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HELLO BABY
HAVE A GOOD START!
A guide to breastfeeding from
and
Introduction
Dear reader,
The birth of your baby is an experience that will change your life. From
now on, you have to make numerous decisions about the care and nutrition of your newborn child. Amongst others, you have to also make a
decision about breastfeeding.
Breastfeeding can demonstrably improve your health and that of your
baby. Besides, you will both develop a deep relationship that may have a
very positive influence later in life. With the decision to breastfeed, you
give your baby the purest, most natural and best nutrition – breast milk!
Breastfeeding is the most natural thing in the world, but nevertheless it is
a process that raises many questions and needs practice. This guide from
ARDO was developed in close cooperation with the breastfeeding and
lactation consultant IBCLC Marliese Pepe, and it should provide a comprehensive range of solutions to your questions and problems so that you and
your baby can enjoy this intimate time.
2
Special consultant: Marliese Pepe, breastfeeding and lactation consultant IBCLC
Copyright 2007 Ardo medical AG Switzerland
3
Table of contents
Breastfeeding – the ideal start in life
6
7
7
8
8
8
9
9
10
Improved development and health for your baby
Better health for you
Breastfeeding difficulties
Anatomy of the female breast
Milk production
What happens during pregnancy?
Preparation of the breast
Flat and inverted nipples
After birth
Interesting facts about breastfeeding
11
11
12
13
4
11
Unique composition of breast milk
Initiation of milk formation
Breast massage and breast compression
Breast care
Breastfeeding – how it is done
14
14
17
18
18
6
The right time
Correct positioning
Breastfeeding rhythm
Breastfeeding frequency
Weaning
14
Breastfeeding – in everyday life
20
21
21
21
Breastfeeding and work
Breastfeeding and spare time
Breastfeeding away from home
Breastfeeding and nutrition
Breastfeeding – when problems emerge
22
23
24
24
24
25
25
25
20
22
Not enough milk
Engorgement & mastitis
Sore nipples
Flat and inverted nipples
Breast milk leakage
The tired inefficiently drinking baby
The nipple-confused baby
Ill or premature children
Breastfeeding aids – the solution to many problems 26
26
26
27
27
29
Pumping with good feeling
Choosing the right breast pump
Storage of breast milk
Defrosting and warming breast milk
ARDO and Ameda breastfeeding aids
– product outline
Useful addresses for breastfeeding problems
32
32
International addresses of associations
5
Breastfeeding – the ideal start in life
Breastfeeding is the best for your baby.
Breast milk protects your baby from
illness. Through breastfeeding, you and
your baby develop a very deep relationship that has already started during
pregnancy. Breastfeeding gives your baby
the best start in life, prevents illnesses,
reduces the costs of our health system,
protects our environment, does not
burden the household budget, reduces
the daily amount of work and - on a
long-term basis - gives you and your baby
more free time to spend together.
However, breastfeeding is a learning
process, which means that mother and
child have to practice. This requires
knowledge, time and patience right
at the start. With this brochure ARDO
wants to give you an insight into the
world of breastfeeding. ARDO and
Ameda breastfeeding products help you
in a fast and meaningful way and make
daily life easier for you.
Turn the pages of this brochure and find
much information that you need as a
breastfeeding woman.
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Your baby needs support and safety from the start.
Improved health and development
for your baby
Breast milk contains everything that your
baby needs for healthy development.
Extensive research has shown that
breastfeeding is healthier than feeding
the baby powdered milk through a
bottle. Breast milk contains many
substances that work actively against
infections. The immune system of the
child needs two years to completely
mature. Therefore, breastfed children
clearly have an advantage. Breast milk
reduces the risk of different illnesses,
such as inflammation of the middle ear,
infections of the respiratory and the
urinary tract, allergies, sudden infant
death syndrome (SID), diarrhoea, nappy
dermatitis, diabetes, bacterial meningitis,
Crohn‘s disease (inflammation of the
intestine), etc. Infant allergies are on
the rise. If a baby is only breastfed
during the first 6 months of its life, the
allergy risk can be reduced by up to 50
%. Breastfeeding reduces the risk of a
child suffering from obesity later in life.
Moreover, many babies are allergic to
artificial powdered milk (replacement
feeding for babies).
Breast milk is easily digestible and
strengthens the digestive tract of the
baby. Sucking at the breast benefits the
development of the entire mouth area
by preventing - amongst other things malocclusions and facilitating language
learning.
Better health for you
Not only your baby benefits from
breastfeeding. Breastfeeding hormones
support the regression of the uterus to
its normal size; they reduce loss of blood
and the danger of an uterine infection.
The hormones have a calming effect and
strengthen the relationship between you
and your baby. You learn to understand
your baby faster and better.
Moreover,
studies
show
that
breastfeeding reduces the rate of breast,
uterine and ovarian cancer. On a longterm basis, the risk of osteoporosis is
also lowered. Mothers who breastfeed
lose weight faster after childbirth.
