Breastfeeding Benefits

This is a good checklist of all the benefits that breastfeeding provides and the
risk of using any kind of subtitutes. Thanks to the California Dept of Health for
creating the poster. Gloria

Your Newborn Baby—What’s Normal?

    Parents’ Guide to the Newborn

Keep your caregiver informed of any concerns about your baby.
Phone number of dr., public health nurse, midwife, or other provider Name_______________________Phone_____________________

Your baby’s breathing

Noises such as snuffles, grunts, wheezes, etc are not a concern by themselves. Babies can be noisy breathers. They have small amounts of mucous in their airways from the birth process and they are adjusting to air breathing. It is normal for the breathing to be irregular—sometimes rapid and then followed by slow, deep breathing. When your baby cries vigorously, he/she will become redder in the face and take deep, gasping breaths. This is normal.

Concerns about breathing to notify your caregiver about are:

1. Chest retractions–if your baby draws the chest wall in noticeably when breathing and you can see the outline of the breast bone with every breath.

2. Prolonged rapid breathing–the rate of breathing in a healthy calm newborn should be about 30 to 40 breaths per minute. If the baby is doing a panting breathing when calm (60 or more breaths per minute) for more than 15 minutes, have your caregiver check.

3. If your baby seems to have worrisome breathing and blueness around the mouth, call your caregiver.

FEEDING Within 8 hours of birth, the baby should be waking to feed every two hours and latching on to the breast well. Demanding to be fed is a very good sign of health in a newborn. Your baby needs only what is in the breast, do not feed water. If baby seems lethargic and doesn’t wake to feed for 4 hours, call your caregiver immediately. This behavior might mean the baby has a serious infection.

COLOUR A small amount of blueness and coolness in the extremities (hands and feet) is normal. Some mottling of the chest and tummy is normal. Many parents are alarmed by the baby’s whole body going dark red like a strawberry, this is a normal result of changing blood circulation in the newborn. Generalized blue or gray colouring (rare) would be alarming.

4 Days old and the milk is in. Continuous skin to skin in bed with mother.

4 Days old and the milk is in. Continuous skin to skin in bed with mother.

TEMPERATURE Only take your baby’s temperature under the armpit. Digital thermometers can be purchased for about $12 at the pharmacy. If the temperature falls below 36.1 degrees Celsius (97 F) or goes above 37.2 degrees Celsius (99F), look to see if you have bundled the baby too warmly or if the baby needs more covering. Adjust the baby’s garments and recheck the temperature in 15 minutes. Call your caretaker if abnormal temperatures persist. The usual rule of thumb for baby covering is to look at what the adults are wearing and then add one more layer for the baby. The baby being skin to skin with the mother is a good way to help the baby have a normal temperature and breathing rate.

URINE The baby may only have one wet diaper per day for the first two days. Once the breast milk is in, the baby should have at least 6 very soaked diapers in 24 hours. Urine should be colourless. Some babies have crystals in their urine (orange staining that looks like face makeup) and this is not a concern in the first 3 days. After the third day, that orange staining can be a sign that the baby is dehydrated. Increase the time at the breast and advise your caregiver. Little girls may have a spot of blood in their diaper which is their first menstrual blood, this is normal. By the fourth day, the baby should have at least 6 very wet diapers per day (the diaper will feel heavy in your hand).

BOWEL MOVEMENTS In the first 24 hours of life, the baby will pass meconium (blackish, tarry stools). Next, the stools will be brownish, greenish and quite soft. Once the milk is fully in (around day 3 of life) the baby’s stools are the colour and consistency of yellow mustard. The baby should have two poops the size of a loonie (silver dollar) as a minimum every day. A well fed baby usually has much more than the minimum.

UMBILICAL CORD Fold diapers down away from the drying umbilical stump. The cord will be dry and blackened within 24 hours and the clamp can be removed. The stump usually rots off by 5 to 10 days after the birth. Don’t put peroxide or alcohol on the cord. It heals best if left alone. Because it is rotting flesh, there is usually a foul odor when it is ready to fall off and it can be quite goo-ey looking. If there is redness on the abdominal skin surrounding the belly button area, notify your caregiver.

EYES The policy in hospitals is to treat the baby’s eyes with an antibiotic cream called “Erythromicin”. If you do not want your baby to receive this antibiotic, let your caretaker know in advance and sign a waiver. Newborns can have plugged tear ducts which cause discharge to accumulate in their eyes. Bring any discharge concerns to the attention of your caregiver.

