When to start solids rch
RCH Discharge Teaching Class
I'd like to welcome you to the newborn
baby class the first 4 to 6 weeks is
going to be somewhat overwhelming and
this is something that all first-time
parents go through first of all it's a
big change in your lifestyle you go from
people that if you slept in for work
it's amazing how quick you can get out
the door but once you have children your
life is going to take a lot more
planning and the other thing that you're
going to find overwhelming is the sleep
deprivation at the beginning for the
first 4 to 6 weeks it's very normal for
babies to be up a lot during the night
time so it's really really important
that when you go home with your babies
that do not rely on getting sleep at
night because quite often that won't
happen so when your little baby sleeps
during the daytime forget about
everything else your house is going to
be there forever right now this little
baby needs you so just go and get your
rest and that will make the transition
to being new parents it will go much
smoother for you so congratulations to
all of you and my name is Jeanie and I
have met some of you and some of you I'm
sure I will be meeting ok so if
everybody in the group is breastfeeding
or practicing breastfeeding I just like
to let you know I say about 35% of our
families do have some trouble with
breastfeeding initially so if you are
having some trouble with breastfeeding
please don't feel like you're the only
one ok
breastfeeding is actually a learning
process for both the mummies and the
babies and sometimes it can take a good
6 weeks to get breastfeeding really well
established where you feel a lot more
comfortable with it now colostrum is
considered the perfect food for your
baby in the first couple of days it does
come in very small amounts but it is
very high in colostrum we really
encourage you to try to weight your baby
up at least every three hours sometimes
the first 24 hours some of these little
babies can be very sleepy some of them
could have swallowed a lot of stuff
during the delivery and their mucousy
spitting up a lot of stuff and they're
not that interested in feeding so if
your baby has gone over that three-hour
period
we really do encourage you to wake them
up get them skin-to-skin and attempt to
breastfeed them you also want to be
watching your little babies for the
feeding cues now the kind of feeding
cues we're talking about their little
hands going up to their lips licking at
their lips turning their little heads
looking for something that's called the
rooting reflex that's the baby's feeding
cues they're showing you they want to
eat now if your little baby is too tired
or too mucusy and you can't get your
baby to the breast then you want to get
your nurse in and you want to get her to
get you to start hand expressing she can
teach you how to hand expression to be
stimulating your breasts at least every
three hours the more often your baby is
at the breast and the earlier right
after birth that will help bring your
milk in much quicker okay
so there's all different kinds of
positions that you can feed your little
babies in and when you go home with your
baby I really encourage you to do some
experimenting at home and find your
favorite little spot for feeding your
baby and don't be afraid to try some
different positions there's one common
thing though about all these positions
and that's the baby's body alignment
okay now we all love to hold little
babies like this and I go in to help
mums with breast feeding a lot and I see
these little babies they're lying in the
crook of mummys arms and mummys trying
to get the baby to the breast when a
little baby's lying like this what is
this baby having to do with their head
to get latched to the breast they have
to turn their head now if you turn your
head sideways try swallowing when your
head is turned to the side it's like
there's a big lump in your throat so if
you notice with all these little babies
body alignment is very very important so
you take this little baby and baby's
tummy mummys tummy you want to take this
baby that's lying on their back turn
that baby and bring the baby right to
you
okay and whether you hold your baby this
way or whether you've got your baby
supported this way
of a look at the ear the shoulder and
the hip joint see how you could draw a
line right down the baby so it's body
alignment that you're looking for in
this football hold if you decide to use
this football hold just have a look at
your baby and you want to make sure that
that baby is not having to turn their
head over their shoulder trying to get
latched onto the breast okay
so tips for comfort
first of all we want to get these little
babies as close as we can to their
mummies if they're wrapped up in several
blankets it's very hard for their little
bodies to get close into mummy your body
temperature is the perfect temperature
for them okay so best way to feed your
babies is the babies in their diapers
okay so remember the tummy to tell me
with my mummy so you bring this baby
tummy to tummy you want to keep this
little bottom end tucked in nice and
close to your body whether you're
holding the baby this way or whether
you've got the baby supported this way
their little bottom end needs to be
tucked in nice and close now when you're
trying to latch your baby we don't
encourage you to grab your baby's head
and bring into the breast this way
because this type of motion when you do
that you're actually pushing the baby's
nose right in to the breast okay so and
the other thing is little babies they
don't like to have their heads grabbed
either so what you want to do is to
support the baby's head with a couple of
your fingers and where you want that
little bit of pressure is right in
between their shoulder blades that is
going to tip their chin into the breast
and bury it well into the breast and it
also tips their head back slightly into
a sniffing position and what do we do
when we drink a glass of water we take
that glass of water and we tip our head
back slightly it's easier to drink that
way and it's easier for your baby to
drink that way if their head is in a
sniffing position also that will help
free up your nose or the baby's nose at
the breast okay
now I've got a couple of really nice
slides here that shows a little baby
that's trying to get latched on to the
Mummy's breasts now you might look at
this picture and say well why is the
mummy aiming the nipple I'll put the
nose instead of having this baby hoisted
up and aiming that nipple straight into
the mouth this way when we latch a baby
where the nipples going straight in the
baby would have the same amount of the
areola all the way around in their mouth
that would be called a symmetrical latch
but an actual fact for better milk
transfer for your baby and a more
comfortable latch for money the baby
should have more of this part of the
breast in their mouth than what sits up
at the nose so it's actually an
asymmetrical latch so if you can just
remember when you're trying to latch
your baby you want to tip up your breast
and when you get that big wide-open
mouth you want to flip the nipple into
