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Lan

Kids’ Fevers: What to Know, When to Get Help

Posted on by Lan

Most children will get a fever at some point. This can feel scary for parents. 

If you think your child has a fever, you may wonder: 

  • How do I know for sure? 
  • How can I keep my child comfortable? 
  • When should I seek health care? 

What is a fever?  

  • A fever is a sign your body is fighting an infection and is not dangerous.
    • Normal body temperature is about 37 C (98.6 F). 
    • A fever is when your body temperature is 38 C (100 F) or higher. 
  • Fevers are most often caused by infections. Your child may have other symptoms such as earache, sore throat, rash or stomachache. 
  • It is common for children to have a low-grade fever up to two days after an immunization. 

How do I know if my child has a fever? 

A child with a fever may: 

  • have red cheeks or pale skin 
  • feel very hot and sweaty or cold and shivery (or both) 
  • be more fussy or tired than usual 
  • not want to eat (loss of appetite) 
  • be more thirsty than usual 
  • feel hot to touch on the face or body but have cold hands and feet 

How do I take my child’s temperature? 

  • The safest way to take a young child’s temperature is to hold a digital thermometer under the armpit. 
  • Once your child is over two years of age, you can use an ear thermometer. 

Safety Tip

Do not use a mercury thermometer.  If it breaks, it can expose your child to mercury, which is poisonous. 

How do I care for my child with a fever? 

Keep your child comfortable by: 

  • Keeping them hydrated by offering plenty of fluids or breastfeeding/chestfeeding 
  • Removing extra blankets and clothing 
  • Dressing your child in light clothing: diapers or underwear and a light shirt to allow the extra heat to escape from your child’s body. 

Did you know? 

If cooling your child is making them shiver, this can increase the fever. Things to avoid doing: 

  • sponging your child with cold water 
  • giving your child a cold bath or ice bath 
  • using ice packs 

Does my child need medicine to lower the fever? 

  • When your child’s body is fighting an infection, they may get a fever. 
  • Your child does not need medicine to bring down the fever. However, a child with a fever may be cranky, sleepy and not want to eat or drink. Fever medication can be used to help your child feel more comfortable, alert and more likely to drink. 
  • Acetaminophen (Tylenol®, Tempra®) or ibuprofen (Advil®, Motrin®) are the medicines that can be used to reduce your child’s aches and pains from the fever and illness.
    • How much you give is based on your child’s age and weight. 
    • Follow the medicine’s directions for how much and how often you can give the medicine to your child. 

Safety Tips

To avoid giving your child too much medication: 

  • Use only the measuring syringe or cup that comes with the medicine. Kitchen spoons are not all the same and can cause overdosing. 
  • Make note of the time and amount you gave. Tip – your calendar or phone works great for this. 
  • Write clear instructions for other caregivers about your child’s medicine. (What medicine, how much and when). 

To keep your kids safe: 

Put all medicine away after every use, even if you are going to be using it again soon. Store it out of sight and out of reach of children. 

Choose the right medication for your child: 

  • Do not give acetylsalicylic acid (ASA, Aspirin®) to children because it can cause a rare and dangerous disease called Reye’s Syndrome. 
  • Do not give ibuprofen if your child is dehydrated, vomiting or has diarrhea because it can harm the kidneys. 
  • Do not give over-the-counter cough and cold medicines to children under six. 
  • Check with your pharmacist if your child is taking two or more medications to make sure it is safe. 

Call your local pharmacist or Health Links – Info Santé (Winnipeg 204-788-8200, toll-free 1-888-315-9257) for information. 

When should I seek health care? Where should I go? 

Call 911 or your local emergency number if: 

  • your child is having a seizure 
  • you cannot wake up your child 
  • your child is having severe difficulty breathing or is turning blue 

Go to your local emergency department or nursing station, or call Health Links – Info Santé at 204-788-8200 or toll-free 1-888-315-9257 if your child has a fever AND: 

  • is less than three months old.
  • has had a seizure today (child does not respond to you and may be stiff or have jerking movements) 
  • has difficulty breathing or is wheezing 
  • is immunocompromised (neutropenia, transplant, steroids, has no spleen) 
  • doesn’t seem like themselves
    • is very cranky, fussy or irritable. 
    • is very sleepy or does not respond to you 
  • has a headache or sore neck that does not go away with pain medicine 
  • has cool skin that looks pale, grey or mottled 
  • develops a rash that looks like bruises or small red or purple dots that do not go away when you apply pressure with your fingers 

Go to your child’s health-care provider or walk-in clinic, urgent care, nursing station or community health centre today if your child has a fever and: 

  • is older than three months old and:
    • looks unwell 
    • has no energy 
    • symptoms do not improve with fever medicine 
  • may be dehydrated:
    • throwing up a lot 
    • is not drinking fluids 
    • has a dry mouth 
    • is not peeing 
  • has a new rash or sore throat 
  • has an earache that does not go away with pain medication 
  • has symptoms of a kidney or urinary infection (pees more often than usual and it hurts to pee) 

Contact your child’s health-care provider if your child has a fever and:  

  • The fever has lasted for more than three days (72 hours) 
  • The fever went away for 24 hours and then returned 
  • Is being treated for a bacterial infection and the fever is not going away after two to three days of being on antibiotics 
  • Your child recently had surgery 
  • Your child has a chronic medical condition 
  • Your child’s immunizations are not up to date 
  • You have recently returned from travelling outside of Canada. 