Together and healthy in life.
Breast milk is always available, easy
to digest and is always at the right
temperature. It is absolutely free.
Studies show that breastfeeding
saves a lot of time, money and effort
compared to bottle-feeding once you
and your baby become accustomed
to it. Breast milk contains everything
that your baby needs for optimal
growth. Breastfeeding is fun, and
it is beneficial for the mother as it
reduces the risk of developing breast
cancer. You will also get back in
shape much faster.
Breastfeeding difficulties
Some mothers feel it to be a disadvantage
being tied down by breastfeeding.
However, after the 4th – 6th week of a
baby‘s life, it can drink pumped breast
milk (if you give your baby pumped
milk sooner, there is a danger that your
baby will get used to the bottle and the
different sucking technique and will not
drink from the breast any longer), and
you can take some time off your 24hour job as a mother. We recommend
using an Ameda breast pump.
Breastfeeding is concerned with the
quality of a baby’s nutrition, but it cannot compare to the quality of being a
mother. However, hormonal changes
mean that many things are easier for
mothers who breastfeed.
Together and healthy in life – with breast milk
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Anatomy of the female breast
The female breast consists for the most
part of glandular, fat and connective
tissue. Between 4 and 18 lactiferous
ducts connect the mammary glands,
which are made up of alveoli, to the
nipples. The lactiferous ducts branch out
in the vicinity of the areola. The areola
contains nerve endings that regulate
milk formation. This means that the
more the areola and the nipple are
stimulated, the more milk is produced.
The more a baby sucks at the breast, the
more milk is available.
The areola also contains special
sebaceous glands, called Montgomery
glands. They release a substance that
keeps the skin of the nipples and
the areola smooth, and also has an
antibacterial effect.
It is triggered simultaneously several
times at both breasts during breastfeeding. The mother can recognise
the let-down reflex from the following
signs:
• tingling warm feeling or stinging in
the breast
• milk starts to run from the other breast
• the baby swallows rapidly and regularly.
Anxiety or stress may have a negative
effect on oxytocin. The milk does not
flow or flows slowly, despite being
present in the breast.
The size of a breast has no influence
on the ability to breastfeed. Women
with small breasts can also breastfeed successfully.
Milk production
Two hormones are basically responsible
for milk production. Prolactin generates
milk in the glands, and oxytocin makes
the milk flow. Once a baby sucks at the
breast, the milk vesicles and lactiferous
glands contract. Milk flows out from
the nipple. This process is termed milk
ejection reflex or ‘let-down reflex’.
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Time, a relaxed atmosphere and a bit of patience are
the ideal conditions for successful breastfeeding.
What happens during pregnancy?
During pregnancy, the glandular tissue
begins to grow. The areola swells and
darkens which makes it easier for the
baby to find the nipple after birth. In
the 20th week of pregnancy, the breast
already begins to produce colostrum,
which is occasionally secreted during
pregnancy.
Preparation of the breast
Preparation of the breast can begin
after the 32nd week of pregnancy. At
no time should the preparation process
be painful. The process should include:
• exposure of the breast to air and sun
• mild ‘invigorating’ through soft rubbing of the nipple on clothes, e.g. by
not wearing a bra
• avoiding the use of soap during
washing or showering to keep the
natural skin protection of the Montgomery glands
• gentle massage of the breasts once a
day (no-risk pregnancy only)
• integration of the nipple into love
play
Flat and inverted nipples
It helps to check the form of the nipple
during the pregnancy.
Softly press together the breast at the
areola close to the nipple. If the nipples do not emerge (inverted nipples) or
remain flat (flat nipples), the baby may
find it difficult to latch onto the breast
properly.
The nipples should bulge so that your baby can
easily latch on.
By wearing an Ameda Nipple Former
directly underneath the bra (from the
32nd pregnancy week on), a soft and
constant pressure is exerted on the areola. As a result, the nipples become erect
and the baby can latch onto the breast.
If premature childbirth is suspected, a
nipple former should only be used following your physician’s instructions.
The Ameda Nipple Former prepares flat
and inverted nipples for breastfeeding.
The ARDO Tulips Nipple Shield protects
and can help your baby grasp the nipple.
9
If the baby is still not able to suck
efficiently at the breast a few days after
birth, an ARDO Tulips Nipple Shield can
be used. Otherwise the milk can be
expressed with, for example, an Ameda
Breast Pump, and the baby can drink
breast milk from the bottle. This way,
it receives all the health benefits that
breast milk has to offer.
If your nipples don‘t bulge, contact an
IBCLC lactation consultant or a midwife
during pregnancy.
After birth
The first hours after birth are very
important for the initiation of the
breastfeeding relationship, as the
search and suction reflex is very strong
at this time. The best way to initiate the
breastfeeding relationship is to place
the baby naked on the stomach of the
mother and leave it there until it sucks
the breast. Some babies crawl on their
own to the breast and latch on without
any help.
