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Breastfeeding

The World Health Organization and UNICEF recommend exclusive breastfeeding for the first 6 months of life and continued breastfeeding for 2 years and beyond with the addition of other foods.

Why breastfeed?

The World Health Organization and UNICEF recommend exclusive breastfeeding for the first six months of life and continued breastfeeding for two years and beyond with the addition of other foods. Breast milk is human made for human babies. It is always ready at the right time and temperature and is environmentally friendly, convenient and free.

Breastfeeding benefits the baby
  • Breast milk provides all of the nutrients, vitamins and minerals an infant needs for growth for the first six months, and no other liquids or food are needed.
  • Breastfeeding promotes proper growth of the mouth and jaw, and secretion of hormones for digestion.
  • Breast milk carries antibodies that help to protect against infections of the ears, urinary tract, lungs and intestines.
  • Breastfeeding also helps to protect against allergies and asthma.
  • Breastfeeding/skin-to-skin care creates a special bond between mother and baby and this relationship has a positive impact on behaviour, speech, sense of wellbeing and security.
 
 
Breastfeeding benefits for the mother
  • It helps the uterus to contract after birth and to control bleeding
  • It helps with weight loss after birth
  • It helps to protect against ovarian and breast cancers and bone loss
  • Breastfeeding, along with skin to skin care, promotes closeness between the mother and her baby
 
 

Daily Breastfeeding Classes at NYGH

Everyone welcome!

When: Monday - Friday 9 to10 a.m.

Where: Mother Baby Unit Patient lounge

  • Tips for success
  • Problem solving strategies
  • Common questions

Our lactation consultants are available to assist staff and mothers with complex breastfeeding issues. They are also actively involved in developing breastfeeding resource information, policies and in providing staff education.

There are breastfeeding consultation services at NYGH's Mother and Baby Follow-Up Clinic.

  • Previous feeding problems
  • History of supply issues 
  • Multiples (twins, triplets)
  • Medication concerns
  • Weight loss >10%
  • Feeding plan for return to work
  • Questions re: pumping, storage
  • Breast reduction/surgery
  • Sick baby
  • Preterm baby
  • Painful feeding
  • Previous negative feeding experience
  • Need for supplementation

Holding your baby skin to skin helps your baby learn how to breastfeed, keeps your baby warm and stabilizes his breathing, heart rate and blood sugar. Skin to skin

Your nurse or midwife will help you to position your baby skin to skin right after your baby is born. Holding your baby skin to skin helps your baby learn how to breastfeed, keeps your baby warm and stabilizes his breathing, heart rate and blood sugar. Skin to skin also helps your uterus contract to control bleeding. If you or your baby need medical attention after delivery, skin to skin can occur as soon as you are both stable.

If you are unable to provide skin to skin care, your baby can be skin to skin on your partner's chest.
 

Colostrum

The first milk that your baby drinks is called colostrum, a thick yellowish fluid that is high in antibody-rich proteins. Colostrum helps to protect your baby from infection and also makes a barrier to bacteria and viruses by “painting” the lining of his/her stomach and intestines. Colostrum meets all of your baby's food needs for the first few days. At first, you will see DROPS of colostrum and each day the amount will increase.


Getting ready to feed

When your baby shows hunger cues, place your baby skin to skin on your chest. Cover his/her back with a blanket. Your baby will stay warm next to your skin. If your baby starts crying soon after waking up, calm your baby first by placing him/her skin to skin. You may need to change his/her diaper after feeding.
 
Getting ready to feed
  • Do what works best for your baby
  • Wash your hands
  • Turn off your cell/take the phone off the hook
  • Have something to drink nearby
  • Get yourself into a comfortable position
  • Sit in a chair with good back support
 
 
Signs that your baby is ready to feed (hunger clues)
  • Bringing his/her hand to the mouth
  • Sucking movements or sounds
  • Sucking his/her fingers or hands
  • Turning towards the breast with an open mouth
 

The first breastfeeding

Many babies are alert and ready to feed in in the first two hours after birth. Keep your baby skin to skin during this time, even while you are both being moved to the Mother and Baby Unit, in order to not interrupt his/her first feeding attempts. You will both be covered for privacy. Watch for signs that your baby is ready to feed (hunger cues). Your nurse will help you to position your baby for the first breastfeeding or your baby may move to your breast all by him/herself. Some will feed well at this time; others will simply lick or nuzzle the breast.

