NUTRITION

Eating a balanced diet is important to meet the nutrient requirements needed for postpartum healing and breast milk production. You will need about 350 to 400 extra calories per day for milk production.
To get those extra calories include 2 to 3 extra servings from Canada’s Food Guide, such as 2 additional servings of vegetables and fruit and 1 additional serving of grain products.
Breastfeeding mothers often feel hungrier during the first several months while producing breast milk for their babies. Try not to ignore your feelings of hunger. Instead, have quick and nutritious snacks on hand, such as pre-cut fruit and vegetables, yogurt, cheese, or crackers.
Eat while breastfeeding or keep snacks near your favourite breastfeeding area.

Points to Remember:

Women following a vegetarian diet need a daily source of vitamin B12, which can be found in vitamin B12 fortified foods or a vitamin B12 supplement. Talk to your health care provider about meeting this requirement.
You may also find you are thirsty during the first few days after delivery, as your body begins to re-establish your fluid requirements. Most mothers also notice they are thirstier when breastfeeding. Drink plenty of liquids, such as water, juice, milk, and soup to satisfy your thirst. Liquids can be in any form, but try to limit your intake of caffeine. Drink water while breastfeeding or keep a water bottle near your favourite breastfeeding area.

For a PDF of the Canada’s Food Guide click here:CANADA’S FOOD GUIDE

CAFFEINE AND BREASTFEEDING

Caffeine is found in a variety of sources, including coffee, iced and hot teas and cola, foods made from cocoa, as well as some medications for colds and/or headaches.It is important to check labels.

Caffeine does pass into breastmilk, but mothers can safely have small amounts of caffeine without it being harmful to the baby. Too much caffeine may cause a baby to be wakeful, unusually fussy, and have trouble sleeping.

Women who are breastfeeding may have caffeine in moderation which is defined as 300 mg of caffeine per day or the equivalent to 1-2 cups of coffee. If a baby becomes jittery, wakeful or irritable, the mother could try reducing or eliminating caffeine from her diet.CLICK HERE FOR INFORMATION ON FISH INTAKE AND BREASTFEEDING

TANDEM FEEDING & SIBLINGS

SIBLINGS

If this is not your first baby, you may wonder about the best way to explain breastfeeding to your older children.As well, you may wonder how you will occupy them while you are breastfeeding your baby.Many mothers find explaining what they are doing in plain language and inviting their older child to sit with them during breastfeeds helps their older child understand and be part of the breastfeeding experience. Since mothers are often sitting and relaxing during breastfeeds, older siblings may enjoy the opportunity to read, draw, or just visit with their mother at that time. Because mothers can breastfeed anywhere, anytime, they often find that breastfeeding is easy to do while also caring for their older children.

TANDEM FEEDING

Tandem feeding refers to breastfeeding two children at the same time.Some mothers may still be breastfeeding a child when they are pregnant and at the time of delivery.Many mothers want to continue to breastfeed their older child once their new baby is born.

Things to consider if you are tandem feeding:

If you decide to tandem feed, it is important to remember to feed your newborn first and prioritize the newborn’s feeds. The reason for this is that the older sibling can eat and drink additional foods and you will want to ensure your newborn is getting all the breast milk he needs.
The milk will have colostrum like properties even if you have been breastfeeding throughout your pregnancy. This milk, which the breast produces over the first days after delivery, is important for your newborns health (refer to the “The Breast Makes Milk” section on the “How to Breastfeed” page for more information on colostrum).
You will want to let your health care provider know you are tandem feeding. Monitoring your baby’s wet and dirty diapers and growth will assist you in ensuring he is getting enough. Refer to the section on “How to Know Your Baby is Getting Enough” on the “The Early Days” page. As well, mothers who tandem feed will want to make sure they are taking care of themselves-getting adequate rest, food and drinks.