the back as far as you can so if you can
just remember tip and flip now this was
a picture of a little baby that was
trying to get latched and as you can see
in the previous picture baby had that
nice big wide-open mouth
but boy oh boy can they ever close that
mouth quickly so right now this may take
you several tries to get your baby
latched and that's normal at this stage
you're going to find your little babies
learn very very quickly
in order to get fed they have to get
latched and to get latched they have to
keep their mouths open longer so it's
going to get much easier in the next
couple of weeks now this is a picture of
a little baby that is well latched to
the breast and as you can see see that
little chin how it's really well buried
into the breast and see how the nose is
slightly away okay so that's what your
little baby should look like at the
breast you might wonder what does it
feel like and what should I look for to
see if I have a good latch when your
baby goes to the breast you should be
feeling a tugging sensation and at the
beginning for the first couple of weeks
some mums find
uncomfortable it shouldn't be painful
shouldn't be pinching pain but strong
tugging is normal and some women do find
that uncomfortable your little baby's
chin should be really well buries into
the breasts and the nose slightly away
and then you want to have a look at your
little baby's cheeks they should be nice
and full and round
they shouldn't be sucking in at the
sides nice full round cheeks when your
baby starts nursing at the breast and
you might not hear a lot of swallows the
first couple of days because the
colostrum comes in very small amounts
and it's usually thicker but as your
milk starts coming in you're going to
start to listen to those swallows at the
at the breast so what it sounds like
it's a little cuff sound every second
2/3 suck so you want to start listening
for that there shouldn't be any clicking
or smacking sounds and one thing that's
really really important that can tell
you a lot about how your baby is latched
is what your nipple looks like after
that baby comes off the breast so
basically it should just be round but
more elongated if it looks like a brand
new lipstick then that showing it is
compressing one side of the nipple or if
there's a white line right across your
nipple that shows that the baby is
compressing your nipple between the
tongue and the roof of the mouth and
pretty soon that white line is going to
start to break down it will start to
bleed and you're going to end up with a
very sore nipple cracks blisters
bleeding that should not be happening if
that starts to happen you want to get in
contact with your public health nurse
right away okay let's just take a look
at tummy size it always amazes me to see
that babies start out with very tiny
tummies but look what happens by one
week the change in the tummy size
because they start out with such tiny
tummies their little tummies are going
to fill up very quickly and breast mouth
is very easily digested so therefore
it's going to leave the tummy quickly
these little babies will need to get in
at least eight feedings in a 24-hour
period but it's very normal for babies
to feed anywhere from 8 to 12 times
24-hour period all babies do lose some
weight the first few days but right
around day four is when that weight
should stabilize and then start to go up
check inside your little baby's mouth
inside the mouth should be nice and wet
and shiny and it shouldn't be dry and
sticky in there and just remember when
your little baby is at the breast you do
want to start listening for those
swallows all right challenges are common
okay so if you're having problems after
you leave the hospital really really
important to get in contact with your
public health nurse right away don't
leave it because it's only going to get
worse and get in and get the help
cluster feeding now usually around the
second night these little babies all of
a sudden wake up they'll have a great
feed this is probably about 11 o'clock
at night and then you'll think to
yourself oh good we're going to get a
couple of hours sleep
15 minutes later baby wakes up again and
they want to eat again and this can go
on for like a five-hour stretch they go
on a feeding frenzy
it's called cluster feeding and now if
it hasn't happened to you yet
be prepared it will happen tonight or
tomorrow night okay and that is
completely normal your little baby is
working really hard to get your milk in
as quickly as possible so just feed your
baby babies will feed more frequently
during growth spurts so around ten days
and then again around a month and then
around three months your baby may go on
little feeding frenzies that's going to
bring the volume of your milk up your
nighttime feeding is really really
important right now now remember I said
at the beginning of the class that
little babies are up a lot during the
night time and the reason that is it's
all connected to the mummy the hormone
for milk production is called prolactin
and it peaks in the night time so when
these little babies are up in the night
feeding they are stimulating that
hormone to all the receptors and mummys
breaths not only to bring in that good
supply but to help maintain that supply
for
many months down the road it's nature's
way of protecting a baby's food source
so your nighttime feeding is really
really important right now
all right so let's just do some breast
feeding basics here your breast milk is
made by supply and demand so when you
are feeding your little baby at the
breast you're actually making the food
for the next feed that's the way the
body works baby should finish the first
breast on their own and then you burp
the baby and always offer the second
side and at your next feeding you are
going to start on the side that you left
off on because they always take more
from the first breast breast milk is
considered the perfect food for the
first six months for your baby and then
you're going to start adding solids to
their diet now you can go down to the
Public Health Unit or you can go to the
best beginnings website because they
have some very current helpful
information on introducing solids to
your baby which can be very helpful and
it has really changed since your parents
started feeding solids to you
so Health Canada the World Health
Organization and the Canadian pediatric
Society they recommend exclusive
breastfeeding for the first six months
then the introduction of solids and
they're really trying to encourage
people to breastfeed their children
longer now you might wonder who came up
with that number - why isn't it one year
of age why isn't it three years of age
what's so magic about - these are all
toddler aged children they may only
breastfeed once or twice in a 24-hour
period so if they're in the age group
thirteen months to about two and a half
years of age okay so it's not for the
calories anymore they're eating lots of
solid food for their calories but what
they've been doing a lot of research in
the last five years is this age group
and their immune systems okay through
their research they found that the
