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Re: INFO SHEET

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It's very good but a few improvements would make it brilliant.

However I can't see the full email addresses so if either of you could

please email me offlist I can reply to them. :)

Ruthie

> Here is a draft text for another NCT information sheet - any

comments

> gratefully received

>

> if you want to adjust the text plse add text in CAPS and but bits

you want

> removed in (brackets)

>

> plse copy you replies to me and Caroline Deacon ( who wrote it)

> carolinedeacon@c...

>

> Making enough breastmilk

>

> If you've decided to breastfeed, you've made the healthiest decision

for

> your baby. However, you're probably feeling a bit worried; perhaps

you know

> someone who wanted to breastfeed but didn't manage. One of the

commonest

> reasons women give for stopping breastfeeding is that they didn't

believe

> they had enough milk. In fact nearly all women are able to make

enough milk

> to breastfeed their babies, given the right help and support.

>

> The first milk - colostrum

>

> From about twenty weeks of pregnancy, and for the first few days

after your

> baby's birth, you make special milk called colostrum. Straw

coloured, it's

> low volume but high in protein and antibodies, with a laxative

effect to

> help your baby clear meconium from his intestines. It is perfectly

designed

> for a baby who has just emerged from a safe womb into a world which

his

> immature immune system may find difficult to handle.

>

> Mature breastmilk

>

> After a few days of breastfeeding, your breastmilk will come in; the

length

> of time this takes depends on how often and how much your baby

feeds. A big

> hungry baby may feed more vigorously, telling your breasts to speed

up the

> production of mature breastmilk. A small or premature baby, with his

weaker

> suck and shorter feeds, will be telling your breasts to keep that

> wonderfully sustaining colostrum going for longer. Human milk looks

thin

> and bluish compared to cow's milk, but it is perfect to feed a human

baby.

>

> Once your milk comes in, each feed from each breast will start with

fore

> milk (milk which comes in before), dilute and thirst quenching,

which

> gradually thickens into hind milk (milk which follows behind) packed

with

> calories. So when your baby latches on, first he has a refreshing

drink,

> then he gets down to a satisfying meal of hind milk, which will help

him to

> grow. If you limit time at the breast, or swap sides too soon, your

baby

> may not get enough hindmilk, and will be hungry again very quickly.

A baby

> who is not positioned well at the breast will also find it difficult

to

> feed well enough to reach the hindmilk.

>

> When your breasts start changing from colostrum to mature

breastmilk, they

> will fill with blood and may feel hot, uncomfortable and perhaps

engorged.

> You may feel weepy and depressed; the so-called " baby blues " . Don't

worry;

> these feelings should pass within twenty-four hours. In the meantime

the

> best thing you can do is to keep feeding your baby to ease the

engorgement.

> Some women find that Savoy cabbage leaves put onto the breast can

bring

> relief.

>

>

> Tailor made for all occasions

>

> Not only does your milk change during each feed, it also varies from

day to

> day. For instance, in hot weather, breastmilk is more dilute,

allowing your

> baby to quench his thirst and replace lost fluids without having to

resort

> to bottles of water. The taste of your milk changes from day to day

> depending on what you eat, letting your baby get used to your

family's

> diet. Antibodies specific to your environment are passed to your

baby,

> whose immune system will take at least a year to mature.

>

> Of course unwanted substances may pass through your breastmilk too.

So just

> as you did in pregnancy, you should think about what you are eating

and

> drinking carefully, and check that any medicines are compatible with

> breastfeeding. Some contraceptives can affect your milk supply.

>

> Often it is difficult to remember to eat yourself when you are

spending so

> much time feeding your baby, so try to eat nutritious snacks

whenever you

> can. It makes sense to take care of yourself by eating well, and by

doing

> so you'll be taking care of your baby too!

>

> How do I make enough breastmilk?

>

> Your breasts have been preparing to feed your baby throughout your

> pregnancy, and as soon as he is born, they contain enough milk for

his

> first feed. What your body is waiting to learn is how much milk your

baby

> is going to need in the coming months.

> It's quite simple to make enough milk, let your baby decide when he

needs

> to eat, and when he has had enough. Only he is capable of deciding

how much

> he really needs. The more you feed, the more milk you will produce -

you

> can't run out. " Saving it up " for later will actually mean you will

have

> less than you need.

>

> To get your milk supply going, start by feeding your baby whenever

he

> wants, using one breast until he falls asleep or lets go. You can

then

> offer the other breast – he may not always want to take it.