FRIENDS

It can be very helpful to spend time with other mothers who are breastfeeding. You may have friends who can provide support or you may not know other breastfeeding mothers. Peer support groups can provide an opportunity to meet other breastfeeding mothers. Mothers can get together and discuss topics of interest to them. Learning from one another and sharing experiences can help new mothers meet their breastfeeding goals. There may be breastfeeding support groups in your area. One example of breastfeeding peer support groups are those run by La Leche League. This organization has been providing peer breastfeeding support to women for many years. For more information, visit: www.lllc.ca.

Go to www.ontariobreastfeeds.ca to search for breastfeeding peer support groups in your community.Watch the video below about mothers’ experiences with La Leche League:

Things Mom Can Do:

Tell your family and friends that you plan to breastfeed and ask then to support you.
Look for support and resources in your community. Many communities and health units offer free breastfeeding support. Support can include one-on-one breastfeeding help, breastfeeding groups and breastfeeding home visits. For more information contact your local health unit.

SEX AFTER BIRTH

The postpartum period is a time of adjustment and change. It is important for new parents to maintain good communication about sex after birth.
Sex after birth should begin again only when both partners feel comfortable and ready. It is a very personal decision and will be different for each couple. A couple may also experience decreased sexual desire after birth due to the demands of a new baby.
Most couples wait for 4 to 6 weeks to have sex or until they speak with their health care provider at the 6-week postpartum check-up. The timing depends on the type of delivery you had and if you had any complications.
For both breastfeeding and formula feeding mothers, the return of a period indicates the need for contraceptive methods if protection is desired.
Sometimes breastfeeding can be used as a form of birth control.

CLICK HERE FOR MORE INFORMATION ON BREASTFEEDING AND BIRTH CONTROLPoints to Remember:

A woman may experience tenderness following a vaginal delivery for several months postpartum, due to an episiotomy or any tearing or stitches that occurred during the delivery.
Postpartum women produce low levels of estrogen until they become fertile. Among breastfeeding women, this can be for the entire time they are breastfeeding. Low estrogen levels may cause vaginal dryness, tightness, and tenderness.
Birth control methods will vary depending on the woman’s circumstance and whether or not she is breastfeeding.
Connect with your partner and maintain good communication. Plan a date night and discuss your desires.

Points to discuss with your health care provider:

Some of the oral birth control methods should not be used while breastfeeding as they can reduce a mother’s milk supply.
Speak to your health care provider about birth control options and breastfeeding if you plan on becoming sexually active.

ALCOHOL

Alcohol passes through breast milk. It is recommended to avoid alcohol when you are breastfeeding.
Drinking alcohol while breastfeeding can affect your baby’s growth and development and may decrease your breast milk supply.
Babies need more time than adults to remove alcohol from their systems.
Breastfeeding mothers who choose to drink alcohol need to have a plan in place. You can express and store your breast milk before consuming alcohol. Wait until there is no alcohol in your breast milk before breastfeeding again.
The time to clear alcohol from breast milk will vary with the amount of alcohol consumed and the weight of the mother.
Drinking water, resting or “pumping and dumping” breast milk will not speed up the removal of alcohol from your breast milk.
You can contact Motherisk for more information on breastfeeding and alcohol use 1-877-439-2744 or (416) 813-6780.

For more information on Breastfeeding and Alcohol click here:BREASTFEEDING AND ALCOHOL

SLEEP

All parents of young babies will experience sleep difficulties at some point. Breastfeeding mothers will notice that their sleep depends on their babies’ sleep-wake and feeding patterns. A lack of sleep can impact parents’ physical and emotional well-being.

Sleep is essential for a baby’s growth and development. Babies tend to sleep more around periods of growth. Babies grow rapidly in the first year of life. Babies awaken frequently in the night because their bellies are small and they need to feed often. Feeding through the night will maintain a woman’s breast milk supply. Nighttime waking is easily fulfilled by breastfeeding, as nighttime feedings do not require preparation or warming of bottles.

