Lactation Services

The Florida Hospital Lactation Center congratulates you on the birth of your baby and on your decision to breast-feed your newborn. The American Academy of Pediatrics states breast-feeding alone can satisfy an infant's nutritional needs for the first six months of life. Any amount of time you breast-feed is beneficial for your baby.
 
21 International Board Certified Lactation Consultants provide personalized care and service to the breastfeeding mothers and babies at Florida Hospital, including:
  • Breastfeeding classes
  • Private consultations
  • Breast pump sales and rentals
  • In-hospital rounds to every breastfeeding mom
  • Weekly support group meetings
  • Breastfeeding HelpLine:  407-303-7650

We hope the following breast-feeding information assists you with any concerns or questions you may have. With good information we know you will find breast-feeding your baby a pleasurable experience.

BREAST CARE
Nipples cannot be "toughened up". Avoid pulling, rubbing or pinching nipples to prevent any breast tissue damage.

Breast Changes during pregnancy provide for a natural lubricant and antibacterial action to occur during lactation. Soaps and creams should be avoided on the nipple and areola because they interfere with the natural lubrication. You do not need to wash your breast prior to or after breast-feeding.

 Nursing bras can be used if comfortable. Avoid underwire bras because the wire often presses into the breast which may result in plugged milk ducts.

 Nursing Pads - Use washable or disposable nursing pads. Avoid any plastic lined pads. Change frequently.

  
BREAST-FEEDING BASICS

 Early Start - Initiate breast-feeding early. Put your baby skin-to-skin and to breast as soon as possible after birth, preferably in the labor/delivery room. Baby is most alert the first two hours of life, making it easier for baby to latch-on.

Frequency - Watch your baby, not the clock!! Your baby needs to nurse eight to 12 times in 24 hours; ideally 15 to 20 minutes per breast.  Listen for swallowing.
TIP: You may feel sleepy while breast-feeding. This is a normal result of natural hormonal adjustments.

Cues - It is most important to watch for the following cues from your baby:
  • "I want to eat" cues: Rooting, hands to mouth, sucking motion, tight fists over chest or tummy, crying.
  • "I am full" cues: Arching of back, pushing away, falling asleep, open or relaxed arms.
  • "I need to rest" cues: Pulling away or looking around. This is a good time to burp your infant.
  • REMEMBER! The more your baby nurses the more breast milk you have to offer. You can never overfeed a breast-fed baby!
Colostrum - Your baby's first food.
  • Small in quantity but high in quality.
  • High in antibodies that aid in protecting your baby against infection.
  • Promotes passage of meconium (baby's first bowel movement).
  • Satisfies baby's thirst and hunger.
Supplement - Before offering your baby artificial milk (formula), check with your baby's physician or a lactation consultant concerning the risks of feeding your baby formula.

Mother's Diet - You may be hungrier than usual. Eat a variety of nutritious foods. There are no steadfast rules on foods to avoid; however some guidelines are:
  • If you feel your baby might be upset over something you have eaten, you may want to eliminate that food for a few weeks. Cow's milk, eggs, peanut butter and citrus are sometimes culprits. You may want to try eliminating them first. Talk to the lactation consultant about how this is done.
  • You may notice you are thirsty when you breast-feed. Drink whenever you feel thirsty, but limit your intake of coffee, tea and soda.
  • Avoid alcohol.
Engorgement
A temporary condition occurring two to five days after delivery when the breasts feel very full and hard; subsides in three to five days; can be avoided by frequent feedings (eight to twelve times/day).

Treatment/Suggestions
  • Nurse frequently
  • Massage breast gently prior to and during breast-feeding.
  • If baby can't latch-on or nipple is flattened, use hand expression or a breast pump to soften areola and stimulate milk flow
  • Apply cold packs (bags of frozen vegetables wrapped in a cloth work well) to breast for 10 to 20 minutes before feedings.
Plugged Milk Duct
Localized, tender area or painful knot in the breast caused by incomplete emptying of the breast. Missed feedings, pressure of an underwire or tight bra, or other factors may contribute to this problem.

Treatment/Suggestions
  • Apply moist, warm heat to the area prior to and in between feedings.
  • Gently massage breast just above the sore area while nursing.
  • Nurse frequently - at least every two hours. Begin each feeding on the affected breast. Position baby with chin or nose close to the plugged duct, if possible. This promotes better drainage of the milk duct.
  • It is important to take care of plugged ducts. Untreated, they may lead to mastitis.
Mastitis
An infection of the breast tissue indicated by soreness and redness in the breast accompanied by flu-like symptoms and/or fever. Causes may include skipped feedings, stress, fatigue, tight bras or ineffective treatment of cracked nipples or plugged milk ducts. Do not stop nursing!