>

> From the beginning

>

> If you can put your baby to your breast soon after the birth, it may

help

> you get off to a good start, as most babies are tuned to breastfeed

at this

> time. If he is not in the mood, perhaps after a long delivery or

pethedine,

> then hold him so the skin on his body is touching your skin. This

will

> start to stimulate your milk supply.

>

> Feeding your newborn baby will feel very different to how it will be

in a

> few weeks time. A newborn's tummy is tiny; only the size of a

walnut, and

> he needs to feed little and often. As he hasn't got used to day and

night,

> he will feed off and on through twenty-four hours, perhaps ten times

or

> more in that time.

>

> Mild jaundice is common for new babies, and breastfeeding as often

as

> possible will help this pass. Research shows that extra fluids such

as

> water are not helpful to the jaundiced baby, in fact they may make

it worse

> by filling up his tummy so there's less room for breastmilk. You

will need

> to wake him to feed often, however, as jaundice makes babies sleepy.

>

> Avoiding problems

>

> In the early days, while your body is finding out how much your baby

is

> going to need, it is quite easy to disrupt your milk supply. For

this

> reason, it is best to avoid giving baby other drinks, and to keep

feeding

> him as often as possible. Trying to introduce routines too early may

give

> your body the wrong message about how much milk to produce. It has

been

> found that babies who were given dummies in the early days are less

likely

> to be breastfeeding later on; perhaps because babies' need to suck

is

> fulfilled with a dummy, reducing time spent stimulating mothers'

supply.

>

> Growth charts

>

> Whenever your baby is weighed, your health visitor will plot his

gains on a

> centile chart. Although these are being updated, many of those in

use still

> represent average weight gains for formula-fed babies. Breastfed

babies

> gain weight at different rates, although length and head

circumference

> should develop at the same rate, and it is equally, if not more,

important

> to plot these. If your baby does not seem to follow the pattern

expected

> from his weight centile chart, but is still making satisfactory

gains in

> length and head circumference, be assured that he is developing

well.

>

> Gains on weight charts are quite small – an ounce or two here or

there, and

> it is easy to get such minute amounts wrong – variations could be

caused by

> a wet or dry nappy, a large bowel movement before weighing,

different

> clothing, or different scales. It is also important to take into

account

> how much weight your baby lost initially. However, if your baby is

> consistently slower than expected overall, or you are feeling

worried, talk

> to your health visitor, breastfeeding counsellor or family doctor

and if

> you are still not sure, ask to be referred to a paediatrician.

>

> How can I tell if he's getting enough?

>

> Think about whether he:

> · Settles contentedly after a feed

> · Seems content and alert and interacts with you.

> · Has several really wet nappies a day (five disposables, six to

eight

> washables)

> · Has frequent, yellow and sweet smelling, bowel moments.

> · His skin is soft and moist, and if pinched or pressed returns to

normal

> immediately.

> · His eyes are bright and clear

> · His cry is generally strong and insistent which stops when you

attend to

> him. These are all good signs. You need to worry if:

> · His fontanelle is sunken

> · Wet nappies are few and far between, or smell strongly of urine

which may

> be dark

> · Bowel movements are green or explosive

> · Your baby seems very placid, and rarely cries.

> In the past, mothers were often told to introduce solids early to

encourage

> their babies to put on weight. We now know that this isn't healthy,

and

> that all babies thrive on just milk for the first six months. Milk

should

> continue to be the main source of nutrition for the first year.

Introducing

> solids earlier than four months can lead to long-term health

problems.

> Recent evidence suggests that it may be beneficial waiting until

your baby

> is six months old before giving any solid food.

>

> Increasing your supply

>

> There are lots of ways to increase your milk supply:

> Feed more often

> Express between feeds

> Have a " babymoon " – rest with your baby for twenty-four hours,

feeding as

> often as possible during this time

>

> A baby who feeds a lot

>

> If your baby feeds little and often, it doesn't necessarily mean

that you

> don't have enough milk. It is more likely that he is not reaching

your

> hindmilk:

> Adjusting positioning may help in case he is not able to drain your

breast

> well

> Try staying on one breast for the entire feed, or returning to the

same

> breast if feeding off and on.

> If your baby is fretful or colicky– consider other options apart

from

> feeding. Perhaps he is tired or over-stimulated and just needs to

rest.

>

>

> If you are at all concerned about your milk supply, talk things over

with a

> breastfeeding counsellor.

>

> National Childbirth Trust Breastfeeding line 0

> Breastfeeding Network Supporters Line 0

> La Leche League 0

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