Bonding is an important event for
you and your baby – take your time
and together with your partner enjoy
the first unforgettable moments in
the company of your child.
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Interesting facts about breastfeeding
Unique composition of breast milk
One drop of breast milk is made up of
4000 living cells. It adjusts to your baby‘s
differing needs and constantly changes
its composition. It depends on the baby’s
age, the time of day and the respective
meal. Sometimes its composition even
changes during one breastfeeding
session when the sugar and fat content
in particular varies. At the beginning of
the meal, the milk seems more watery
(foremilk), and after the triggering of
the milk-ejection reflex, it contains much
more fat (hind milk) and has a creamywhite appearance.
viscous and easily digestible milk. It
contains many more proteins (particularly
anti-bodies) and less fat than mature
breast milk. These antibodies line the
intestinal wall of the baby and protect
it from infections. The first milk contains
three times the concentration of sodium
found in mature breast milk. Therefore,
your healthy, full-term baby does not
need many fluids in the first days of its
life, which means that the colostrum
already present is usually enough.
Colostrum also stimulates bowel actions,
meconium is excreted more quickly, and
the danger of jaundice is reduced.
Every drop of breast milk is precious – it contains
4000 living cells!
Transition from colostrum to mature
breast milk
The gradual transition to mature breast
milk occurs between the 2nd and 4th
days after birth (sometimes between
the 6th and the 7th days and with
mothers of premature infants between
the 10th and the 14th days). The start
of this phase is termed initial milk letdown. It lasts about 14 days. The
breasts become warmer, are heavier
and the veins become visible. Breast
glands often swell at this time, and the
breasts feel hard and are painful. In this
case, we recommend the use of ARDO
Temperature Packs as a cold compress.
Frequent breastfeeding of the baby
and regular breast massage also have a
soothing effect.
Foremilk quenches the baby’s thirst
while hind milk satisfies the infant’s
hunger. Breast milk contains all the
important vitamins, minerals and trace
elements required for the optimal
growth of the baby and meets all
hygiene requirements.
Initiation of milk formation
First milk
In the first days of a baby‘s life, colostrum (first milk) is formed. It‘s a yellow,
11
Mature breast milk
After two weeks have passed, the breast
milk will have adjusted in its consistency
and quantity to the fast development of
your baby. The breast milk is now referred
to as ‘mature’.
Afterwards you repeat the same procedure by placing your breast between
your hands held vertically.
Breast milk is always optimally adjusted to the age of
your baby – your baby knows what‘s good!
Breast massage and compression
Breast massage promotes the blood
circulation in the breasts - as well as the
flow of milk - and has a positive influence
on milk production. This massage
should be briefly performed before
any breastfeeding session, particularly
in the first days and weeks after your
baby’s birth to prevent engorgement.
It is especially useful for the prevention
of breast inflammation. Breast massage
should be carried out gently and should
never be painful. Hands should be
washed thoroughly before any massage.
Instructions:
1. Place your breast between your
hands, which should be held horizontally, and move the gland tissue back
and forward - as shown in the picture.
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2. One hand supports the breast. Place
three to four fingertips of your other hand
flat on the breast and massage the gland
tissue with circular movements. The fingertips are shifted 2-3 cm every now and
then and the procedure is repeated until
you have massaged the entire breast.
3. Use your fingers to gently caress the
breast from the base of the areola to the
nipple. Through this movement, you can
bring the milk to flow.
5. The rhythmical repetition of step
4 around the areola can relax a tense
breast or even empty it. Alternatively,
you can express the breast milk using
a gently- functioning breast pump (e.g.
Ameda Elite or Ameda Lactaline).
4. Try to gently squeeze out a drop of milk
by placing the thumb and the finger (as
shown in the picture below) behind the
areola and pressing slightly in direction
of the chest. Then, by applying gentle
pressure, move your thumb and finger
towards the nipple without rubbing the
skin.
Breast care
The breast needs no special hygienic
measures during breastfeeding. Daily
showers or washing are sufficient.
However, avoid your nipples or areolas
coming into contact with soap or
shower gel, as they destroy the natural
protection of the skin. After the
breastfeeding session express a drop of
breast milk as described and spread it
over your nipple. In the case of sensitive,
slightly reddened, dry or chapped
nipples, special care products like high
quality Lanolin nipple ointment may be
used.
You can wet your nipple with the resulting drop of breast milk and encourage
your baby to suck the breast.
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Breastfeeding – how it is done
nipples and to regularly empty the
breasts.
The right time
The sooner, the better!
In most cases, it does not take long before the baby begins to search for your
breast. Some babies suck energetically
right from the start. Others suck or lick
the nipple carefully. The most important
requirement for successful breastfeeding is early and correct positioning.
Correct positioning
Through correct positioning from the
start, you can prevent breastfeeding
problems such as sore nipples, lack of
milk etc., and after a few days’ practice
you can happily enjoy breastfeeding.
