Bringing a child into this world can be one of the most fulfilling and exciting times in your life — and at St. Luke's Cornwall Hospital we want to make sure that you have a warm, safe, caring environment for the birth of your baby. Our beautiful, state-of-the-art Birthing Center is designed to meet the physical and emotional needs of mothers, mothers-to-be and their birthing partners as they embark on this exciting journey.
Education and communication are essential to our family-centered model of care. That’s why we work with the family members and others in the new mom’s support network, whenever possible, to make sure there is a good understanding of how to care for both mother and baby before they leave the hospital. Our lactation consultant provides assistance and education to breast-feeding mothers – including techniques and nutrition advice.
In this podcast, Christina Cassidy, RN, IBCLC, RLC, from St. Luke’s Cornwall Hospital Birthing Center, discusses the many benefits of breast feeding for new moms and their babies, and how you can get started planning for that special day.
The Many Benefits of Breastfeeding
Featured Speaker:
Christina Cassidy, RN
Christina Cassidy received her nursing degree from Muhlenberg Regional Medical Center in 1997. In 2013, she became an International Board Certified Lactation Consultant. Christina works one-on-one with mothers, teaching not only how to breastfeed in the hospital, but also how to be successful achieving their goals of exclusively breastfeeding after discharge. She has been part of the St. Luke’s Cornwall Hospital’s Birthing Center since 2017, working with the healthcare professionals in both the Birthing Center and Elaine Kaplan Neonatal Intensive Care Unit. She brings forth not only her clinical expertise but the personal knowledge gained as a mother of seven children, ages 2-16. Transcription:
The Many Benefits of Breastfeeding
Melanie Cole (Host): Having a baby is so exciting, but there are some things you should look to and plan for when you know you’re going to have a baby, and one of those, is breastfeeding. My guest today, is Christina Cassidy. She's a Registered Nurse and an Internationally Board-Certified Lactation Consultant at St. Luke's Cornwall Hospital’s Birthing Center. Welcome to the show, Christina. What are some of the benefits of exclusively breastfeeding the baby for both mother and baby?
Christina Cassidy (Guest): Sure. Exclusively breastfeeding in the hospital is going to help the mother make enough milk for her baby and it’s also going to decrease the problems with latching the baby. What happens is, the more other things that you introduce, such as pacifiers or formula bottles, it can interfere with the number of times the baby goes to breast, which ultimately, can cause problems. By the time the mom leaves the hospital, she’s kind of struggling. Our goal is to really help a mother be successful and feel confident by day of discharge that she is able to breastfeed her baby without any kind of problem successfully.
There are many well-documented short-term and long-term advantages for mom and baby. It’s not just a lifestyle choice; it’s more like a public health priority. Benefits will include – for the baby, will decrease ear infections, lower chance of respiratory illnesses, decrease in SIDS. And also, it reduces the chance of childhood leukemia, diabetes, obesity, asthma. And for mom, it’s beneficial because it decreases the postpartum blood loss, and of course, it’s wonderful for bonding and stress reduction. It increases the chances of mom losing weight a little bit quicker also because those hormones clamp down on the uterus and help slow down the bleeding and helps you lose weight quicker. There is a decrease in ovarian and breast cancer, and a reduced risk for type two diabetes.
For moms that breastfeed for at least 12 to 23 months have a significant reduction also in high blood pressure. As you can see, there are tons of advantages for mom and baby. And of course, the best reason is that it saves you money, right? It’s always the right temperature, and you can always take it wherever you go.
Melanie: That is certainly true, absolutely. Now, some people, Christina, really they want to use a pacifier because they think it soothes baby, or maybe they don’t want to nurse quite as often, but how can pacifier use and formula feeding affect that latching and milk supply?
Christina: Sure, so, the pacifier use – the American Academy of Pediatrics does recommend the pacifier use around week two. That’s usually when breastfeeding is well-established, and babies have already regained birth weight because pacifier use has been shown to reduce the chance of SIDS. However, when you’re in the hospital, what happens is that if the baby is using a pacifier, you don’t see those early feeding cues. That’s usually the time when the baby puts the hand to mouth or licking the lips. That’s when the baby is supposed to be put to the breast. What happens is, by the time the baby spits out the pacifier, the baby is crying, which is a late sign of hunger. Ultimately, it’s a lot harder for the mom to latch a baby when the baby is crying, and that can be a little frustrating too.
We try to keep the baby nice and calm. That’s the best time when to put the baby to breast. Pacifier use can cause decreased feeding times at the breast. And also, kind of have a hard time seeing those early feeding cues when you should first put the baby to breast.
