HOW TO TELL IF YOUR BABY IS GETTING ENOUGH MILK:

Every mother-baby pair is different! That makes it hard to say exactly how your baby should be eating. In the first few days, your baby is getting rich, yellow colostrum (first milk). Signs that your baby is getting enough milk are:

• An alert, bright-eyed infant
• A baby who wants to eat every 2-3 hours and is satisfied between feedings
• At least 3-4 wet diapers per day by day 3 of life
• The normal change in stools over the first 2-5 days of life: meconium (dark green, tarry) to transitional stools (lighter green) to true breastmilk stools (yellow, seedy, curdy or loose). The number of stools will increase each day.

After 3-5 days, when your milk "comes in", you will also notice:

• Your breasts feel full before a feeding and softer afterwards
• A letdown sensation or milk dripping from the other breast
• You can hear your baby swallow
• You can see milk in your baby's mouth
• The processed product (stool!) coming out the other end!

After the first week, your baby should:

• Nurse at least 8-12 times in 24 hours (every 2-3 hrs)
• Nurse about 10-20 minutes at each feeding
• Be happy during and after a feeding
• Gain about 4-7 oz per week (after a small weight loss the first week)
• Return to birth weight by 2 weeks of age
• Have 6 or more pale colored, wet diapers in 24 hours
• Have 4-12 stools in 24 hours
• Be alert and bright-eyed

Call your baby's doctor if:

• Your infant sucks only briefly, very softly or irregularly
• Your baby is very jaundiced (yellow) and getting more yellow
• You have severe, constant nipple pain
• Your baby fights the breast or cries after a minute or two
• Your baby has fewer than 6 wet diapers a day
• Your baby has little or no stool, or has dark green mucus stools
• Your baby seems weak, tired, or not interested in feeding
  

BY: San Diego County Breastfeeding Coalition
Editor: Nancy E. Wight MD, IBCLC, FABM, FAAP

SPONSORED BY:

Back to the top

HOW TO FIND HELP - BREASTFEEDING SUPPORT SERVICES
We often assume that breastfeeding is such a natural process that anyone should be able to do it. The truth is, breastfeeding is a learning process for both mother and baby. Problems that arise can often be managed with help. Breastfeeding support services offer information, support, and technical assistance, both before and after your baby is born. This is a guide to those services.

BREASTFEEDING CLASSES
Prenatal breastfeeding classes can provide general information on breastfeeding basics, teach ways to make it easier, and suggest ways to solve problems. Knowing the normal course of breastfeeding and how to avoid the most common pitfalls before the baby is born will lead to a longer, more satisfying breastfeeding experience. The knowledge and confidence you get is worth the few hours you will spend in a prenatal class.

Classes may be offered as part of a childbirth preparation series, as a separate class at a hospital, as a part of WIC services, or be taught privately. Fees may vary, or the classes may be free. Small group classes are best. Bring the baby's father, a friend or family member with you. Classes may include demonstration of techniques. After your baby is born, a follow-up by phone or personal consult may be included. You can use this directory or ask your childbirth educator, hospital or health care provider for a referral.

More information can be found in a good breastfeeding book or from other nursing mothers. Mother-to-mother support groups like La Leche League are also good resources. See this directory for phone numbers.

Back to the top

YOUR MILK SUPPLY
You may feel that you do not have any milk in your breasts for the baby during the first few days. YOU DO! The nutrition your baby gets at your breast for the first few days is colostrum, or "first milk". It is creamy and yellowish in color. Although it is a small amount, it will help your baby fight infection.

After 2-4 days the colostrum changes to "mature" milk and gradually becomes bluish-white. Breastmilk is both food and drink to your baby. It is balanced to meet all your baby's needs, and changes according to your baby's age. When your milk starts "coming in" your breasts may become very firm and feel warm and tender. This is due to more blood supply, some swelling, and the milk. Feeding your baby often will relieve the fullness.

If your breasts become very full, your baby may have trouble getting on the breast (latching-on). Apply warm, wet towels or take a warm shower to start your milk flowing. Try expressing some milk by hand or use a breast pump briefly to soften your breasts. Cold, wet towels or ice bags after feedings may reduce swelling. Breast fullness should decrease as your baby learns to empty your breasts. If your breasts are still very full and tender after 1-2 days, call your lactation specialist or doctor for help.