It is important that parents understand that babies will wake during the night for various reasons. For example, they may be experiencing a growth spurt, they may be ill, or they may need to feed. Understanding a baby’s sleep patterns will help parents feel less frustrated and disappointed when a baby does wake during the night.

Points to Remember:

It is important for parents to get as much sleep as possible. You may need to ask for assistance with household chores from family, friends, or neighbours.

For information on babies sleeping well and safe click here:SLEEP WELL

TAKING TIME FOR YOURSELF

Being a breastfeeding mother can be very busy. It is a 24 hours a day, 7 days a week job and there are no scheduled breaks, weekends off, or holidays. Although it is a wonderful job, it is hard, and it is important to take care of yourself as well as your baby.

Here are some tips:

Take a few minutes for yourself every day and do something you enjoy. Read or take a warm bath to relax.
Find opportunities for company and conversation with adults. Spend time with friends and family. Try not to become isolated.
Consider joining a new mothers or breastfeeding support group. Get to know other women who are going through similar experiences.
Be realistic with expectations. You cannot do everything at once.
Give yourself credit for breastfeeding. It is important work for your baby.
Accept help from family and friends.
It is alright to complain and let others know when you are having a hard day. Your feelings matter.
Enjoy the time you are spending nourishing and getting to know your baby while breastfeeding.

EXERCISE

Exercise is an essential part of a healthy lifestyle. Light to moderate physical activity is safe and beneficial for breastfeeding mothers and their babies. Exercise should not influence the amount, taste, or composition of breast milk.

If you had a vaginal delivery without any complications, and if you were exercising before, it is probably safe to start exercising again after 6 weeks. Speak to your health care provider before starting any new exercise routines. If you had an episiotomy or a caesarean section, you will have to wait until you have completely healed.

Before starting any postpartum exercise, check with your health care provider.

During the first few weeks after your delivery, it is important to get enough rest and build up your milk supply. When you exercise, be sure to start the activity slowly and for short periods of time, and gradually increase the intensity and duration. If you become too tired, or start to feel overwhelmed, cut back or stop exercising. You can always start again later.

If you start to have bloody vaginal discharge and/or pain or discharge from your caesarean incision, stop exercising immediately and contact your health care provider.

The benefits of exercise for breastfeeding mothers include:

Improves overall health and energy level.
Stimulates the release of feel-good hormones that can help boost your mood and relieve stress.
Raises your body’s levels of prolactin, the hormone responsible for milk production.
Helps with a better night’s sleep.
Helps you to lose your pregnancy weight.

Points to Remember:

Check with your health care provider before beginning an exercise program.
Start exercising for short periods of time, a few days a week, and gradually increase your activity level.
Stop exercising if you feel pain or experience heart palpitations, dizziness, shortness of breath, or vaginal bleeding.
Drink water to avoid dehydration before, during, and after your workout.

FEELING DOWN

It is normal for mothers to have emotional ups and downs after having a baby. Coping with the demands of a newborn and healing from the delivery can be overwhelming. Some mothers will experience “postpartum blues.” It usually begins on the third or fourth day after delivery.

Symptoms may include feelings of:

Sadness
Hopelessness
Exhaustion
Guilt and anger
Frustrations
Worry
Panic or anxiousness

Some women may also experience difficulty:

Sleeping
Relaxing
Remembering things
Concentrating
Eating

For most mothers, these symptoms will typically disappear on their own in about 1 to 2 weeks. However, some women may experience these symptoms for more than 2 weeks and they may not disappear on their own. In these situations mothers may be experiencing “postpartum mood disorder.”

It is important to know that you cannot control or stop a postpartum mood disorder from occurring. It is not a weakness and there is help available.

Treatment options include:

Medication
Counselling
Support from other mothers with similar experiences.

Points to Remember:

While some of these symptoms are normal after the birth of a baby, if they continue for more than 2 weeks talk to your health care provider.
Contact your local public health unit to find out about support groups available in your community.

