The American Academy of Pediatrics recommends breastfeeding exclusively for the first six months. After the introduction of solid food, breastfeeding is recommended until the child is 12 months of age and may continue as long as both mother and baby desire. However, any time spent breastfeeding will benefit your baby.
Our goal is to assist all mothers and babies to feed in a comfortable and healthy way. We support women in meeting their goals for successful breastfeeding. We also assist women in choosing to formula feed by providing safe formula preparation and bottle feeding information.
Call the Warm Line at 1-800-711-7011
We provide new parents with a toll-free telephone support system. Staffed by experienced nurses/lactation consultants, offers helpful information regarding new babies, breastfeeding, and postpartum issues.
With the right information, support, and practice, breastfeeding is comfortable and satisfying for mothers and babies.
As a Designated Baby-Friendly® USA Hospital, Women & Infants Hospital supports the American Academy of Pediatrics' recommendation that babies should be fed breast milk for their first year of life and into their second year. This information will help you get started and answer many frequently asked questions about breastfeeding. If you have other questions about breastfeeding, please call the nurses on our Warm Line at 1-800-711-7011, Monday through Friday from 9 a.m. to 9 p.m. and Saturday and Sunday from 9 a.m. to 5 p.m. They can provide advice and information, and make referrals to our lactation consultants if needed.
The first milk, called colostrum, is very thick and sticky and may look like cloudy water or the color of butter. It has millions of living cells that protect against infection and is easy to digest for a baby learning to nurse. Your baby's stomach is about the size of his or her fist, so each feeding will only be about a teaspoon the first day and about a tablespoon the second day.
Your breasts will feel heavier and fuller by day three or four as your milk changes to mature milk. There will be more milk. This looks like skim milk and provides all the nutrients your baby needs for the first six months of life. This is all your newborn needs in the first days after birth.
Feed your baby on cue, at least eight to 12 times in each 24 hour period. Remember the phrase "8 or more in 24." Look for these signs that he or she is ready to nurse:
Crying is a late sign of hunger. A crying baby needs to be calmed before feeding. To calm your baby, do skin-to-skin. Let your baby suckle on your clean finger with your fingernail touching his or her tongue. Stroke your baby. Talk to him or her. Swaddle or rock the baby.
Preview the feeding cues for preterm and full-term infants.
Having a new baby can be as overwhelming for dads and partners as it can be for moms. They often wonder how they can help. Dad/partner can:
Help is available on all aspects of breastfeeding and its impact on daily life – from starting to stopping and all the variations in between. Baby Café drop-ins are run by a range of staff including health professionals such as board-certified lactation consultants (IBCLCs), midwives, and nurses, and other qualified and accredited breastfeeding counselors.
All pregnant or breastfeeding moms are welcome to drop in at any time during open hours. The Baby Café is open most Thursday mornings from 10 a.m. to 12 p.m. and is located at the Scalabrini Dukcevich Center, 300 Laurel Hill Ave., Providence, RI 02909.
The following playlist can help guide you through the many steps of breastfeeding. You can watch the complete playlist, or select a topic such as side lay holding, skin to skin, or clutch holding. If you have questions after previewing the videos, ask your nurse or call the Warm Line at 1-800-711-7011.
When your baby bobs his or her head on your chest and starts moving toward the nipple, ease him or her down to face the breast. Support his or her buttocks with your elbow while your forearm supports the back and the palm of your hand supports the shoulders. Make sure the web between your thumb and first finger is at the nape of the baby's neck; your thumb is on one side of the head and one or the rest of your fingers support the other side of the head. Notice that the baby's ear, shoulder, and hip are in a straight line and the legs are curled around your waist. Your arm should support the baby's weight and a pillow can support your arm. Your other hand supports the breast with your fingers far away from the areola (the darker part of the breast). This is called the "cross cradle hold." If it is hard to support the breast, try putting a rolled facecloth under the breast.
