Being able to produce enough milk following breast surgery depends on several factors:

• The kind of surgery you had.
• The way the surgery was done.
• Whether there is damage to nerves and ducts.
• The length of time since the surgery was done.

It is impossible to predict what success a woman will have with breastfeeding after breast surgery. The only way to know for sure if you can breastfeed is to try. It may take longer than usual to get breastfeeding started. Your baby should be seen by a health care provider regularly in the first few weeks. A visit with a lactation consultant would also be helpful. See Breastfeeding Help and Support in Grey Bruce.

Most babies will learn to latch regardless of what size or shape your nipples are, even if they are flat or inverted. It may take some time for you and your baby to learn what works for you. If you and your baby are having problems, get help right away. See Breastfeeding Help and Support in Grey and Bruce.

Adapted with permission from the Best Start Resource Centre.

If you notice a lump in your breast while you are breastfeeding it is most likely a blocked duct. Continue to breastfeed your baby. Vist the International Breastfeeding Centre website for tips on dealing with blocked ducts. Also see Breastfeeding Help and Support in Grey Bruce.

Tell your health care provider if you have a lump in your breast that does not go away.

Adapted with permission from the Best Start Resource Centre.

If you have pain, swelling or redness in your breast and have a fever, you may have a breast infection, also called mastitis. It is okay to continue breastfeeding. In fact, it is very important to empty the breast with the infection regularly, or the infection may get worse. Contact your health care provider to get treatment. Seeing a lactation consultant may also be helpful - see Breastfeeding Help and Support in Grey Bruce. You can also visit the International Breastfeeding Centre website for more information.

Adapted with permission from the Best Start Resource Centre.

Even when you are sick you can usually still breastfeed your baby. If you have a cold, flu or another type of infection, your body will make antibodies to fight the illness. You will pass these to your baby through the breastmilk. This will give him some protection against the illness. When you are sick, it is always best to check with your health care provider if there are any precautions you should take.

Adapted with permission from the Best Start Resource Centre.

Some mothers feel sad or have no interest in anything, not even their baby. You are not the only mother this happens to. About 1 in 5 mothers will develop a postpartum mood disorder. There is help. Postpartum mood disorders can be treated with medications, counselling, support from other mothers who have gone through a similar experience and help and support from family and friends. Contact your health care provider if you are feeling like this. You can also get information from the Postpartum Adjustment section of this website.

Adapted with permission from the Best Start Resource Centre.

Enjoy a variety of nutritious foods in Canada’s Food Guide to help you feel your best while breastfeeding. Avoid dieting while you are breastfeeding to meet your body’s needs. Drink water often to keep your body well hydrated. You can also get fluids from milk, fortified soy beverages or from foods like soup. It’s best to limit the amount of caffeine you have to no more than 300 mg a day. That includes caffeine in coffee, tea, and soft drinks. Be aware that herbal teas may not be safe to use while breastfeeding. Learn more about safe caffeine intakes and herbal teas.

Adapted from UnlockFood.

Sometimes the milk comes very fast at the beginning of the feeding. This is called over-active milk ejection reflex (let-down). It may cause your baby to be gassy, spit up or have watery stools. It is most common in the first 6 weeks of breastfeeding. Here are some things you can do:

• Breastfeed immediately when your baby wakes up, before she gets too hungry. Your baby will suckle more gently.
• Hand express some breastmilk before you begin feeding. Once your milk starts to spray, wait until the spray stops before putting your baby on the breast.
• Lie down or lean back while feeding so your milk will be flowing uphill.
• Let your baby breastfeed for a longer time on the first breast before switching him to the other side. In some cases it is helpful to feed on one breast per feeding. Switch to the other breast at the next feeding.
• Stop and burp your baby whenever your baby gulps, coughs, or chokes.

Adapted with permission from the Best Start Resource Centre.

Sometimes a mother or her baby will develop a condition called thrush. This can cause your nipples to become sore. You may also notice white patches in your baby’s mouth. Contact your health care provider.

Adapted with permission from the Best Start Resource Centre.

Every baby is different and babies need to feed around the clock, especially in the early days. This meets your baby’s needs because of his small tummy and helps you by stimulating your breasts frequently. Going long stretches at night without feeding your baby is not helpful in the first few months.

You may notice your baby wakes more frequently at night if:

• Your baby has a growth spurt.
• Your baby is sick.
• Your baby is learning a new skill like rolling over or standing up.
• Your baby needs to feel secure.
• You have gone back to work or school and are away from your baby more often during the day.

