breastfeeding for dummies

(bell tones) (gentle piano music) - hello, my name isdoctor bonny whalen. i am the medical directorof the newborn nursery here at dartmouthhitchcock medical center. welcome to the birthing pavilion and congratulationson your pregnancy. and if you'vealready given birth, congratulations toyou and your new baby.

in this video wewould like to share some important informationabout the birthing pavilion and the kinds of thingsyou and your new baby will experience in his orher first few days of life. we'd also like to offeryou some tips and advice on caring for yournew little one. the birthing pavilion isa comfortable, private and calm place to give birth. it has it's own operating rooms

and the intensive carenursery is right next door should you need any specialcare right after delivery. the birthing pavilion isan especially safe place for you and your baby. (soft piano notes) the first few minutesand hours after birth is an importanttime for a mother and her new baby to bond. spending time togetherand skin to skin contact

for the first hour oflife is especially helpful in making the transitionsafter the birth's successful skin-to-skin contact means the baby's naked skincomes in direct contact with the mother's bare skin. the skin-to-skincontact helps stabilize the baby's blood sugarsand body temperature. it helps the baby'sheart rate and breathing become more stable and it'svery calming for the baby.

this quiet bondingtime is also helpful with the baby's first feeding. a mother's body benefits fromskin-to-skin contact too. it helps the mother'suterus contract which helps decrease bleeding and it also helps stimulatea mother's milk hormones if she is breast feeding. - does he look likeyour other son? - we encourage you to holdyour baby skin-to-skin

as much as possiblein the first few hours and days of life. baby's who are heldagainst their mother's or father bare skin areoften happier and healthier. there may be timeswhen your baby might not be able tobe placed skin-to-skin right after birth, dueto a medical problem. if this is the case, we willdo our best to let you know ahead of time and explain why.

after the first hour of life, we will apply an antibioticointment called azithromycin to your baby's eyes. this helps preventeye infections that can be caused bybacteria in the birth canal. this ointment should not causeany problems for your baby. we will also give yourbaby a shot of vitamin k soon after birth. this is a special vitaminthat is made by the liver.

vitamin k helps blood to clotand helps prevent bleeding. baby's are born withlow levels of vitamin k and it takes a fewweeks for their liver to start making enough vitamink to help stop bleeding. without the vitamin k shot, babies can develop seriousbleeding in their skin, intestines and brain. the shot will cause somebrief discomfort at first but should not cause anyother problems for your baby.

(bouncy positive music) after birth yournewborn is given a foot band and an armband. these are stamped withyour baby's name, date and time of birth. mothers and theirsignificant others receive a matching band. our healthcare staffwith check the bands to identify both thebaby and the parents

before any test orprocedure is performed and anytime your babyis returned to you after spending timeoutside of your room. an infant security tag will beattached to your baby's ankle as a special security measure. if this tag gets close to one of the birthingpavilion's exits, it will set off analarm and lock the door. to keep from setting thisalarm off accidentally,

please try to stayclear of the exits when you wheel yourbaby through the hallway in his bassinet. the alarm will also triggerif the tag gets wet, if it falls off or ifsomeone damages it. babies often loseweight after birth so tell your nurse ifthe tag becomes so loose that it might fall off. for safety and security reasons,

when babies areoutside of the room, they must be pushedin their bassinet. staff members willquestions anyone carrying a baby in their arms. even another staff member. this is one of the best ways we can make sure yourbaby remains safe. a day or two after the birth, we will perform severalimportant procedures

and tests for your newborn. sometimes these are donein the newborn nursery and sometimes they areperformed in your room. if your baby needsto go to the nursery, you are welcome to come along and help soothe him or herwith your voice and your touch. to help keep your baby healthy and to identify certainmedical conditions before they become problems,

we will perform aspecial blood test called the newbornmetabolic screen. this is sometimescalled the pku test. we will take a few drops ofblood from your baby's foot to perform this test. this test can tell us ifthe newborn has problems in producing certaintypes of hormones such as in hypothyroidism. it can also detect if ababy will have problems

breaking down food orin using his nutrition such as with conditionscalled pku and galactosemia. without screening, these problems may not show up until a baby becomes very sick or has delays inhis development. if the screening test showsthat there may be a problem, your doctor willdo extra testing. if this follow up testing shows

that there is truly a problem, a special medicine ordiet can be prescribed to help keep your babyfrom getting sick. you will receive results onyour baby's newborn screen at the two weekwell child visit. if there is a problemon the newborn screen, you should hear from yourbaby's doctor before this visit. your baby will also betested for jaundice, a common newborn conditionwhich makes a baby's skin

turn yellow. jaundice develops when a yellowchemical called bilirubin builds up in the body. bilirubin is formedwhen a baby's redblood cells break down which is a normalprocess after birth. babies get rid ofbilirubin through the liver and then throughtheir stool or poop. since a newborn's liver isnot very mature at birth and because babiesdon't pass a lot of poop

in their first few days of life, extra bilirubin can buildup in the baby's blood. the bilirubin canthen get into the skin and cause it to look yellow. most babies geta little jaundice in the first few days of life and normally this doesnot cause problems. but some babiescan get so yellow that they need help gettingrid of their jaundice.