Pay attention to the following points:
1. Correct positioning of mother and
baby
A comfortable position for the mother
and correct positioning of the baby contribute substantially to successful breastfeeding. Therefore, it is not that important whether you breastfeed lying down
or seated. However, it is recommended
that you change the breastfeeding positioning during the day to relieve the
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A nursing pillow makes breastfeeding
comfortable. It provides relief and you
do not have to support the weight of
your baby with your muscles, instead
relaxing your arm on the pillow. The pillow serves as a support for the mother’s
arm but is not a pillow for the head of
the baby. By holding your baby, you can
control the positioning better. In particular, this means that you have to hold
your baby so that
• it lies stomach to stomach with the
mother (ear, shoulder and hip form
one line)
• the mouth is at the same height as
the nipple
• the arm of the mother is supported,
and her shoulders are relaxed
• the tip of the nose and the chin of
the baby touch the breast throughout
the breastfeeding session
A nursing pillow provides comfort and
allows you to relax while breastfeeding
your baby
The most common positions are explained as follows:
Breastfeeding in a sitting position
Dorsal posture
The back of your baby rests on your
lower arm, your hand supports its head,
and the legs are stretched out behind
you. The sucking of a newborn baby in
this position can be easily measured and
controlled. This position is particularly
recommended at the beginning of the
lactation period. It is especially suitable
for breastfeeding twins, premature
babies, after a Caesarean section or
when your baby has a cold.
The classic cradle hold
The baby lies on its side in the arm of
the mother (in the so-called ‘cradle
hold’) so that its entire body is turned
towards the mother. Her hand supports
its bottom.
Breastfeeding in a lying position
Lying position
You and your baby lie very close together
on your sides, stomach to stomach. This
breastfeeding position is especially recommended at night or when you want
to relax while breastfeeding during the
day.
2. Correct positioning of the breast
The breast is held with the other hand,
with four fingers supporting it from
underneath. The thumb is positioned
above the areola.
15
The skin is gently pushed forward to
stretch the areola and to help the baby
take a lot of breast tissue into its mouth
during latch-on.
As a consequence, the nipple is centred
in the middle of the mouth, and the
baby is quickly drawn close. The chin
and the tip of the nose touch the breast,
the nipple is deep in the palate of the
baby and the upper and lower lips are
folded outwards. If the baby has been
correctly positioned a feed does not
have to be limited in time.
The baby is pulled towards the breast not the breast towards the baby!
3.The right way to grasp the nipple and
the areola.
Using the nipple to tickle the infant’s
lower lip will make it open its mouth.
If it hurts right at the start then the
baby is probably not positioned
correctly.
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4. Releasing the baby gently from the
breast
When you want to remove your baby
from the breast, we recommend loosening the vacuum first by sliding a finger
between your breast and the corner of
your baby’s mouth. However, in most
cases, the baby, when it is full, let’s go
of the breast on its own.
Breastfeeding rhythm
The breastfeeding rhythm constantly
changes in the course of development.
The best breastfeeding results are obtained when a healthy, full term baby is
breastfed as needed.
During the first days, the breastfeeding
rhythm amounts to approximately 4
– 8 times a day. On the 3rd to 4th day
after birth, the frequency can climb to
between 12 and 14 times a day and
often levels off to between 2.5 to 3
hours within 24 hours.
It is normal for a baby to want to be
breastfed even at night in the first weeks
of life. During growth spurts (at the age
of 2 to 3 weeks, six weeks and three
and six months), the rhythm changes.
High temperatures or restlessness and
tension can change this rhythm too.
The burp
Contrary to widespread opinion,
most breastfed babies do not have
to burp. Compared to babies who
are fed with a bottle, breastfed
babies rarely swallow air during
breastfeeding. However, babies
who drink fast and avidly and
who choke during breastfeeding
are more likely to have air in their
stomach. If your baby is restless
after breastfeeding, pick it up and
softly rub its back. Most of the
time, the excess air escapes.
Breastfed and full – and romping with Mummy is fun
17
Breastfeeding time
The time taken for breastfeeding
depends on the character and age
of your baby. It can vary between 10
and 20 minutes per breast. Offer your
baby both breasts. If the baby is full
after feeding at one breast, offer it the
other breast at the next breastfeeding
session. Pay attention to your baby’s
sucking noises and intensity. Short and
fast movements at the beginning make
the milk flow, and slower, more intense
sucking means that the milk has begun
to flow. The milk supply is sufficient
when your baby gains at least 120 –
140g per week.
Breast is best – long after the first steps!
Weaning
A mother can basically wean at any
time. The weaning process takes approximately 14 days. Through slowly
reducing the breastfeeding meal frequencies and lengths, the breast milk
diminishes gradually. That means that
the baby will be only briefly breastfed, or
the breast will only yield a small quantity
of milk before the mother feels an uncomfortable strain in her breast. Sage
and peppermint tea and parsley help to
reduce the quantity of milk produced.
