Cerner Maternity
Breastfeeding Toolkit
BREASTFEEDING - the gift that keeps on giving.
Any amount of breastmilk you give your child is a gift.
Breastfeeding is a learned process for both you and your baby. This toolkit is designed to help guide you and provide helpful tips for getting started on your breastfeeding journey. We also invite you to engage in and take advantage of Cerner’s robust maternity programming and multiple resources to assist you and your partner during this exciting time.
Breastfeeding Resources • • • • •
Lactation consultants at delivery facility Pediatrician Cerner Maternity Navigator-IBCLC Remote visits/video visits Health plan coverage for lactation consultation
Contents Breastfeeding FAQ 5 6 7
Benefits for mom Benefits for baby Common FAQs
Common concerns 9 10 11 12
Latch Low milk supply Oversupply symptoms Managing oversupply
Pumping your breastmilk 14 15 16 18 19
Breast pump reimbursement Adding pumping into your breastfeeding schedule Storing your pumped breast milk Using your pumped breast milk Cleaning and sterilizing pump parts
Resources 21 22 23
Privacy rooms Checklist for traveling moms Additional resources
BREASTFEEDING FAQs Review some of the most common breastfeeding questions and discover the benefits of breastfeeding for both mom and baby.
Breastfeeding FAQ Benefits for mom Women who breastfeed longer have lower rates of type 2 diabetes, high blood pressure, and heart disease Women who breastfeed have lower rates of breast cancer and ovarian cancer Breastfeeding triggers the release of oxytocin that causes the uterus to contract and may decrease the amount of bleeding you have after giving birth Breastfeeding burns as many as 500 extra calories each day, which may make it easier to lose the weight you gained during pregnancy
https://www.acog.org/About-ACOG/ACOG-Departments/Toolkits-for-Health-Care-Providers/ Breastfeeding-Toolkit/Breastfeeding-Infographic
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Breastfeeding FAQ Benefits for baby Breast milk has the right amount of fat, sugar, water, protein, and minerals needed for a baby’s growth and development
Breast milk is easier to digest than formula, and breastfed babies have less gas, fewer feeding problems, and less constipation Breast milk contains antibodies that protect infants from certain illnesses, such as ear infections, diarrhea, respiratory illnesses, and allergies Breastfed infants have a lower risk of sudden infant death syndrome
If your baby is born preterm, breast milk can help reduce the risk of many of the short-term and long-term health problems
https://www.acog.org/About-ACOG/ACOG-Departments/Toolkits-for-Health-Care-Providers/Breastfeeding-Toolkit/Breastfeeding-Infographic
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Breastfeeding FAQ How long should I breastfeed for?
It is recommended that babies exclusively breastfeed for the first 6 months of life. Exclusive breastfeeding means to feed your baby only breast milk and no other foods or liquids unless advised by the baby’s doctor. Breastfeeding should continue as new foods are introduced through the baby’s first year. You can keep breastfeeding after the first year as long as you and your baby want to continue. (ACOG)
Does breastfeeding hurt?
Breastfeeding can be uncomfortable the first week, as your body is getting used to the friction from baby’s mouth. This is new to you! A correct latch decreases discomfort and you should feel a gentle tug, not a pinch or bite on your nipple.
How do I know if baby is getting enough?
If baby is gaining weight, has wet and bowel movement diapers daily, and is content after feedings - these are great signs baby is getting enough.
How will I know if my baby is hungry?
Baby’s are born with hunger cues. Signs of hunger include, opening and closing of the mouth, sucking on hands and fingers, rooting around. Late signs include frantically crying. The goal is to get baby to breast during the early or active phase of hunger, not the late stage. Baby’s will typically want to breastfeed every 2-3 hours and its encouraged to feed them on demand, not by looking at a clock.
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COMMON CONCERNS Learn about common concerns during breastfeeding and pumping and how to manage your breastmilk supply.
Common concerns
Latch
Components of a correct latch: • Wide open mouth • Touch points: Chin and nose touching your breast • As much of the areola in baby’s mouth as possible • Shoulders and hips in alignment
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Common concerns
Low milk supply
If baby is gaining weight with current supply, then you do not have low supply. A correct latch is imperative in stimulating and developing supply.
Make sure to drink plenty of water
Limit caffeine intake throughout the day
Make sure you eat enough calories based on the amount you nurse (average for a lactating mother is ~500 calories/day)
Other tips: • Nurse more often – removing milk from breast more often, triggers body to increase supply • Power Pump for 2 hours (10-minutes on, 10-minutes off) • “Nursing vacation” or “pump-in-weekend” – spend 2-3 days having baby with you at all times, nursing every 1-2 hours • Offer both breasts at every feeding/switch 2-3 times • Pump after nursing • Take care of mom – rest, calories, hydration, reduce stress • Add oatmeal to diet, brewer’s yeast, mother’s milk tea, fenugreek (make sure you are consulting with your doctor or lactation consultant prior to taking anything new) • Increase skin-to-skin time with baby 10
Common concerns • Breasts feel very full or hard most of the time • Baby struggles to maintain a deep latch during feedings and may come off the breast when letdowns happen • Milk sprays when your baby comes off the breast, especially at the beginning of a feeding • Baby may gain weight rapidly, from taking in large amounts of milk. Or, they may have slower-than-average weight gain because they struggle to nurse effectively
Oversupply symptoms
• Baby may arch away from the breast, sometimes fussing or crying • Feedings can seem like battles, with your baby never relaxing at the breast • Baby may fill up fast so feedings may be short • Baby may struggle with trapped air and need to burp or pass gas frequently
• Baby may clamp down on the nipple while feeding • Sore nipples • Baby may have green, watery or foamy, explosive stools • Frequent engorgement and plugged ducts, which can lead to mastitis
• Baby may spit up a lot of milk, frequently • Baby often gulps, chokes, and sputters during feedings
https://breastfeedingusa.org/content/article/oversupply-symptoms-causes-and-what-do-if-you-have-too-much-milk
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Common concerns
Managing oversupply
Uphill nursing
Feed in positions where the milk has to flow up the breast, rather than down the breast. For example:Â Laid back breastfeeding. You can play around with the degree of incline where you and your baby feel most comfortable.