Many babies are alert and ready to feed in in the first 2 hours after birth. Keep your baby skin to skin during this time, even while you are both being moved to the Mother and Baby Unit, in order to not interrupt his/her first feeding attempts.

Baby-led latching

Sit comfortably. You may need pillows behind your back and a stool or cushion at your feet.

Start with a calm baby. Hold your baby skin to skin between your breasts. Cuddle the baby, talk to him/her and make eye contact. Being skin to skin helps your baby to be calm and to follow his/her instincts to breastfeed.

Wait for your baby to move to your breast. Babies follow their instincts when hungry and find the breast by smell and touch. The baby may bob his/her head on your chest, slide down slowly or quickly move to your breast. You may need to pull the baby's bottom over to your other side as he/she moves down.

Getting ready to latch. When the baby feels your breast on his chin and your nipple over his top lip, the baby will lean his/her head back, open his/her moth wide, reach up and latch onto your nipple/areola.

Keep the baby's bottom close to your body. This position helps keep the baby's chin firmly on your breast, nose clear and provides good body support. Hold the baby so his/her back is straight, his/her body close to yours and so that you are both comfortable. The baby may be across your body, under your breasts or even diagonal.

If the baby becomes upset while trying to latch or if the latch hurts, move your baby back to your chest between your breasts and calm him/her. The baby will start to move down when he/she is ready.

 
Cross-cradle holdCross-cradle hold
  • Use in the beginning when both you and your baby are learning to breastfeed.
  • Hold your baby snugly under your breasts.
  • Turn the baby so the face, chest, tummy and hips are facing you.
  • Place one arm along the baby's back and your hand behind his/her neck and shoulders.
  • Tuck the baby's bottom under your elbow and bring him/her close to you.
  • Aim your nipple just above his top lip.
  • Let your breast fall in its natural position. Use a “U” hold if needed to help your baby latch. (See How to hold your breast).

Cradle hold
  • Use when both you Cradle holdand your baby are comfortable with breastfeeding.
  • Hold the head in the crook of your elbow and body on your forearm.
  • Hold your baby across your body with one arm.
  • Turn the baby on his/her side so that the face, chest, tummy and hips are facing you.
  • Hold the bottom or upper leg with your hand.
  • Place baby's lower arm around your waist or alongside his/her body.
  • Aim your nipple just above his/her top lip. Let your breast fall in its natural position. Use a "U" hold if needed to help your baby latch. (See How to hold your breast)

Football hold Football hold
  • Use if your baby was born early, if you had a caesarean section or if you have large breasts.
  • Sit upright in a chair with 1-2 pillows behind your back so there is room for your baby's legs and feet .
  • Place your baby on a pillow at your side.
  • Let your breast fall in its natural position. Use a “C” hold if needed to help your baby latch. 
  • Move your baby back so that his/her bottom is level with your back and your nipple is aimed over his/her top lip.
  • Support his/her body with your arm and his/her neck and shoulders with your hand.
 
Side-lying hold
  • Use after a caesarean delivery or if sitting is uncomfortable or you are resting.
  • This position takes time to learn as it is harder to see how you are latching your baby. Avoid if your nipples are sore.
  • Lie down on your side with your head on a pillow and place a pillow between your knees for support. Side-lying hold
  • Place your baby on his/her side facing you– tummy to your tummy.
  • Hold your baby close with your arm alongside his/her back or place a rolled towel behind his/her back.
  • Place your baby so your nipple is aimed over his/her top lip.
  • To latch your baby in side-lying position:

    • Pull your baby to your breast with your lower arm
    • You may need to hold your breast in an upside-down “U” to help your baby to latch
    • Raise yourself onto your elbow and support your breast with the same hand
    • Bring your baby to your breast with your other hand, supporting his/her neck and shoulders
    • Once latched, hold your baby close and carefully remove your hand from your breast and lie down.