Treatment/Suggestions
  • Call your doctor; antibiotics may be necessary.
  • Go to bed, if you haven't already.
  • Remove your bra.
  • Nurse frequently, at least every two hours and begin each nursing on the affected breast.
  • Apply moist heat to the breast frequently throughout the day and gently massage the breast.
  • Increase your fluid intake.

CHANGES WITH TIME

Baby Bowel Movements
In the first few days, your baby's stools turn from black, tarry meconium to yellow or mustard in color with curdles. Bowel movements can be as frequent as after every feeding or with time, as few as once a day or even less, depending on the age of your baby.

Baby's Weight.
Most breast-fed babies will be back to birth-weight by two weeks of age. Breast-fed babies gain about four to seven ounces per week. Babies usually double their weight by five to six months and triple their weight by one year.

Growth Spurts.
Your baby may want to nurse more frequently around two to three weeks, at six weeks and at nine weeks of age. These are growth spurts, and your baby is telling you he is growing. If you feed your baby more frequently for two to three days, your milk supply will increase to meet your baby's needs.

Mom Breast Changes
Your breasts naturally soften as your baby gets older. This does not mean a decreased milk supply.

Return of the Menstrual Cycle.
Ovulation and menses can resume while breast-feeding. Do not stop breast-feeding. Discuss contraception methods with your physician.

Weaning.
How long you breast-feed your infant is a personal decision. When you do decide to wean your baby, do it gradually. If you have a specific question about weaning, call the Florida Hospital Lactation Center at 407-303-7650.
Returning to Work.
You can continue to breast-feed when you return to work. To maintain your milk supply, you will need to pump your breasts regularly when away from the baby. For more information about combining work and breast-feeding, call the Florida Hospital Lactation Center at 407-303-7650.

POSITIONING

Successful breast-feeding depends on correct positioning and good latch-on.

Cradle position
  • Place a pillow or two in your lap to support your baby.  
  • Place your baby's head on the crook of your arm.  
  • Make sure your baby is turned toward you, chest-to-chest at breast level.  
  • Support your breast with your hand in an "L" or "C" position; thumb on top of breast, fingers below, away from areola.  
  • Tickle your baby's upper lip until he opens WIDE, then quickly pull your baby onto your breast. Be patient. This may take several attempts.
  • Make sure your baby's lips are encircling the areola (not just the nipple).
  • Your baby's chin should be touching the breast.
Football/Clutch position:
  • Put a pillow or two at your side to help support your arm and your baby.  
  • Support your baby's neck and the lower back of your baby's head in your hand. With your forearm, support your baby's upper body against your side.  
  • Follow the last four steps under cradle position.
Lying-down position
  • Lie on your side with pillows supporting your back and your top leg, which is bent forward.
  • Place your baby on his side facing you.
  • Follow the last four steps under cradle position.

PROBLEM SOLVING

Sleepy Baby
In the early days of your baby's life, we suggest that you nurse your baby "on cue". However, we encourage you to wake your baby every two to three hours during the day to breast-feed and every three to four hours at night.

How to wake a sleepy baby:
  • Undress baby down to his diaper.
  • Tickle his feet or rub his back.
  • Change your baby's diaper
  • Gently wash your baby's face with a wet wash cloth.
Sore Nipples
Sore nipples are most frequently caused by improper positioning and latch-on.
  • Latch-on tenderness that peaks at two to three days and disappears within one to two weeks is normal.
  • Blisters, cracking and/or bleeding nipples are abnormal and should be followed-up by a lactation consultant or physician.
Treatment/Suggestions:
  • Ensure proper latch-on: tummy to tummy/chin to breast.
  • Vary nursing positions.
  • Provide short, frequent feedings.
  • Nurse the least sore side first.
  • Massage expressed milk on nipple and let air-dry after feeding.
  • Avoid use of soap, alcohol and breast creams.
  • Wear nursing pads without plastic liners.
  • Break suction before taking baby off the breast.
  STORAGE
Breast Milk Storage Guidelines
  Room Temp Refrigerator Home Freezer -20 degrees
Freshly Expressed Breast Milk 4-10 hours 5-7 days 3 months 12 months
Thawed Breast Milk Do not store 24 hours Never refreeze Never refreeze

INTAKE

Average Intake by age:
0-2 months 2-5 ounces per feeding
2-4 months 4-6 ounces per feeding
4-6 months 5-7 ounces per feeding

Average Intake by weight:
8 lbs. 21.3 ounces in 24 hours
9 lbs. 24.0 ounces in 24 hours
10 lbs. 26.7 ounces in 24 hours
11 lbs. 29.3 ounces in 24 hours
12 lbs. 32.0 ounces in 24 hours
14 lbs. 37.3 ounces in 24 hours
16 lbs.
Call the Lactation Center
407-303-7650

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