YOUR GUIDE TO SUCCESSFUL

BREASTFEEDING
 Congratulations
on your newborn!
page
As you get to know your little
one, expect many changes
The benefits of breastfeeding 3
awaiting you, many of which
Importance of skin-to-skin
you may be unprepared for. contact soon after delivery 4
At Thomson Medical Centre, Rooming-in 24 hours 5
we believe that breastfeeding is
a key pillar of every mother’s
maternity journey. Because
Feeding cues 6
7
breastfeeding offers numerous
Breastfeeding positions
health benefits, we firmly
believe that breast is always
Signs of a good latch &
best. We are committed to
helping as many mothers as effective suckling 8
we can in their breastfeeding
efforts with support from our Feeding methods when baby
team of lactation consultants is not latched on to the breast 9
and healthcare professionals.

What you need to know about

This handy guide has important breastfeeding a newborn 10
tips to help parents understand
Common breastfeeding
breastfeeding basics. As the
postpartum period is crucial to problems & the solutions 11
breastfeeding mothers, we
have helplines as well as useful
info that will help you nurse
How to hand express breast milk? 12
successfully, so that you will
enjoy support even after you
Sterilisation of equipment 13
leave the hospital.
Storage of expressed
breast milk (EBM) 14
Breastfeeding log 15
All rights reserved. No part of this book may be reproduced, or utilised in any
form or by any means without prior written permission from Thomson Medical.
 The benefits of breastfeeding

The World Health Organisation recommends exclusive breastfeeding for the

first 6 months, with continued breastfeeding for 2 years or more.

How breastfeeding How breast milk

benefits the mother benefits the baby
• Helps restore the body back to its • Easily digested and absorbed
pre-pregnancy condition
• Provides balanced nutrition
• Reduces risk of breast and
ovarian cancer • Boosts immunity

• Lowers risk of postnatal depression • Breast milk contains antibodies

that fight viruses and bacteria
• Helps uterus return to its normal size
• Lowers risk of getting asthma
• Lowers risk of delivery bleeding or allergies

• Promotes bonding between • Optimises brain development

mother and baby
• Lowers risk of obesity and
• It’s convenient and saves cost diabetes
• Delays menstrual cycle • Breastfeeding reduces risk of dental
caries and orthodontic problems
• Helps space children naturally

3
 Importance of skin-to-skin
contact soon after delivery

Early initiation of skin-to-skin increases the likelihood of successful breastfeeding.

The best start

for the journey
of your
baby’s life
Happy mother Happy baby
• Promotes breastfeeding immediately • Warm and calm
after birth
• Less crying
• Enhances bonding between
• More stable heart rate,
mother and baby
breathing pattern, blood oxygen
• Increases chance of successful and sugar levels
breastfeeding as mother will
• Helps baby in attachment for
recognise baby’s early feeding cues
breastfeeding
• Releases hormones (oxytoxin)
• Protect baby with “good bacteria”
from body which reduces stress
• Enhances confidence in care of baby

4
 Rooming-in 24 hours

Great reasons to keep your baby in your room throughout your hospital stay

Benefits
• Establishes a closer bond with your little one

• You will recognise baby’s feeding cues, and to be able to feed on demand

• Feeding on demand helps to develop good breast milk supply

• Enhances confidence in caring for your baby

• The risk of infection is lowered when baby stays in your room

• Baby cries less, mother gets more rest

5
 Feeding cues

Breastfeed your baby when he/she shows early feeding cues.

This helps to increase breast milk supply.

Early cues
“I am interested in feeding”

Mouth Stirring
opening
Turning head

Mid cues
“I am really interested in feeding”

Licking of lips
Hand to
mouth

More
movements

Late cues
“Calm me, then feed me”

Crying Face
turning red
Agitated
movements

6
 Breastfeeding positions

Finding a comfortable position that works for you and your baby is well worth
the effort. A relaxed mother is able to trigger her letdown reflex.

Below are several positions you may adopt when you breastfeed:

Football position Modified cradle hold position /

Cross cradle hold

Cradle hold

Side-lying position Lying on your back

7
 Signs of a good latch &
effective suckling

Signs for the mother Signs for the baby

• Strong tugging on breast tissue • Head and body are supported at
which is not painful your breast level
• Thirst • Chin is touching the breast
• Postnatal contraction pain or • Mouth is wide open and covers the
increased flow of lochia during or areola as much as possible
after feeding for the first 3 to 5 days
• Your’s baby’s lips form a seal on
• Milk leaks from the opposite breast your breast, the upper and lower
during breastfeeding (after milk lips are turned outward
comes in)
• Body is properly aligned
• Feeling relaxed or sleepy while
breastfeeding
• Breast feels soft and less full
How do I know if my baby is
getting enough breast milk?
• Nipples are elongated and round
- Your baby appears content after feeds
after a nursing session
- Your baby gains weight after the
first two weeks
- Your breasts and nipples don't
feel too sore
- Your baby is a healthy colour
with firm skin that bounces back
when pinched
- You’ll be changing a lot of
diapers daily
(Refer to ’Monitor your baby’s output’ chart on page 10)