Melanie: How does a mother know how often to nurse? Are there some cues or signs that a baby is hungry? How does she know?
Christina: The best time would be when the baby is quiet, awake, alert, putting a hand to mouth, licking the lips. That’s usually the early feeding cues, and it usually works out to be about every two to three hours. Sometimes in the hospital, if the baby is being swaddled and being passed to family members, it’s right about that time that a baby should be fed about 8 to 12 times in a 24-hour period. There may be times where a mom may need to unwrap the baby, do some skin-to-skin, and then feed the baby.
Melanie: And what about how to tell if the baby is getting enough milk? How do you know that?
Christina: Sure. What we usually do is we have an infant feeding log, which tells you based on how old the baby is, what the output is – what it should be in terms of wet diapers and bowel movements. In the first 24 hours of life, the baby had one wet diaper and one bowel movement, and that’s an indication that the baby is getting enough. By day two of life, two wet diapers, two bowel movements, and the baby is getting enough.
We usually, by day of discharge, we will assess the baby’s weight loss also – the percent weight loss. And usually when there is a close to a 10% -- around about 10% weight loss, what we do is we make sure that we assess the latching and assess there are no risk factors for low milk supply just to identify – at that point, we may ask the mom to put the baby to breast a little more often. We try to stabilize that weight loss by about 10% really. We don’t usually like it to go too much more above that.
One thing to mention, if the mom has a lot of IV fluids during labor, sometimes that can actually affect the baby’s weight believe it or not and the baby can appear to have a little bit more of a greater weight loss, and so we have to kind of take that into consideration, also.
Melanie: What about latching? Is that always as easy as people think? Also speak Christina, about getting the partner involved in this exclusive breastfeeding journey.
Christina: Sure, absolutely. That’s an excellent question. Now, it’s not always as easy that when you see these breastfeeding videos and instructional videos, they always seem like everyone has the perfect anatomy, the babies always have the perfect latch. There are some issues, such as inverted nipples or flat nipples, that can cause latching problems, but there are certain things – that’s why it’s good to speak to the OB doctor prenatally – or even attending a prenatal breastfeeding class because that way you could get all this information beforehand and not wait for until that baby is delivered before you start to explore your options or until you know exactly what kind of tools can help you.
In terms of having a dad help – a lot of times mom is tired during the day, just by – a dad can also do skin-to-skin with the infant, of course – and just by having him hold the baby or calm the baby down if the baby is crying while mom is getting ready to feed the baby – or he can bring mom some water, or just being hand on just to kind of help out with – even bringing mom a pillow. Little things like that can make a big difference, so definitely, there’s plenty of things that dad can also do to help calm the baby down or to help make breastfeeding better for mom.
Melanie: Do you have some advice for new moms that are breastfeeding – about eating healthy while they’re breastfeeding? Should they avoid certain things like spicy foods or alcohol? What should they be thinking about?
Christina: I know that there was some thought in the past about avoiding spicy food or gassy foods, but they kind of – the current studies are really just steering away from that. It’s really just basically a healthy diet like you had when you were pregnant. An extra 500 calories are beneficial because milk-making burns a lot of calories. A baby will metabolize caffeine a little bit slower, so you don’t have to abstain from it completely, but just – you want to think about your daily dietary intake of caffeine and kind of limit it to maybe a cup of coffee or – and if you notice the baby is getting – if you’ve had a little bit more -- if you had coffee, and chocolate, or whatever – other dietary sources of caffeine -- if you notice there are some changes in the baby’s sleeping patterns or infant’s behavior, then you may want to cut it down a little bit more.
Also continuing to take the prenatal vitamins the whole time that you’re breastfeeding is also a good idea, not so much that it’s going to make the milk more healthy for the baby, it’s more to replenish mom’s nutrients that she is going to be using during the whole breastfeeding process.
Melanie: We’re talking about all of these benefits of breastfeeding, but I’m thinking that some parents might be a little nervous about it if their child, God forbid, had to be admitted to the NICU. Does that mean that they can’t breastfeed? How does that work, Christina?
Christina: I know it definitely could potentially be a little bit of a hurdle, but there is a lot of support for moms who have babies in the NICU. Of course, depending on the diagnosis, we still try to encourage as much skin-to-skin as possible because that helps increase the prolactin levels – the milk-making hormone. It’s good for the babies for blood sugar purposes, for respiratory, again, multiple benefits for both baby and mom. But it also depends just on the diagnosis and whether or not the baby is allowed to be able to breastfeed medically.