Some mothers prefer the "clutch" or "football hold," a nice position for babies who weigh more than eight pounds. Bring the baby's hip to your hip with your elbow supporting the other hip and your arm supporting his or her side. The palm of your hand supports the shoulders. The web between your thumb and first finger is at the nape of the baby's neck, thumb on one side of the head, and one or the rest of the fingers supporting the other side of his or her head. Your arm supports the baby's weight and a pillow can support your arm. Your other hand supports the breast with your fingers away from the areola (the darker part of the breast). If it is hard to support the breast, try putting a rolled facecloth under the breast.
Support the baby's head and tilt it back slightly. Brush the bottom lip with the tip of your nipple to make the baby open wide as a yawn. With the baby's chin lifted and leading the latch, nose in line with your nipple, bring the baby to your breast. The chin will touch first and be deep into the breast with the nose not quite touching. Notice that the baby's neck is straight, making it easy for the baby to swallow. A swallow sounds like an "ah" or a little puff of air. When the baby is latched well, you will hear a few swallows of colostrum. When your milk changes to mature milk (about day three or four), you will hear a swallow with about every four to five suckles. Keep the baby close to you, supporting the shoulders and back and bracing the buttocks against your side.
When your baby is latched well, it feels like a tug or a pull, but never painful. If there is any pinching or pain, be sure the baby's lips are rolled out and bring the baby closer to your body. If this does not help, re-latch. Most of the time if it hurts, it has something to do with positioning. Ask your nurse for help or once you go home, call the Warm Line at 1-800-711-7011 for help from a nurse or lactation consultant.
If the baby is not latched in five minutes, stop. You can hand express in the first 24 hours. If your baby is more than 24 hours old, pump. Keeping the baby skin-to-skin, you can feed him or her the expressed breast milk.
Let the baby nurse as long as he or she is actively sucking and swallowing. You can watch the jaw move all the way to the ear and hear soft puffs of air. When the swallowing slows, massage your breast to move more milk into the baby's mouth and bring the baby closer to you with the palm of your hand. When the swallowing stops, slide your little finger into the baby's mouth to release the suction and protect your nipple. Your nipple should have the same shape (gumdrop) as before the feeding. If it looks creased, like a used lipstick, be sure the baby opens wide and takes in more breast tissue at the next feeding. Breastfed babies take less air, so you only have to burp your baby for a few minutes. Offer the second breast if the baby is still awake and showing feeding cues.
Babies will take about one to three teaspoons of the first milk, colostrum, at any one feeding in the first days. Feedings last about 10 to 20 minutes. It is healthy for your baby to nurse every 90 minutes to three hours from the beginning of the last nursing. But, since breast milk is more easily digested, feed your baby on cue rather than by the clock or a schedule.
Wet diapers and stools are one of the ways you can tell if your baby is taking in enough breast milk. A Breastfeeding Log English/ Breast Feeding Log Spanish can help you keep track in the first busy days. Keep track of the color of the baby's stool, which will change in the first four days. This is another way to know your baby is taking in enough. Count any stool that looks like a tablespoon or more. Bring the log to the first pediatric visit or lactation consultation.
Weight gain is the best way to tell if your baby is getting enough. It is normal for babies to lose about 7 to 8 percent of their weight in the first five days and return to birth weight by 10 to 14 days. You will establish a milk supply for the baby in the first three weeks. The more the baby eats, the more your body produces. That is why we and the American Academy of Pediatrics advise you to exclusively breastfeed your baby, avoiding formula, bottles and pacifiers in the first three to four weeks if all is going well. Then your supply will meet your baby's needs as long as you choose to nurse.
When your milk changes to mature milk, your breasts may feel very full and firm. If the baby cannot latch and/or you have pain, you can:
You can also try a technique called "reverse pressure softening" to reduce swelling of the areola. This briefly moves the swelling backward into your breast and helps the nipple soften and go deeper into the baby's mouth during breastfeeding. This technique should never cause you pain.