to find out if jaundiceis going to be a problem for your baby, we will performa bilirubin blood test. this will be done at the sametime as the newborn screen to help limit an extrapoke for your baby. your baby may have a bilirubintest performed earlier if there are any concernsabout her looking too yellow for her age. while we perform these tests, we will give your baby a verysmall amount of sugar water

to suck on, thishelps lower pain. breast feeding your baby and holding herskin-to-skin a little, just before these tests,can also help to limit pain. most new babies hear wellat birth, but some do not. about one to threeof every 1000 babies will have a true hearing loss we screen your newbornfor hearing loss with a special machine.

the screening test is easy and is done while your babyis resting or sleeping. some babies may notpass on the first try. this can be due tonoise in the room or because the babyis moving around. if your baby does notpass on the first try, we will repeat the hearingscreen one more time before you go home. if he does not passon the second try,

we will contact theaudiology department and ask that theycall you at home to schedule an appointmentfor more testing. we also recommendthat your baby receive the hepatitis b vaccine beforegoing home from the hospital. the hepatitis b vaccine isan important first vaccine for a baby. it has been recommendedfor all newborns by the americanacademy of pediatrics

and the centers for diseasecontrol for almost 20 years. if a new baby is exposedto the hepatitis b virus, a serious infection ofthe liver can develop. the vaccine helpsto prevent this. this vaccination is recommended even if the mother'shepatitis b test result is negative duringher pregnancy, because testing isnot always accurate or sometimes themother can develop

the hepatitis b infectionafter her test is done. the hepatitis b vaccine isa safe an effective vaccine. the shot will causesome brief discomfort to your baby at first, but itshould not continue to hurt and it is unlikely tocause any other problems. some babies are born witha dangerous heart condition that can cause a low levelof oxygen in the blood. for this reason, we willperform a special oxygen test on your baby before you go home.

this test is painless and can be done rightin your own room. if this test shows that yourbaby has a low level of oxygen in the blood, we willperform extra oxygen testing to make sure that youbaby's heart is healthy. if the extra testingshows that your baby may have a heart condition, we will perform an ultrasoundof your baby's heart called an echocardiogram.

this will look at thestructure of your baby's heart to see if there is a problem. (pleasant bouncy music) - [nurse] just above it. - one of the bestthings a newborn can do to get the best start in life is to be a healthy eater. babies need to eat often because their stomachsare very small.

at first they can only eat about two to threeteaspoons at a time. sometimes theirstomachs are full of amniotic fluidright after birth. for this reason some babiesare not very hungry at first. as their stomachs grow and they get rid of this fluid, they are able to eat more. usually newborns eat aboutevery two to three hours or so

whether it is daytimeor night time. sometimes they need to eat only one to one and a halfhours after their last feeding. this pattern is calledcluster feeding. in the first few days of life, babies often arehungriest at night and do most of theircluster feeding then. this can be quitetiring for new parents so make sure you take everychance to nap during the day

when your baby is sleeping. limit visitors during the day for these first fewdays to make sure you and your baby get allthe sleep you need. babies will show youwhen they are hungry by licking their lips,sucking on their hands or opening their mouths wide when you touch theirlips or cheeks. your baby shouldshow you these cues

at least every few hours. if it has been about twoand a half to three hours since the last feeding, unwrap your babydown to the diaper and use skin-to-skin contactto help or her wake up and get interested in feeding. some parents worry thatallowing their baby to feed very frequently willspoil their baby. you cannot spoil your newborn.

try to feed your babywhenever he or she shows you hunger cues and beforehe or she start to cry. crying causes air toenter a babies stomach leaving less room for milk. crying also causes babiesto be gassier and fussier. you will find thatyour baby is happiest when you feed her just as sheis starting to get hungry. brest feeding is thehealthiest type of feeding for new babies andhas many benefits

for their new mothers as well. for newborns, breastfeedingis especially important in helping fight off infections because the mother's earlymilk called colostrum has a lot of infectionfighting properties. breastfeeding also helpsto lower a baby's chance of developing asthma, acondition of the lungs that causes problemswith breathing. eczema, an itchy skin condition.