"C" hold
Make a "C" with your thumb and fingers. Cup your breast and hold it with your fingers well back from the areola with your thumb resting on top. This is a good hold to use for the football and the cross-cradle position.
 
 
 




"U" hold

Make a “C” shape with your thumb and fingers. Turn your hand so your thumb and fingers are pointing up to the ceiling. Your thumb and fingers are now in the shape of a “U”.

Place the “U” under your breast so the thumb is on one side and your fingers are on the other side, well back from the areola. Use this hold if your baby is in cross-cradle or not grasping enough areola.




How a baby drinks milk from the breast

Your baby needs to latch onto your nipple and some of your areola (the dark circle around your nipple) in order to get your milk.Your baby needs to latch onto your nipple and some of your areola (the dark circle around your nipple) in order to get your milk. The baby opens their mouth wide and grasps the breast with their tongue and lips so that your nipple is far back in the mouth. The baby moves their tongue from front to back against your areola to move colostrum/breast milk to your nipple and drops the back of his/her tongue to pull the colostrum/breast milk from your breast. Your baby sucks until s/he has enough colostrum/breast milk to swallow.

In the first couple of days, your baby may suck 5-10 times between swallows because colostrum is thick. Your baby may take in small amounts to fit their small tummy. As your colostrum increases and thickens and looks more like milk, your baby will suck a few times and then swallow many times during a feeding. Ask your nurse to show you what swallowing looks and sounds like.

Latching

  • Start with your baby's nose aimed to your nipple.
  • Rest his/her chin on your breast under the areola and touch your nipple over his top lip.
  • Wait for your baby to open his/her mouth wide.Quickly bring your baby onto your breast, chin first, your nipple pointing to the roof of his/her mouth.
  • Your nipple and areola are pulled deep into the baby's mouth.
  • His/her nose will be away from your Slight nipple tenderness is normal for the first minute as baby latches and the nipple stretches to the back of the mouth. You should feel a strong tub or pull with each suck.breast. If his/her nose is touching your breast, pull his/her bottom closer to you.
  • Your baby will feed best with his/her head tilted slightly back.
  • Avoid pushing on the breast with your thumb. Your baby may unlatch or the breast milk may not flow to your baby.
  • Hold your baby close to you for the whole feeding.
  • You may need to put a small rolled towel under your hand for support.

Is my baby latched well?

Slight nipple tenderness is normal for the first minute as baby latches and the nipple stretches to the back of the mouth. You should feel a strong tug or pull with each suck. It should not hurt. If the latch hurts or pinches or if you feel biting or rubbing, your baby may not have enough areola and nipple in his/her mouth. Pull your baby\s bottom closer to you or pull your baby's chin down with your thumb or finger. If it still hurts, tell your nurse so she can help you to get a comfortable latch.

Signs of a good latch
  • A lot of the areola is covered by the baby's mouth
  • Some areola is seen above the top lip
  • Baby's lips are rolled outward
  • Baby's chin is touching your breast
  • It does not hurt when the baby sucks
  • Baby's nose is far away from the breast
 


How to unlatch your baby

Slide your clean finger into the corner of your baby's mouth until you feel his/her gums. Push until you feel that your baby has “let go.” Keep your finger in your baby's mouth as you slide him/her off your breast.

After the first breastfeeding

After the first wakeful period, your baby may sleep for a few hours before showing feeding cues again. It is easier to see feeding cues if your baby is close to you, skin to skin. Your nurse will show you how to hold your baby safely. A warmly wrapped baby may not show clear feeding cues and may sleep longer.

How often to breastfeed

Babies need to feed every 2-3 hours or about 8-12 times in 24 hours. Babies eat often because their tummies are small and colostrum and breast milk are digested quickly. Breastfeed your baby whenever he/she shows hunger cues or at least every 3 hours. This way the baby will get as much colostrum/breast milk as he/she needs and you will be able to make enough milk for the baby. It is okay for your baby to have one long sleep, about 4 hours, in each 24 hour period, as long as the baby feeds at least 8-12 times during the rest of the day. Feed your baby before he/she starts crying as the baby needs to be calm in order to latch.