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How long should breastfeeding
continue?
Ideally, the baby should be fed
exclusively with breast milk during
the first 6 months. It contains
everything that the baby needs for
healthy growth. After 6 months,
the baby should begin taking solid
food as well.
Breastfeeding is then gradually
replaced by solids. The WHO
(World Health Organisation) and
UNICEF recommend continuing
with breastfeeding up to the
second year of life. Breastfeed for
as long as you and your baby want
to.
Breastfeeding brings you and your baby
into harmony
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Breastfeeding in everyday life
how you can express and store milk and
other breastfeeding accessories on pages
26-31.
Breastfeeding and work
Returning to work is not necessarily a
reason to wean. It is rather a reason to
continue breastfeeding, as your child will
miss you during your absence. Through
breastfeeding, it can again ‘fill up’ with
proximity. However, a certain degree of
organisation is required. It is important
that you inform your employer in advance that you want to breastfeed your
baby.
If you want to express your milk, you
should start expressing approx. two
weeks prior to the first day of work so
that you can build up a supply. You can
rent a pump or buy one. We recommend
the compact Ameda Lactaline Personal
Breast Pump. If you express at work,
you can carry it in a separately available discrete backpack. You can keep
the milk cool on your way home in the
Ameda freezer carry bag. You can also
express directly into an Ameda freezer
bag, thus saving storage space. Breast
pads like the ARDO LilyPadz are effective in preventing milk leakage.
You will find further information about
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For the mobile mother: Breastfeeding set ‘Mobile’ with
the Ameda Lactaline breast pump and a wide range of
breastfeeding accessories
Swimming, sleeping without a bra, going out at work:
no problem with ARDO LilyPadz, the re-useable breast
pads for all everyday situations
Your rights at work
When you return to work and want
to continue breastfeeding, you usually have the right to the time required
for breastfeeding or expressing milk
(legally guaranteed in certain countries). If in doubt, contact your breastfeeding or lactation consultant, midwife or the relevant institutions.
Breastfeeding and spare time
Try to find time for yourself in your 24hour job as a mother. Short rests and
regular leisure activities are very important
for your well-being, and ultimately also
for your child. With an expressed milk
supply you ensure that your baby is fed
with breast milk even if you are absent.
Breastfeeding away from home
You can breastfeed wherever you please.
For example, with a bit of practice, you
can do without the nursing pillow, and
be even more independent.
Breastfeeding and nutrition
Healthy and balanced nutrition is very important, particularly during breastfeeding. The calorie consumption increases
by approx. 400 kcal. A breastfeeding
mother can generally eat anything she
wants. However, there is one important
rule to be considered: food products
that do not agree with her, which cause
flatulence, regurgitation or indisposition can give the child stomach ache
and should be avoided. Breastfeeding
When Mummy is not around, Daddy can feed me
too
mothers should avoid nicotine and alcohol. However, as a general rule, there is
nothing wrong with treating yourself to
a glass of wine after a good meal after
breastfeeding. Through breastfeeding,
your demand for fluids is higher, and
your fluid intake should be approximately 2 to 2.5 litres a day. There is also
special ‘breastfeeding tea’, which can
promote milk production. Fennel, lime
blossom or alcohol-free beer have a similar effect. To reduce the amount of milk,
it is recommended that you drink peppermint or sage tea and eat a bunch of
parsley every day.
Smoking during breastfeeding
Milk production can be impaired
by nicotine. You should not smoke
while breastfeeding. If this is not
possible, smoke only after breastfeeding and never in the presence
of your baby. Try to reduce nicotine
consumption as much as possible.
21
Breastfeeding – when problems emerge
Not enough milk
The weight gain of your child determines if you have enough milk or not.
If it gains 120-140g per week you have
enough milk.
Almost every mother can breastfeed her
child. However, insecurity, incorrect information or also fear sometimes lead
new mothers to question their ability to
breastfeed. Many mothers do not realise during pregnancy that breastfeeding
starts immediately after birth and that it
has to be learned.
Good breastfeeding preparation can
prevent many breastfeeding problems,
in particular sore nipples.
In this section, we want to encourage
you and help you cope with certain difficulties.
However, in the event of breastfeeding
problems or uncertainties, do not hesitate to ask specialists for help. Trained
IBCLC breastfeeding and lactation consultants work in clinics and hospitals
and will gladly assist you, even after
discharge.
It is possible for your milk supply to
be limited for a number of days if, for
example, you are overtired or your child
is going through a growth spurt. More
breastfeeding, more frequent change of
sides (ping-pong breastfeeding), enough
rest, balanced nutrition and additional
measures such as breastfeeding tea,
lime blossom and fennel tea, alcoholfree beer, brewer‘s beer flakes and
breastfeeding massage oil can stimulate
milk production, and within 2 to 3 days,
the milk supply will have adjusted to the
baby’s demands.
