Some newborn babies are sleepy. That means your baby may not wake up on her own at least 8 times in 24 hours. Or your baby may latch and may fall asleep shortly after the feeding has started. Until your baby is waking up regularly and gaining weight steadily, you may sometimes have to wake your baby.

Tips to wake and feed a sleepy baby:

• Keep your baby close so you notice when she shows some feeding cues.  Babies can feed even when they are not fully awake or drowsy, but feed best when they show feeding cues.
• Feed your baby as soon as she shows some feeding cues, or she may go back into a deeper sleep.
• To learn about feeding cues, See Cue-Based Feedings in the Getting Started section of this website for more information.
• Your baby will breastfeed more often, if she is kept skin-to-skin on your chest while you are awake.
• Unwrap your baby and undress her. Change her diaper if it is wet or dirty.
•  Lift her to your shoulder and rub her back. Massage her body.
• Roll her gently from side to side. Talk to her.
• Express a little milk from your nipple when you bring her to the breast so there is something to tempt her.
• Using breast compressions during feeds will encourage sleepy babies to be more alert and increase the amount of milk they take in. To learn about breast compressions, see this information in the Breastfeeding Positions section of this website.  You may also find Dr. Jack Newman’s video on Breast Compressions, the International Breastfeeding Centre website, and this Breastfeeding Compressions Animation helpful.

Adapted with permission from the Best Start Resource Centre.

Babies cry for many reasons – discomfort, loneliness, hunger, fear, tension, or tiredness. Some babies cry more than others even when they are healthy and well fed. This happens more often in the first three months. It also happens more at night. You cannot spoil your baby by holding and comforting her. In fact, babies develop best when their parents respond to their needs and cues.

When your baby seems to cry for no reason, try these suggestions:

• If you know your baby has been well fed and burped, try skin-to-skin, walking, rocking or standing and swaying. Babies become familiar with their mother’s heartbeat, voice and movements in the months before birth and are calmed this way.
• Change your baby’s diaper if it is wet or dirty.
• Adjust your baby’s coverings or clothes if he seems too warm or too cool.
• Offer your breast again. Use breast compressions and offer the first and second breast again.
• Use calming strategies to calm yourself, such as counting slowly to ten, breathing deeply, or pretending you are blowing bubbles. These strategies will often calm your baby, too.
• If you are getting frustrated, ask your partner or someone else to hold your baby while you take a break.

Adapted with permission from the Best Start Resource Centre.

Babies have some days when they seem hungrier than usual. These times are called growth spurts and commonly occur at around 10 days, 2 - 3 weeks, 6 weeks, 3 months, and 6 months of age.

When this happens, some mothers worry that they do not have enough milk. There is no need to worry. The more you feed your baby, the more milk you will produce.

Adapted with permission from the Best Start Resource Centre.

At first, most mothers feel a tug when their baby sucks. This can be a little uncomfortable. You should not experience any nipple pain. The most common cause of sore nipples is a poor latch.

If your nipples are sore from a poor latch, you may find:

• The pain started 1 – 4 days after birth.
• The pain may be worse at the start of feedings, and then improve.
• Your nipples may appear pinched or misshaped after feedings.
• Your nipples may be damaged or bleeding (swallowing blood from your nipples will not harm your baby).

To prevent and improve sore nipples make sure:

• Your baby has a wide open mouth and is latched on to the areola.
• Your baby’s tongue is under the nipple and her lips are flared out.
• Your baby’s head is tilted back a little so he can open his mouth wide.
• Your hand is positioned back from the nipple area and your fingers are not touching your baby’s cheeks or lips. For more information on getting a deep latch, see the Helping your Baby to Latch information in the Breastfeeding positions section of this website.  You may also find this video from Peel Public Health on The Latch and the Breastfeeding Videos – International BreastFeeding Centre (ibconline.ca) helpful. If you are unable to latch your baby, ask for help right away. See Breastfeeding Help and Support in Grey and Bruce

If you have sore nipples:

• Rub expressed breastmilk on your nipples after feeding.
• Air-dry your nipples following feedings. You may find it more comfortable to leave your bra flaps down as much as possible between feeds and wear a loose cotton T-shirt. You can also expose your nipples to air while you are sleeping.
• Keep your nipples dry and change damp nursing pads often.
• Breastfeed on the least sore side first until your nipple feels better.
• Try laid-back breastfeeding (see the Baby Led Latching information in the Getting Started section), or try a different position (see the Breastfeeding Positions section).
• If you are sitting up, support your breast during the feeding.