Back to the top

BREASTFEEDING (LACTATION) SPECIALISTS
Finding and choosing a breastfeeding professional can be a confusing matter. There are many people offering services to help you breastfeed. They may call themselves Lactation Educator, Lactation Consultant, or Lactation Specialist. To find a qualified person that you can work with, consider the following:

Academic Credentials and Experience: What kind of education about breastfeeding do they have? Where did they get their training? A practitioner may have no formal training, may have taken a university certification course, may have passed a written certification exam, or taken a correspondence course. They may be a doctor (MD), nurse (RN, LVN), nurse practitioner (NNP, CPNP), certified nurse midwife (CNM), registered dietitian (RD), occupational therapist (OT), certified lactation educator (CLE), certified lactation consultant (CLC or IBCLC), or certified lactation specialist. You can ask to see their credentials if you wish. Training and experience vary widely, so ask about it. How does the practitioner keep up with the current research and issues in breastfeeding? Is the practitioner currently a member of a professional lactation organization?

Services: What kinds of services do they offer? Classes, in-person home or office consults, phone counseling, rental and/or sale of breast pumps or other breastfeeding accessories are possible. Where are services provided? Are home or hospital visits made? When are services available? Can you get help on evenings, weekends, or holidays? Is the practitioner affiliated with a hospital or medical group?

Fees: What are the fees for the various levels of service? Costs may be eligible for insurance reimbursement. Fee schedules vary, so shop around. Ask for an official bill to submit to your insurance carrier.

Back to the top

BREASTFEEDING HELPLINES *Spanish spoken

Grossmont Hospital Women's Center (619) 740-4983
Kaiser Permanente Lactation Clinic # (619) 516-6170
La Leche League of San Diego County (858) 646-9779
Naval Medical Center San Diego (619) 532-5261
North County Health Services WIC* (888) 477-6333
Palomar Pomerado Health (858) 613-4605
Scripps Memorial Hospital – Chula Vista*(619) 691-7272
Scripps Memorial Hospital - Encinitas (760) 633-7850
Scripps Memorial Hospital - La Jolla (858) 626-6268
Scripps Mercy Hospital (619) 260-7098
SDSU Foundation WIC* (888) 999-6897
Sharp Women’s Pavilion Chula Vista (619) 482-5848
Sharp Mary Birch Hospital for Women+ (858) 939-4127
Tri-City Medical Center (760) 940-7745
UCSD Medical Center (619) 543-7149
+ part-time (Mon 11-3, Wed, Thurs)
# Spanish 858-792-5009

Breastfeeding and Drugs Information

National Library of Medicine

http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

Thomas Hale PhD

http://neonatal.ama.ttuhsc.edu/lact/

Back to the top

PROVIDERS OF BREASTFEEDING (LACTATION) SERVICES
Although listed by address, the sources listed below provide services throughout San Diego County. The credentials listed after their names are listed as the individual requested and have not been verified by the San Diego County Breastfeeding Coalition. The San Diego County Breastfeeding Coalition does not certify or guarantee any services provided. Some breastfeeding services accept insurance and Medi-Cal. Ask when you call. *Spanish spoken

CENTRAL SAN DIEGO/ LA JOLLA/BEACH CITIES
Beach Area Breastfeeding (858) 454-4596 (H)
Annie VerSteeg, IBCLC, RLC (619) 540-7153 (C)
www.beachareabreastfeeding.com or annieibclc@gmail.com

For all postpartum needs for you and your family! Care in the privacy of your own home.  Please visit my website to learn more!

Beautiful Beginnings (858) 650-3305
www.beautifulbeginnings.org
Education, Support and Referrals for Childbirth Education Classes, Fitness Classes, Labor Support Doulas, Postpartum Doulas, Breastfeeding Support, Massage Therapists, Trainings.

Mari Dowling RN, IBCLC (760) 807-1701
Breastfeeding consultation & support in the comfort of your home.

Healing Connections (619) 794-6771
Teresa Rzesiewicz, RN, BSN, PHN, IBCLC, CIMI trzesiewicz@aol.com Lactation visits and infant massage in your home.