It is absolutely normal that after some
weeks, your breasts don‘t feel as full
as they used to between breastfeeding
meals - this has nothing to do with the
quantity of milk produced. However, if
your baby does not gain enough weight
and, during the first four weeks, does
not have at least one bowel movement
a day and does not wet nappies six
times a day, do not hesitate to contact a
breastfeeding specialist.
Baby scale for weight check
22
Engorgement and mastitis (breast
inflammation)
During the entire breastfeeding period
and especially in the first weeks at home,
the breasts may harden and be painful
after breastfeeding, and you could feel
as if you have flu (e.g. fatigue, pains
in the joints, headaches, fever). These
symptoms point towards engorgement.
We recommend that you act as soon as
possible against engorgement and do
the following:
1. Place a warm damp compress (e.g.
ARDO Temperature Pack) on your
breast for approximately 10 minutes
before breastfeeding to make the
milk flow better.
2. Position your child so that its chin
points in the direction of the hardened area.
3. Massage the hardened area gently
during breastfeeding.
The Temperature Pack, applied when warm before
breastfeeding stimulates the flow of milk. When applied cold after breastfeeding, it relieves engorgement.
If the symptoms do not diminish within
a few hours or if fever develops, contact
an IBCLC breastfeeding and lactation
consultant or midwife, as there may be
danger of breast inflammation (mastitis). Contrary to belief, a woman with
breast inflammation or who is taking
antibiotics does not have to wean.
4. If the breast is still hardened after
breastfeeding, use a gentle milk
pump (e.g. Ameda Elite) to express
while massaging the hardened area.
5. After breastfeeding/expressing, cool
your breast for about 20 minutes
with a cold compress (e.g. ARDO
Temperature Pack).
6. Allow yourself enough rest (ideally,
go to sleep together with your baby)
and drink plenty of fluids.
When breasts are hardened, express the milk preferably with a gentle breast pump – such as the Ameda
Lactaline
23
Sore nipples
Sensitive nipples in the first 2 to 3 days
after birth are normal. If the discomfort
continues, or if the nipples become sore
or cracked or bleed, it is due in most
cases to incorrect positioning. For example, the baby may have taken too
much of the nipple and not enough of
the areola into its mouth, the baby may
not have opened its mouth sufficiently, its lips may be turned inwards, the
mother may have bent forward during
positioning instead of pulling the baby
towards her, the baby may be lying on
the pillow instead of being held in its
mother’s arm, etc. (see page 14 to 17,
‘correct breastfeeding positions’).
Sucking problems, thrush (a white
fungal infection, which leaves white
spots in the baby’s mouth) or a short
fraenulum are rarely the cause of sore
nipples.
As sore nipples cause intense pain, seek
the advice of a breastfeeding specialist
as soon as possible. In addition, ARDO
and Ameda breastfeeding products can
help you. It is recommended that you
wear an Ameda Nipple Protector inside
a breastfeeding bra to protect the nipples from unnecessary friction.
The Ameda
Nipple Protector
provides reliable protection.
24
A high quality lanolin product can
prevent dry and sore nipples and
promote selfhealing. There is no need to
wash the breasts before breastfeeding.
Flat and inverted nipples
See page 9 -10
Breast milk leakage
Breast milk may leak while breastfeeding.
To stop milk leakage and to avoid wet
spots on clothes, breast pads like the thin
ARDO LilyPadz, made from breathable
high-tech silicone, are available.
The tired inefficiently drinking baby
Some babies fall asleep during breastfeeding and do not drink efficiently. It
often helps to change the breast when
sucking noises become less noticeable
or to change the baby and to reposition
it. Alternatively, you can help the baby
to suck more efficiently. You could try
the following:
1. Breast massage before breastfeeding
to make the milk flow.
The nipple-confused baby
Sucking on the breast differs fundamentally from sucking on the bottle.
One meal given with the bottle can
sometimes confuse the baby and it may
no longer want to drink from the breast.
The younger the baby, the greater the
risk of nipple confusion. Therefore,
many clinics and hospitals do not top up
with the bottle but use an Ameda drink
cup, for example, as an alternative.
2. Place the baby on its back, supporting it carefully and making sure that
baby‘s feet touch a pad to give it the
opportunity if reaching out with its
hands.
3. Support the breast well during breastfeeding (see p. 15).
4. Support baby‘s chin with the index
finger.
5. Listen to the baby’s gulping noises.
6. In the beginning and when the gulping noises diminish in frequency,
strike the breast with the thumb or
apply breast compression (pain-free
squeezing of the breast) without
changing the form of the nipples.
By making the baby suck more efficiently,
it obtains more breast milk with less
effort. This procedure is also beneficial
for ill or premature babies or after a
difficult birth or Caesarean section.