If for whatever reason, the baby is born early and cannot, there are several things here that we do. We also have, donor milk available – pasteurized, donor milk available for premies. We get mom using a hospital-grade breast pump as soon as possible – as soon as she feels that she is able to. We give them the support, the education – so they know exactly how often to pump and how to get their retail pump, usually through their insurance company so by the time that they go home, they have all of the supplies that they need to continue obtaining breast milk for the baby.
Melanie: Some moms go back to work after six weeks, and they assume that they are going to have to introduce formula at that time. Explain to them and is that really the case?
Christina: No, and unfortunately, a lot of moms come in here -- when we ask them when they’re first admitted, “What are your plans for feeding the baby -- a lot of moms choose to say both because they feel that they’re going to have to give formula because they have to go back to work soon. But really, they don't realize that a lot of their insurance companies will pay for a breast pump – a retail breast pump. It’s really a New York State lab that employers must provide a time and a place for moms to express their milk and to be supportive of a mother during these times.
There are bottle introductions that are done around week four. If it’s done too soon, what happens is the baby usually – the bottles are very easy and then baby kind of uses those extra muscles – which is good for gross motor development – when the baby is breastfeeding. Early introduction of a bottle can cause problems with latching, and if you wait too long, like three or four months, sometimes the baby just wants the breast and nothing else. That week four is the best time to introduce. A mom could start pumping to increase – it takes two to three days or so to increase their breast milk supply. Keep that in mind depending on when you do have to go back to work.
There are also a lot of resources, as well. We have a breastfeeding support group here at the hospital, and they actually cover important topics, such as what was just discussed today, such as pumping and working, or how dad, grandma, or family can help, what to do if the breastfeeding hurts, and how to know when that baby is getting enough. I really encourage prenatally, to get as much education as possible, so that way, by the time they come here and have their baby, they have that education and they know more what to expect.
Melanie: Well, you just pretty much answered my last question, which was to wrap it up. Anything you’d like to add, Christina, to the benefits of breastfeeding for mom and baby?
Christina: No, just that it’s helpful for a mom to know before she has her baby just what her goals are and to communicate that to the staff. If you don’t want to do the formula or if you don’t want to – just let the staff know, so that way we can be good support. Don’t hesitate to ever ask for help. Not only do we have me here, who is a Board-Certified Lactation Consultant, but we do also have Certified Lactation Counselors available, and we don’t want to – the earlier you get help, the better, and it increases the chance of your success. Definitely, if you feel like things are not going the right way, if you feel like you’re not positioning the baby right if you feel like you’re having pain and you don’t know why just call for help. That way, we can address any important issues before mom and baby go home.
Melanie: Thank you so much, Christina, for being with us today. Really great information. This is Doc Talk, presented by St. Luke's Cornwall Hospital. For more information, you can go to StLukesCornwallHospital.org that’s StLukesCornwallHospital.org. This is Melanie Cole. Thanks so much, for tuning in.
The Many Benefits of Breastfeeding
Melanie Cole (Host): Having a baby is so exciting, but there are some things you should look to and plan for when you know you’re going to have a baby, and one of those, is breastfeeding. My guest today, is Christina Cassidy. She's a Registered Nurse and an Internationally Board-Certified Lactation Consultant at St. Luke's Cornwall Hospital’s Birthing Center. Welcome to the show, Christina. What are some of the benefits of exclusively breastfeeding the baby for both mother and baby?
Christina Cassidy (Guest): Sure. Exclusively breastfeeding in the hospital is going to help the mother make enough milk for her baby and it’s also going to decrease the problems with latching the baby. What happens is, the more other things that you introduce, such as pacifiers or formula bottles, it can interfere with the number of times the baby goes to breast, which ultimately, can cause problems. By the time the mom leaves the hospital, she’s kind of struggling. Our goal is to really help a mother be successful and feel confident by day of discharge that she is able to breastfeed her baby without any kind of problem successfully.
There are many well-documented short-term and long-term advantages for mom and baby. It’s not just a lifestyle choice; it’s more like a public health priority. Benefits will include – for the baby, will decrease ear infections, lower chance of respiratory illnesses, decrease in SIDS. And also, it reduces the chance of childhood leukemia, diabetes, obesity, asthma. And for mom, it’s beneficial because it decreases the postpartum blood loss, and of course, it’s wonderful for bonding and stress reduction. It increases the chances of mom losing weight a little bit quicker also because those hormones clamp down on the uterus and help slow down the bleeding and helps you lose weight quicker. There is a decrease in ovarian and breast cancer, and a reduced risk for type two diabetes.