8
 Feeding methods when baby
is not latched on to the breast

Observe colour of baby’s face while he feeds

• Wash your hands before handling baby

• Baby is awake and alert
• Swaddle baby to keep his hands out of way to prevent spills
• Hold baby in an upright position
• Support his neck and shoulder securely and make sure his body is properly aligned
• Baby should be facing you, so that you can observe baby’s colour while he feeds

Cupfeed Syringe feed

• Hold the cup in the other hand, • Hold the syringe, then insert a
so that it touches baby’s mouth finger into baby’s mouth, so that
he will open his mouth
• Tilt the cup untill milk is touches
baby’s lower lip • Gently use your finger to stimulate
roof of baby’s mouth before releasing
• To pace the feed, let baby lap the milk
milk slowly (place the syringe
• To prevent choking, do not pour towards inner side of the cheek)
milk into baby’s mouth
• Allow baby to pace the feed
• Burp him during and after the feed
• Burp him during and after the feed

9
 What you need to know about
breastfeeding a newborn

Size of a newborn’s stomach

Your 6 days onwards
Baby’s age 1 day 2 days 3 days 4 days 5 days
Baby’s intake per day:
150ml X Baby’s weight
(Example: 150ml X 4kg
Your baby’s = 600ml per day)
tummy size Baby’s intake per feed:
Size of a Size of a Size of Size of Size of Based on 8 feeds per day
cherry. (Few strawberry a plum an apricot a kiwi fruit (Example: 600ml / 8 feeds
drops to 5ml) (5-15ml) (15-30ml) (30-45ml) (45-60ml) = 75ml per feed (every 3hourly))

Frequency of breastfeeding How often should you breastfeed?

8 to 12 feeds per day (on demand) *Per day, on average over 24 hours

Supplementation of How much milk would a mum be

expressed breast milk (EBM) pumping if her baby is not nursing?

Target amount to pump 1st month - 600 to 700ml per day

2nd month - 700 to 800ml per day
If you have twins or a
800-950ml by 14 days post delivery
higher order of multiples

How much to supplement

Day 1 - 20-25ml 3 hourly Day 4 - 45-50ml 3 hourly
Day 2 - 30ml 3 hourly Day 5 - 150ml/kg, which is divided by
Day 3 - 35-40ml 3 hourly the numbers of feeds/day
How do I
know if my baby
Monitor your baby’s output
is drinking
Baby’s minimum output requirements enough?
Baby
age Colours of stools Soiled diapers Wet diapers

1 day Black

2 days Black

3 days Greenish

4 days Brownish to yellowish

After Yellowish (with small seedy curds)

5 days

10
 Common breastfeeding
problems & the solutions

Engorged Sore nipple

breast
(breast is full,
hard and sore)

Missed feeds OR insufficient Usually caused when baby is not latched on

removal of milk because of properly/incorrect positioning that leads to a
poor latch/weak suckling poor latch/when baby is detached incorrectly

Problem Management

Engorged • Massage breast gently

breast - Before and while feeding to encourage milk flow
• Relaxing
- Will improve milk flow
• Express breast milk
- After breastfeeding/every 3 hours if breasts still feel
hard/swollen
• Cold cabbage/Cold compress
- Apply for 30 mins to 60 mins, 1 to 2 times only
• Painkiller
-Take to relieve pain

Sore nipple • Ensure baby is properly positioned and latched on

• Breastfeed on the other breast
- To allow sore nipple (tender side) to heal
• Reposition and relatch baby
- When suckling becomes painful
• Colostrum/Breast milk/Nipple Cream
- Express a few drops of colostrum/breast milk on the
nipple to soothe them before a breastfeeding session/
express your breast milk. Apply nipple cream if needed.
• Express milk from the affected breast
- If it is too painful when baby latches on

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 How to hand express breast milk?

Why express your milk?

• When baby is unable to latch or suck well.
• Store breast milk when you are at work

Why express by hand?

• Stimulates your breasts to increase its milk supply
Encourage milk to flow,
stroke breast towards nipple • Gives sore nipples time to heal
• In the first few days before breast milk comes in,
it is easier to express by hand
• Provides baby with nourishment if he/she is
unable to latch on

Find the milk ducts and How to express milk by hand?

feel the edge of the areola
1. Wash hands with soap and water
2. Massage the breast gently
3. Hold a sterilised cup and hold below the breast to
collect the milk
4.Place thumb and forefinger (index finger),
over the areola area, which is 2-3cm from the nipple
5. Apply steady pressure on the areola in a
rhythmic action
6. Gently compress the areola without sliding your
finger over the skin
7. Change positions frequently to clear all ducts
8. Express 6 to 8 times in 24 hours – during night as well

Expressing milk for a baby who is premature /

separated from the mother because of medical reasons
It is important to start expressing your milk as soon as possible after your baby
is born. So as to ensure that you produce plenty of milk, you will need to express
at least 6 to 8 times in 24 hours, day and night.