INFORMATION ON PERINATAL MOOD AND ANXIETY DISORDERS

BREASTFEEDING AND ILLNESSES

Even when you are sick you can usually continue to breastfeed your baby. If you have an infection, your body makes antibodies to help fight the illness. Your baby will receive the antibodies through your breast milk. The antibodies will give your baby some protection against the illness.
When you have the first signs of illness, you have likely already exposed your baby to the illness. Very few illnesses will require you to stop breastfeeding.
Women with mastitis or breast abscesses are encouraged to continue breastfeeding.
You do not need to stop breastfeeding if you become pregnant while breastfeeding.
Rarely do you need to stop breastfeeding if you or your baby become ill. Speak with your health care provider about infant health conditions where breastfeeding is not recommended.
A baby’s immune system is still developing. Babies rely on breast milk to receive antibodies that help them fight infection.

Points to Remember:

When sick, you are encouraged to speak with your health care provider about any precautions you should take or if breastfeeding is not recommended during the illness.
Speak with your health care provider to determine if your immunizations are up to date prior to receiving any routine immunizations.
Wash your hands with soap and water before you breastfeed your baby and after you change your baby’s diaper.
If you are unable to breastfeed during your illness, hand expression or pumping can help maintain your milk supply. By maintaining your milk supply you may be able to resume breastfeeding once you recover. A lactation professional in your area can help you with your specific situation.
If you have HIV, there is a risk of the HIV virus being passed on to your baby through breastfeeding. If you are HIV positive talk to a trained health care provider about reducing the risk of infecting your child. If you are HIV positive, Health Canada recommends feeding your baby formula instead of breastfeeding in order to prevent the transmission of HIV through breastfeeding.
Encourage friends and family to not visit the baby if they are sick.

RETURNING TO WORK OR SCHOOL OR STAYING HOME WITH YOUR BABY

Mothers who are breastfeeding may stay at home to care for their child or may return to work or school. In each case there may be situations where a mother is away from her breastfed baby for extended periods of time. In each case it is important for mothers to know:

Mothers have the right to breastfeed in public, at work or school and this is protected by legislation. When staying home, many mothers will want to get out and socialize in the community. Mothers are welcome to breastfeed in public places, restaurants, schools and workplaces.
When separated from their babies for longer periods of time due to work, school, or additional commitments, mothers are able to express and store their breastmilk. This enables mothers and their babies to continue their breastfeeding experience and ensures the baby is able to receive breast milk.
Many mothers who return to school or work while breastfeeding find they are able to maintain their breastfeeding relationship with their baby. Additional benefits of continuing to breastfeed are that the baby will receive the immune protection from breast milk and as a result be less likely to get sick. This means less sick days from work or school. As well, breast milk is easy to prepare and feed to the baby in your absence.

Points to Remember:

Know your breastfeeding rights in relation to work as outlined by the Ontario Human Rights Commission.
Choose a childcare provider close to your work or school. This will give you the opportunity to visit your child during the day and to breastfeed if you choose to.
Ask your childcare provider to feed your expressed breast milk while you are away. Expressed breast milk can be given from a bottle, cup, or spoon.
Meet with your employer/teacher before returning to work or school to develop a plan to support your breastfeeding goals. The plan should include appropriate space and time to feed your child or express breast milk.
You may need to pump or hand express and store milk while away from your child.
Hand expressing/pumping can be done to provide breast milk for feedings, increase your comfort, and maintain your milk supply. The frequency of hand expressing/pumping will depend on your feeding goals.

BREAST MILK STORAGE

Storage times for healthy babies who are at home If you have expressed some breastmilk and want to keep it for your baby, store breast milk using the following guidelines:

At room temperature – 3 to 4 hours
Cooler with a freezer pack – 24 hours
Fresh milk in refrigerator – 3 to 5 days
Thawed milk in refrigerator – 1 day
Freezer that is inside a refrigerator – 2 weeks
Refrigerator freezer (separate door) – 3 to 6 months
Deep freezer – 6 to 12 months. (BHFN, p.30)

Click here for information on expressing and storing breast milk:EXPRESSING AND STORING BREAST MILK

THINGS TO CONSIDER

BREASTFEEDING ACCESSORIES AND PRODUCTS

It is easy to be overwhelmed by all the breastfeeding accessories and products available. There are certainly products that may make your life easier, but they are not necessary for a successful breastfeeding experience. If it is within your budget, feel free to pick up a few items that may help your breastfeeding experience.

