Thanks for making a lactation appointment! Here are a few important things you need to know.

1. Please arrive 15 minutes before your first appointment to complete paperwork. Be sure to bring your insurance card with you. If the baby has a different insurance than you and you have this card, bring it as well.

2. There will be two specialist copays collected at this visit. One is for you and one is for the baby.

3. You and your baby will each be charged according to your respective insurance plan.

Please note: IF you have a high deductible plan and you or your baby have not yet met this deductible, you will be responsible for the full price of the visit.

Contact your insurance company to see how the appointment will be covered.

4. If for any reason you need to cancel or reschedule your appointment, we require 24 hours notice. Many mamas need help with breastfeeding, so we need time to give your slot to another mama in need!  Call and speak to the receptionist to do this. Call 302-658-2229.

5. Please bring the baby and your breasts ready to feed. We will be completing a full measured breastfeeding session together, so we need a hungry baby. A good rule of thumb is to not pump or breastfeed within an hour or two before your scheduled appointment time.

6.  Please bring the following:

  • Yourself and your baby
  • You are more than welcome to bring a support person with you. Two sets of ears are always better than one!
  • Any feeding equipment that is necessary in your current situation. This may include your pump, your nipple shield, bottles, pre-expressed milk, and formula. We are going to do our best to get baby to breastfeed during our appointment, but if that doesn’t work out, baby needs a “Feeding Plan B.”

In the meantime…

Until your appointment with a member of our team, you will need to make sure baby is getting enough to eat, and make sure you are protecting your milk supply. If you are sure to do these two critical things, we have plenty of time to fix breastfeeding!!
Feeding Method #1: Breastfeed – The first choice for feeding your baby is at the breast. If you are not sure that baby is getting enough milk, consider a few questions.

2. Is your baby content after feedings, (or is she showing hunger cues and crying very frequently)?

3. Do you feel like your breasts are filling up and then becoming softer after feedings?

(If your milk came in within the past few days and it feels like your entire breast(s) are filling up and not draining well after feedings you may be dealing with engorgement.  If there is one section of your breast that isn’t draining well, you may be dealing with a plugged duct)

4. If you have access to a weight check, is your baby gaining close to one ounce every day (after your milk has come in)?
If you answered “yes” to these four questions, then your baby is most likely getting enough at the breast and you should continue to breastfeed on demand until your appointment, or at least 8 times every 24 hours.

If you answered “no” to any of these questions, or there is doubt that your baby is getting enough to eat at breast, move on to the next feeding method.

Feeding Method # 2: Pump and bottle feed.
You will use this method if breastfeeding has become too painful, if baby is struggling to latch, or if you are not sure baby is getting enough from your breasts.

You should be feeding your baby these amounts of expressed milk (and/or formula) at least 8 times in 24 hours.

Day 1 of life: 5 – 10 ml per feeding

Day 2 of life: 10 – 15 ml per feeding

Day 3 of life: 20 – 30 ml (30 ml = one ounce) per feeding

Day 4 of life: 30 -45 ml (1 – 1.5 ounces) per feeding

Day 5 onwards – your baby will continue to take a little more milk each day, until around the end of the first week, when she will take about 2-3 ounces of milk per feed. Once your baby is around a month old, she will be taking about 2-4 ounces per feed, and this amount will stay constant until baby starts solids.

If you are unable to pump the amount of milk needed for each feeding, use formula to make up the difference.

If you are horrified at the thought of feeding formula, consider these two facts.

1. Your baby needs to eat a certain amount of milk every day to thrive.

2. Formula is a safe and readily available alternative to breastmilk, proven to help babies grow and thrive. So please use it if your baby is not getting enough breastmilk, and know that formula use certainly does not mean the end of breastfeeding or that you have failed in any way. You are feeding your baby what she needs with love and attention, while trying to get breastfeeding back on track. This is an all around mommy “win.”

Read more on using formula here
Here is some more great information from Katie Madden on pumping and bottle feeding: 

Feeding Method #3: Pump and formula feed.

If you are unable to express any breastmilk, you will need to feed your baby formula in the amounts listed above. You will also need to continue pumping, even if there is nothing coming out. Pumping sends a hormonal signal to your brain to “make milk!” and that is the most important part of keeping up the breast stimulation.

Pumping Guidelines:
To establish and protect your milk supply, and to make enough milk for baby’s demand, you will need to pump at least 8 times a day with a double electric pump. If you don’t have a pump, contact The Birth Center and ask about getting one ASAP. In the meantime go to Target or BabiesRUs and buy a manual pump for about $20. If you have no way to get a pump, you can use hand expression to remove milk and stimulate production.

Here is a tutorial on hand expression
You will pump for about 15 minutes with the double electric pump, or 10 minutes on each side with the manual pump. Follow either pumping session with 5 minutes of hand expression for each breast. This helps to fully drain the breast which in turn helps to boost your supply.

How To Bottle Feed

How you feed your baby is almost as important as what you feed your baby in the early days. You’ll need to use a paced feeding technique with the bottle. Check out how to do it here.

Take Care of Your Nipples