To do reverse pressure softening, you should:
Do this right before every feeding. It may take two to four days before your breasts feel comfortable. Make pumping sessions short.
If your breasts are heavy and hard and your nipples are flattened out, you might be unable to express milk by hand.
If your baby is nursing enough to make the breasts soft, you do not need to pump. However, you may need to remove breast milk if:
We recommend that you wait three weeks before giving your baby a bottle if breastfeeding is going well. There are many ways to feed breastfeeding babies without using bottles and rubber nipples. If you have questions, ask your nurse or call the Warm Line at 1-800-711-7011.
If your baby is healthy, follow these instructions for pumping and storing your breast milk at home:
Use the Breastfeeding Log when you breastfeed and when your baby needs a diaper change during the first week. This will help you keep track of how well your baby is breastfeeding.
It is okay if your baby has more wet diapers or more bowel movements than the goal for the day. You can write in additional W or BMs. If your baby has fewer wet diapers or bowel movements than the goal for that day, call your breastfeeding helper or the baby's health care provider.
Expect a BM to be at least the size of a tablespoon. Diapers should be very obviously wet by day two or three.
Keep track of how many wet/dirty diapers your baby has in the breastfeeding log.
There are no strict rules about what you should and should not eat while breastfeeding. Eating foods you normally enjoy is the best approach. Eat as well as you can.
It is safe to lose one to two pounds per week while breastfeeding, but it is best to give your body six weeks to recover from birth before actively trying to lose weight. Talk to your health care provider before starting an exercise or weight-loss program.
The Warm Line is a free service you can call to ask questions about yourself or your baby. Leave your message, name, and phone number and an experienced nurse/lactation consultant will call you back within an hour. The Warm Line is open weekdays from 9 a.m. to 9 p.m. and weekends from 9 a.m. to 5 pm.
Lactation consultations are available while you are in the hospital when you are referred by your nurse or health care provider.
Call the Warm Line at 1-800-711-7011 for visits with a lactation consultant after you go home. Please check with your insurance provider to see if this service is covered.
These postpartum support groups are free and no registration is needed. Take advantage of helpful hints and support from other mothers. Call Health Education (401) 276-7800 for more information.
This unique store located in the hospital rents and sells breast pumps. The store also sells nursing bras, books, videos, nursing pillows, and baby carriers, as well as other products. The store is open Monday through Saturday from 10:00 am to 4:00 pm and Sunday from 10 am to 2 pm. For more information, call (401) 274-1122, ext. 43149 and 43151.
As more women become aware of breast milk's many unique qualities, more are choosing to breastfeed their babies. Although breastfeeding is the "natural" way to feed a baby, it is a skill that the new mother and baby learn in the first days and weeks after birth. To assist in this learning process, Breastfeeding Support Services offer families the expertise of lactation consultants in a variety of settings:
Our 2.5-hour class is offered frequently at our Providence and East Greenwich locations. This class covers the benefits of breastfeeding, proper positioning, and attachment, feeding frequency and duration, signs of adequate breast milk intake avoiding and managing common problems. To register, call (401) 276-7800 or register online.
Certified lactation consultants are available during your hospital stay to provide support for those families who are experiencing breastfeeding difficulties. Speak with your nurse to arrange a visit with a lactation consultant.
Families having difficulty with breastfeeding after they go home may return to Women & Infants to meet privately with a lactation consultant. Appointments are made through the Warm Line at 1-800-711-7011. There is a charge for the visit, however, some medical insurers will cover the cost of the visit.
In order to provide additional help once breastfeeding moms go home after delivery, Women & Infants offers a weekly Breastfeeding Support Group. The group meets on Wednesdays from 12 to 1:30 pm in the Malcolm and Elizabeth Chace Education Center, South Pavilion, Women & Infants Hospital, 101 Dudley Street, Providence. Please bring your baby's birth date, birth weight, and weight at discharge. Call the Warm Line 1-800-711-7011 for more information.