How long to feed

  • Feed your baby on the first side until he/she stops sucking and swallowing. This is usually several minutes. The baby may slide off your breast or you may unlatch the baby

  • Burp your baby and check his/her diaper. The baby may show hunger cues again in about 10 minutes. Offer your other breast. Let your baby feed for as long as he/she is sucking and swallowing.

  • Some babies always drink from both breasts and some will want only one. Let your baby decide

  • If baby is still showing hunger cues after feeding on both sides, put him/her back on the first side again.

  • Burp the baby after each breast


Cluster feeding

Many babies will start cluster feeding (when they want to eat more often) around 18-24 hours of age and feed on and off for 2-6 hours for the next few nights. Feed your baby for as long and as often as he/she wants during this period. Read “Baby's Second Night” which you will find posted in your postpartum room for helpful tips.

Sleepy baby Lightly stroke the hands and arms or rub the feet to help the baby stay awake during feeding.

  • Babies need to feed every 2-3 hours or 8-12 times in each 24 hours.
  • Check to make sure your baby is properly latched and drinking.
  • Remove blanket and clothes and feed the baby skin to skin.
  • Compress your breast when your baby sucks to increase colostrum flow.
  • Lightly stroke the hands and arms or rub the feet to help the baby stay awake during feeding.
  • If your baby is jaundiced you may need to feed more often.
Signs your baby is feeding well
 
  • Your baby sucks quickly at first to bring the colostrum/breast milk to the nipple.
  • Your baby then feeds with a suck-pause-swallow rhythm as s/he drinks the colostrum breast milk (listen for a soft "K" sound).
  • Your baby sucks and swallows for several minutes at each feeding.
  • You feel a strong pull or tug as your baby sucks.
  • Your baby is content after feeding.
  • Your breast feels softer after feeding.
  • Your baby has the expected number of wet and dirty diapers for his/her age.
  • Your baby has regained his/her birth weight by two to three weeks.
Signs your baby is not feeding well

  • Little or no swallowing.
  • Baby feeds for only a few minutes then falls asleep or always seems hungry.
  • Noisy feeding with lip smacking.
  • Baby's cheeks dimple when he/she sucks.
  • Baby has only shallow sucks.
  • Your nipples are sore or you feel pain, pinching, biting or rubbing.
  • Baby is restless or sleepy at the breast.
  • Baby is not relaxed after feeding.
  • Your baby has less pees or poos than expected for his age.
  • Poo is still black or green on day 4.
  • Your breasts are hard and hurt.
  • Your baby is not waking up to feed every few hours after the first two days.
  • It is hard to wake your baby for feedings.

Breast compression

Some babies need help to drink more milk. Breast compression will bring more colostrum/breast milk to your nipple. Compress your breast if your baby is sleepy, is not actively sucking when feeding, has long or frequent feeds, or is not gaining weight well.

  • When your baby sucks, gently squeeze your breast with your hand.
  • Hold the squeeze until your baby stops sucking.
  • Avoid pulling on the breast or pressing close to the areola as your baby may unlatch.

Growth spurts

During growth spurts, which occur every 2-3 weeks, your baby will show hunger cues more often, sometimes every 1-2 hours. Feed your baby as often as he/she wants during these growth spurts so that you will make more milk for your baby.

How to tell if baby has enough milk?

Many parents worry that their baby is not getting enough milk. Babies drink small amounts at each feeding. Their tummies are small and colostrum is rich in the nutrients they need. Wet and dirty diapers and weight gain help you to know that your baby is getting enough to drink.

 
Why express colostrum/breast milk
  • To help your milk production
  • To bring your own milk down to your nipple so your baby can taste it
  • To help your baby to begin latching and sucking at the breast
  • To give your baby colostrum/breast milk if he/she is not latching well enough to get milk on his/her own
  • To apply colostrum/breast milk to your nipples after feeding to help with nipple soreness
  • To relieve sore, full breasts
  • To soften the areola so your baby can latch if your breasts are full
 
 
 
How to express colostrum/breast milk
  • Wash your hands with soap and water.
  • Use a clean cup/bowl to collect the milk.
  • Gently massage your breast for 3-5 minutes with the flat part of your fingers in a circular motion.
  • Massage all around the breast to help the colostrum/breast milk move to the nipple.
  • Avoid rubbing the skin as this could cause redness or bruising.
  • See the diagrams below.
 