Lactation Consultants of San Diego (858) 740-7900
Annalee Hulburt, IBCLC, RLC www.BreastfeedingSanDiego.com Professional Lactation Consultations ~Customized care for the breastfeeding issues concerning you and your baby. Please see our website for much more information; Bébé au Lait retailer.

Milkmade at Home (619) 325-1630
Eve Moeran, RN, IBCLC 4045 3rd Avenue, # 302, San Diego, CA 92103 www.breastpumpsandiego.com Professional and informative lactation consults in our office or at your home; free breastfeeding support groups three days a week; Medela breast pump rentals, sales & accessories; and many other nursing products.

Not to Worry, Inc. (619) 297-9601 or (760) 471-5135
www.nottoworryinc.com , 7801 Mission Center Court #106, San Diego, CA 92108. High quality daytime and over-nighttime care, breastfeeding support at home for postpartum moms, newborns, and infants in San Diego and North County.

Mary Pennington RN, IBCLC (858) 395-4764
Breastfeeding support and consults in your home.

Serenity Breastfeeding (619) 990-6479
Christine Hennes IBCLC, CCE chennes@cox.net
Breastfeeding consultations and support done in the comfort of your home. Over 10 years experience working with moms & babies.

The Sweetest Milk (619) 222-1043
Margaret Goebel, IBCLC,RLC www.thesweetestmilk.com
Consultations and breastfeeding support in your home.

NORTH COUNTY COASTAL

Attach Baby (760) 828-8090 www.attachbaby.com
Amy Ma, IBCLC, RLC, CLE, Carlsbad, CA. Private breastfeeding classes, consults in office or client's home, support groups, Mommy & Me classes, & Montessori preschool. Breast pump rental & sales, nursing bras and accessories. Bilingual in Chinese.

Babies in Bloom (760) 940-BABY
Rochelle McLean IBCLC, CCE, CD 161 Thunder Drive #102, Vista, CA 92083 www.babies-in-bloom.com
Classes, support and natural products for your baby & family: breastfeeding supplies and accessories (including Medela breast pump and scale rentals), nursing bras, baby carriers, cloth diapers & more. Personal lactation consultations in our office or your home.

Grandma 2 Go (619) 507-6108
Vicki Wolfrum CNM www.granda2go.com ; midwifevicki@grandma2go.com , Nurse-midwife, lactation consultant. Pregnancy, breastfeeding & parenting education, wisdom & support. Private classes and consultations.

HoneySuckle & Mommy (858) 792-8867
Nazie Moalemi, Lactation Educator, BS in Nutrition. www.4mom4baby.com, 2673 Via de la Valle Suite H, Del Mar, CA 92014. Breast pump sales with all additional accessories; pump rentals; beautiful nursing bras& clothing, Mustela baby care. Free lactation support by phone or in person and free baby weighing. Military discount.

Momma's Pump, Inc. (760) 929-8400
Rose Kast, RN, IBCLC mommaspump@aol.com
5315 Avenida Encinas, Suite 232, Carlsbad, CA 92008.
Breast pump rental and sales. Specialists in assisting working mothers.

The Original Comfort Food Lactation Services*
North County (760) 941-0855, San Diego (619) 395-3960
Veronica Tingzon, IBCLC, RLC www.theoriginalcomfortfood.com
Helping the breastfeeding mother with a wide gamut of lactation services. Breastfeeding consultations and support in your home. Se Habla Español.

NORTH COUNTY INLAND

Becker Pediatrics (951) 600-2681
Lynn Becker RN, IBCLC 41011 California Oaks Road #101, Murrieta, CA 92590. Breast pump rentals, supplies, consultation.

North County Lactation Services (858) 513-1327
Ann Russell, IBCLC, RLC, LLLL
12621 Hedgetree Court, Poway, CA 92064.
Breastfeeding consultations and support in your home or my office, breast pump rentals and sales of breastfeeding aids. Phone consults also available. Focus on latch and suck problems.

Shari Silady Lactation Services (858) 271-0913
Shari Silady, IBCLC , RLC. email slsilady@san.rr.com
Breastfeeding consultations and support in the comfort of your home or in my home office. I offer prenatal breastfeeding consultations and specialize in multiples and suck-related issues. Military discount.