For moms that breastfeed for at least 12 to 23 months have a significant reduction also in high blood pressure. As you can see, there are tons of advantages for mom and baby. And of course, the best reason is that it saves you money, right? It’s always the right temperature, and you can always take it wherever you go.
Melanie: That is certainly true, absolutely. Now, some people, Christina, really they want to use a pacifier because they think it soothes baby, or maybe they don’t want to nurse quite as often, but how can pacifier use and formula feeding affect that latching and milk supply?
Christina: Sure, so, the pacifier use – the American Academy of Pediatrics does recommend the pacifier use around week two. That’s usually when breastfeeding is well-established, and babies have already regained birth weight because pacifier use has been shown to reduce the chance of SIDS. However, when you’re in the hospital, what happens is that if the baby is using a pacifier, you don’t see those early feeding cues. That’s usually the time when the baby puts the hand to mouth or licking the lips. That’s when the baby is supposed to be put to the breast. What happens is, by the time the baby spits out the pacifier, the baby is crying, which is a late sign of hunger. Ultimately, it’s a lot harder for the mom to latch a baby when the baby is crying, and that can be a little frustrating too.
We try to keep the baby nice and calm. That’s the best time when to put the baby to breast. Pacifier use can cause decreased feeding times at the breast. And also, kind of have a hard time seeing those early feeding cues when you should first put the baby to breast.
Melanie: How does a mother know how often to nurse? Are there some cues or signs that a baby is hungry? How does she know?
Christina: The best time would be when the baby is quiet, awake, alert, putting a hand to mouth, licking the lips. That’s usually the early feeding cues, and it usually works out to be about every two to three hours. Sometimes in the hospital, if the baby is being swaddled and being passed to family members, it’s right about that time that a baby should be fed about 8 to 12 times in a 24-hour period. There may be times where a mom may need to unwrap the baby, do some skin-to-skin, and then feed the baby.
Melanie: And what about how to tell if the baby is getting enough milk? How do you know that?
Christina: Sure. What we usually do is we have an infant feeding log, which tells you based on how old the baby is, what the output is – what it should be in terms of wet diapers and bowel movements. In the first 24 hours of life, the baby had one wet diaper and one bowel movement, and that’s an indication that the baby is getting enough. By day two of life, two wet diapers, two bowel movements, and the baby is getting enough.
We usually, by day of discharge, we will assess the baby’s weight loss also – the percent weight loss. And usually when there is a close to a 10% -- around about 10% weight loss, what we do is we make sure that we assess the latching and assess there are no risk factors for low milk supply just to identify – at that point, we may ask the mom to put the baby to breast a little more often. We try to stabilize that weight loss by about 10% really. We don’t usually like it to go too much more above that.
One thing to mention, if the mom has a lot of IV fluids during labor, sometimes that can actually affect the baby’s weight believe it or not and the baby can appear to have a little bit more of a greater weight loss, and so we have to kind of take that into consideration, also.
Melanie: What about latching? Is that always as easy as people think? Also speak Christina, about getting the partner involved in this exclusive breastfeeding journey.
Christina: Sure, absolutely. That’s an excellent question. Now, it’s not always as easy that when you see these breastfeeding videos and instructional videos, they always seem like everyone has the perfect anatomy, the babies always have the perfect latch. There are some issues, such as inverted nipples or flat nipples, that can cause latching problems, but there are certain things – that’s why it’s good to speak to the OB doctor prenatally – or even attending a prenatal breastfeeding class because that way you could get all this information beforehand and not wait for until that baby is delivered before you start to explore your options or until you know exactly what kind of tools can help you.
In terms of having a dad help – a lot of times mom is tired during the day, just by – a dad can also do skin-to-skin with the infant, of course – and just by having him hold the baby or calm the baby down if the baby is crying while mom is getting ready to feed the baby – or he can bring mom some water, or just being hand on just to kind of help out with – even bringing mom a pillow. Little things like that can make a big difference, so definitely, there’s plenty of things that dad can also do to help calm the baby down or to help make breastfeeding better for mom.
Melanie: Do you have some advice for new moms that are breastfeeding – about eating healthy while they’re breastfeeding? Should they avoid certain things like spicy foods or alcohol? What should they be thinking about?