The Ameda drink cup for
topping up with breast milk
Ill and premature children
In the case of a mother-child-separation
or a preterm delivery, a child can also
be fed with breast milk if the mother
expresses her milk. Ameda breast
pumps are the perfect choice. If the so
expressed milk is not given immediately
to the baby, it can be stored, cooled or
frozen. It is important not to interrupt
the cooling process during transport.
For this purpose, convenient cool
bags can be ordered from ARDO.
25
Breastfeeding aids - the solution to many problems
The choice of the right breast pump
In principle, there are two kinds of
pumps - hand-operated and electrical
pumps. For frequent expressing, an
electrical breast pump is recommended.
For occasional use, a hand pump may
also be used. For long-term use, it
might make sense to purchase a small
electrical pump such as the Ameda
Lactaline Personal, which also works
with batteries.
Happy to express!
The use of a breast pump can be necessary if the newborn initially sucks weakly and milk production is not sufficiently
stimulated. Also in the case of mother
-child separation, e.g. work, premature
birth or illness of the child, milk production can be built up and maintained
through regular expressing. As a result,
the baby can be fed with precious breast
milk, and expressing is beneficial for
subsequent breastfeeding.
Occasionally, milk does not start flowing
immediately. Fear and pain can block
the milk ejection reflex. However, the
milk ejection reflex can be promoted
with a breast massage (see page 12-13)
or relaxation exercises. The warmth of
the ARDO Temperature Pack also has a
stimulating effect.
Double expressing increases milk
quantity The simultaneous expressing of both breasts reduces the
pumping time by half and evidently
improves the milk quantity.
26
In our opinion, there are five essential
technical features that should be considered when you make your choice of an
electrical breast pump and the Ameda
breast pumps offer you all these features.
Vacuum and suction
cycle with progressive
individual adjustability
This allows you to adapt the pump to
your needs and to the usual suction
cycle of your baby. A high cycle and
simultaneous low vacuum simulates the
weak but fast suction rate of the baby
and the milk ejection reflex is triggered.
Once the milk starts flowing, start to
express effectively by increasing the
vacuum and reducing the suction cycle
according to your comfort level. The
expressing should never be painful.
The milk collection
system should be sealed
The closed milk collection
system guarantees that no milk ends up in
the pump. The Ameda Pumpset guarantees maximum protection and safety for
mother and baby. A patented silicone diaphragm offers maximum protection from
contamination of breast milk and also
from dust and germs. The patented Ameda Pumpset is therefore the only set available worldwide that is certified by the FDA.
Pumping:
gentle, effective
and harmonious
You can regulate the operating strength
of the pump and adapt it to your comfort level. A highly sophisticated suction
curve makes expressing with Ameda
breast pumps as effective and harmonious as possible for you at any level. It
has been scientifically proven that breast
pumps with a speed of 30 - 60 cycles
and a vacuum of 0-330 mbar cover the
recommended range.
Separately available: large breast
shell and a soft comfort shield
Common breast shells press the lactiferous ducts of women with large
nipples together, and milk can no longer
flow. We therefore recommend the use
of the Large Ameda Breast Shell.
A soft shield, like the Ameda Flexishield,
is recommended for sensitive nipples
and stimulation of the milk ejection reflex. It makes expressing more comfortable and stimulates milk flow.
The Pumpset converts into a
one-handed breast pump
Mothers in a transition period often
express with an electrical pump. We
recommend the hand pump if you only
want to express occasionally and for
brief absences. You can simply purchase
a pump grip in addition to the existing
pump set. The set is modestly priced
and can quickly be converted into a
hand pump (Ameda EHP).
27
Storage of breast milk
Expressed Breast milk can be kept in the
refrigerator (4 - 6° C) for three days. In
order to stock up, the expressed breast
milk can be stored for three months in
the freezer compartment of the refrigerator and six months in the deep-freezer
at a temperature of at least -20°C. For
example, each portion (60 to 120 ml) is
expressed preferably into special and separate freezer bags, cooled and frozen
immediately afterwards.
The special Ameda Freezer Bags are
made out of high quality three-layer material and do not absorb foreign flavors.
They are hygienic, practical and guarantee optimal storage of the breast milk.
It is important to mark each freezer bag
with the expressing date.
Repeated expressing and storage In case of repeated expressing within 24 hours, the freshly
expressed breast milk can be added to the already cooled milk. If
the milk has already been deep
frozen, it is best to cool the freshly
expressed milk first in the refrigerator for half an hour, add it to the
rest of the deep-frozen milk and
then deep freeze it.
Defrosting and warming breast
milk
Breast milk can be defrosted in the refrigerator or at room temperature and
then placed in a warm water bath or
held under running lukewarm water
until the milk reaches 37˚C. Breast milk
should not be warmed in the microwave.
Breast milk may separate during defrosting into aqueous and fatty parts.
Careful shaking of the milk will reunify
these components. Small changes in
color are not a cause for concern. They
do not mean that the milk is bad; it can
still be used .
