Breastfeeding information & resources
Breast milk is the best food you can offer your new baby. The Canadian Paediatric Society recommends exclusive breastfeeding for the first six months of life. Breastfeeding early and often is important to increase your milk supply, reduce the incidence of engorgement and reduce jaundice in newborns.
At about six months, your baby will be ready for other foods, but you can continue breastfeeding until your child is two years of age and beyond.
While in the hospital, you are welcome to attend a breastfeeding class, held daily at 10:30 AM in room M5 155. All new mothers are encouraged to attend each day while in the hospital.
The class covers a variety of areas including:
- What to expect when breastfeeding a newborn
- How to get breastfeeding off to a good start
- Understanding your baby’s cues
- Where to get help
We provide outpatient breastfeeding counselling, education and care plans to all women who deliver their babies at Sunnybrook. Support includes daily breastfeeding classes taught by the nurses and International Board Certified Lactation Consultants (IBCLCs), a 24-hour telephone helpline, a 7-day-a-week appointment schedule and a hospital grade pump rental service.
The clinic operates with a unique model of care for consultation. Our lactation consultants work individually with each family to develop a plan of care, while more complex cases are referred to the nurse practitioner or physician.
If you have difficulties beyond the initial challenges of establishing breastfeeding, your nurse may refer you to the clinic before you go home from the hospital.
Location & Contact Details
Reception for the breastfeeding clinic is in M-wing, 5th floor, room 203
Having your baby skin-to-skin will encourage the first breastfeed to happen as soon after birth as your baby and you are ready. Nursing staff will encourage this mother-baby contact within the first hour. Ninety percent of women delivering at Sunnybrook will learn how to breastfeed their babies before they are transferred to their post delivery room. Your nurse will help you with getting into a comfortable position to initiate nursing.
Newborn babies have natural feeding instincts to want to breastfeed. Some babies will snuggle, sniff and lick the breast during the first feed. Others will latch and suck eagerly. These behaviours are natural. If things don’t come together immediately, don’t forget to have confidence in your body’s ability to nourish your baby. Remember, it can take time to establish breastfeeding. Spending as much time skin-to-skin with your baby as possible is important for both you and the baby.
It’s common for babies to be alert for the first few hours after birth. When they have their first breastfeed they often go into a deep sleep, rousing once or twice to feed. At about 24 hours they may want to have short, frequent (clustered) feeds. At this time is important to have an optimum latch to avoid getting sore nipples.
Learn more about this at Biological Nurturing.
Spending lots of time skin-to-skin with your baby is important. So are the following:
- Offer your baby your breast at least eight times every 24 hours and initially within 3 hours from the start of the previous feed.
- Until you feel breastfeeding is becoming easier, undress your baby to their diaper and feed them skin to skin.
- Bring your baby to you, instead of your breast to the baby.
- Take time to achieve a good latch with your baby's mouth open like a yawn, with the bottom jaw well under the areola (the darker skinned area around your nipple). Supporting your baby’s neck and shoulders but avoiding holding the baby’s head will encourage this.
- If your baby is sleepy, encourage his interest in feeding by undressing your baby down to his diaper and gently stroking your baby's back or head.
- Let your baby feed for as long as he/she wants on the first breast. After changing the diaper and burping, you can offer the second breast. Some feeds will be two breasts, some will only be one.
- Look for your baby’s early feeding cues, such as wiggling or eye movement during sleep. Feed your baby before they begin to cry, as this is a late sign.
- Do all soothing at the breast. Avoid pacifiers or bottle nipples until your baby is breastfeeding effectively. Pacifiers and bottles can lead to breastfeeding problems while you and your baby are still learning how to breastfeed.
- Keep a record of your baby's feedings, wet diapers and bowel movements. Adequate wet & dirty diapers are the best indication that your baby is getting enough to eat.
You no longer need to record this information after the first week unless asked to do so by your baby's physician or the Breastfeeding Clinic.
- The majority of women can produce sufficient milk for their babies.
Colostrum is the name given to the first milk. It is a thick & yellowish and is rich in proteins, minerals, anti-infective and immune properties. It is very beneficial for your baby.
A newborn receives 1-1.5 teaspoons of colostrum with every feed. Initially, this is all your baby needs. As the colostrum changes to breast milk, the amount of fluid increases, and it becomes whitish and thinner.
Latching & positioning
As you will be feeding your baby 8 times a day or more, it is important to be comfortable. Here are a few tips on how to begin:
- Breastfeeding may be easier if you recline comfortably with your back well supported, feet flat on the floor or raised on a stool. Another option is to pull down the bed rail of your bed and rest your feet on it.
- Feed your baby skin to skin so that you can see and position him/her more easily
- If your baby is having trouble breastfeeding, you can try undressing him down to a diaper since skin-to-skin contact can help your baby figure out what they need to do.
- Bring your baby to you with his/her tummy against yours.
- To help support your baby, bring him up to breast level, put a pillow or two on your lap.
- Support your baby’s neck and shoulders, leaving their head free to tilt back and move onto the breast.
- You can support your breast in a U-hold (cross cradle position) and C-hold (football position) with your thumb well above and fingers well below the areola, so that your baby can take a large mouthful of breast.
- Your baby needs to open wide to breastfeed well. To encourage this, lightly tickle your baby's lower lip with your nipple. It's important to be patient until your baby opens their mouth wide like a yawn, and then bring them very close onto the breast.
- With each feeding baby should gape his mouth widely and take a large mouthful of breast.
- A baby who is latched well will have his chin and nose lightly touching your breast. The baby will be able to breathe.