toddler age group does not get up to the
adult levels of immunity until they hit
in the range anywhere from 22 months to
26 months
beige is when it's boosted up and one or
two breast feedings in a 24-hour period
brought those levels up to the adult
levels to help protect this age groups
from infection this age group is at very
risk for contacting a lot of infections
because toddlers are little explorers
and they go around their whole world is
explore explore touch everything and
their hands are always in their mouths
so this is a way that you can help
protect your toddlers from infection
okay if for some reason you're needing
to supplement your baby with some
formula some of our babies for medical
reasons or if you need to go home doing
this while you're waiting for your milk
supply to get established it's very
important that you get the correct
information on doing this in a safe way
there are two sheets that we need to
give you so you would want to ask your
nurse for those and also just to be very
very careful what you're buying out
there and make sure you read the
directions very carefully there are two
types of liquid formula on the market
one of them is a ready to give so you
don't do anything with it the other
liquid formula is a concentrated liquid
where you have to bring it home boil a
certain amount of water cool the water
and then add it to it and there has been
a few cases in the last year where
parents have gone home and they're tired
and run out and bought the formula and
accidentally bought the concentrated
formula thinking it was the ready to
give and given their babies concentrated
formula without mixing it with the water
and that can cause kidney damage to your
babies so please be very careful that
you read the directions very very
carefully okay burping your baby there's
lots of different ways that you can burp
your baby I really like this way when
they're little or supporting the baby on
your chest this way here and this way
here is great for when the babies are a
little bit older so if you're using this
way I'll just demonstrate with my little
baby here
you just sit the baby on your lap and
you want to take the baby with your
thumb and first finger and just put them
right around the baby's jaw not
around their necks but right around
their jaw and let the baby fall into the
palm of your hand because right about
where the palm of your hand sits is
right about where that little baby's
tummy is and that provides a little bit
of pressure on the baby's tummy to help
bring up the burp and then you just do
some gentle passing you should get into
the habit of trying to burp your little
baby after each breath now in the early
days your baby might not do a lot of
burping because they're taking very
small volumes but as the volume starts
to increase then you're going to find
that your babies are going to start
burping a lot more okay
all right you've been keeping track of
your baby's feeds and the wet diapers
and the bowel movements on those little
sheets that we have given you now we've
got a different version of the sheets
that you've been using right over here
and I really encourage you to come and
collect three or four of these sheets to
take home with you and you're going to
put these by your change table at home
you're going to keep the record for 24
hours and then you're going to add it up
and on the back of these sheets it's
going to give you ideas what to look for
because another way of assessing how
your baby is transferring milk with the
breast is what goes in needs to come out
so if your baby is not meeting these
guidelines then you know you need to get
some help right away so as you look at
this okay you can see the first couple
of days babies might not have a lot of
wet diapers and sometimes you open up
that day for it's just got a very little
bit of urine in it and it can be really
dark strong smelling urine but right
around day four or five all of a sudden
you're going to start increasing you're
going to start noticing that those wet
diapers are increasing the diapers are
getting heavier and the urine should
almost get to be a pale very light
colored urine with very little smell to
it so it shouldn't be strong smelling so
that by one week your baby should be
having at least six to eight good wet
diapers in a 24
our period that's what you want to look
for okay
some little babies in the first few days
of their life may pass Ricki colored
crystals in their urine
now that baby's diaper has a lot of
Ricky colored crystals in the urine
sometimes you just open up a diaper and
there's just a little trace that you see
basically it's just telling us the urine
is quite concentrated now that is normal
up to about day four day form beyond
your baby should not be passing bricky
colored crystals in the urine the urine
should get to be a lot more dilute the
diapers should start to feel heavier
okay have you all changed that really
black sticky stool now that is called
the meconium and that is what built up
in the baby system over the past nine
months when they were growing in money
okay so once the babies get rid of that
meconium you're going to find that your
baby's bowel movements are going to have
a lot of changes in this next week so I
will warn you this next slide has a lot
of poopy diapers on it so this is the
meconium so that's the first stool
that's what built up in the baby system
over the past nine months and then this
is what we call a transitional stool
okay it turns to sort of brownie green
now this is quite green it usually isn't
quite that green it's usually more
brownie green but it gets a lot runny
err when your breast milk is completely
and this is the color you're going to be
looking for it's like a mustard yellow
now some little babies it's kinda Kirti
some little babies it's more seedy then
we get the other little babies where
it's very watery now that is not
diarrhea in a breastfed baby that is
completely normal
if you ever see blood in your baby's
bowel movement that is of a concern you
should take your baby into the doctor
and have your baby seen right away now
all of you should have received one of
these little charts here now the nursing
staff we all call them the poop charts
okay so this condition is known as
billary atresia and just to let you all
know this is not something that
is common but if it's caught early these
babies are very treatable but if it's
not caught early these little babies can
go into complete liver failure and
require a liver transplant so this is
why we are educating all families on
this because if we can prevent just one
case of this it's worth it to educate
everybody your nurse will be going over
this little chart with you but basically
it's these top three boxes here that is
of concern and you don't wait till their
bowel movements are completely like that
if you see traces of colored bowel
movement that looks like those colors
you would want to take your baby into
the doctor right away and have your baby
assess the first two months are the
critical period but your nurse will be
going over this with you
before you get discharged and if you
didn't get one of these little charts
