Manitoba Health

Baby Friendly Manitoba: Information for Parents

Taking Care of Yourself

Nutrition

Eating Well with Canada’s Food Guide can help you eat healthy during your pregnancy, when breastfeeding, and for the rest of your life. During these stages in your life, your body requires more nutrients. Your food choices become very important for your health and your developing baby.
Drink lots of water to satisfy your thirst.
Whenever you are breastfeeding, have a glass of water, milk, soup, or juice within reach.
You may continue to take a multivitamin if you choose.

Rest

You will be up during the night to feed your baby so rest whenever possible.
Breastfeeding takes time. Don’t take on too many activities and responsibilities other than caring for your baby.

Menstruation (Period)

Your period may not start as long as your baby's only source of food is breastfeeding. If you do not breastfeed, your period will usually return 4–9 weeks after the birth. You can become pregnant again before your period starts once more. If you do not want another pregnancy, use some form of birth control.

Baby's Best Chance (see pages 93-96)
Birth control for new moms

Alcohol and Street Drugs

Alcohol may affect your baby’s sleep or decrease the amount of milk your baby takes at feeding time. It’s best not to drink at all while breastfeeding the first few months. However, if you choose to have a drink, feed your baby first. Since breast milk is so good for your baby, you do not need to stop breastfeeding if you have a drink. Alcohol is not trapped in breast milk. It is continually circulated into and out of breast milk.

If you are taking street drugs or drinking alcohol in large amounts, do not breastfeed. These substances pass through your breast milk and can affect your baby. Talk with your doctor, pharmacist, health care practitioner, public health nurse, or the Health Links/Info Santé at 204-788-8667 OR Toll Free at 1-888-315-9257, about getting help. The Motherisk Alcohol and Substance Use Helpline can be reached at 1-877-327-4636.

The Alcohol and Drug Information Referral Service has information regarding drug and alcohol programs. Call them toll-free at 1-800-663-1441.

Being Healthy

If you get sick with the cold or flu, you should continue to breastfeed.

Before taking any prescription or non-prescription medications—including natural health products—speak with your doctor or pharmacist. Some medications will pass into the breast milk. While most are safe, others are not. Check to be sure that all your medications are safe to take while breastfeeding.

Keeping Breasts healthy

Wash your hands before handling your breasts.
Express a bit of milk onto your nipples and allow them to air dry after each feeding.
If you wear nursing pads, change them as soon as they are wet.
Be sure your bra fits well.
If your bra leaves a mark on your breast tissue, it is too tight. A good estimate is to buy a bra two sizes larger than you normally wear.

What should I do if I have full, heavy, painful breasts (engorgement)?

This usually occurs after your milk increases between the third or fourth day. It may also happen if you miss a feeding. The nipples are often flattened against a swollen, sore breast. This condition usually doesn’t last long and can be avoided by feeding early and frequently.

To help:

Feed your baby at least every two to three hours. Night-time feedings are important.
Before feeding, take a shower or place warm wet washcloths on your breasts. Massage your breasts as well.
Soften the nipple area by expressing a small amount of milk before feeding in order to help the baby latch on.
Position and latch your baby correctly.
Express some milk from your breasts if they are still full and painful after feeding your baby. Make sure both breasts are well drained at least once a day.
Apply ice packs or a bag of frozen peas to your breasts after feedings. Place a cloth between you and the ice pack.
Chilled, washed, and dried raw cabbage leaves can also be placed on your breasts or inside your bra for comfort.
Get as much rest as possible and drink water, milk, or juice when you are thirsty.

What causes a red sore area in a breast?

This may be a plugged duct. This can occur when a duct is not fully emptied often enough. Pressure builds up behind the duct and can cause soreness in the surrounding area. Plugged ducts can become infected. With continued nursing, plugged ducts usually clear up in 24 to 48 hours.

