Starting to Breastfeed Immediately After Birth
If the mother’s milk is very low and insufficient in the first 24-48 hours, can the baby experience hypoglycemia and other issues? If so, what should be done to prevent this?
In term newborns, even if the mother’s milk is insufficient in the first 48-72 hours, there is no need for support such as sugary water or formula, as the body’s reserves are sufficient. However, premature infants or those with intrauterine growth restriction are more prone to hypoglycemia and other issues. Blood sugar monitoring should be done for such babies; if this is not possible, they should be given 10% dextrose or appropriate formula intermittently until the amount of breast milk increases. A breastfeeding mother should drink 8-12 glasses of water a day and consume 2300-2700 calories. Smoking should be avoided.
Umbilical Care for Newborns
For umbilical care, solutions like alcohol can be used 2-3 times a day.
First Bath
It is recommended that babies not be washed immediately after birth. Only if the mother is HIV positive, has genital herpes, or is positive for hepatitis B antigen should the baby be washed immediately after birth. The first bath should wait until the umbilical cord falls off. If conditions are appropriate, the baby can be bathed daily; otherwise, every other day is acceptable. The bath water should be 37-38 °C, and the room temperature should be 27-28 °C.
Additional Vitamin Requirements
Every baby should receive vitamin D until they are one and a half years old. Being a summer baby does not affect this. Additionally, if the baby needs it, iron drops can be started and continued until the age of one.
Recommendations for Solid Foods
For the first 6 months, babies receiving breast milk, including water, should not be given solid foods. What are the extraordinary situations that break this rule? Unless the mother is taking medications that can harm the baby through breast milk or has a serious illness, it is unnecessary to give formula in addition to breast milk during the first 6 months. If weight gain is insufficient during monitoring, additional formula may be considered.
Cleaning Bottles
The best method for cleaning bottles is sterilization. If a sterilizer is not available, bottles can be boiled in a pot of water. Glass bottles and silicone nipples should be preferred.
Insufficient Breast Milk
The insufficiency of breast milk should be determined by monitoring body weight. If a daily increase of 20-30 grams/kg is not achieved, or if a decrease is seen on the graph, supplementary feeding may be started.
Pacifier Use
While there are publications suggesting that pacifier use can lead to early cessation of breastfeeding, it is also mentioned that pacifiers can promote the release of endorphin-like endogenous substances in the baby, helping them fall asleep faster and reducing their restlessness. For premature or growth-restricted babies, using a pacifier for 10 minutes before breastfeeding can help establish wakefulness and sucking habits.
Breast Care
For breast care, daily body hygiene, showering, or bathing is sufficient. Cleaning before each breastfeeding is not necessary. It should be remembered that remaining breast milk can create a risk of infection. Therefore, it is important to clean the nipple after breastfeeding and ensure it stays dry. If there are issues like cracks or irritation, appropriate ointments should be used, but remember to wipe them off before breastfeeding.
Working Mothers
Working mothers should be encouraged to exclusively breastfeed until their baby is at least 6 months old. While it is easier for mothers who work half days, full-time working mothers can also pump and store their milk. Breast milk can be stored in the refrigerator for 24 hours and retains its freshness for 3 months if frozen.
Gassy Babies
Gas pain usually starts at night and at the same times. After each feeding, the baby should be held upright in the mother’s arms and patted on the back to help release gas. Gas drops can be used.
Constipation in Newborns
Constipation is rarely seen in newborns. The definition of constipation is important. Having less than two bowel movements a week and hard stools should be considered constipation. In breastfed babies, the frequency of bowel movements may decrease after the 6th week. This complaint alone does not indicate constipation. If a baby who is exclusively breastfed is truly constipated, the most common cause is anal fissure. Changes in formula or feeding solely with commercial formula can lead to constipation. Conditions like abdominal distension, vomiting, and feeding disorders should not be considered unless there are periods of diarrhea. Administering olive oil or gently stimulating the anal area are temporary solutions. The risk of aspiration with olive oil and the potential trauma from stimulating the anal area should be remembered. If there is an anal fissure, warm sitz baths, anesthetic ointments for the anal area, and lactulose-containing syrups can be given if the baby is passing very hard stools. In these cases, a doctor’s supervision is essential.
Doctor Follow-ups
After the baby is born, samples are taken for jaundice, hematocrit, blood type, and screening tests at 3-5 days old. A doctor’s check-up should be done within the first week. Monthly check-ups are required until the baby is six months old. After that, follow-up intervals are determined based on the doctor’s decision.