type one and type two diabetes, childhood leukemia, obesity and sudden infantdeath syndrome. babies are born withnatural instincts to help them breastfeed. just placing a babyon a mother's chest whilst she is layingback a little bit will bring out the baby'snatural feeding insticts. babies can often findtheir way to the breast

and latch on withoutany help at all. sometimes babies can havedifficulties breastfeeding just as some babies can have difficultieswith bottle feeding. our nurses will help you learn how to breastfeed your baby. we also havelactation consultants or breastfeeding specialists who can help you if youare having any problems.

breastfeeding is thehealthiest choice for both moms and their babies. on rare occasions,some mothers and babies are not able todirectly breastfeed. if you will be bottlefeeding your baby breast milk or formula, wewill also help you learn how to do this safely. whether breast feedingor bottle feeding, it is important to feedyour baby when hungry

and until she or he is content. babies show contentmentby falling asleep after a good feeding or by pushing the nippleout of their mouth. babies often pause alittle during feeding to take a rest to decide ifthey are hungry for more milk. after you baby hastaken this rest, see if he or she isinterested in feeding more by squeezing your breastto give a little more milk

or by tickling your baby'slip with your nipple. if you baby doesn't seeminterested in feeding anymore, see if he or she needs to burp. most babies will beable to bring up a burp within a few minutes, while other babies maynot need to burp at all. an excellent way to judgehow well your baby is eating is by noting the number of wetand dirty diapers each day. your baby should haveat least one dirty

and one wet diaper inthe first day of life. then one more of eachfor each day older. so on the second day thereshould be at least two wet and two dirty diapers and on the third daythree of each and so on. this starts leveling offto about six to eight of each wet anddirty diaper per day when your baby'sabout one week old. it is a good idea tobuy lots of diapers now.

in the first few days, ababy's poops are very dark and tarry lookingand are very sticky. these poops are called meconium. a baby usually passesall of her meconium in the first two days of life. then the stools start to getless sticky and turn green. then brown, then yellow. when you see these changes, you can feel goodknowing that your baby

is feeding very well. the most excitingevents after a birth is finding out thebaby's birth weight. your baby will beweighed right after birth and then early each morningduring your hospital stay. most babies will lose about8% of their birth weight in the first few days of life. this is because they are born with extra fluid in their body

to help them stay hydrated and when they peethey lose this weight. the first few stoolscalled meconium also weigh a lot and this causes babiesto lose weight too. some babies will lose morethan 8% of the birth weight if their mothers had alot of fluid during labor or if their labor was very long. we will help watchyour baby's weight

and make sure he or she is losing the rightamount and not too much. by about day four, your newborn willstop losing weight and then will start gainingabout a half an ounce a day. babies are usually backto their birth weight by the time theyare two weeks old and some get there sooner. feeding your baby often athis or her early feeding cues

and at least every three hours helps keep your baby fromlosing too much weight. it also helps your babystart gaining weight and the right amountat the right time. remember to feed your babyat the first sign of hunger and until she or heis totally content. (soft playful piano notes) one of the biggesttransitions for a new baby is learning to be awayfrom his or her mother.

while living in your belly, you held your baby all the time so it'll be natural for yourbaby to want to be with you all the time after birth. a mother's touch makes the baby feelsafe and secure. we strongly recommendagainst falling asleep in bed with your baby. mothers are often verysleepy after labor

and from their pain medicine as well as from the baby'sfrequent night time feedings. falling asleep inbed with your baby increases the riskof suffocation and of falling out of the bed. our hospital beds are narrow so they are especiallyunsafe for bed sharing. if you are feedingyou baby in bed and you feel sleepy,

please let your nurseor support person know so that they can helpyou hold your baby. when you are finished feeding, place your babyinto the bassinet so that you both can havea restful safe sleep. after the birthit will be helpful to find ways to make yourbaby feel comfortable lying alone in the bassinet, whether awake or asleep.

while you're in the hospital, we will teach you how to helpyour baby feel comfortable sleeping alone in the bassinet. we'll also teach you howto make her sleep time the safest to help preventa condition called sids or sudden infant death syndrome. having your baby sleepon his or her back is one of the bestways to prevent sids. it is also reallyimportant to make sure

there are no loose blankets,pillows or stuffed animals in your baby's sleep space. you and your partner need to sleep wheneveryour baby sleeps. this is especiallyimportant during the daytime so you can be morerested at night for night time feedings. (cheerful piano music) (baby whimpers)

remember to limit visitorsduring the daytime so you can get your sleep. please ask visitors not tocome in between two and four in the afternoon sothat everyone canhave some quiet time and a nap. we have signs that youcan put up on your door when you are taking a nap so that no oneinterrupts your sleep. it's a good idea to ask visitors

to wash their hands beforethey hold your baby. baby's immune systems arenot well developed yet so they are at a high riskfor getting infections. as we mentioned earlier, breastfeeding helps babiesdevelop their immune system and can help fight off infection but they are still atrisk of getting sick. we also recommend that you donot allow anyone with a cough, cold, fever or othercontagious illness to visit you

