# Presentation: 666112

## Slide 1

## Learning Objectives

- Describe typical growth for babies during the first six months
- List three causes of low milk supply and three management techniques to remedy this difficulty
- List two ways to know a baby is ready to begin solid foods

## What is ‘Typical’ Weight?

- Weight gain of around 6 ounces a week
- Babies typically double birth weight by four to six months
- Babies are all different in how they grow
- Growth charts help track baby’s individual growth curve

## Appetite Spurts

- Occur around two to three weeks
- Baby wants to eat more often
- The mother often interprets this as meaning her milk is going away and supplements with formula
- Suggest mothers keep baby at the breast as much as possible
- Typical periods for appetite spurts
- Six weeks
- Three months
- Six months

## Maintaining a Healthy Milk Supply

- Chief concern throughout first six months
- Getting off to a slow start may impact milk supply later
- Mother’s perception of low milk supply is just as important as a real low milk supply
- Peer counselors can give mothers confidence
- Baby is doing well if gaining weight
- Baby has four to six wet diapers per 24 hours
- Baby is fed when he or she seems hungry
- If the mother will be separated from her baby, she will need help in removing her milk

## Causes of Low Milk Supply

- Replacing feedings with formula
- Introducing solids early
- Limiting baby’s time at the breast
- Delaying feedings
- Illness in baby or mother
- Mother returned to work/school
- Birth control pills

## Birth Control

- Barriers methods are considered safe for breastfeeding
- Progestin-only methods can affect milk supply if given before six weeks
- Estrogen-containing birth control methods can affect milk supply
- Yield mother with questions about birth control

## Dealing with Low Milk Supply

- Check baby’s position and latch
- Increase feedings
- Don’t limit baby’s time at the breast
- Use breast massage with moist heat before feedings
- Use breast compression
- Spend lots of time with the baby

## Breastfeeding and Returning to Work or School: Is It Worth the Effort?

- Many mothers wean during this time
- Many mothers do not know how to combine breastfeeding and working
- Support mother’s wishes to breastfeed as long as she is able

## What About Solid Foods?

- Advice many mothers get may be based on someone’s personal experience rather than scientific evidence
- AAP recommends waiting until around six months
- Baby’s digestive system not ready
- Early solids leads to allergies and choking
- Replaces a superior food with an inferior food
- Introduces food-borne illnesses to baby
- Know signs baby is ready for solid foods

## I’ll Breastfeed Until my Baby has Teeth

- Babies can continue to breastfeed with teeth
- If correctly latched, the nipple tissue is protected from teeth
- There are ways to deal with babies who “teethe” at the breast

## Getting Back to “Normal”

- “I want to start exercising again”
- “My husband is worried about us resuming sex”
- “When can I start eating my favorite foods”
- “I want to get away... without the baby”

## Practicing 3-Step Counseling Skills

- 3-Step Principles
- Ask open-ended questions
- Affirm
- Educate

## When to Contact Mothers

- Monthly contacts
- More frequent calls if she has milk supply issues...she is at high risk for weaning
- If returning to work, contact her two weeks before returning to work and a few days after she returns to work

## Opening the Conversation with Mothers

- What are your plans for working or going to school?
- How do you feel about your milk supply?
- How is your baby growing and developing?
- What does your baby currently eat?
- What do people tell you about when to start solid foods?
- How does your partner feel about breastfeeding now that things are well established?

## I have invaluable memories and love
working with WIC families. It is good to
see the moms come back to the clinic and look for
me, even months later, because they are so
thankful for the assistance I was able to give them.
It is almost like having an extended family member
giving information and support to assure a healthy
baby and mother.
WIC Peer Counselor

*working with WIC families. It is good to*
*see the moms come back to the clinic and look for*
*me, even months later, because they are so*
*thankful for the assistance I was able to give them.*
*It is almost like having an extended family member*
*giving information and support to assure a healthy*
*baby and mother.*
- WIC Peer Counselor