What Supplies Do I Need?

Breastfeeding Books: Helpful but not necessary. Try attending a local breastfeeding group or visiting a lactation professional. Ask friends and family what helped them to be successful at breastfeeding.
Nursing Bra: Convenient for most women. You might need to try several bras until you find one that suits your needs. Choose a bra without underwire.
Nursing Clothing: Convenient, but not necessary. Most women will wear regular non-nursing clothing. For example, a loose fitting shirt that is easily pulled up.
Nursing Pads: Convenient for moms that leak. Use nursing pads made of breathable materials, avoid nursing pads made of plastic. Be sure to change the nursing pad regularly, especially when it gets wet.
Nursing Pillow: Helpful for some, but not necessary. Some women do not use any pillows. Others will use a bed or throw pillow.
Nursing Stool: Helpful, but not necessary. Most women do not use a stool when they are breastfeeding at home or in public.
Nipple Ointment/Cream: Helpful for some, but not necessary. Some women will use nothing and others will use expressed breast milk. Ensure your latch and position is comfortable, this will help prevent sore nipples. If you have sore nipples, contact your local public health unit or breastfeeding group for assistance.
Nursing Cover: Helpful for some, but not necessary. Some women will use a blanket or scarf. Others find they can breastfeed in public without a cover and still breastfeed very discreetly.
Breast Pump: Helpful in some scenarios. A breast pump might be an option if mom and baby are separated, the baby is unable to breastfeed, or mom is returning to work or school. You can use hand expression in place of a pump.

PRESCRIPTION, OVER THE COUNTER MEDICATIONS, AND HERBS

MEDICATION

It is important to check with your health care provider and/or Motherisk before taking any medicine while breastfeeding, as different people break down medication differently. This includes prescription drugs, over-the-counter drugs, herbal remedies and traditional medicines.
If you are taking medication or herbal remedies, watch for any changes in your baby’s feeding or sleeping patterns, fussiness, rash, constipation, or diarrhea. These changes should be discussed with a health care provider.
You can contact Motherisk for more information about breastfeeding and medication use 1-877-439-2744 or (416) 813-6780.

TEETHING, SOLIDS, AND WEANING

TEETHING

Teething and teeth do not have to impact breastfeeding. When teething, some babies will have sore mouths and they may find breastfeeding soothing. Many mothers worry that once their babies have teeth, he will bite or chew on the nipple. Do not assume this will be a problem. Teeth do not usually impact breastfeeding because of the way the baby suckles at the breast. When your baby gets teeth and if he bites down while breastfeeding, your natural response of being startled and removing him from the breast will tell the baby that it is not a good idea to bite. Babies usually learn quickly not to use their teeth at the breast. Speak to a lactation professional in your area for suggestions if this is an issue you are dealing with.

SOLIDS

Most babies need only breast milk and vitamin D for the first 6 months. Solids are usually introduced when the baby is around 6 months old, while breastfeeding continues for up to 2 years or beyond. Breast milk will still remain an important part of your baby’s diet, as it provides immune protection and nutrients to your growing baby.

Click here for more information on feeding your baby solids:FEEDING YOUR BABY SOLIDS

WEANING

Weaning is the process whereby the baby moves away from complete dependence on his mother’s milk. It may begin with the introduction of solid foods and it ends when the last breastfeed is done.

Weaning is a personal decision. The ideal time to wean is when both the mother and baby are ready. A mother may feel mixed emotions when she starts to wean her baby. She may enjoy her “freedom” from not breastfeeding, but she may also mourn the change in the intimate time she spends with her baby.