or your baby in thefirst few months of life. (gentle piano notes) one other important thingto know about babies is that they can crya lot, this is normal. crying is a baby'sspecial way of saying she or he is hungry,uncomfortable, or stressed about something. sometimes babies seem tocry for no reason at all. one of the best waysto calm a fussy baby

is to put her skin-to-skinwith her mother or another care giver. another way to helpcalm a fussy baby is with swaddling. swaddling means wrappinga baby in a blanket. holding a baby close and gentleswaying, rocking or jiggling is also very calming. having a baby suckon your own hand, an adults finger or a pacifier

can help calm a crying baby too. we do recommend waiting onintroducing a pacifier however until you knowbreastfeeding is going well. and sometimes sucking on apacifier can cause problems with how a baby breastfeeds. it is also important to seeif you baby is hungry first, anytime it looks likeshe wants to suck. babies like a shushingsound because it sounds like the noises inside the womb.

you can make a sound like (shushes) in your baby's ear tohelp calm her down. if you have a very fussy baby especially one who'shard to calm down, it is important to havefriends or relatives close by who can help. if you are feeling overwhelmedwith your baby's crying, gentle place yourbaby in the bassinet

and ask a friend orfamily member to help while you take a break. if you are alone it is also okay to put your baby in the bassinet and walk away for a while togive yourself a little break. the bassinet is a safe place and it will be okay for yourbaby to be on his or her own for a little while. remember that it isnormal for babies to cry.

sometimes babies cryfor long periods of time and sometimes forno reason at all. it is important to knowthat you should never ever shake your baby tostop the crying. shaking can be very dangerous and can cause serious braindamage and other injuries. (soft cheerful music) some parents choose tohave their son circumcised for cultural, religiousor personal reasons.

if you would likeyour son circumcised you will be asked tosign a consent for and watch a video thattalks about circumcision and reviews it'srisks and benefits. your baby's pediatric provider will make sure your baby'spenis and foreskin look healthy and that he is healthy enough to have thecircumcision performed. if your pediatric provider doesnot think your baby is ready

to have a circumcisionperformed before you go home or a provider is not availableto perform the circumcision, we will help coordinate thisprocedure as an out-patient. because a circumcision isnot medically necessary, some insurance companies do not cover the costof the procedure. check your company's policy before having yourbaby circumcised to find out whether or notthey will help pay for it.

there are a few otheractivities that will happen in the birthday pavilionbefore you go home. our secretary willcome to your room to help you fill outa birth certificate. you will use your baby's name if you have made a decision. but a name is not requiredto complete the form. you will however need asocial security number for both parents as wellas your places of birth.

when it's almost timeto bring your baby home, we will help you set up yourfirst medical appointments with your baby'sprimary care provider. - [woman red top]that's perfect. - if you have not chosena primary care provider for your baby yet, we can help you pickone soon after birth. we will need to have aspecific provider's name to set up your baby'sfirst appointments

and to include on the newbornmetabolic screening card, so the results will goto the right provider. this is especially importantif there are any problems on this early screening. before you go home, a clinical resource coordinator will meet with youto help you identify your discharge needs aswell as to talk to you about any community resourcesthat may be of use to you.

she can help set up a homevisit with a visiting nurse if there are concernswith your baby's feeding, weight or jaundice. or if you need tohave a nurse visit you for any complicationsyou may have had, either with thepregnancy or delivery. the resource coordinatorcan also help you obtain a rental breast pump,if that is needed and a referral to a goodbeginnings volunteer

if one is availablein your area. by law and for safety's sake, your baby must ride in anapproved car seat at all times. a nurse will lookat your car seat to make sure it isan approved one. we will help showyou how to make sure your baby fits wellin his car seat. we will also help you learnhow to use it properly. the safest place in yourcar for your baby's car seat

is in the back middleseat facing to the rear for his first year of life. if your baby was bornbefore 37 weeks gestation we will also performa special safety test to make sure that hisbreathing and heart rate remain healthy whilein the car seat. your baby's nurse anddoctor will help teach you how to best care for your baby and discuss any medical problems

that your baby may have. as you prepare to go home, your nurse will also give yousome extra discharge teaching. much of thisinformation can be found in our going home withyour newborn booklet, that we developedespecially for new parents to help them learnhow to provide the very best carefor their new babies. it is helpful toread through this

during your stay herein the birthing pavilion when you have time. congratulations again onyour pregnancy or birth. if you have anyquestions of concerns regarding any of the information we have shared in this video, please be sure to speakwith your baby's nurse, the birthing pavilion'sresource coordinator or your baby'spediatric provider.

if at anytime you havequestions about your baby, please ask your nurseor your baby's doctor. we are happy to answer anyquestions that you might have. welcome to the birthingpavilion and newborn nursery.