 
 
Place your thumb and index finger about 1-1.5 inches away from the nipple. Thumb and fingertip opposite each other.

Place your thumb and index finger about 1 to 1.5 inches away from the nipple. Thumb and fingertip opposite each other.
 
 
 
 
 
 
 
 
 
 
 
 


Push your thumb and finger straight back into the breast.




Push your thumb and finger straight back into the breast.
 
 
 
 
 
 

3.
 
Bring your thumb and finger together behind the nipple. Repeat in the same spot until there are no more drops of colostrum. Avoid squeezing the nipple as this will make your nipples sore.
 
 
 
 
 
 
Bring your thumb and finger together behind the nipple. Repeat in the same spot until there are no more drops of colostrum. Avoid squeezing the nipple as this will make your nipples sore.
 
 
 
 
 
 
 
 

4.
Move your fingers to that you press on the breast tissue all around the areola. Switch to the other breast when there are no more drops and repeat the above steps. Express for 10-15 minutes on each side if your baby is not latching.Move your fingers so that you press on the breast tissue all around the areola. Switch to the other breast when there are no more drops and repeat the above steps. Express for 10-15 minutes on each side if your baby is not latching.
 
 
 
 
 
 
 
 
When you first hand express, you may get a few drops of colostrum/breast milk. This is NORMAL. You will get more each time you hand express. If you see no colostrum/breast milk, ask your nurse to help you. You may need to express a few times before you see any drops.
 
Storing Colostrum/Breast Milk

Expressed or pumped colostrum/breast milk should be stored in a clean BPA-free container labelled with the date and the time. Freeze milk in 2 ounce (60 mL) portions to avoid waste.
 
 Room temperature  (<25²C)
Refrigerator
Insulated cooler bag with ice
Fridge freezer
Deep freexer
 4-6 hours in  hospital
 6-8 hours at home
 5 days at the
back of the   fridge
 24 hours
 3-6 months at the
back of the freezer on the middle shelf

 6-12  months

Thaw frozen breast milk in the fridge or under cold running water, gradually adding warm water. Once thawed, it can stay in the fridge for 24 hours and should not be refrozen. Warm the milk in a container of very warm water. Do not warm in the microwave or on the stove. Use warmed milk within one hour.
 
Effects of early bottles and pacifiers Bottles or pacifiers may cause problems with breastfeeding. Milk flows more quickly from a bottle and babies suck differently on bottles and pacifiers than they do on the breast.

Bottles or pacifiers may cause problems with breastfeeding. Milk flows more quickly from a bottle and babies suck differently on bottles and pacifiers than they do on the breast. If your baby needs extra fluids while he/she is learning to breastfeed, give your expressed colostrum/breastmilk by cup or spoon or with a tube attached to your finger or your breast. Your nurse will show you how. When your baby has been breastfeeding well for 4-5 weeks, an occasional pacifier or bottle will not usually interfere with breastfeeding.

Sore or cracked nipples

Nipple tenderness is normal in the first few days and usually gets better each day. There should be no pain. Ongoing pain and nipple damage is an indicator of poor latch. This in turn is linked to ineffective milk transfer, slow weight gain, poor output, jaundice, dehydration.If your nipples hurt, tell your nurse or midwife.They will help you to fix your baby's position and latch and check to make sure your baby is sucking well.

  • Express some colostrum/breast milk onto your nipples after feeding and let it dry or put a warm wet cloth on your nipples for a few minutes.
  • Some mothers find a pure lanolin ointment helpful.
  • Ask your health care care provider for a prescription for an all purpose nipple cream.
  • Avoid washing your nipples with soap as this can dry your nipples more.

