Key Suggestions

1. Offer both breasts on demand; ensure baby has a mouthful of the breast and start with the side that is fullest
2. Pump after each breastfeeding; 15 minutes each side (minimum 8 sessions in 24 hours including once at night)
   • Q2-3 hr (< Q4hr), 15 min each breast
3. Continue to supplement with pumped milk/formula after breastfeeding (offer pumped milk first if available)
4. Frequent skin-to-skin
5. Monitor output; at least 6 wet diapers and 3 poos in 24 hours**:**

Medication Precaution

• Contraception → uses only Progesterone-related drugs pills/IUD bc Estrogen can decrease milk production
• Medication Use in Breastfeeding

Problem with breastfeeding

Milk Production Problem

Domperidone

Milk Extraction Problem

cleft palate/cleft lip

Ankyloglossia