As your baby grows he will wake less often. This takes time for most babies. You are not alone. All new parents dream about when they will be able to sleep through the night. For now, ask for help and rest when your baby is sleeping whenever possible.

Adapted with permission from the Best Start Resource Centre.

The Public Health Agency of Canada and the Canadian Paediatric Society advise that all breastfed babies be given Vitamin D drops. 10µg (400 IU) of Vitamin D is recommended every day for exclusively and partially breastfed infants. You can get these at your local pharmacy. Talk to your health care provider about the products available.

Babies need only breastmilk and Vitamin D drops for the first 6 months and continued breastfeeding, with appropriate complementary foods, for up to two years or beyond.

Once your baby is around 6 months old and the signs of readiness are present, introduce solid foods that are nutritious and high in iron. To find out about introducing solid foods to your baby check out our Family Nutrition page.

Many mothers worry that once their baby has teeth, he will bite or chew on the nipple. Many babies never use their teeth while breastfeeding. If your baby bites, your natural reaction will be to take the baby off the breast. This will often discourage further biting.

Adapted with permission from the Best Start Resource Centre.

Small and large breasts can make the same amount of milk. The amount of milk you make is directly related to the amount of milk that is removed from your breasts when your baby breastfeeds, or when you express breastmilk.

Watch the video The Breast Makes Milk for more details.

Adapted with permission from the Best Start Resource Centre.

Most women have more than enough milk for their babies. Here are some things you can do to make sure you have plenty of milk for your baby:

• Start breastfeeding as soon as possible after your baby is born.
• Breastfeed your baby often, at least 8 times in 24 hours or more.
• Hold your baby skin-to-skin as much as possible.
•  Offer your breast whenever your baby is fussy or shows feeding cues.

If you are concerned, get help. See Breastfeeding Help and Support in Grey and Bruce.

Adapted with permission from the Best Start Resource Centre.

The amount of milk in your breasts in not related to how your breasts feel. Your breasts change over time and adapt to your growing baby. Usually, having an older baby means having softer breasts.

Adapted with permission from the Best Start Resource Centre.

It is quite normal for some mothers to have more milk than the baby needs during the first few weeks of breastfeeding, especially if you have a small or premature baby. It usually settles down in a few weeks.

Some mothers continue to have an over-abundant milk supply. This may be natural for your body or it may be caused by expressing milk regularly as well as feeding your baby. If you are expressing your breastmilk, decrease the number of times you are expressing your milk gradually until you are no longer expressing more than your baby needs.

If your milk supply is over-abundant without expressing, try feeding your baby from one breast only at each feeding. This will reduce your milk production.

You can use the milk you have stored in your freezer to mix with infant cereal, or other baby food once your baby starts solids. If you want to provide your milk for sick or premature babies, contact a human milk bank. In Ontario go to: www.milkbankontario.ca.

Adapted with permission from the Best Start Resource Centre.

Alcohol is transferred through breastmilk. It can affect your baby’s development, and lower the amount of milk you make. It is best to choose no alcohol while you are breastfeeding. If you choose to have a drink, it is best not to breastfeed for at least 2 hours per drink.

For more information please contact your health care provider or pharmacist.

Adapted with permission from the Best Start Resource Centre.

Speak to your health care provider about breastfeeding if you use street drugs. Street drugs can harm your baby. If you have any questions about medications or other drugs and breastfeeding, please contact your health care provider or pharmacist.

Adapted with permission from the Best Start Resource Centre.

Breastfeeding is good for your baby even if you smoke. If you can, try to cut down on smoking or quit. Smoking can cause your baby to be fussy. Heavy smoking can decrease the amount of milk you make. If you or someone else in your home smokes, decrease your baby’s exposure to second hand smoke. Babies and children are especially vulnerable to the effects of second hand smoke.

Here are some ideas:

• Breastfeed before you smoke.
• Smoke outside of your home and car.
• Wash your hands well and remove your outer clothes after you smoke.
• Ask people not to smoke around you and your baby.

If you would like to quit smoking, call the smoker’s helpline at 1-877-513-5333 or visit www.smokershelpline.ca. You can also visit the Smoke Free Living: Quitting Smoking section of our website for a list of more resources.

Adapted with permission from the Best Start Resource Centre.

All mothers have the right to feed their babies in public, anywhere, anytime. Most mothers become comfortable with breastfeeding in public once they have done it a few times. You can place a blanket over the baby to cover your breast, or wear layers of clothing to cover any exposed skin. If you don’t feel comfortable feeding in public, many malls and public buildings have a clean, private place for breastfeeding mothers. If you don’t know where it is, just ask. See the Rights of Breastfeeding Mothers information on this website.

