Baby Friendly Manitoba:  Information for Parents

Getting Help with Breastfeeding

A new baby can be overwhelming and exhausting. It is important to have people around you to talk to or help with your concerns. If you are having difficulties with breastfeeding, such as sore nipples, or are tired or having emotional difficulties, call for help right away.

Health Links/Info Santé at 204-788-8667 OR Toll Free at 1-888-315-9257can help with breastfeeding questions.

The Winnipeg Regional Health Authority has breastfeeding clinics where Winnipeg mothers can access help with feeding. Many of the other health offices and hospitals have access to extra breastfeeding help.

If you have a midwife, she will help you with breastfeeding. La Leche League Canada is also a valuable resource. Phone help is available through the Manitoba La Leche League Help Line 204-257-3509. Calls will be returned by a Leader. La Leche League Leaders are accredited volunteers, and all are mothers who have breastfed.

Using a Bottle or Cup

Once they have settled into a breastfeeding routine after four to six weeks, some mothers introduce an occasional cup or bottle of pumped breast milk. Remember to empty your breast if you have missed a feeding. This milk can be stored for future use.

If the baby is getting several bottles a day on a regular basis and your milk supply decreases because the baby is nursing less, it is possible that the baby will start refusing the breast, even if he is very well established in breastfeeding.

Expressing Breast Milk

You may want to express breast milk:

  • If your baby is unable to breastfeed (ill or in the special care nursery).
  • If you are going to be away from your baby for longer than a few hours.
  • To relieve full breasts so your baby can latch better.
  • If you are going back to work.
  • So your partner can feed the baby after 4 to 6 weeks when your milk supply is well established.
How can you express breast milk?
  • by hand
  • with a hand pump
  • by an electric pump

All bottles, containers, and pump pieces used for expressing milk should be washed and cleaned daily before use until your baby is three months old.

Before cleaning all bottles, containers, and pump pieces:

  • wash hands well
  • take pump pieces apart so each piece can be cleaned separately
  • rinse milk off all pump pieces using cold water
  • wash in hot, soapy water and rinse well
  • air dry by placing on a paper towel

If your baby is preterm or ill, you will also need to disinfect the pump parts once a day. Use one of these methods:

  • Put pump parts in a pot, cover with water, and boil on the stove for 10 minutes.
  • Soak pump parts for 10 minutes in household bleach. Use 250 ml (1 cup) of bleach and 2.25 litres (10 cups) of tap water. Rinse with boiled water. Air dry.
  • Use the sani cycle on your dishwasher. Place pump parts on the top rack.

When your milk supply is first coming in, you may only get a few drops when you express. This will increase as you practice and your milk supply increases. If you express milk for a preterm or sick baby, or a baby having difficulty breastfeeding, express or pump for every feeding (eight times in 24 hours). If you are expressing to get extra milk for a feeding when you will be away, you may need to express milk several times to get enough milk for one feeding. Find the time that works best for you. You may feel fullest in the morning, so this is a good time to try to express your milk.

You can tuck a small (non-breakable) container under your nipple on the second breast while your baby is nursing. You may find you leak milk from both breasts when you have the let-down reflex. Save this milk for use later.

Hand Expressing
  • Wash your hands with soap and water and get comfortable.
  • Have a clean cup, bowl, or jar ready to catch the milk.
  • Gently massage your breast in a circular motion, working from shoulder to nipple.
  • To start the let-down reflex, roll your nipple between your thumb and finger.
  • Put your hand in a C-shape on your breast. Put fingers on the bottom and your thumb on the top at the outer edge of the areola.
  • Gently push your thumb and fingers back towards your chest, then squeeze them together while you move them towards the nipple, but do not pinch your nipple.
  • Catch the milk in the clean cup, bowl, or jar.
  • Move your fingers around the areola in a circle to express from different parts of your breast. Press and release, repeat the movement on your breast, and switch between breasts every few minutes.
Hand Pumps

Some women like to use hand pumps. These pumps can usually be bought in a drug store or child care supply stores.

Electric Pumps

Electric pumps are fast and efficient. They are useful if you will be expressing milk often or for a longer period of time. You are able to express both breasts at the same time with some electric pumps. Electric pumps that suck and release automatically work best. Many mothers find that pumps requiring them to create and release the suction with their fingers do not work well. Talk with the nurses in the hospital or your public health nurse about renting or buying an electric pump.

