# Presentation: 510661

## Slide 1

## Learning Objectives

- List four things new mothers commonly deal with when breastfeeding during the first two weeks that may lead to early weaning
- Identify a strategy for dealing with some common situations that occur during the first two weeks
- Identify two situations in which a peer counselor should refer mothers experiencing concerns outside her counseling scope of practice

## Baby is Home –What can Moms Expect?

- Time of excitement and adjustment
- Stress feeds a woman’s lack of confidence
- Easy for mom to interpret stresses as a sign breastfeeding is not going well
- Many WIC mothers begin supplementing during this time

## Take Time to Recover

- May be tempting to overdo activities
- Strategies for taking care of herself
- Spend lots of time resting with baby
- Try to limit visitors
- Accept offers of help
- Take care of herself
- “Baby blues” is common

## Dealing with Baby’s Transitions

- Environmental changes can be stressful to babies
- Baby may be ready for faster flow of milk
- Keep baby close to mom, with continual access to the breast
- Calm baby

## When Will My Baby Sleep Through the Night?

- Mothers have different definitions of what “through the night” means
- Babies need the nutrition of night feeds
- Night feedings help mother’s breasts from becoming overly full
- Babies feed at different time intervals

## What’s Happening to My Breasts?

- Mother’s breasts become noticeably fuller with fluid, milk, and nutrients
- Delaying feedings can cause engorgement
- Engorgement flattens the nipple and makes it hard for baby to latch

## Dealing with Engorgement

- Before feeding, massage breasts with a warm, wet washcloth
- Hand express a little milk to soften the breast tissue
- Use ice packs between feedings to reduce swelling
- Breastfeed frequently
- Use a breast pump if baby cannot remove milk

## Hand Expressing Breast Milk

- Gently massage
- Place fingers where the “dark meets the light”
- Go back towards chest wall and roll fingers toward nipple
- Avoid pinching directly behind the nipple
- Praise the mother for any amount of milk that begins to drip or spray

## Dealing with a Plugged Milk Duct

- Prevent plugged ducts
- Proper positioning
- Do not delay/miss feedings
- Take care of breast fullness/engorgement
- Comfort measures
- Warmth and massage
- Feed on side with plug
- Breastfeed more often
- Express milk after feeding

## Talking with Mothers in the Early Weeks

- The 3 Steps
- Ask open-ended questions
- Affirm
- Educate
- Listening is as powerful as education
- Mothers may believe weaning to the bottle will solve all problems
- Monitor baby’s intake and mother’s comfort
- Affirm to build mother’s confidence and break down barriers

## When to Contact Mothers

- Every day or two in the first two weeks until mother’s confidence level grows
- Follow up within 24 hours if concerns arise
- Gauge contact frequency according to mother’s support and need for contacts
- Focus teaching on small chunks of information
- Remind mothers to keep WIC and physician appointments

## Opening the Conversation With Mothers

- What was your first day home from the hospital like?
- Tell me how you are feeling about breastfeeding now that you are home from the hospital?
- What people are around to help you right now? What are some of the ways they are helping?
- What are some of these people telling you about breastfeeding?
- How does your baby show you that he’s ready to eat?
- What is your baby’s typical feeding pattern?
- How is everyone in the house sleeping now that there’s a new baby in the house?
- How are your breasts feeling before and after feeding your baby?

## “My peer counselor helped me breastfeed 
my son. On one occasion in the early days
when I was having such a hard time, I told her it
would be easier to just bottle-feed, and she
encouraged me to breastfeed. She
explained the process and helped me
successfully breastfeed. Now I feel happy
because my son is so healthy and strong.”
                                                WIC Mother

*my son. On one occasion in the early days*
*when I was having such a hard time, I told her it*
*would be easier to just bottle-feed, and she*
*encouraged me to breastfeed. She*
*explained the process and helped me*
*successfully breastfeed. Now I feel happy*
*because my son is so healthy and strong.”*
*                                                *WIC Mother