12
 Sterilisation of equipment

Wash all parts of the breast pump that come into contact with your
breast milk in warm soapy water and rinse thoroughly.

Sterilise using the following methods:

Method 1
• Use an electric steamer/
a UV steriliser according to the
manufacturer’s guidelines

Method 2
• Place the breast pump and accessories
in boiling water for 10 minutes

Method 3
• Soak in a sterilising solution with
sterilising tablet, according to the
manufacturer’s guidelines

Method 4
• Use a microwave steam steriliser bag,
according to the manufacturer’s
guidelines

13
 Storage of expressed breast milk (EBM)

Use sterilised breast pump accessories and containers Thaw frozen

to collect expressed breast milk. breast milk in fridge
and store for
Write date and time of collection on the containers. up to 24 hours

How to store expressed milk in various conditions

Location Temperature Duration

Room temperature > 25°C 1 hour

Air-conditioned room < 25°C 4 hours

Cooler box < 15°C 24 hours

(during transportation of EBM)

Bar fridge < 15°C 24 hours

Refrigerator ≤ 4°C 48 hours

Freezer in single door fridge 0°C 2 weeks

Separate door freezer < 0°C 2 to 6 months

Deep chest freezer - 20°C 6 to 12 months

Refrigerator
(≤ 4°C)
48 hours
Room temperature
(> 25°C)
1 hour Deep chest freezer
(- 20°C)
6 to 12 months

Separate door freezer

(< 0°C)
2 to 6 months

14
 Breastfeeding log
Date & time of birth:
Day 1 (First 24 hours) Date:
No. of feeds 1 2 3 4 5 6 7 8 9 10 11 12 Minimum requirements
Time 8 to 12 feeds per 24 hours
Duration As long as baby wants
Urine (tick) Urine 1x / 24 hours
Stools (tick) 1 black stool/ 24 hours
• Wake sleepy baby for feeding every 3 hours • Allow baby to suckle as long as the baby desires

Day 2 (24 to 48 hours) Date:

No. of feeds 1 2 3 4 5 6 7 8 9 10 11 12 Minimum requirements
Time 8 to 12 feeds per 24 hours
Duration 15 minutes / feed
Urine (tick) Urine 2x / day
Stools (tick) 3 black stools / day

Day 3 (48 to 72 hours) Date:

No. of feeds 1 2 3 4 5 6 7 8 9 10 11 12 Minimum requirements
Time 8 to 12 feeds per 24 hours
Duration As long as baby wants
Urine (tick) Urine 3x / day
Stools (tick) 3 greenish stools / day

Day 4 (72 to 96 hours) Date:

No. of feeds 1 2 3 4 5 6 7 8 9 10 11 12 Minimum requirements
Time 8 to 12 feeds per 24 hours
Duration As long as baby wants
Urine (tick) Urine 4x / day
Stools (tick) 3 brownish to yellowish stools /day

Day 5 (96 to 110 hours) Date:

No. of feeds 1 2 3 4 5 6 7 8 9 10 11 12 Minimum requirements
Time 8 to 12 feeds per 24 hours
Duration As long as baby wants
Urine (tick) Urine 6x / day
Stools (tick) 3 yellowish stools / day

Day 6 Date:
No. of feeds 1 2 3 4 5 6 7 8 9 10 11 12 Minimum requirements
Time 8 to 12 feeds per 24 hours
Duration As long as baby wants
Urine (tick) Urine 6x / day
Stools (tick) 3 yellowish stools / day

Day 7 Date:
No. of feeds 1 2 3 4 5 6 7 8 9 10 11 12 Minimum requirements
Time 8 to 12 feeds per 24 hours
Duration As long as baby wants
Urine (tick) Urine 6x / day
Stools (tick) 3 yellowish stools / day
15
 THOMSON PARENTCRAFT CENTRE
(Breastfeeding Consultation / Home Visit)

6251 4090 / 6251 4043

HOTLINE 9119 3502

www.thomsonmedical.com

Programmes & Services

• Childbirth Education Course • Dad’s Enrichment Programme
• Homecare Service • First Aid Training Programme
• Breastfeeding Workshop • Confinement Nanny Service
• Weaning Talk • Confinement Food Home Delivery
Printed on April 2019

• Baby Massage • Personalised Antenatal Counselling

• Hypnobirthing • Personalised Consultation on
• Infant Care Training Programme - Breastfeeding & Weaning
- Bath and Caring for the Baby’s Skin
- Setting a Crying and Fretful Baby