Unlatch for letdowns
When the first letdown happens, gently unlatch your baby and let the milk spray out until the pressure subsides. If you want to collect and save the milk, be ready with a clean bottle or milk saver bag. If your letdowns remain strong throughout the feeding, you can decide whether to unlatch your baby again or if that will disturb her feeding rhythm. Many babies are able themselves to adjust to changes in milk flow.
Avoid unnecessary pumping sessions
If milk is flowing and baby is gaining weight appropriately, there is no need to pump. Pumping to save milk in case of separation from baby can usually be delayed for at least several weeks postpartum, if not longer.
https://breastfeedingusa.org/content/article/oversupply-symptoms-causes-and-what-do-if-you-have-too-much-milk
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PUMPING YOUR BREAST MILK Learn about Cerner’s breast pump reimbursement policy, strategies for fitting breastfeeding into your schedule and how to use and store your pumped breastmilk.
Breast Pump Reimbursement Available for Cerner Health Benefits members Reimbursement amount
• Reimbursement is available for the purchase of a breast pump up to $270 for the nursing mother participant in the event of a live birth or infant adoption • You may submit for any brand and style of breast pump, from anywhere (in-store or online) • Breast pump rentals are covered at 100%, if rented from a Cerner approved rental provider
Reimbursement requirements
• Documentation of the birth or adoption • Receipt verifying the purchase You have up to 1 year from the date of the live birth or adoption to submit for reimbursement.
Breastfeeding supplies
The plan will cover breastfeeding supplies for covered breast pumps Approved supplies include: • • • • • • •
Tubing for breast pump, replacement Adapter for breast pump, replacement Cap for breast pump bottle, replacement Breast shield and splash protector for use with breast pump, replacement Polycarbonate bottle for use with breast pump, replacement Locking ring for breast pump, replacement Breast pump bras
Ineligible supplies include: bottles, ice packs, and cleaning supplies
Access the reimbursement form here For more information, please refer to Cerner’s Summary Plan Description. 14
Add pumping into your breastfeeding schedule
Pump on one side while nursing on the other.
Pump after nursing.
Pump while baby has a longer stretch of sleep.
While baby is getting a bottle, you can pump.
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Storing your pumped breast milk • All milk should be dated before storing • Storing in 2-4 ounce amounts may reduce waste • Cool fresh milk in the refrigerator before adding to previously frozen milk • Preferably, human milk should be refrigerated or chilled right after expressed
Acceptable guidelines for storing human milk At room temp
In refrigerator
In freezer
66-78°F
<39°F
-0.4 to -4°F
IDEAL
IDEAL
IDEAL
4 hours
72 hours
6 months
ACCEPTABLE*
ACCEPTABLE**
ACCEPTABLE
Up to 6 hours
*Some sources use 8 hours
Up to 8 days
Up to 12 months
**Acceptable if collected in a very clean, careful way.
https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
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Storing your pumped breast milk Best options for storing human milk
Glass or hard-sided plastic containers with well-fitting tops
Containers not made with controversial chemical bisphenol A (BPA)
Containers have been washed in hot, soapy, water, rinsed well and allowed to air-dry before use
Containers should not be filled to the top *leave an inch for milk to expand as it freezes
Freezer milk bags designed for storing human milk
Put only 60-120 ml (2-4 ounces) of milk in the container to avoid waste
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Using your pumped breast milk Frozen milk
Refrigerated milk
Previously frozen milk
• Thaw in the refrigerator overnight or under cool running water
• Warm milk under warm running water for several minutes
• If thawed, milk can be kept in the refrigerator for up to 24 hours
• Gradually increase temp. of water to heat milk to feeding temp
• Or, immerse container in a pan of water that has been heated on stove, bottle warmer • Do not heat milk directly on stove
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Cleaning and sterilizing pump parts In between pumping sessions at work you can rinse parts with water, use a breast pump cleansing wipe, or just put parts in gallon zip lock and keep in refrigerator or cooler then clean at home after work. Sterilize using a sterilization microwavable bag or large pot of boiling water.
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RESOURCES Review all the breastfeeding and pumping resources available to you, whether on-site or traveling for Cerner.
Privacy rooms Privacy rooms and a select number of designated lactation/pumping privacy rooms are available throughout Cernerâ&#x20AC;&#x2122;s campuses for your lactation and pumping needs. To learn more about our privacy rooms and how to book, please visit our Cerner Maternity SharePoint site.
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Checklist for traveling moms Determine breastfeeding and travel priorities with support person/spouse Discuss with manager and/or AR Partner Logistics for storing and/or shipping breast milk back home Identify back-up childcare Click here to review tips for pumping and traveling
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Additional resources • • • • • • •
Cerner Maternity SharePoint Site Breastfeeding Support Maternity Experience in the United States Cerner Maternity classes (Breastfeeding Parts 1 & 2) Schedule a visit with a Maternity Navigator HealtheAtCerner.com Human Resources Knowledge Base
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