INTACT PENIS Keeping your son’s penis intact is now the recommended policy of physicians’ groups. There is no special cleaning that needs to be done. Simply bathe your baby in a warm bath and leave the foreskin alone. The foreskin is attached to the glans in babies (much like the fingernail is attached to the finger) and the separation process may take years to complete. Only the boy should retract his own foreskin, this should not be done by parents or medical professionals. For more info on caring for your intact son, there is a handy free brochure at this link http://www.nocirc.org/publish/pamphlet4.html

JAUNDICE Yellowing of the skin of the newborn in the first 24 hours of life is unusual and should be called to the attention of your caregiver.
After Day 2, some yellowing is normal. Usually the face and chest are the most yellow places on the body. The baby may be sleepier than normal with jaundice and you may have to wake the baby to feed every two hours. It’s important that the baby remains well hydrated in order to get rid of the yellow cells from the body. Let your caregiver know if you are having trouble waking/feeding the baby or if the yellowness extends out to the hands and feet.

Slightly jaundiced newborn

Slightly jaundiced newborn

Gloria Lemay, Vancouver, BC
March 2016

CHEAT SHEET FOR PARTNERS –Breast feeding support

CHEAT SHEET FOR PARTNERS

    Breastfeeding Support

This is a brief list of ways to make a big difference for the woman who is breast feeding. Do one, some, or all, everything matters.

1. When the breast comes out, you run to get a big glass of something for her to drink. (Trust me, the minute the baby latches on, her throat will go dry).
2. Find (or buy) a low foot stool for her. (Rubbermaid makes a good one and Ikea has a cheap, functional one). Putting her feet on a stool brings baby up to the breast so she doesn’t have to hunch forward.
3. Watch her shoulders, if they are hunched forward, she’s not relaxed. Find some soft pillows to bring baby up higher or support her arms. She’ll forget about this so you keep on top of it.
4. Tell her what you authentically appreciate about her feeding the baby. E.g. Thank you for all you do to make our baby healthy. You look so beautiful when you’re feeding the baby., etc etc.
5. Put a snack beside her, she needs extra calories to produce milk. A plate of sliced apples, toast with almond butter, cheese and crackers, etc.
6. While she’s feeding, scan the environment she’s looking at. When she’s sitting, you’re moving. Empty the trash, clear the clutter, mop the dust bunnies, water the plants.
7. Give her a shoulder massage.
The partner being an active participant in the breast feeding support can strengthen the family. Please add your ideas in the comments section.

A partner who actively works to make the breast feeding go smoothly is a treasure.

A partner who actively works to make the breast feeding go smoothly is a treasure.


Gloria Lemay, Vancouver BC Canada

Paul M. Fleiss, M.D., M.P.T.

In Loving Memory
Paul M. Fleiss, MD, MPT
Sept. 18, 1933 to July 19, 2014

Paul Fleiss 1933 - 2014

Paul Fleiss 1933 – 2014

Dr. Fleiss was a father of 6 children and a much-loved and respected Pediatrician for 50 years in the Los Angeles, CA area.
He spoke up for babies and was a voice of reason about the importance of breastfeeding, attachment parenting and keeping boys intact. He genuinely loved babies and wanted them to have the best health possible. In 1997, Dr. Fleiss wrote an article for Mothering Magazine called “The Case Against Circumcision”. Peggy O’Mara, the founder of the magazine adopted that title for the forum on her website on the subject of ending circumcision. Peggy would not permit any discussion that endorsed male genital cutting and the name of the forum was self-explanatory. To read Dr. Fleiss’ article go to this reprint. http://www.mothersagainstcirc.org/fleiss.html

I met Dr. Fleiss when we both attended the International Symposium for Genital Integrity in Seattle, Washington; August 24–26, 2006. I was thrilled to meet him and be able to thank him for all his efforts to make life better and healthier for children.

Dr. Paul Fleiss, Gloria Lemay, Gillian Longley, Jenn Beaman and other intactivists in Seattle.

Dr. Paul Fleiss, Gloria Lemay, Gillian Longley, Jenn Beaman and other intactivists in Seattle.

Carla Hartley of Ancient Art Midwifery Institute brought us together again at a Trust Birth Conference in 2008 in California. I will remember him as a warm and happy man who made a big difference in the lives of those who were fortunate enough to read his books/articles, meet him professionally or use his services. He provided leadership to many physicians who have joined him in urging the abolition of male genital mutilation.

Jay Gordon, M.D. wrote about his memories of training with Paul Fleiss at http://drjaygordon.com/in-the-news/paul-fleiss-md-1933-2014.html

I offer deepest condolences to the family and close friends of Paul Fleiss. This fine man will be remembered with love and appreciation by doulas, midwives, lactation consultants, nurses and parents who will benefit from his work for a long time into the future. Gloria Lemay, Vancouver, BC Canada

Remembering Tine Thevenin

We mourn the death of La Leche League Leader, Tine Thevenin, aged only 68.

