealth.gov/itsonlynatural/my-breastfeeding-story/dadsperspective-on-breastfeeding.html.
Another helpful video discusses how to build a support network if you’re a
single mom:
http://womenshealth.gov/itsonlynatural/finding-support/breastfeeding-as-asingle-mom.html.
103
104
105
Resources: Breastfeeding in Public
106
Video: Breastfeeding in Public
Consider sharing the following video with mothers and families to educate
them about women’s rights to breastfeed in public.
Available at:
http://womenshealth.gov/itsonlynatural/fitting-it-into-your-life/breastfeeding-indaily-life.html.
BREASTFEEDING TIP
To help get comfortable
breastfeeding in public,
practice breastfeeding in a
mirror – you’ll be surprised at
how little of your breast shows.
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Source: http://www.illinoisbreastfeeding.org/media/4731878d4b25fe75ffff837fffffe41e.pdf