If you develop sore cracked nipples after you leave the hospital:

  • Check to see that your baby is positioned well and latching with a wide mouth.
  • Review the sections on this page: Baby-led latching, Latching, Signs of a good latch, How to hold your baby for breastfeeding.
  • Your nipples will heal if your baby is latched well at each feeding.
  • If it is too painful to breastfeed, express your milk at each feeding to keep up your milk production.
  • Call the NYGH Mother and Baby Follow-Up Clinic (416-756-6410) or your public health nurse for help with breastfeeding and to learn how to safely give your milk to your baby while your nipples heal.

Flat or inverted nipples

Babies need a mouthful of your breast in order to feed well. If your baby is having a problem latching, it is helpful to roll your nipple between your fingers or use a pump to help them stand out before latching your baby. Try different positions, such as football, cross-cradle or lying down. Most women can breastfeed their baby successfully with support, even if they do have flat nipples. Some mothers may need to use a nipple shield to help the baby latch. Ask to see the lactation consultant or call the NYGH Mother and Baby Follow-Up Clinic for an appointment.

Some mothers have nipples which turn inward when the baby latches on. If your nipples are inverted, it may be more difficult for your baby to latch or keep a good latch. Your nurse will suggest that you use your fingers to push back on your breast behind the nipple or use a breast pump until your baby is able to latch well. While your baby is learning how to latch, you can feed your expressed colostrum/breast milk to your baby using a cup or spoon, or by using a tube attached to your finger. Your nurse will show you how. Some mothers may need to use a nipple shield to help the baby latch. Ask to see the lactation consultant or call the NYGH Mother and Baby Follow-Up Clinic for an appointment.


Engorgement (hard breasts)

Your breasts may be sore and firm as your milk increases about the 3rd or 4th day. Signs of engorgement are if they are hard, reddened, hot, and if they hurt. The best way to prevent breast engorgement is to feed your baby at least 8-12 times in each 24-hour period for as long as your baby wants. If your breasts become engorged:
  • Feed your baby more often. Breastfeeding will help to soften your breasts.
  • If your milk is dripping, massage your breasts, apply warm wet cloths for a few minutes or have a warm shower before feeding.
  • If the milk is not dripping from your breasts, apply an ice pack or very cold wet cloth before feeding.
  • If the areola is hard and your baby can't latch, hand express or pump your milk to soften the areola, and then latch your baby.
  • Expect that your breasts will get hard again an hour or two after feeding.
  • If your baby is not ready to feed, hand express or pump some milk until you feel comfortable.
  • Put ice packs on your breasts between feedings for comfort.
  • Engorgement usually lasts 24 to 48 hours.

Leaking

Leaking sometimes happens in the first month or so as your body adjusts to make the amount of milk your baby needs. Wear breast pads and printed tops rather than plain tops to make leaking less noticeable.


Blocked ducts and breast infection (mastitis)

If you have a hard, tender, reddened area on one breast that does not soften with a feeding, you may have a blocked duct. Continue breastfeeding, put warm compresses on the area and massage gently towards the nipple before and during the feeding. Position your baby with his/her chin aimed toward the hard area.

Breast infections are rare. If part of your breast is reddened, firm, painful, and warm, and you have a fever and feel like you have the flu, you may have a breast infection. Continue to breastfeed, put warm compresses on the area to help the milk flow, drink lots of fluids, rest and contact your health care provider without delay. You may need to take pain medication. If the infection does not go away within 24 hours or gets worse, your health care provider may prescribe antibiotics.

It is safe for your baby and important for you to continue breastfeeding to keep up your milk production and to prevent the infection from getting worse. Some babies will not feed on the breast that is infected. If that happens express your milk at each feeding by hand or with a breast pump and give the expressed milk to your baby by cup or spoon. Call the NYGH Mother and Baby Follow-Up Clinic for an appointment to learn how to do this. Your baby will feed on the other breast more often or for a longer period of time.