She influenced two generations with her best-selling self-published book,
“The Family Bed: An Age Old Concept in Child Rearing.” It sold over 150,000
copies and was translated into Dutch and German. In 1993, she came out with
a second book on child rearing: “Mothering and Fathering: The Gender Differences
in Child Rearing.”

http://www.republican-eagle.com/event/article/id/67362/
Norma Ritter, IBCLC, RLC

Dear Norma, what sad news! Tine certainly has made a difference through
her book, “The Family Bed”. I remember an interview on the Donahue Show which
featured Tine, Dr. Robert S. Mendelsohn and a psychiatrist and the debate was “should
children sleep with their parents?” Tine made her points first, the
psychiatrist argued strenuously that children would be emotionally scarred
if they were kept in the family bed, and, then, it was Dr. Mendelson’s turn.
He said “I agree with both the previous speakers. Every child should be
sleeping with the parents unless one of the parents happens to be a
psychiatrist and, then, they might be emotionally messed up by sleeping with
him or her.” (that’s a paraphrase; I don’t have his exact quote). It was
so funny.

I only knew her through her books but I am feeling the loss of a woman who spoke her truth.
Best regards, Gloria Lemay, Vancouver BC

AFRICA: Can you ever forgive what we have done?

From: “Angela Gorman”
Date: 18 October 2011 18:53:39 ACDT
To: “HIFA2015 – Healthcare Information For All by 2015”
Subject: [HIFA2015] Attitude and behaviour of
health workers (17) Midwifery practice: I think we owe developing
countries an apology Reply-To: “HIFA2015 – Healthcare Information For
All by 2015” <HIFA2015@dgroups.org>

Hi everyone,
On our first visit to Africa in 2005, we noticed that women were
delivering on their backs.. exactly as I had done 34yrs before, plus
the babies were kept away from the mothers, exactly as my own babies
were kept away from me for up to 12hrs following delivery. No choice
for me…that was how it was done here in the UK. We also noticed that
babies were often left on cold tiled surfaces wrapped in thin sheets,
this did not happen to my babies. When we asked the midwives why they
used the supine position for birth and kept the babies away from their
mothers, we were told, “this is what we were told you do in the west.”

African mother and baby

We then explained that this was how women used to be delivered
(including me) but that now women were delivered as upright as
possible and their babies were given to them to breast-feed
immediately. The midwives looked astonished and said “but what you are saying is how our mothers taught us to deliver, but we changed because that was what we were told you did in the west!”

Sadly we have, for all the right reasons, changed practices which were subsequently shown to be better and safer. By keeping babies from mothers and not encouraging early breast-feeding, we have increased the risk of PPH for the mother and caused hypothermia/hypoglycaemia in the babies! I think we owe developing countries an apology! Best wishes, Angela

HIFA2015 profile: Angela Gorman is a nurse and is chair of Life for
African Mothers (formerly Hope for Grace Kodindo), a charity based in
the UK. Life for African Mothers provides life-saving drugs such as
magnesium sulphate and misoprostol to help reduce maternal deaths in developing countries. angelagorman AT aol.com Click here to read online.
HIFA2015: Healthcare Information For All by 2015: www.hifa2015.org
HIFA2015 requires financial support for 2011-2012. Please contact the
coordinator: neil.pakenham-walsh@ghi-net.org Thanks to our 2010-2011
financial supporters: British Medical Association, CABI, Global HELP,
International Child Health Group (Royal College of Paediatrics and
Child Health), Joanna Briggs Institute, Network for Information and
Digital Access, Public Library of Science, Rockefeller Foundation
(Monitoring and Evaluation), Royal College of Midwives, Royal College
of Nursing, THET, and UnitedHealth Chronic Disease Initiative. To send
a message to the HIFA2015 forum, email: hifa2015@dgroups.org To join or unsubscribe from HIFA2015, email: hifa2015-admin@dgroups.org Join our sister forums:

CHILD2015 (child health); HIFA-Portuguese (collaboration with WHO
ePORTUGUESe network); HIFA-EVIPNet-French (collaboration with WHO Evidence for Informed Policy Network) ; HIFA-Zambia (collaboration with the Zambia UK Health Workforce Alliance)

NOTE from Gloria: Yes, the people of Africa deserve a profound apology for all the unnecessary suffering of the past caused by Westerners. More than that, we could look after nutrition and clean water so the misoprostol and mag sulphate would not be used. These Western drugs are the “instant quick fix export from the west” that will also make the next generation of Westerners bow their heads in shame. We must also stop allowing Western crackpots to circumcise men and boys in unethical experiments in vain attempts to curb AIDS. By changing our ways on a deep level, our apologies to Africa will ring true.

Breast is best

This is a 7 minute trailer of a video on breastfeeding that I highly recommend. I own an older copy that I use all the time but it looks, from this clip, like the film has been updated. This shows the importance of getting a newborn skin to skin with the mother even in adverse circumstances like cesarean surgery. Operating rooms are kept quite cold so they recommend towel drying the baby before contact with the mother. I would prefer the baby to remain covered in the birth fluids and then covered in heated soft blankets for warmth. There are lots of good tips in this clip for how to reduce engorgement and get a good latch on the breast.