please ask your nurse for one of those
all right
newborn jaundice this is quite common in
our babies and this can happen anytime
after your baby is born up to about 10
to 12 days when babies can develop what
we call newborn jaundice and so this is
why we tell you about it because it
could actually happen after you you
leave the hospital so this is a little
baby that's jaundice can you see how
that little baby's skin looks kind of
yellow it looks like you snuck outside
and got a little suntan without you the
whites of the baby's eyes can even get
yellow and generally speaking when these
little babies get jaundice they tend to
get quite sleepy and they don't feed
very well now all of your little babies
are going to have a Billy meter test
done before they go home so the nurse
will be coming in with this level meter
she'll do these little flashes on the
forehead or flashes on the chest that
gives us a readout number okay and if
that number is too high we will order a
blood test for your baby because it's
much more accurate now if that test came
back to high your baby might require
some help
to get rid of that jaundice okay so what
we do is we put them under a special
light it's called a photo therapy light
or you might hear it called a billy lie
eight and then sometimes we lay them on
a little blanket called a billy blanket
and the treatment is usually about 24
hours and if you're in the hospital here
and that happens we set up that
treatment in your room we teach you how
to look after the baby end of the light
and you just stay an extra 24 hours
while your baby's having that treatment
if you've gone home and you need to
bring your baby back
you would go next door to Pediatrics and
the baby would go under photo therapy
there and mummy would come in so she can
continue to feed the baby now you might
wonder what would cause my baby to be
jaundiced and somebody else's baby
didn't get jaundiced
little babies are born with a lot of
extra red blood cells their hemoglobin
that's the red blood cells is way higher
than ours and the reason that they're
born with that extra hemoglobin and all
those extra red blood cells is when they
were in their mummies they had to get
their oxygen from their mummies red
blood cells so in order to get enough
from their mummy
they had way more so they're born with
all those extra red blood cells but once
they're born and they're transferring
their own air they don't need all those
extra red blood cells so they get sent
off to the liver to get broken down and
one of the byproducts that's released
during that break down is called
bilirubin and it's washed out through
the baby's urine and the baby's bowel
movements okay now some little babies
their livers are just a little bit in
the cheer they can't process it quick
enough and get it through the system so
it backs up into the liver then it backs
up into the bloodstream and that's what
causes these little babies to get
jaundiced so this is just something you
do have to watch for it because it could
happen after you go home okay so things
that you can do to help if your baby
slightly jaundice trying to encourage
the baby frequently will help the more
the baby is peeing and pooping that is
going to help clear the system of that
extra bilirubin that they are carrying
around but like I say if you get home
with your baby your baby's looking
yellow or the baby's sleepy and not
feeding as well please make sure you
take your baby back to the doctor
and have your baby checked ok passing
your baby I understand all of you I've
got to see your baby bath so that's
great they do have little bathtubs like
this for babies it's a very cute picture
but these little bathtubs or $85.00
believe it or not and I just think well
why couldn't we just buy a nice little
bucket to put the baby in but I thought
it was a cute picture just remember you
can buy all kinds of support systems to
put babies on in bathtubs remember don't
ever ever turn your back on a baby
that's around any kind of water source
because these little babies they start
moving around very very quickly and also
remember your little baby does not need
a bath every day there are going to be
days when you are overwhelmed the main
thing is keeping their bottom ends
really clean and under their chins where
they might get milk is really really
important but they do not need to be
backed every day please do not be using
powders around your babies when you are
putting powder baby powder on bond a
little babies bottoms those little
babies are inhaling all that powder and
please stay away from perfumed products
babies smell absolutely wonderful just
the way they are your little baby's cord
it should fall off anywhere in about 5
to 15 days now that we leave them alone
we're finding that they fall off much
quicker now a lot of your little babies
cords will have the cord clamp still on
them if that cord clamp is down really
close to the baby's skin you might want
to ask your nurse to take that off for
you if it's going to be interfering with
cleaning around your baby's court okay
we are asking you to fold the diaper
down below the cord and the reason that
we asked you to do that is so that the
air can circulate around the cord your
little baby's cord has no feeling in it
so it's not that the diaper is hurting
the cord it's like your fingernails or
your hair so it's no feeling but we want
it folded down so that the air can
circulate around it now as far as
cleaning the baby's cord we just
recommend good old soaking water when
you bath your baby we're going to get
you to wash the cord
when you take the baby out of the tub
you want to dry it really well where
it's going into the body we don't care
about the end of it here it's where it
meets the body so you can take the
corner of the towel dry it really well
and then have some q-tips at your change
table and three or four times during the
day any little bits that start to slough
off it because that will happen take a
q-tip and just clean them away okay now
this is a picture of a little baby's
cord that has just fallen off you might
get a little bit of old dark spotting
that's normal
bright red bleeding is not normal bright
red bleeding you would want to take the
baby into the doctor now have a look at
this little baby's cord here do you see
how it's very red and swollen and it
probably has a mucky smelly yellow
discharge as well that little baby has a
Corden section cord infections are very
serious in the newborn so if you see
anything like that with your baby's cord
you would want to take your baby into
the doctor immediately please don't
leave that okay sleeping positions what
do we notice about all of these little
babies they're all sleeping on their
backs another thing that we notice all
the baby's arms are free none of them
are swaddled like tight little mummies
and then the other thing all these
sleeping places they look very bare
there's no bumper pads in them there's
no quilts there's no pillows there's no
big stuffed animals back in 2004 and for
the sudden infant death syndrome society
started asking us to put babies on a
firm flat surface on their backs to