EAST COUNTY

Happy Health Moms and Babies (619) 992-1933
Rose deVigne Jackiewicz RN, IBCLC www.hhmb.org
Breastfeeding assistance and referrals.

SOUTH COUNTY

A Better Birth (619) 434-9188
Gerri Ryan, LM, CPM, FACCE, CLE
www.a-better-birth.com Email: babycatcherglr@cox.net
3802 Alameda Way, Bonita, CA 91902. A Better Birth offers complete, highly personalized midwifery services for birth and postpartum and well woman care.

Family Health Centers of San Diego* (619) 515-2300
Lourdes Sanabria, Supervisor, Perinatal Support Services Logan Heights Family Health Center (619) 515-2428 1809 National Ave. San Diego, CA 92113 www.fhcsd.org

HOSPITAL BREASTFEEDING SERVICES:

SCRIPPS HEALTH LACTATION SERVICES
1 (800) SCRIPPS or www.scripps.org
Scripps Mende Well Being (858) 626-7024 4305 La Jolla Village Dr. Ste. L-5, San Diego, CA 92122. Breastfeeding classes and support groups; breast pump rentals and sales.
Scripps Mercy Hospital (619) 260-7098
4077 5th Ave, San Diego, CA 92103. Breastfeeding classes, breast pump rental and sales. Nursing Notions Store open 9 a.m. - 2 p.m.
Scripps Memorial Hospital-La Jolla (858) 626-6268
9888 Genesee Ave, La Jolla, 92037. Breast pump rental and sales.
Scripps Memorial Hospital-Encinitas (760) 633-7850
354 Santa Fe Drive, Encinitas, 92024. Breastfeeding classes; inpatient and outpatient consults; breast pump rental and sales. Nursing Nook Store opening soon!
Scripps Mercy Hospital-Chula Vista (619) 691-7272
435 H Street, Chula Vista, CA 92190. Breastfeeding classes; breast pump rental and sales.

Kaiser Permanente Hospital OB Patient Education (619) 528-5013 (inpatient) (619) 516-6124 (outpatient), 4647 Zion Ave, San Diego, CA 92120. Breastfeeding classes; consults in office and hospital. Breast pump rentals and sales, call (619) 528-5153. Kaiser members ONLY.

Naval Medical Center San Diego (619) 532-5261
34800 Bob Wilson Drive, San Diego, CA 92134-5000. Breastfeeding classes; office and hospital consults, with help for special needs mothers and infants; staff and client education.

Naval Hospital Camp Pendleton (760) 725-1331
Susan Mojica RN, MSN, 149 Los Padres Dr., Oceanside, CA, 92058

PALOMAR POMERADO HEALTH LACTATION SERVICES (800) 628-2880 www.pph.org email tlc@pph.org
Palomar Medical Center (760) 739-2434
555 E. Valley Parkway, Escondido, CA 92025. Breastfeeding classes; inpatient and outpatient lactation consults; telephone advice warmline; other related services.
Pomerado Hospital (858) 613-4605
15615 Pomerado Road, Poway, CA 92064. Breastfeeding classes; inpatient and outpatient lactation consults; telephone advice warmline; other related services.
Palomar Pomerado Women's Health Connection Boutique (858) 613-4894 Christine Gleason, RN, CLE
email cwg@pph.org 15725 Pomerado Road, Suite 100, Poway, CA 92064. Medela breast pumps for rental or purchase; pump kit accessories, nursing bras, breast-care products, breastfeeding classes and support groups.

SHARP HEALTHCARE LACTATION SERVICES
Grossmont Hospital Women's Center (619) 740-4983
5555 Grossmont Center Drive, La Mesa, CA 91942-4998. Inpatient and outpatient support services; individual consultation, group classes & support groups available; breast pump rentals & sales.
Sharp Chula Vista Medical Center Women's Pavilion (619) 482-5848, please leave a message after the beep.
751 Medical Center Court, Chula Vista, CA 91911.
Sharp Mary Birch Hospital for Women & New Beginnings Boutique (858) 939-4127 3003 Health Center Drive, San Diego, CA 92123. Hours: M-F 9-6, Sat 9-5, Sun 10-3 Breast pump rentals and sales, nursing apparel, large selection of nursing bras in many sizes, breastfeeding accessories, books and videos, breastfeeding classes and inpatient & outpatient lactation consultations.