To relieve plugged ducts:

Breastfeed every two to three hours. Sucking will help relieve the plugged duct.
Before feeding, take a shower or place warm, wet washcloths on your breasts.
Massage your breast before the feeding. During feeding, firmly massage the breast from behind the lumpy area towards the nipple area to help the milk come out of the breast.
Change the baby’s nursing position to encourage proper drainage.
Drain one breast well before switching sides.
Express the milk from your breasts by hand or with a pump if they are still lumpy after feeding.
Get as much rest as possible and drink whenever you are thirsty.
Make sure your clothing and bra are loose.

Mastitis

If you develop a fever greater than 38˚C, feel as though you are getting the flu, or your breast is red and sore, you may have mastitis. Continue to breastfeed. Mastitis is an infection of the breast tissue and/or milk ducts. It may come on suddenly and make you feel sick with chills and aches. The breast may feel firm, swollen, hot, and painful and may appear red or have red streaking. If you think you have mastitis, contact your health care practitioner or the Health Links/Info Sante at 204-788-8667 OR Toll Free at 1-888-315-9257 immediately.

Mastitis can be treated with frequent feedings, antibiotics, and pain relievers. Rest is extremely important in treating mastitis. Keep the breast well emptied by breastfeeding and expressing milk frequently if necessary. Your baby will not get sick from this infection.

Caring for Damaged Nipples When You’re Breastfeeding

If your nipples are damaged – cracked, bleeding, scabbed, or blistered – talk with your public health nurse, midwife, or lactation consultant about your baby’s latch. A poor latch can result in damaged nipples. It may help to nurse on the least sore side first.

When nipples are damaged, the first few sucks from your baby will be painful, even if the feeding is going well. If the nipple feels better after the first few sucks, your baby is likely latched on properly.

When Your Nipples are Damaged:

Help your baby latch better. If the pain persists, get help latching on.

Express some colostrum or breast milk and rub it onto your nipples. Allow it to air dry. Expose your nipples to the air.

Keep breastfeeding or express or pump your milk. If your nipples bleed, you may see blood in your milk or in your baby’s mouth. That's OK - the blood is not harmful and you can still give your milk to your baby.

Look at your baby’s tongue. Sometimes a poor latch and damaged nipples happen because the baby has a ‘tongue tie’ or tight frenulum - the piece of skin under the tongue. A tongue tie is only a problem if your baby cannot latch well or if it's causing damage to your nipples. Your doctor, a dentist or a pediatrician can fix the tongue tie very easily.

Sensitive Nipples

Nipple tissue is normally very sensitive to touch, but even women with very sensitive nipples can breastfeed. When babies are latched well and feed well, sensitivity isn’t a problem.

Thrush

If you have red, itching, persistent sore nipples, burning or shooting pain in the breast during and after feeding, or cracked nipples that don’t heal, you may have thrush or a yeast infection. Both the mother and the baby may show signs of infection, or just one may show signs.

Your baby may refuse to breastfeed, may repeatedly pull off the breast during feedings, be gassy and cranky, and have slow weight gain. The baby may have thrush in the mouth (white patchy areas that look like milk that won’t rub off) or in the diaper area (red rash).

If you have thrush, both you and your baby need to be treated. See your health care practitioner as soon as possible. Antifungal creams are used to help clear up thrush. Wash bras daily and avoid using breast pads if possible. If you are using a breast pump, boil the parts daily. If you have chosen to use a soother for your baby, replace or boil the soother for two minutes each day to prevent re-infecting your baby’s mouth. Babies need a prescription for antifungals. Mothers can use non-prescription medications.

Postpartum Depression

Having a new baby can be challenging both physically and emotionally, even at the best of times. It is normal to go through an adjustment period following childbirth; new mothers may experience many different emotions, feeling joyful one minute to feeling depressed the next. Up to 75% of new mothers experience "baby blues" feelings of sadness, anger, anxiety, fear, overwhelmed, weepy, irritable, fatigued and have trouble sleeping. By taking good care of yourself and giving your body what it needs -sleep, healthy food, companionship - the baby blues will usually go away on its own by the time your baby is two weeks old. However if these feelings don't go away or get worse, you may be experiencing Postpartum depression. Postpartum depression is treatable. Please refer to these resources for more information and where to seek help in your area visit PPD Manitoba.

Managing Engorgement