sleep and take all that stuff out of the
crib bumper pads quilts pillows big
stuffed animals the incidence of sudden
infant death syndrome went down
significantly so this is why we're
asking you to do this as far as loose
bedding in the crib babies when they get
a little older they can pull that right
over their head so that can interfere
with the air that circulates around
their face they don't think that these
little babies got into the bumper pads
or the little stuffed animals and
suffocated but what they think happens
is when they get in close to surfaces
like that it does interfere with the air
that circulates around the baby space so
if you're going to be using bedding in
the crib you would want to make sure
that that's well tucked under the
mattress so that the baby can't get it
anywhere around their face okay this is
a little sleep sack these things I find
worked really well you can get summer
weight winter weight sleep sacks and if
it's the winter time you put them in an
undershirt you put them in a winter
weight sleeper and then you just pop
them in a winter weight sleep sack that
keeps all the heat in there their arms
are free they can move around they can't
pull anything up over their head so
these little things work very well when
little babies are sleeping on their
backs if they need to bring anything up
the baby needs to be able to move around
freely in order to do that so if you've
got your baby swaddled so tightly that
they can't move the baby could actually
choke so arms should always be free okay
newborns love to be swaddled so if you
have your baby and you're holding your
baby swaddling is great or if you've got
your baby right beside you watching your
baby that's fine but if you're putting
your baby down to sleep and you're going
to sleep please make sure they're on a
firm flat surface on their backs with
their arms free okay how can we keep
these little babies safe just to review
firm flat surface on their backs to
sleep with their arms free have the baby
sleep in very close proximity with the
parent so in other words in the parents
room for the first six months
maintaining babies at comfortable
temperatures an overheated baby is at
more risk so if you pick up the baby
from their sleeping spots and they're
sweating behind the near ears or they're
sweating behind the neck that shows that
the baby's too hot okay
breastfeeding decreases the risk now if
you were your partner or smokers even if
you only smoke outside that little baby
should not be sleeping in the same room
with you
and they are greater risk of dying from
sudden infant death syndrome so we
really encourage you to get the help to
quit smoking not only for yourselves
for your children as well any use of
alcohol or drugs of course is going to
increase the risk of sudden infant death
syndrome okay okay so you might want to
know what you should look for when you
think you need to take your baby to the
doctor or signs that your baby might be
sick now not all babies display the same
kind of sign so first of all we've gone
over a lot of these already if your baby
is not having enough wet diapers or
bowel movements or showing no interest
in feeding well then of course you would
want to call and get some help for it
away don't leave it we've already gone
over cord infections if your little baby
has a fever you would want to take your
baby into the doctor now some little
babies when they get sick they'll get
extremely fussy now those little babies
tend to get seen sooner than these
little babies the little baby that goes
to sleep they start sleeping more and
more the parents have to go in every
time to waste them up for a feed baby
gets two breaths they have a five minute
feed and then they want to go right back
to sleep now sometimes first-time
parents confuse that very sleepy
behavior with they thought oh we've got
such a Content baby as all the baby does
asleep when in actual fact the baby was
sick we call that kind of behavior
shutting down behavior if you have a
preterm baby a little baby that we call
preterm or a near term baby that's
thirty five thirty six even 37 weeks
those little babies we are going to be
giving you feeding plans where you're
going to go in wake them up and ensure
that they are eating at least every
three hours okay if your baby has any
breathing problems skin color gray dusky
undertones
those are 9-1-1 calls this is going to
be your very best guideline trusting
your instincts as parents when people
bring their babies into the hospital or
into the doctor thinking that there's
something wrong with them
ninety nine percent of the time the
parents are absolutely right you'll you
have that inner connection to your
babies so always
go by your instincts don't ever ever
leave your baby if you think that
there's something wrong all right
skin-to-skin contact if you do lots of
this in the next couple of weeks when
you go home with your baby you're going
to find your babies are going to be a
lot more content it does all these
wonderful things you've got to remember
that that baby was in the perfect spot
for nine months and then all of a sudden
they're born out into this world and
that can be very stressful for them so
first of all your body temperature is
the perfect temperature for them so that
stabilizes their temperature it
stabilizes their heart rate and when
they're lying on your chest skin-to-skin
that whole sensation of you breathing
encourages them to stabilize their
breathing a breathing rate also it
increases a baby's blood sugar now you
might wonder how could it increase a
baby's blood sugar even if the baby
wasn't eating when a baby is warm and
cozy and feeling really secure their
blood sugars actually go up but when a
baby gets cold and they're stressed
their blood sugar drops quite quickly
this is great for bonding as well and it
also helps to promote breastfeeding
because baby is in the right place and
you've got to remember that little baby
was in the perfect place so this is
going to really ease that transition
from that intrauterine life to the extra
uterine life by spending lots of
skin-to-skin time with their mommies and
daddies and dads if mummys gone off to
take a nap you just get that little baby
skin-to-skin with you and put a little
blanket over the baby the babies
absolutely love it and dads you don't
have to shave off your hairy chest
babies love a hairy chest they're very
tactile they just love that tummy time
how many times really important in our
babies because they spend so much time
on their backs when they're sleeping
they're lying on their backs traveling
around in a car where is their little
head pressed it's pressed to the back of
the car seat and right now the bones in
your baby's skull are quite soft so if
you don't get them down on their tummies
enough they can start developing a flat
spot on the
their head that does not cause brain
damage but if you don't take care of it
quickly it actually could become
permanent and there are people out there
that are walking around that have these
very flat heads at the back and that's
very preventable the other thing that is
really important about tummy time it