Collecting and Storing Breast Milk

Store your expressed breast milk for:

  • Up to 4 hours at room temperature.
  • 3 days in a fridge that has a temperature of 0 to 4°C. Store in the main part of the refrigerator, not in the door. If you do not have a fridge thermometer, it is best to freeze milk you do not intend to use within 24 hours.
  • 1 month in a freezer compartment that is inside a fridge.
  • Up to 6 months in a separate-door fridge freezer (the temperature changes if the door is opened often). Keep milk on the back top shelf at a temperature of -18°C.
  • 6 to 12 months in a deep freeze (-20°C).
How do I use frozen breast milk safely?

Always use the oldest milk first. Breast milk can separate when it is frozen. Gently shake to remix once it thaws.

  • If your baby is sick or premature, ask your baby's health care provider if there are different recommendations for how long to store your milk and discuss the option of receiving donor breast milk for your baby.
  • Donating Breast milk If you are a mother with extra breast milk and you are thinking about donating to a milk bank, you can contact The Women's Health Clinic for more information.

Thaw breast milk by:

  • putting the container in the fridge
  • running the container under warm tap water
  • putting the container in a bowl of warm water (take care that the water does not touch the lid of the container).

Once milk has thawed, it may be refrigerated for up to 24 hours. Do not store at room temperature. Avoid wasting thawed breast milk. Thaw only what you need for one feeding.

Do not refreeze breast milk.

Do not heat breast milk on top of the stove. It can get oo hot too fast.

Do not microwave breast milk because the uneven heating can burn your baby’s mouth.

Warm breast milk by:

Formula Feeding

Breastfeeding is recommended until your baby is 2 years old and older. It is rare that a woman is unable to or advised not to breastfeed her baby. If you are unsure about breastfeeding or are considering formula feeding, talk first with your health care provider or Health Links/Info Sante at 204-788-8667 OR Toll Free at 1-888-315-9257. They have many ways to help you with breastfeeding.

Babies should not be given anything other than breastmilk or iron fortified formula in the first 6 months. Cow’s milk can be offered once your baby is 9-12 months old and eating a variety of iron rich solid foods.

Refer to Manitoba Health’s leaflet on Infant Formula with Iron PDF for further information on feeding babies and toddlers.

Breastfeeding and Work

You can breastfeed and work outside the home. In Manitoba, employers must make reasonable efforts to allow you to breastfeed or express milk at work.

How can you be successful?

  • Have breastfeeding well established before returning to work. The first six weeks or more are the most important for getting a good milk supply for your baby.
  • Contact your public health nurse, lactation consultant, La Leche League, or breastfeeding support group for help and advice.
  • Talk to your boss before you go back to work. Talk about the importance of support for breastfeeding. Breastfed babies are healthier. Their mothers need less time off work to care for sick babies.

You will need:

  • A quiet, smoke-free place to feed or express milk.
  • A fridge to store expressed milk. If you don’t have a fridge at work, use a Styrofoam box with an ice pack to store expressed milk that will be fed to your baby within 24 hours.
  • A reasonable workload.

To keep enough breast milk, you will need to pump your breasts or feed your baby one to three times during an eight-hour work shift.

Remember to take healthy snacks to work, as well as breast pads, breast pump, clean cups or jars to store your breast milk, and phone numbers of support people.

How can I get ready to go back to work?
  • Learn how to express your milk by hand or pump. Start storing milk 10 to 14 days before you plan to return to work.
  • About two weeks before you go back to work, slowly introduce your baby to other ways of feeding. Let your baby get used to a cup or bottle. It may help if someone other than you feeds the baby at these times. If you use a bottle and your baby refuses the nipple, try a different nipple or a cup.
  • Breastfeed as soon as you see your baby after work and breastfeed often on your days off, in the evening, and at night.
  • Your baby may refuse food, wake at night, or be fussier when you are away.
  • Tell your child care provider how important breastfeeding is to you and your baby. Talk about when you will be gone, when you will breastfeed your baby, and about your baby’s feeding routines. Make sure your caregiver knows how to safely prepare and store milk.
  • Get extra help with chores at home.
  • Breastfeeding helps your baby adjust to you going back to work.

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