Skin to skin, above all else

I’m sharing below an e-mail conversation with a Midwife/Lactation Consultant from Israel. Gloria

From: Leslie Wolff, Israel

Subject: Lactation Consultants in the labor & delivery room

I was a midwife in the labor/delivery ward for 14 years – and am now a IBCLC for the past four years – working as the coordinator of breastfeeding at my hospital, which means getting to Labor and Delivery also…mostly when the midwives ask me if I can give some help…

I have a few of my own beliefs about breastfeeding immediately after delivery. I feel that skin to skin after birth for the first two hours is SO important -more important than making a big effort to get that baby to breastfeed.. MAINLY because I realize that it helps the diad – mother and baby – to recover from the birth experience, is a Win Win situation that requires no effort , there is nothing to “succeed” in – it is just a “being” situation that is beautiful for Mom and baby. And if the baby goes for the breast – great..and if not, or the breast is offered and the baby doesn’t GO FOR IT – that’s fine. .I also truly don’t like to give “instructions/ advice” during those first two special hours..I know that proper latching is important, but that mother JUST GAVE BIRTH – I could never see myself “instructing her” – maybe a little helping the baby get the nipple farther into the mouth , maybe a word here or there – there is plenty of time to help her when she is in Postpartum ward – those first two hours after birth seems like a special, quiet , almost holistic time ( having nothing to do with the fact that the baby had a natural or very intervened-with ( is there such a word?) birth, maybe even a C-Section…..I know that babies are “supposed to” “immediately” start breastfeeding beautifully – but I see so many mothers and babies that are SO content just lying there Skin to Skin, relaxing, bonding in their own special way. In the past, before I discovered the beauty of Skin to Skin ,I remember many frustrated Moms and babies doing their best to breastfeed, because Mom and Dad both knew that was the best thing to do immediately after birth…)

I’m glad that you brought the subject up – because I too am interested in how others ” do it” during that first period after birth labor/delivery ward, and am interested in any comments about what I wrote..

Close to the Heart

Leslie Wolff, Israel

—————————————————————————————————————————————-

Leslie, may I have permission to put your wise words on my blog. I attend only homebirths and have the same attitude. It’s the skin to skin contact and little (or big) noises of the baby that cause the uterus to contract powerfully post partum. It is a sacred time right after birth that can never be recaptured. When the mother and baby have warmth and privacy they will “discover” each other and fall madly in love. This is the best child protection method both in the short and long term. We are mammals. We must sniff, lick, coo, cuddle, look at and hear our young. In turn, the baby does many “pre-nursing behaviours”-climbing, licking, looking, hearing, sniffing. . . who knows what they are doing because it’s dark and private, remember? How do I know this? Because I had it with my own 2 homebirths. Just like sex, it has to be experienced to be believed. My mission in life is to learn how to take my interference away from the mammatoto. Gloria Lemay, Vancouver, BC
—————————————————————————————-

Dear Gloria – it is my honor and pleasure to be quoted on your blog!
Tomorrow I am giving a power point presentation – two lectures – one on Skin to Skin for the Healthy Newborn and the second : Kangaroo Care for the Premature – for nurses and midwives and a few doctors at a breastfeeding course in Tel Aviv ( an acknowledged course for IBCLC). For the first time I am going to take a firm stand on my thoughts about those first two hours , with the support of the feedback I got from you and others.

Linda Smith wrote me, when I mentioned to her that the words of the 4th Step of Baby Friendly put more emphasis on breastfeeding than skin to skin, and I think it should be the opposite):

From Linda Smith: “Take a look at how Step 4 is currently interpreted:

http://whqlibdoc.who.int/publications/2009/9789241594967_eng.pdf

Step 4: Help mothers initiate breastfeeding within a half-hour of birth.
Place all babies in skin-to-skin contact with their mothers immediately following birth for at least an hour. Encourage mothers who have chosen to breastfeed to recognize when their babies are ready to breastfeed, offering help if needed. Offer mothers who are HIV positive and have chosen not to breastfeed help in keeping their infants from accessing their breasts.

It’s very clear from this interpretation that getting babies ONTO their mother’s bodies after birth is the point. What they DO once they’re touching mom’s body is up to the baby and mother. Some will latch quickly; others will take longer. Letting the mother & baby follow their instincts is key.
Our role is to STOP INTERFERING.

This is WAY more than your beliefs – the science on this is very clear!
Linda J. Smith, BSE, FACCE, IBCLC, FILCA Bright Future Lactation Resource Centre, Ltd.

So these past letters – yours and others – have come for me just at a perfect time – and I appreciate your feedback very much…
CLOSE TO THE HEART and MIDWIFERY IN PEACE
Leslie