MODULE 4

Advice to relieve sore nipples

ADVICE TO RELIEVE SORE NIPPLES
	The baby is positioned correctly if: the head and body are level with the breasts. the chest is facing your chest. the mouth is facing your breast.
	Your baby is latched properly if: the mouth is wide opened. the lips are turned outward. the chin is pressing against your breast.
	If you want to remove the breast from the baby, slide your little finger in the baby's mouth between the gums to stop the sucking.
	After feeding, extract a little milk and spread it on the nipples and the aerola. Let your breasts dry before putting on your bra.
	Certain creams and ointments can help. For additional information, contact a breastfeeding specialist.
	Wait until your baby is comfortable with breastfeeding before giving a bottle or soother. This will occur between four and six weeks.

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TIPS TO HELP THE BABY TAKE THE BREAST CORRECTLY
	Hold the breast in your hand with your thumb on top and your fingers below the breast. Fingers and thumb stay well back from the aerola.
	Hold the baby's head with your hand so that it will be slightly inclined towards the back. Stroke the baby's upper lips with your nipple. Wait until the baby's mouth is wide open like a yawn.
	Pull the baby towards your breast with head tilted back and chin forward. The chin and the lower jaw must touch first. The baby's mouth should cover a larger part of the aerola on the lower part of the breast than on the top.
	Your baby is latched on properly if the baby's mouth is opened wide, the lips are curled out and the chin is pressed against your breast and you have no nipple plain.
	If your baby falls asleep after a few minutes, squeeze your breast to increase your milk flow. Continue squeezing while baby is actively feeding. Do not squeeze so hard that it hurts. Release the pressure on your breast when the baby stops suckling. Then repeat the process.

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THAWING BREAST MILK
	Check the date on the container. Use the milk that has been stored for the longest time.
	That the milk by placing it in the refrigerator for four hours.
	You can also place the container under running cold water. Once the milk has begun thawing, you can run hot water to finish the process.
	Never thaw the milk at room temperature.
	Heat the milk by placing it in a bowl of hot water but not boiling.
	NEVER HEAT THE MILK ON THE STOVE OR IN A MICROWAVE OVEN.

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Store containers of 60 to 120 ml (2 to 4 ouces) so as not to waste any milk.

Cool the freshly expressed milk before adding it to the milk already cooled or frozen.

Always add a smaller quantity of cooled milk to the frozen milk.

Fill the container to approximately 2.5 cm (1 inch) from the top when freezing.

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CONTAINERS USED TO STORE BREAST MILK
	Use glass or plastic containers with tight fitting covers. Indicate the date of expression on the container.
	Bags designed especially for breast milk may also be used. Indicate the date of expression on the bag. Do not use bags made for bottles. These bags are made of thin plastic and are easily damaged if manipulated.
	For healthy babies, wash the containers with hot soapy water, rinse well with hot water, and air dry.

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BREAST PUMPS
Electric breast pump
	The electric breast pump is the one to use if you cannot be with your baby immediately after birth or if you plan on using the pump over a long period. You can express from both breasts at the same time saving time. The electric breast pump is often rented because it is very expensive. Call your local Public Health Office for more information. Certain insurance plans cover the cost of renting an electric breast pump.
Battery operated breast pump
	The battery operated breast pump is a good choice if you plan on expressing occasionally or for a short time. It may be used with one hand. It is easy to carry. The batteries must be replaced often. (It is better to buy a pump that can also be plugged in).
Manual breast pump
	This is a good choice if you plan to express milk occasionally or over a short time. Certain pumps may be used with one hand and others require both hands. (depending on the type of pump) It is easy to carry. It can be tiring for the hands and wrists. It should not be used by mothers who have problems with their hands, wrists, or arms. It is less expensive.
Breast pump with rubber bulb
	Avoid using this type of pump. The suction is too strong and can cause bruising to the nipple.

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MANUAL EXPRESSION OF MILK
1. Wash your hands with water and soap.
2. To help the milk flow, massage your breasts between 5 and 10 minutes with a warm damp towel.
3.If your baby is healthy, use a glass or plastic container to store the milk. The container must have been washed with soapy hot water, rinsed thoroughly, and air dried.
4. Place your thumb and two fingers 2.5 cm (1 inch) or 4 cm (1 1/2 inch) from the nipple.
5. Push your thumb and two fingers toward your chest.
6. Turn your thumb and two fingers simultaneously.
7. Repeat steps 4,5 and 6 until the milk flow decreases; do the same thing with the other breast.

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