Signs of mastitis

  • Red, warm, firm, painful breasts
  • Fever
  • Feeling like you have the flu

Treatment of mastitis
 
  • Continue to breastfeed
  • Warm compresses
  • Drink lots of fluids
  • Rest
  • Tylenol or Advil
  • Contact your health care provider if you don't feel better within 24 hours— you may need antibiotics
 

Nutrition

A new mother needs to eat a well-balanced diet to give her the energy needed to care for a new baby. There are no foods that you need to avoid when you are breastfeeding. However some foods might bother some babies. If you think your baby is fussy due to something you ate, don't eat it for five days. If your baby reacts again you may want to stop eating the food and speak to your health care provider. Some foods that you eat flavour the milk and this helps the baby learn about different tastes. Many breastfeeding mothers will naturally loose some of the weight gained during pregnancy. If you are concerned about your weight, losing a pound to a pound and a half a week will not alter the quality of your breast milk. For further diet advice consult your health care provider or public health nurse.


Day 6 Breastfeeding Check

  • Is your baby having several bowel movements in 24 hours that are mustard yellow with curds in them?
  • Is your baby wetting six (6) diapers in 24 hours?
  • Do your breasts feel full before feeding and softer after feeding?
  • If you had initial nipple soreness, has it gone away?
  • Do you hear swallowing when your baby is breastfeeding?
  • Is your baby feeding at least eight (8) times in 24 hours?
  • Does your baby seem satisfied after feedings?
  • My breasts do not have any sore, tender, or red and firm areas.
  • Has your baby started gaining 2/3 to 1 ounce per day?

If you answer "No" to any of these questions, contact your baby's health care provider today!


When and who to ask for breastfeeding help
 
You
  • You are having difficulty positioning your baby.
  • You have engorgement that doesn't go away by breastfeeding.
  • Your nipples are sore, cracked, bruised or bleeding.
  • You have breast or nipple pain while breastfeeding.
  • You think you do not have enough milk.
  • You have red, hot, lumpy areas on one or both breasts.
  • You feel like you have the flu, have a red, hard area on one breast and have a fever.

Your baby Babies who are breastfed should get a vitamin D supplement of 10 micrograms (µg) or 400 international units (IU) each day. This will prevent vitamin D deficiency and help your baby develop strong bones.
  • Your baby is sleepy and hard to wake for feedings.
  • Your baby falls asleep on the breast without feeding.
  • Your baby is fussy, and often seems hungry.
  • Your baby has less pees or poos than expected.
  • Your baby has difficulty latching.


Babies who are breastfed should get a vitamin D supplement of 10 micrograms (µg) or 400 international units (IU) each day. This will prevent vitamin D deficiency and help your baby develop strong bones.
 
 
Resources


North York General Hospital

Mother and Baby Follow-Up Clinic
North York General Hospital , Room 2S-210
4001 Leslie Street
Toronto ON M2K 1E1 Tel: 416-756-6410
(The clinic supports mothers whose baby was born at NYGH)

Hours 9 a.m. to 4 p.m., seven days a week, Monday to Monday

Telehealth Ontario

Telehealth Ontario offers 24 hours, 7 days a week breastfeeding advice and support service
Tel: 1-866-797-0000
TTY: 1-866-797-0007

City of Toronto

Toronto Public Health
8:30 a.m. to 4:30 p.m. Monday to Friday (closed statutory holidays)
Tel: 416-338-7600
TTY: 416-392-0658
Email: publichealth@toronto.ca

York Region

Health Information Line 
Monday to Friday from 8:30 a.m. to 4:30 p.m.
Tel: 1-800-361-5653
TTY:1-866-512-6228 (for the deaf or hard of hearing)
Email: AccessYork@york.ca

Region of Peel
 
Peel Public Health
Monday to Friday, 8 a.m. to 5 p.m.
Call Peel Health at 905-799-7700
Caledon residents call free of charge: 905-584-2216

Durham Region

Durham Health Connection Line
Tel: 905-666-6241 or 1-800-841-2729

Useful websites, publications and guides

International Breastfeeding Centre
 
 

Breast pump rentals and sales

Some moms will need to pump breast milk while they are in hospital. These moms will be required to purchase a breast pump kit for $20. This kit can be taken home with the mom for use with a pump rented or purchased from the Mother and Baby Unit. Read the Consumer Reports breast pump buying guide.
Some insurance plans will cover part or all of the cost of a breast pump. Check with yours and if so, your care provider can write you a prescription.
At discharge, breast pumps can be rented for use at home. Breast pump rental rates are $40 for a minimum initial 10-day rental — after 10 days the cost is $3 per day. A credit card is required to rent a breast pump for home use.