Adapted with permission from the Best Start Resource Centre.

When you go back to school or work, you can still feed your baby breastmilk. Check out the brochure Returning to Work After Baby at http://www.beststart.org/resources/wrkplc_health/pdf/Return_to_Work_ENG_Final.pdf.

Adapted with permission from the Best Start Resource Centre.

Breastfeeding and birth control are compatible. Ideally, allow at least 18 months between the birth of one child and the conception of another. You and your partner have several reliable birth control options to choose from.

The following choices have no effect on the breastfeeding relationship and can generally be started soon after childbirth or the postpartum check-up:

• Lactational Amenorrhea Method (explained below)
• Condoms (male and female)
• Spermicides (foam, gel, vaginal contraceptive film)
• Intra-Uterine Device (I.U.D.)
• Diaphragm (must be refitted after childbirth)
• Vasectomy (permanent for male)
• Tubal ligation (permanent for female)

There are also hormone-based contraceptives. If you decide to use a hormonal birth control, it is recommended that mothers use progestin-only type birth control which can be started after your baby is 6 weeks old.

Hormone-based birth control choices include:

Progestin-only:

• Mini Pill
• Depo Provera

Estrogen and progestin:

• Birth Control Pill
• Birth Control Patch
• Vaginal Contraceptive Ring

Also see this Health Unit pamphlet on Breastfeeding and Contraception (Birth Control) for more information.

Lactational Amenorrhea Method (LAM)

LAM is an effective form of birth control, but only if you answer yes to all of the following statements:

• My baby is less than 6 months old.
• My monthly period has not yet returned (this is what “Amenorrhea” means). My baby is fully or nearly fully breastfed (see below for definitions of “fully” or “nearly fully” breastfed).
• My baby breastfeeds at least every four hours during the day and at least every six hours at night.

“Fully breastfed” means that your baby gets all his food from suckling at your breast. “Nearly fully breastfed” means that in addition to breastfeeding and Vitamin D, your baby is only receiving one or two mouthfuls per day of any other fluids or solids.

If you are not planning a pregnancy and have answered no to even one of the statements, you will need to use another form of birth control.

Also see this Health Unit pamphlet on Breastfeeding and Contraception (Birth Control) for more information.

Adapted with permission from the Best Start Resource Centre.

Breastfeeding is natural, but it can take time to learn. There are times when you may need to get help from a professional. If you need help, see Breastfeeding Help and Support in Grey and Bruce.

Be sure to get help right away if you notice any of these signs:

• Your baby is nursing fewer than 8 times in 24 hours.
• After Day 4, your baby has black stools.
• After Day 4, your baby has fewer than 3 stools or fewer than 6 very wet diapers in 24 hours.
• Your baby is unusually sleepy, fussy, or restless.

These are other signs that something is wrong.

• Your nipples hurt.
• Your breasts feel hard and painful.
• You feel like you have the flu.

Adapted with permission from the Best Start Resource Centre.

 Breastfeeding Help and Support in Grey Bruce

 Telehealth Ontario –24 hour health information and breastfeeding support from a registered nurse. Call 1-866-797-0000 or visit www.health.gov.on.ca/en/public/programs/telehealth/

 La Leche League Canada:  Mother-to-mother breastfeeding support. Groups are active in Owen Sound and Kincardine.  Hanover LLL leaders are available for individual support, but there are no group meetings at this time. You can also visit La Leche League Canada at www.lllc.ca or call 1-800-665-4324.

 Breastfeeding Buddy Program: Mothers helping other mothers. Moms and moms to be can be matched with an experienced breastfeeding peer support volunteer prenatally or after baby arrives, for up-to-date breastfeeding information, encouragement and texting, telephone, email or in-person support. Contact Mary Lynn Houston-Leask from M’Wikwedong Native Cultural Resource Centre at 519-377-4931.

 Healthy Babies Healthy Children Program- Whether you have questions about your infant or toddler, a public health nurse and parent support worker can help out. Public Health Nurses and Parent Support Workers can meet with you in your home and offer information and support. During challenging times we can help you make the best of the situation.Call the Grey Bruce Health Unit at 519-376-9420 or 1-800-263-3456 ext. 1433.

 EatRight Ontario: www.eatrightontario.ca or call 1-877-510-510-2.

Adapted with permission from the Best Start Resource Centre.