Weaning may be baby or mother-initiated and it can be gradual or abrupt. Gradual weaning is done over a period of time with minimal complications. It allows the mother’s milk supply to decrease slowly and reduces the chances of plugged ducts and mastitis. Abrupt weaning is done immediately and does not allow the milk supply to decrease slowly. It has an increased risk of complications such as severe pain, mastitis, and breast abscess. It can also be more traumatic for the mother and baby. It is easiest on the mother and baby when weaning occurs gradually, dropping one feed at a time over a number of days, weeks or months.

If you have questions or concerns about weaning, speak to your primary health care provider for more information.

SMOKING & DRUGS

SMOKING CIGARETTES

Mothers who smoke are encouraged to quit. However, breast milk remains the recommended food for a baby even if the mother smokes.
Tobacco products are transferred into breast milk and may decrease the milk supply.
It is recommended to use nicotine replacement therapy in place of cigarette smoking because it is a safer option. Speak with your health care provider about which type of nicotine replacement therapy would work for you.

Points to Remember:

It is recommended that everyone smoke outside the home to prevent exposure of second-hand smoke to the baby. Second-hand smoke has been shown to be a strong risk factor for Sudden Infant Death Syndrome (SIDS).
Remember to wash your hands thoroughly before picking up or cuddling the baby.
Decrease the number of cigarettes smoked or try to quit smoking while you are breastfeeding.
Delay smoking until AFTER breastfeeding and while the baby sleeps for long periods.
Allow as much time as possible between smoking and breastfeeding.
You can contact Motherisk for more information about breastfeeding and smoking: 1-877-439-2744 or (416) 813-6780

Make your home and car smoke-free. This will limit the amount of times the baby is exposed to second-hand smoke.

RECREATIONAL DRUGS

Side effects of recreational drug use on breastfed babies range from mildly toxic to extremely hazardous. There is no safe level of exposure to these drugs.
Recreational drugs can transfer to the baby through breast milk and have serious negative effects. If exposed, breastfed babies should be closely watched and a health care provider should be contacted.
The following side effects are seen in babies exposed to recreational drugs: irritability, tremors, seizures, vomiting, diarrhea, excessive drowsiness, sedation, poor feeding, respiratory distress, increased heart rate, and poor sleeping patterns.

You can contact Motherisk for more information about breastfeeding and recreational drug use at
1-877-439-2744 or 416-813-6780MOTHERISK WEB SITE

ANYWHERE / ANYTIME – BREASTFEEDING IN PUBLIC

Breastfeeding in public may be uncomfortable for some parents. Most people think it is okay for a woman to breastfeed in public.
Women have a right to breastfeed their babies in public – anytime, anywhere.
Many women can breastfeed in public and go unnoticed. Some women wear nursing covers or use a blanket while nursing but this is an individual decision and not necessary.
If you decide to breastfeed in public, each time will become easier and you will feel more confident.
If you don’t feel comfortable breastfeeding in public, most public places have a private room for breastfeeding mothers.
Many mothers find it helpful to find a relaxing place to breastfeed and begin breastfeeding when the baby shows signs of hunger. Breastfeeding in public when the baby is relaxed may make it easier. Waiting until the baby begins to cry may cause a woman stress.

Points to Remember:

You have the right to breastfeed your baby in a public places including malls, restaurants, stores, schools, and parks.
People should not ask you to “cover up” or ask you to move to another place that is more “discreet.”

If you are asked to stop breastfeeding:

Do what you need to do so that you and your baby remain comfortable. Remember you are not doing anything wrong.
Ask to speak to the manager/owner. Try to find out what the main concern is and discuss that breastfeeding is permitted under the Ontario Human Rights Code. You can also leave the establishment and follow-up about your rights later.

For more information about the rights of breastfeeding women visit these websites:

NUTRITION

CAFFEINE AND BREASTFEEDING

TANDEM FEEDING & SIBLINGS