- Circle the hour closest to when your baby starts each breastfeeding.
- Circle BM when your baby has a bowel movement.
- Circle the W when your baby has a wet diaper.
It is okay if your baby has more wet diapers or more bowel movements than the goal for the day. You can write in additional W or BMs. If your baby has fewer wet diapers or bowel movements than the goal for that day, call your breastfeeding helper or the baby's health care provider.
Expect a BM to be at least the size of a tablespoon. Diapers should be very obviously wet by day two or three.
- Hold your baby skin-to-skin as much as possible. This calms a fussy baby, wakens a sleepy baby and helps you see a baby's early feeding cues (wiggling while asleep, fluttering eyelids, bringing hands to mouth, or sucking on hands). Crying is a late cue and baby needs to be calmed first.
- Feed on cue, eight to 12 times in 24 hours. Your baby may feed several times in a row and then sleep for a stretch of time. Practice makes perfect for both moms and babies!
- Your baby's body should be completely facing you with your baby's ear, shoulder, and hip in a straight line.
- Hold skin-to-skin, chest to breast, your baby's chin lifted, leading latch, nose in line with your nipple.
- Keep your baby close to you, supporting the shoulders and back. Brace your baby's hips close against your body.
- If there is any pinching or pain, bring your baby closer to your body. If this is not better, re-latch for optimal comfort. If your baby does not latch comfortably in the first few tries or gets fussy, return to skin-to-skin holding. If unable to latch, hand express, pump, and feed the baby expressed breast milk. Use formula if necessary.
- Mouth wide open.
- Tongue over the gum line.
- Lips rolled out.
- Comfortable and feeling like a tug, a pull or a draw.
- Allow your baby to finish the first side then offer the second. Your baby may only nurse on one side.
- Massage and compress the breast during feeding to increase milk flow.
- Listen for frequent swallows.
Monitor OutputKeep track of how many wet/dirty diapers your baby has in the breastfeeding record log.
Nipple and Breast Care
- Massage and hand express.
- Apply expressed breast milk to your nipple and areola. Let air dry.
- Expose to air for 10 to 20 minutes.
- Wear shells as instructed. Do not use while sleeping.
- Use Lansinoh three times a day sparingly on damaged skin only.
- Use salt water solution after feeding if needed. Rinse and pat dry. Apply expressed breast milk.
- Use reverse pressure to lessen any areolar swelling.
Frequency of Pumping
- Apply warm compress, massage, and hand express before pumping to increase milk flow.
- Pump eight to ten times every 24 hours.
- Double pump 12 to 15 minutes or single pump 15 minutes on each side.