Get help to make sure your baby has a deep latch or to check what is causing your nipples to be sore.

If you do not feel some improvement within 24 hours or you notice redness, bruises or cracks call your health care provider for help or see Breastfeeding Help and Support in Grey and Bruce.

Adapted with permission from the Best Start Resource Centre.

If you are expressing for a healthy full-term baby at home, store breastmilk using the following guidelines:

• At room temperature: 3 – 4 hours
• Cooler with a freezer pack: 24 hours
• Fresh milk in refrigerator: 3 – 5 days
• Thawed milk in refrigerator: 1 day
• Refrigerator freezer (separate door): 3 – 6 months
• Deep freezer: 6 – 12 months

Use clean glass or hard plastic containers that are BPA free, or bags made for freezing milk. Do NOT use baby bottle liners because they often break. Mark the date you expressed the milk on the container. Use the older milk first. Throw out any milk that is older than the storage times given. You can cup or spoon feed your baby expressed breastmilk. If you would like more information or help, see Breastfeeding Help and Support in Grey Bruce.

Adapted with permission from the Best Start Resource Centre.

A breastfed baby does not swallow much air. It is still a good idea to burp your baby. Some babies fuss if they need to burp. Burping may also help to wake your baby up so she can continue to feed if she wishes. Watch your baby to see how often she needs to be burped.

• Some babies need to be burped during a feeding and again at the end.
• Some babies burp on their own, while feeding, or when they are done.
• Some babies may not burp every time.
• Some babies spit up after feedings. As long as your baby appears content and gains weight as the weeks go on, don’t worry about spitting up mouthfuls of milk.

To burp your baby:

• Hold your baby against your shoulder or have her sitting on your lap.
• Support her head and pat or rub her back. A bubble of air can come up more easily if her back is straight.

Adapted with permission from the Best Start Resource Centre.

Pacifiers - Document courtesy of the Grey Bruce Health Unit

Many breastfed babies never use a pacifier. The way babies suck on a pacifier is different from the way they suck at the breast.

While your baby is still learning to breastfeed she may find it difficult to go from breast to pacifier and back again. Sometimes babies change the way they suck at the breast and become less efficient. This may cause sore nipples, or the baby may not gain weight well. Using a pacifier can cause mothers to make less milk.

Pacifiers can also increase the risk of babies getting ear infections and having later dental problems. If you decide to use a pacifier, avoid using it until breastfeeding is going well and only give it to your baby for a short time after she has fed.

Adapted with permission from the Best Start Resource Centre.

Most women find their breasts feel larger and heavier on day 3 or 4 after the baby was born. This may last for about 48 hours. If your breasts feel swollen and tender, it is called engorgement. If your breasts become engorged, it may be more difficult for your baby to latch. Engorgement usually happens during the first week of breastfeeding, when your milk production starts to change from colostrum to milk. It can be due to:

• Increased blood flow to your breasts.
• Swelling of your breast tissue.
• More milk in your breasts than your baby is removing.

You can prevent engorgement if you:

• Breastfeed whenever your baby wants to, at least 8 times in 24 hours.
• Make sure your baby is latched well and feeding efficiently. You should hear your baby swallowing often.
• Use both breasts at each feeding. If your baby will not take the second breast, and it feels very full, express enough milk from that side to make you feel comfortable. After a few days your breasts will feel more comfortable.

If your breasts are engorged:

• Breastfeed your baby more often.
• If your baby will not latch, express breastmilk to soften the areola, then try again.
• Some mothers find it more comfortable to wear a bra. Other mothers prefer to go without.
• If you wear a bra, make sure it is not too tight.
• Apply a wrapped ice pack or cold compress to your breasts between feedings.
• If the engorgement does not improve and your baby does not seem to be feeding well, express milk from your breasts until they feel softer and get help. See Breastfeeding Help and Support in Grey Bruce.

After your engorgement is completely gone (at about 10 – 14 days) your breasts will feel softer and less full. This is because the swelling has gone away. It does not mean you are losing your milk.

Adapted with permission from the Best Start Resource Centre.