- Babies are primarily nose breathers and are able to flare out their nostrils so that you do not worry about him not being able to breathe.
- You can tell your baby is latched well when his mouth is wide and both top and bottom lips are flanged out with a reasonable amount of breast/areola inside their mouth.
- Sucks should be mostly strong and rhythmic, with pauses between each episode of sucking.
Tips on ineffective latches
- The baby should not suck on the nipple looking as though they are sucking a straw.
- When the baby is latched effectively you will feel ‘pulling’ and ‘tugging’ but it should NOT be painful.
- Your nipple should look the same when it comes out of the baby’s mouth as it did when it went in but longer.
- There should be no colour or shape changes to your areola and nipple
If you experience any problems or your nipples are sore, GET HELP. A comfortable latch is the key to successful breastfeeding and you can be supported and helped by your nurse, or after leaving hospital from the Breastfeeding Clinic.
Some babies swallow a little air when they breastfeed, while others swallow more. After your baby has fed on one breast you can burp them by:
- Placing your baby over one shoulder and gently patting or stroking the back
- Holding your baby in a sitting position on the lap, then leaning them forward against one hand, with the index finger and thumb supporting the head.
Many babies are sleepy in the first 24 hours after birth.
- Wake your sleepy baby and attempt to nurse every 3 hours. Some babies will easily awaken with gentle stimulation such as unwrapping blankets from around the baby or changing their diaper.
- When attempting to breastfeed, try holding your baby skin to skin against your body and express a drop(s) of colostrum into their mouth. If your baby does not wake after 10 to 15 minutes of trying, simply take a break and try again in an hour or two.
- You may need to continue with some gentle stimulation to keep your baby feeding. Try lifting the baby's upper arm, stroking legs, feet and head and blowing on baby's face.
- After long periods of sleep, some babies go through a marathon nursing phase where they want to nurse all the time & can't be put down. This is the way your baby stimulates your body to establish a good milk supply. Allowing your baby to eat as often as they want is best. If your baby does finally fall asleep during this frequent feeding phase, your baby may settle if they are held and cuddled. If you put your baby down, she may soon awaken and want to nurse again.
- Remember, the more you nurse, the sooner your milk will come in and your milk supply will increase.
How often should my baby feed?
Babies should feed at least 8 times in 24hrs.
It is normal for babies to have times when they feed several times in a 4-5 hour period. This "cluster feeding" behaviour does not mean your baby isn't getting enough. It is a natural way to increase your milk supply, and is very common in the evening, though it can occur any time.
It is more important for your baby to breastfeed frequently during these times and not be given formula or water. Any other food offered to your baby would decrease your milk supply.
Is my baby getting enough & doing ok?
Baby is doing well if you see:
- Your baby breastfeeds at least 8 times every 24 hours.
- Your baby has adequate wet and dirty diapers (see chart below)
- Your baby is satisfied and sleepy after feedings.
- By day 3-4 you see deep rhythmic sucking and regular swallowing at the beginning of feeding.
|Day||Wet diapers*||Dirty Diapers|
|1 (0-24h)||1||1 to 2 (loonie-sized)|
|2 (25-48h)||2||1 to 2|
|5 to week 6 (after milk comes in)||at least 6||4 or more. Stool should be turning golden, liquid & seedy|
*To get a feel for a 'wet' diaper: pour 3 tablespoons of water (45mL) onto a clean diaper.
At first, a baby’s stool is black and sticky meconium. By day 5 a breastfeeding baby’s stool should be turning golden, liquid and seedy.
Your baby may need to feed more often if you see:
- Fewer wet and dirty diapers than expected
- Dark yellow urine.
- Baby's lips and inside their mouth looking dry.
If you have any questions or concerns, always follow up with your nurse, the Breastfeeding Clinic, or your care provider immediately.
On average, babies lose up to 7% of their birth weight in the first four days. After this initial loss, they usually gain 20 - 30 grams (half to one ounce) per day. This rate of growth continues throughout the first six months.
The World Health Organization and the American Academy of Pediatrics encourages the use of breast milk for the first 6 months following their birth. It is recommended that any additional supplementation be avoided during this time as it can disrupt breastfeeding and decrease your milk supply.
If you are unable to breastfeed because of medical or personal reasons please talk with your health care provider or nurse about safe recommendations for the use of formula for newborns. You can find more information on the Health Canada and Infant Feeding websites.
Birth control after baby is born
After your baby is born, it’s important to think about what’s ahead for you, including birth control. Breastfeeding can be used as birth control when, after giving birth, a woman breastfeeds her baby exclusively. That means the baby does not drink anything besides breast milk. Please visit the Planned Parenthood website for more information.
Toronto Public Health also has a new sexual health site featuring e-chats with sexual health counsellors
Did you know you may be able to donate your extra breastmilk?
Please visit the Rogers Hixon Ontario Human Milk Bank to learn more about how to donate your breastmilk to hospitalized babies to help prevent life-threatening illnesses and infections. This non-profit organization is a joint initiative between Sunnybrook, Mount Sinai Hospital and the Hospital for Sick Children.
- Toronto Public Health
- La Leche League Canada
- Baby's Second Night (pdf file)
- Breastfeeding Resources Ontario
- Breastfeeding Your Baby: Guidelines for nursing mothers (pdf file)
- Breastfeeding Matters (pdf file)
- Healthy Babies: Health Canada
- Breastfeeding & Drugs: Motherisk at Sick Kids
- Breastfeeding: Canadian Paediatric Society
Location and contact
Sunnybrook Health Sciences Centre
2075 Bayview Avenue,
M-wing, 5th floor,
room M5 203
Toronto, ON M4N 3M5