Staffed by nurses and lactation consultants, the Warm Line is here to answer questions and concerns you may have regarding you and your baby.
Warm Line hours of operations: Monday through Friday 9 a.m. to 9 p.m.; Saturday and Sunday 9 a.m. to 5 p.m.
Nursing Moms, Etc. offers both supplies and gifts to meet the needs of breastfeeding mothers and their infants. Located on the first floor of the hospital, Nursing Moms, Etc., has breast pumps for rental or purchase as well as a wide range of new mom and newborn supplies. To reach the store call (401) 453-7940 or (401) 274-1122, ext. 41749, or stop by before or during your hospital stay. Nursing Moms, etc. is open Monday through Saturday, 10 a.m. to 4 p.m., Tuesdays and Thursdays until 8 p.m., and Sundays 10 a.m. to 2 p.m.
Thinking of ordering a breast pump? Healthy Baby Essentials is working with Women & Infants Hospital to provide you with a new breast pump. Breast pumps are now usually covered with no copay or deductible, but please check with your insurance provider.
To order your pump, please fill out one of these forms.
Email a photo of the completed form to firstname.lastname@example.org or fax it to 1 (508) 404-1761. For further assistance, you can call Healthy Baby Essentials at 1 (888) 495-7491.
You may also submit your order online at Healthybabyessentials.com. To ensure you receive your breast pump before your baby arrives, please submit your completed order form to Healthy Baby Essentials about one month prior to your due date.
At Women & Infants Hospital, our goal is to help and support new mothers. If a new mother cannot or chooses not to breastfeed, we will make sure she feels confident about safe formula feeding before leaving the hospital. Helpful hints for bottle feeding:
Sterilize bottles and nipples before using them for the first time. Recommendations vary for how often you should sterilize them after the initial use. Check with your baby's health care provider for guidelines. If you use a dishwasher, sterilizing is not necessary. If you are washing bottles and nipples by hand, use hot soapy water and rinse well. Turn them upside down to dry. Before you begin to prepare the bottles, clean the work area and your hands.
Why? Cleaning and sterilizing kills harmful bacteria on equipment that may grow in the formula once it is prepared.
Water to be mixed with powdered infant formula must first be boiled for two to three minutes. Do not use water that has sat for longer than 30 minutes after boiling.
Why? A boiling temperature will kill harmful bacteria that may be present in powdered formula.
Formula comes in three forms: powder, concentrate, and ready-to-use. Carefully follow instructions on the formula can. For powder, use the scoop that comes in the formula can. Measure the amount of water exactly. For liquid concentrate, pour the needed amount in a clean bottle using ounce markers on the bottle. Measure the amount of water exactly.
Why? Using too much or not enough water can make your baby sick.
Once a bottle is prepared, quickly cool to feeding temperature and feed your baby immediately.
Why? The longer a prepared bottle is kept after it is prepared, the greater the chance that harmful bacteria will grow in it.
If you need to store prepared bottles for use later, put them in the refrigerator (41º F or less). To heat the refrigerated formula, put the bottle in a container of warm water. DO NOT MICROWAVE.
Why? Low temperatures (41ºF or less) will slow down or stop the growth of harmful bacteria.
Throw out the prepared formula that has not been consumed within two hours. Throw out refrigerated formula that has not been used within 24 hours.
Why? The longer formula is kept after it is prepared, the greater the chance that harmful bacteria will grow in it. Storing prepared bottles in the refrigerator means that you can store them for a little bit longer.
Like many things, learning to bottle feed is new to you and your baby. We recommend that you help your baby learn to feed by teaching him/her “paced bottle feeding.”
In paced bottle feeding, the parent controls the flow of milk. This allows your baby to drink at a comfortable rate and helps prevent overfeeding.
Discard any milk your baby does not finish.