gets the baby developing the muscles
their neck and shoulders by lifting up
their own heads and if they're not ever
on their tummies they don't have the
opportunity to do that so you can start
this right away you don't have to wait
till the cord falls off some of these
babies are very young babies this is a
set of twins they're very new there's a
little baby and there's a newborn on his
daddy's chest so there's lots of
different ways of doing tummy time you
should try and do tummy time
approximately 10 minutes 3 or 4 times a
day and you want to do the tummy time
when the baby's in that nice awake alert
state where they're just kind of looking
around and this is supervised tummy time
it's not time for you to run off and get
your dishes done or get the laundry done
this is the time you're going to spend
and join your baby talking to your baby
singing to your baby playing lots of
music to your baby and also very very
important we want you to start reading
to your little babies right away don't
even wait three or four weeks down the
road if you start reading to these
little ones right away and right now you
would want to choose two very simple
books and you want to try and get the
books that rhyme because at this age
little babies they love repetition and
they love rhyme and yes you will get
sick and tired of reading those same
little stories over and over again but
if you start this right away within
about five or six weeks when you pull
that little book out and you start
reading you want to pay attention to
your baby's eyes it's just like the
light bulb goes off it's just amazing to
watch so this is going to really help
your children in their later years so
taking care of yourself like I said at
the beginning of the class it's really
important to sleep when your baby sleep
okay
don't rely on getting sleep at night and
try not to have too
many visitors at the beginning the best
kind of visitors are the ones that knock
on the door pass you a casserole and say
we're going to leave you you call us
when you want us to come and visit ok
because you're going to find you're very
tired when you feel ready try to get
involved in your baby groups out in the
community this can be a huge support
network they do have them through the
public libraries and they also have them
through the Public Health Unit and they
have groups right from newborns all the
way up to 18 months of age and you're
going to be there to support new mummies
coming into the group when you go into
the group there's going to be mummies
there that are going to be there to
support you it's really nice to be able
to talk to somebody that's had a bad
night just like you've had a bad night
and you can share that with somebody now
as far as the healing process goes we
really encourage you to take that little
plastic wash ball that we've given you
we want you to take that home and you
just use warm water in it just like
you've been using here and you should
use that bottle until your flow has
completely gone now your show your flow
should be gone by around a 15 to 20 you
are going to find your flow does
increase when you're breastfeeding and
the reason that that happens is the
hormone that ejects the milk when you're
breastfeeding is also the same hormone
that clamps your uterus back down to
that too little outside that was before
you got pregnant change your pads very
frequently because blood is the perfect
breeding ground for bacteria and if you
sit in those pads for long hours you're
putting yourself at risk of developing a
nasty infection okay for those of you
that have had a cesarean section you
want to keep your incision nice and
clean and dry as well and you shouldn't
be lifting anything heavier than your
little baby for the first four to six
weeks and that does not mean your baby
in a car seat car seats with babies in
them that is way too heavy remember to
take your pain relievers as you need
them so that you're able to care for
your baby and the other thing is it's
really important that you check with
your doctor or with your obstetrician
when you are allowed to draw
okay okay so let's look at nipple care
care as you can see from this mummy's
nipple the front of this nipple the skin
has come right off and now she is
developed a scab over that that's
extremely painful
so nipple tenderness is normal you have
to expect some nipple tenderness but
excruciating pain is not normal so
cracking bleeding scabbing blistering
that is not normal so this type of thing
starts to happen to you
you do not want to leave that you want
to get into your public health nurse as
quickly as possible because you need to
find out why that is happening to you
there's something about the latch that
is causing that kind of damage to a
nipple now hopefully you will not get
engorged this can happen sometimes with
mummies when their milk all of a sudden
comes in quite quickly by frequent
feeding okay you don't want to go long
periods between feedings if you
breastfeed your baby frequently
hopefully you won't get engorged but if
you do get engorged where the breasts
get very very hard and firm and it might
be difficult for the milk to let down
you want to call your public health
nurse and get the help the use of cold
compresses can really help take that
swelling down but call the public house
nurse get in to get the help to help so
that you can get the help to resolve
that engorgement and it can take three
or four days for that to go down now all
of you should have received this little
pamphlet in your packages that you got
during your pregnancy so you might want
to just get this out and review it and
it's pretty well the same guidelines for
pregnancy as it is for breastfeeding
except you're going to find you're
really really hungry and you need to eat
more food now please don't worry that
you're going to gain weight because
you're eating more food
breastfeeding is the most wonderful diet
of all you get to eat lots of food
because the weight just falls right off
you so enjoy it while you can but just
remember whatever you're eating your
baby is eating four or five hours later
you do want to stick to that really nice
healthy well-balanced diet you're going
to find your release thirsty when you're
breastfeeding so you do need to drink
extra fluids you don't need to over
drink there used to be an old wives tale
out there that if you drink lots and
lots of fluids you'd make more milk well
that's not true but you need to drink
too thirst foods that you should avoid
fishtest high in mercury so you wouldn't
want to be choosing a lot of tuna fish
halibut is not a good choice as well
salmon is fine you can eat salmon foods
that are contaminated with Listeria okay
the deli luncheon meats while they're
not good for you anyway
okay please don't ever diet while you're
breastfeeding you're going to find just
with breastfeeding and eating a healthy
diet you will lose weight you want to
expose your baby to lots of flavors
quite often I get asked questions Oh
should I avoid cauliflower or am I
allowed to have chocolate well who could
I couldn't live without my piece of
chocolate every day it's everything in