Christina: I know that there was some thought in the past about avoiding spicy food or gassy foods, but they kind of – the current studies are really just steering away from that. It’s really just basically a healthy diet like you had when you were pregnant. An extra 500 calories are beneficial because milk-making burns a lot of calories. A baby will metabolize caffeine a little bit slower, so you don’t have to abstain from it completely, but just – you want to think about your daily dietary intake of caffeine and kind of limit it to maybe a cup of coffee or – and if you notice the baby is getting – if you’ve had a little bit more -- if you had coffee, and chocolate, or whatever – other dietary sources of caffeine -- if you notice there are some changes in the baby’s sleeping patterns or infant’s behavior, then you may want to cut it down a little bit more.
Also continuing to take the prenatal vitamins the whole time that you’re breastfeeding is also a good idea, not so much that it’s going to make the milk more healthy for the baby, it’s more to replenish mom’s nutrients that she is going to be using during the whole breastfeeding process.
Melanie: We’re talking about all of these benefits of breastfeeding, but I’m thinking that some parents might be a little nervous about it if their child, God forbid, had to be admitted to the NICU. Does that mean that they can’t breastfeed? How does that work, Christina?
Christina: I know it definitely could potentially be a little bit of a hurdle, but there is a lot of support for moms who have babies in the NICU. Of course, depending on the diagnosis, we still try to encourage as much skin-to-skin as possible because that helps increase the prolactin levels – the milk-making hormone. It’s good for the babies for blood sugar purposes, for respiratory, again, multiple benefits for both baby and mom. But it also depends just on the diagnosis and whether or not the baby is allowed to be able to breastfeed medically.
If for whatever reason, the baby is born early and cannot, there are several things here that we do. We also have, donor milk available – pasteurized, donor milk available for premies. We get mom using a hospital-grade breast pump as soon as possible – as soon as she feels that she is able to. We give them the support, the education – so they know exactly how often to pump and how to get their retail pump, usually through their insurance company so by the time that they go home, they have all of the supplies that they need to continue obtaining breast milk for the baby.
Melanie: Some moms go back to work after six weeks, and they assume that they are going to have to introduce formula at that time. Explain to them and is that really the case?
Christina: No, and unfortunately, a lot of moms come in here -- when we ask them when they’re first admitted, “What are your plans for feeding the baby -- a lot of moms choose to say both because they feel that they’re going to have to give formula because they have to go back to work soon. But really, they don't realize that a lot of their insurance companies will pay for a breast pump – a retail breast pump. It’s really a New York State lab that employers must provide a time and a place for moms to express their milk and to be supportive of a mother during these times.
There are bottle introductions that are done around week four. If it’s done too soon, what happens is the baby usually – the bottles are very easy and then baby kind of uses those extra muscles – which is good for gross motor development – when the baby is breastfeeding. Early introduction of a bottle can cause problems with latching, and if you wait too long, like three or four months, sometimes the baby just wants the breast and nothing else. That week four is the best time to introduce. A mom could start pumping to increase – it takes two to three days or so to increase their breast milk supply. Keep that in mind depending on when you do have to go back to work.
There are also a lot of resources, as well. We have a breastfeeding support group here at the hospital, and they actually cover important topics, such as what was just discussed today, such as pumping and working, or how dad, grandma, or family can help, what to do if the breastfeeding hurts, and how to know when that baby is getting enough. I really encourage prenatally, to get as much education as possible, so that way, by the time they come here and have their baby, they have that education and they know more what to expect.
Melanie: Well, you just pretty much answered my last question, which was to wrap it up. Anything you’d like to add, Christina, to the benefits of breastfeeding for mom and baby?
Christina: No, just that it’s helpful for a mom to know before she has her baby just what her goals are and to communicate that to the staff. If you don’t want to do the formula or if you don’t want to – just let the staff know, so that way we can be good support. Don’t hesitate to ever ask for help. Not only do we have me here, who is a Board-Certified Lactation Consultant, but we do also have Certified Lactation Counselors available, and we don’t want to – the earlier you get help, the better, and it increases the chance of your success. Definitely, if you feel like things are not going the right way, if you feel like you’re not positioning the baby right if you feel like you’re having pain and you don’t know why just call for help. That way, we can address any important issues before mom and baby go home.
Melanie: Thank you so much, Christina, for being with us today. Really great information. This is Doc Talk, presented by St. Luke's Cornwall Hospital. For more information, you can go to StLukesCornwallHospital.org that’s StLukesCornwallHospital.org. This is Melanie Cole. Thanks so much, for tuning in.