If you are planning to breastfeed your baby for as long as possible, purchasing a breast pump might be the right choice for you. The Purely Yours Breast Pump, which is very similar to a hospital grade pump, can be purchased from the Mother and Baby Unit for $271.20. The pump can also be purchased in the hospital's Outpatient Pharmacy.

Some insurance plans will cover part or all of the cost of a breast pump. Check with yours and if so, your care provider can write you a prescription.

Breast pump prices

Rental rates
  • Initial 10-day rental rate: $40
  • Subsequent rental rate: $3/day

Pump kits

  • Short term disposable kits used for in-hospital pumping are not recommended for use with rental pumps
  • Single Hygenikit: purchase for $45
  • Dual Hygenikit: purchase for $60

Purchase prices

  • Purely Yours: $271.20 (tax included)
  • Purely Yours Ultra: $429.40 (tax included)

Breastfeed or formula feed

Choosing how to feed your baby is one of the most important decisions you will make in your baby’s life. Many mothers worry that they will not have enough breast milk. Some mothers have had a bad experience with breastfeeding before or are going back to school or work in a few weeks or months. Some mothers have personal or health reasons for deciding not to breastfeed. You may have decided to feed your baby formula instead of breastfeeding or in addition to breastfeeding. Here is some information to help you make your decision about feeding. Health Canada, Canadian Pediatric Society, Dieticians of Canada and Breastfeeding Committee for Canada all recommend exclusive breastfeeding for the first six months of life.
 
  • Your baby is born with extra fluids to keep him/her well hydrated while he/she is learning to feed.

  • The first breast milk, colostrum, is just right for your baby and meets all of his/her needs for the first few days.

  • Colostrum is small in amount to fit into the baby's tiny tummy and thick so the baby can learn to suck, swallow and breathe easily while feeding.

  • Colostrum “paints” your baby's tummy and intestines to help protect him/her from infections.

  • Any amount of colostrum is good for your baby. If you do not want to put your baby to your breast, your nurse can show you how to express your colostrum and give it to your baby.

  • Milk production starts in pregnancy. In the first few days you are literally producing drops per feed. This is a clear fluid called colostrum and it's very concentrated. Small volumes for small baby tummies. The baby instinctively feeds often, not just to feed, but to help establish mom's milk supply. In the first few days there may be cluster feeding, which is normal.

  • If your baby is not feeding well, you can increase your milk production by expressing your milk at least eight (8) times per day. Your nurse will show you how to give this milk to your baby.

  • Giving formula in the first few days may reduce your baby's interest in feeding at the breast and also reduce mum's milk supply.

  • Formula feeding does not protect your baby from developing allergies, childhood diabetes, some childhood cancers and ear, lung and intestinal infections.

  • Breast feeding protects you against breast and ovarian cancers as well as bone loss. Formula feeding does not.

  • Breastfeeding will help you lose the weight you gained during your pregnancy. Formula feeding will not.

  • Occasionally a baby may need extra milk for medical reasons. Colostrum/breast milk is the first choice due to its protective effects. If you decide not to breastfeed or to breastfeed and formula feed your baby, s/he needs a commercial iron-fortified infant formula.

  • If a baby needs extra milk above what is produced, formula will be used as your baby's immediate health is most important.

  • If you had problems before with breastfeeding, the nurses and lactation consultant can work with you to increase the chance of breastfeeding going well this time.

  • If you decide to give your baby both breast milk and formula, exclusive breastfeeding in the first few weeks will help your body to keep making breast milk later when you introduce formula.

If you decide not to breastfeed or to breastfeed and formula feed, your baby needs a commercial iron-fortified infant formula. Talk to your baby's care provider about which formula to use. Formula will be provided for your baby while your baby is in hospital.



You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.