moderation so yes you can have a piece
of chocolate you can have broccoli you
can have cauliflower spicy food your
baby loves spicy food the research shows
babies that have been exposed to a lot
of different flavors while they were
breastfeeding are less picky toddler
eaters okay we really encourage you to
continue taking your prenatal vitamins
for as long as you're breastfeeding and
also make sure that your calcium intake
is good okay for the coffee drinkers
that just can't give up their coffee one
cup of coffee a day is okay for the two
tea drinkers 2 to 3 cups of tea a day is
okay but if you're drinking massive
amounts of coffee and tea your baby is
going to be like this and your milk
supply could take a little bit of a dip
okay so vitamin D for our babies it is
recommended that all breastfeeding
babies be supplemented with vitamin D so
we would like you to speak to your
Midwife or your doctor and you can do
this before you go home or you can do it
on the first visit that you take the
baby to and they will recommend
there's a couple different products out
there there's a D drop product where
it's just a drop which provides four
hundred national international units or
sometimes you can buy the vitamin D
liquid form and they get a little half a
dropper full but you would want to
discuss this with your doctor or your
Midwife and they will let you know the
dosage that they would like you to give
to your baby and when to start it
all right the baby blues we all go
through the baby blues after we've had a
baby and it's not just the mummy that
goes through the baby blues it's the dad
as well and dads usually go through the
baby blues a little bit later than mummy
first of all the birth experience is
overwhelming for both parents and then
you're both going through that sleep
deprivation which you're not used to and
then on top of that Mommy goes through
this huge hormonal shift really really
quickly in her body so you might come
into the room mums crying her eyes out
she has no idea why she's crying okay
this can go on for a couple of weeks and
dads I will let you know when it's going
to happen to you usually it's after you
go home you've been home for three or
four days and mum says you know what you
got to go out and get some diapers and
some milk and all kinds of groceries
daddy comes back into the house with all
the groceries mums crying her eyes out
baby screaming the little head off and
dad just wants to throw his hands up in
the air and start crying too like what
happened to us and I always say dads
have a good cry with mom everybody's
going to feel a whole lot better okay so
this is normal this can go on for a
couple of weeks but unfortunately
postpartum depression has increased
significantly over the last five years
and quite often when a mummy goes into a
postpartum depression she doesn't see it
happening to herself you can say to her
well how's everything going you know how
is it with the baby she'll have this
great big plastered smile on her face
oh yes everything's fine because isn't
that what you're supposed to say after
you've got this beautiful little baby
isn't that what it's supposed to be all
about but for many women once dad has
gone back to work especially if they
they
used to having their career where
they're around people talking to people
all of a sudden they're at home with
this little baby and sometimes that can
be very lonely for a lot of women and
they may not even recognize it in
themselves so we really encourage
partners family members to watch mummy
very carefully for the first few months
after she's had a baby and sometimes
they pick up on it quicker
so if you notice mums just not herself
she's not sleeping even when the baby
sleeps you can just tell something's
wrong she said she's not enjoying the
things that she used to enjoy please
make sure that you get her in and get
her the help as soon as possible
that first year of your baby's lives are
the most incredible journeys you're
going to go through with your children
they go from being these little babies
like this one year of age a lot of them
are running around all over the place
it's just an amazing year and mummies
that go through postpartum depression
they don't enjoy that year at all in
fact it's a huge struggle for them to
get through that every mummy has the
right to enjoy that special year with
her baby so please get mum in and get
the help this specific postpartum
support society is a wonderful society
that you can get in touch with that is
very supportive of the entire family of
somebody that's going to postpartum
depression the period of purple crying
you should have all received one of
those little DVDs the little purple DVD
and we really encourage you to watch
this probably before your baby hits
about two weeks of age would be a good
time now the reason that they call it
purple crying is they found through
their 25 year study all over the world
that babies cried the most around 2 to 3
months it was unpredictable resisted
soothing pain like look long bouts of
crime generally happening late afternoon
evening time when the parents were
getting really tired so that's what the
purple stands for now back in my day we
used to call these babies colicky babies
you might have heard your parents say oh
you were such a colicky baby you cried a
lot so if your baby does start this
behavior you would want to take your
baby into the doc
to make sure there's nothing wrong with
them now if we just take a look at this
graph here as you can see all babies
start crying more around two weeks it
peaks between two to three months and
look what happens here it drops down
significantly by four to five months
look at that little group of babies
there they could cry for five to six
hours in a 24-hour period generally
happening all together late afternoon
evening time when the parents are
getting tired and some of them can be
very difficult to consult but they
studied these babies for many years
after and they found this group of
babies that went through this 99% of
them turned out to be perfectly happy
healthy children because if you have one
of these little babies that screams and
screams and screams for hours on end and
you're walking the floor and they're so
you start to wonder is there something
wrong with my baby that they could cry
like that and I can't console them
also the other nice things for parents
to realize there is light at the end of
the tunnel it's going to get better so
parents find that very helpful as well
okay so things you can do to help soothe
your baby and every baby is different so
you will have to do some experimenting
first of all try putting the baby back
on the breast several times in a row
sometimes that can interrupt a crying
cycle now a breastfed baby will not
overfeed you can't do that with a bottle
fed baby because they will over feed
some babies responded really well to
motion so the little baby swings were
well or in a rocking chair going out for
a stroller ride hopefully you won't have
to drive around for two or three hours
every night at the cost of the gas but
some babies respond well to that as well
putting on a vacuum or putting on a