Defrosted breast milk should be used
within 24 hours. Breast milk that has
already been warmed up once must be
thrown away.
Ameda Freezer Bags preserve your precious breast milk
up to six months
28
Breastfeeding products - Breast pumps
ARDO your specialist for breastfeeding products
Ameda Lactaline Personal Breast Pump
The Lactaline Personal is the world‘s smallest,
electric, interval double breast pump and offers
ultimate mobility. It is easy to handle, small, quiet
and efficient – the favorite breast pump for private use. The vacuum and cycle can be adjusted
separately and continuously to meet the specific needs and requirements of the mother. The
pump meets the highest hygienic standards and
can also be battery operated.
Ameda Elite Breast Pump
Elite is the quiet, electric, interval double
breast pump for professional use. It is a
proven, cutting-edge model. The vacuum
and cycle can be adjusted separately and
continuously to meet the specific needs
and requirements of the mother. The
baby‘s natural sucking rhythm can thus
be imitated perfectly.
Patented Ameda Pumpset Studies prove: the Ameda silicone diaphragm creates a barrier protecting pump
and breast milk from potential viruses and bacteria.
Ameda One-Handed Breast Pump
The One-Handed Breast Pump is designed for onehanded operation. The ergonomically designed
and rotatable grip takes the effort out of expressing the breast milk and leaves a hand free for
breast massage.
29
ARDO your specialist for breastfeeding products
Breastfeeding products - Breast care
30
The Ameda Nipple Former
helps women with inverted or flat
nipples to prepare for breastfeeding.
The ARDO LilyPadz
are the only reusable and nonabsorbing breast pads made of breathable
material. Applying light pressure to
the nipple prevents milk leakage. Ardo
LilyPadz are not visible under a bathingsuit or an evening dress.
The Ameda Nipple Protector
prevents unpleasant rubbing against
clothes when nipples are sore or
sensitive to touch.
The ARDO Tulips Nipple Shield
protects sore nipples and prevents direct
contact during breastfeeding. Available
in size M or L
The ARDO Temperature Pack
is used as a warm/cold breast compress before or after breastfeeding
and/or expressing.
The Flexishield
is a soft breast shell insert. Its gentle
massaging effect stimulates the milk
flow and makes expressing more
pleasant.
Breastfeeding products - Accessories
The Ameda EHP Combi-Kit
converts the One-Handed Breast Pump
(EHP) into a ‘Hygiene Pumpset’.
Das Ameda ‘Hygiene Pumpset’
The milk flow is visible through the totally transparent ‘Hygiene Pumpset’, which
encourages the milk discharge reflex.
The Ameda Freezer Bag
is used for the collection, hygienic storage and freezing of the breast milk.
The Freezer Bag does not absorb foreign odors and optimally preserves the
quality of the breast milk.
The Large Ameda Breast Shell
offers women with large breasts/nipples
more comfort and optimum conditions
for expressing.
Travel Set Lactaline
The Ameda Pump Grip
converts the ‘Hygiene Pumpset’ into the
One-Handed Breast Pump (EHP).
The competitively priced Set with everything needed by a mother on the go.
It includes the AMEDA Lactaline Personal Breast pump with `Hygiene double
Pumpset`, cool box, milk bottles, frezzer
bags…. ( cool box and backpack also
available separately).
31
Useful addresses for breastfeeding problems
International addresses of associations:
VELB European Lactation Consultant Association, Postbox 139, Brünigstr. 12,
6055 Alpnach Dorf / Switzerland, Phone +41 (0)41 671 01 17, Fax +41 (0)41 671
01 71, [email protected], www.velb.org
ILCA International Lactation Consultant Association, 1500 Sunday Drive, Suite
102, Raleigh, North Carolina, 27607 / USA, Phone (919) 861-5577, Fax (919) 7874916, [email protected], www.ilca.org
BFHI WHO/UNICEF - The Baby-Friendly Hospital Initiative
For more informations: http://www.unicef.org/programme/breastfeeding
Our subsidiary in Germany:
Ardo medical GmbH Argelsrieder Feld 10 82234 Oberpfaffenhofen Germany
T +49 (0)8153 40 66 00 F +49 (0)8153 40 66 01 [email protected] www.ardomedical.de
Our subsidiary in Netherland:
Ardo medical BV Serenadestraat 8 1312 EL Almere Netherland
T 036-5361600 F 036-5470445 [email protected] www.ardomedical.nl
ARDO - your specialist for breastfeeding products
Company stamp
Ameda/ARDO Stockist
Ardo medical AG
Gewerbestrasse 19
6314 Unterägeri
Switzerland
T +41 (0)41 754 70 70
F +41 (0)41 754 70 71
[email protected]
www.ardo.ch
11/2007
Richard Cassidy Limited
Walsall, United Kingdom
T+44(0)121 325 0300
T+44(0)1922 421488
[email protected]
www.richardcassidy.co.uk
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