Rady Children's Hospital San Diego (858) 576-1700 x7758
3020 Children's Way, San Diego, CA 92123. Inpatient lactation consults.

Tri-City Medical Center (760) 940-7745 Warm line
4002 Vista Way, Oceanside, CA 92056. Inpatient consults, classes (760) 940-5784; clinic appointments (760) 940-5500; and support group every Wednesday at 9:15 a.m. - 10:45 a.m.

UCSD Medical Center, Lactation Services (619) 543-7149*
200 West Arbor Drive, San Diego, CA 92103. Lactation consults; help for special needs mothers and infants; breastfeeding classes; support groups; staff and client education; breast pump rentals.

TONGUE-TIE (ANKYLOGLOSSIA) CLIPPING (FRENULOTOMY):
James W. Ochi, MD, FAAP (858) 792-4800
Children's ENT of San Diego, Inc.
324 Encinitas Blvd, Encinitas, CA 92024
http://ent4mykids.com

James G. Murphy MD, FAAP (619) 532-6863
Naval Medical Center, San Diego
34800 Bob Wilson Drive, Suite 201, San Diego, CA 92134. Military dependents only.

OTHER RESOURCES
Leon Kelley MD, FAAP (619) 262-8624
Children's Primary Care Medical Group, 292 Euclid Avenue #220, San Diego, CA 92114
Breastfeeding-supportive pediatric care.

La Leche League of San Diego County (858) 646-9779 www.lllusa.org/web/SanDiegoCA.html
International Headquarters 1-800-LA LECHE (847) 519-7730 www.lalecheleague.org Mother-to-mother support via monthly meetings & phone help countywide.

Birth Resource Network (619) 525-7753
www.birthresourcenetwork.org 3802 Alameda Way, Bonita, CA 91902. Gerri Ryan, Founder and President. BRN is a non-profit professional association of independently practicing doulas serving all of San Diego county.

March of Dimes (858) 576-1211
Jaqueline Nicholson jnicholson@marchofdimes.com
9325 Sky Park Court,Suite 250, San Diego, CA 92123.
Planning for a healthy pregnancy and a healthy baby.
Pre-conception information, prenatal, presentations, and referral.

Welcome Home Baby (760) 796-6859
Mary Bussen RN, LC mary.bussen@pph.org
Newborn home visiting and lactation support for first-time mothers funded by First 5 of San Diego.

WIC (Women, Infants, & Children) PROGRAMS
WIC offices offer classes, support groups, counseling and other services. Ask your local WIC office for details.
American Red Cross WIC Program * (800) 500-6411 www.sdarc.org/wic/ 3950 Calle Fortunada, San Diego, CA 92123
North County Health Serv WIC Program* (760) 471-2743
(888) 477-6333, Warm Line in Eng & Span, M-F 8am-4:30 pm, 150 Valpreda Rd, Suite 202, San Marcos, 92069
SDSU Foundation WIC Program* (888) 999-6897
8057 Vickers St. San Diego, CA 92111-1917
Scripps Mercy Hospital WIC Program* (619) 260-7054
550 W. Washington, #520, San Diego, CA 92103
San Ysidro Health Center WIC Program * (619) 426-7966 Remedios G. Reyes, J.Salazar@ext.dhs.ca.gov
1655 Broadway, Suite #18, Chula Vista, 91911 & 4004 Beyer, San Ysidro, 92173

UCSD Extension Lactation Training (858) 964-1069 http://extension.ucsd.edu/healthcare,
Email: unexhealthcare@ucsd.edu Healthcare Department, 9500 Gillman Drive, 0170-E, La Jolla, CA 92093. Online & in-class Lactation Specialist, Lactation Educator/Counselor and Lactation Consultant Specialized certificate; classroom and clinical education; BRN & CDR available

Back to the top

I Home I About Us I Contact Us I Education/Events I Newsletter I BF Resource Guide (English) I BF Resource Guide (Spanish) I
I Articles I Links I California Coalitions I Donor Human Milk I Advocacy/Legislation I Breastfeeding & Drugs I
I Statistics/Research I Search the Site I Fun Facts I FAQ's I Breastfeeding Promotion Phrases I