dishwasher now I always find that
amazing all of a sudden the baby stops
crying it's very very strange but some
babies it just interrupts that cycle
some babies have been overstimulated
they need to get into a quiet spot like
a bedroom maybe with a rocking chair
could help try taking warm
with your baby holding a baby in
different positions now if you're going
through this with your baby and your
partner works afternoon shift nobody
should have to go through this
themselves it's very stressful on the
parents so please make sure you do get
some help into the house and always know
it is okay to take a break from a crying
baby
quite often parents feel very guilty
about putting a baby down that's crying
because as humans when you hear a baby
cry you want to pick the baby up and you
want to control the baby and I don't
care who you are you can have the
patience of a saint when you're dealing
with this night after night it wears you
down and your little clue that you will
need to take a break you'll be walking
that baby and all of a sudden you might
not say it out loud but inside you'll
say I just can't take this any longer
that's your - you need to take a break
and the best thing to do put your baby
in a safe place
safest place is the crib shut the door
and walk away and don't be afraid to do
that your baby's not going to hurt
themselves crying in a crib get on the
phone if you're by yourself and see if
you can get somebody to come over and
help you but even if they can't come
immediately they say that little 5-10
minutes telephone conversation with
another album helps to bring down the
stress level so that you're able to go
back and try and console your baby again
okay all right car seats we would like
you to bring your car seat up to the
unit we don't want you to bring the base
the base should already be properly
installed in your motor vehicle and then
we are going to ask you to put your baby
in the car seat and we're going to come
and check it and if there's any advice
we can give you we will now it is the
law that babies are in the rear-facing
position for one full year now okay but
the new recommendation out there is
keeping these little babies rear-facing
for at least two years so the law is one
year but the new recommendation which
will become the law
is at least two years and beyond these
little babies do way better when they're
involved in a motor vehicle accident
when they're in the rear-facing position
okay very important that your babies are
put in their car seats properly with
every car trip baby should not be
traveling around in cars where they're
slumped all over this way they're
slumped all over this way this can
interfere with the baby's airway if
they're they're not positioned properly
in the car seat if your baby does need
positioning in the car seat with
rolled-up blankets your nurse will show
you how to do this and please do not be
bringing your babies into the house if
they've fallen asleep in their little
infant car seat you do not bring the
baby into the house drop them down in
the hallway and then go about your
business and just leave them coming back
when they wake up car seats are not
meant for that there has been two
tragedies in the last year where babies
have succumbed in car seats that were
not positioned properly in the car seat
all slumped over and it interfered with
their airway so please do not do that
okay on the day that you go home we are
going to be giving you this little
pamphlet your nurse will give it to you
and we fax the public health nurse all
the information about your babies births
so this program is called the best
beginnings program and it's run through
the Public Health Unit you will receive
a phone call from one of the public
health nurses 24 to 48 hours after you
go home now they are there to follow you
up for a six to eight week period after
you've had your baby I cannot promise
that they will come to see you in your
home they will come out to see some of
you but they may not come out to see
everybody but you can go into the public
health unit for that full six to eight
weeks you can call them seven days a
week
8:30 to 4:30 if you want any information
if you have questions regarding yourself
or your baby so they are there for
follow-up care so you will all receive
this little pamphlet on the day that you
go home do you all
of this little book called babies best
chance this is a wonderful resource it's
also on the internet so you can pull it
up on the internet if you like that's a
great resource for all the way up to six
months that we encourage you to go to
and the other thing is this little best
beginnings website now if you would like
you can come and tear one of these
little sheets off because this gives you
all the information that's on this
website and this website is very current
it was put out by Frazer health and it
goes all the way from preparing for
pregnancy all the way up to children 2
years of age so if you're looking on how
to introduce solids to a baby there's
lots of very good information on
breastfeeding you can try looking up
this website it's very very helpful
alright now I know this is a little bit
early to be talking to you about milk
donation but we are always looking for
milk donors in Frazer health we have a
level-3 nursery at Royal Columbian
Hospital here and we have some very
fragile babies down in our NICU that are
sometimes born 24 weeks 25 weeks 26
weeks 27 weeks and sometimes for one
reason or another their mummies may not
be able to produce breast milk or they
could be on some kind of medication that
is contraindicated with breastfeeding
and it is critical that these very
fragile babies receive breast milk so if
you go home in the next six to eight
weeks and you find that you have an
abundant milk supply you could become a
milk donor the screening process is very
easy you will get a telephone call if
you decide to do this you will get a
telephone call from one of the lactation
consultants down at BC women's and
children so it's just a telephone
interview then you have to go for a
blood test which is paid for by the
donor around clinic and then your milk
that you collect once you've been
screened can be dropped off at any of
the pub
health units and Fraser health so it's
very convenient and then what they do
they take that donor milk it's sent down
to BC women's and children's where it's
pasteurized and it does retain many of
its very very beneficial products for
these very fragile babies and then we
get that melt back into our NICU for
these very fragile babies so if you do
find you have an abundant milk supply we
would really appreciate you becoming a
milk donor so questions when you go home
please make sure that you have a piece
of paper and a pen that's handy in your
house because a lot of questions are
going to come up about yourself and
about your babies and when the public
health nurse calls you or when you take
your baby to the doctor or the Midwife
comes over all the questions that you
were going to ask are going to fly right
out of your head so please make sure
that you write your questions down thank
you very much for coming to the class