If you do not have a health-care provider, Family Doctor Finder can help. 

Do you still have questions?  

Call Health Links – Info Santé (Winnipeg 204-788-8200, toll-free 1-888-315-9257). You can speak to a nurse 24/7, 365 days of the year in over 100 languages. They can answer any of your health questions and help you find services in your community. 

What to do if a seizure occurs 

In some cases, seizures can happen with a fever. This is known as a “febrile seizure.” Not all seizures cause stiffness or jerking movements of the arms and legs. Some seizures look like “passing out.” If your child develops a seizure: 

  1. Stay calm. 
  2. Place your child on a flat surface on their side. 
  3. Do not move them unless they are near something dangerous. 
  4. Do not restrain them (do not hold them down). 
  5. Wipe away any vomit or saliva outside their mouth, but do not put anything between their teeth. 
  6. After the seizure stops, keep your child on their side. 
  7. Call 911 for further instructions. 
  8. On the same day, take your child to their doctor for a check-up. 

Do I need to keep my child home? 

If your child is prescribed antibiotics, ask the doctor when the child can return to school or daycare. 

References: 

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How to Care for Your Child During Respiratory Virus Season

Posted on by Lan

Having a sick child can be scary. Know what symptoms to watch for, how to provide care and comfort at home, and when to seek help — it’s all part of providing good Kid Care! At an emergency department, the sickest patients are always seen first. Less sick patients will have to wait for care. 

Depending on your child’s symptoms, you may be able to provide care at home, or be seen faster by your doctor, at a walk-in clinic or urgent care, nursing station or health centre. When deciding where to go, consider these cold and flu symptoms to determine whether your child needs emergency care. 

EmergencyNot an Emergency
Breathing Problems
  • in respiratory distress, having difficulty breathing, breathing faster than usual
  • pale skin with blue lips
  • wheezing, not responding to medication
  • nasal congestion and cough
  • mild wheezing that is responding to medication and there is no difficulty breathing
Fever
  • in a child less than three months old
  • immune system or chronic health problems
  • difficult to wake or excessively sleepy
  • fever ongoing for more than five to seven days
  • neck stiffness with vomiting and sleepiness
  • unable to walk or weakness of arms or legs
  • fever with a new rash
  • in healthy and vaccinated babies older than three months
  • in children who are generally well
  • on its own a high fever does not require a trip to emergency
Vomiting or Diarrhea
  • in a child less than three months old
  • repeated vomiting and unable to keep down any fluids
  • signs of dehydration (no tears, has a dry mouth or sunken soft spot) or if no urine is passed for 12 hours
  • vomiting with blood
  • vomiting or diarrhea less than three or four times per day
  • ongoing diarrhea after the “stomach flu” as this can last for up to two weeks
  • see a doctor if there is bloody diarrhea or recent travel out of the country

Not sure where to go? 

For more information visit KidCareMB.ca. 

Vaccination 

All children in Manitoba aged six months and older can get COVID and flu vaccines. Keeping your kids up to date on vaccinations can prevent them from getting sick. There are many locations across the province where they can be immunized, and we have an online map to help you find a spot that is convenient. 

Book Now at Manitoba.ca/vaccine or Protect Our People MB  

Fevers

Fever is not dangerous. It is the body’s natural response to infections and actually helps to fight infection. Higher temperatures do not mean the infection is more serious and a fever on its own does not require medical attention in most children.

You do not need to treat fever with medicine. Cool your child by dressing them in light clothing, offering extra fluids and keeping the room cool. 

*Children under three months of age and those with chronic health conditions should be seen if a fever develops. See Kids Fevers: What to know, when to get help. 

A Dose of Prevention Goes a Long Way! 

A house: Stay home - Keep sick kids at home to slow the spread. A hand and drops of water: Hand washing - Teach your kids to wash hands with soap for at least 20 seconds. A figure coughing into a tissue: Cough - cover your cough or sneeze. A mask: Masks - consider wearing a mask when indoors in crowded locations.)

Need Advice? 

Health Links – Info Santé can help 24/7. Call 204-788-8200 or 1-888-315-9257 

In an emergency, call 9-1-1 or your local emergency number. 

Visit KidCare! 

Kid Care – How to Care for Your Child During Respiratory Virus Season 

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Caring for Your Child with Pertussis

Posted on by Lan

What is pertussis (whooping cough)? 

Pertussis is an illness caused by a type of bacteria (germs) known as Bordetella pertussis that gets into your child’s nose, throat and lungs. Pertussis is very serious because: 

  • It causes long, intense coughing spells that makes it hard for infants and children to eat, drink or even breathe. 
  • It can lead to pneumonia, brain damage, seizures and death, especially in infants.
    • About one in 400 infants with pertussis dies because of pneumonia or brain damage. 
  • A child can be sick with pertussis for two to three months .

What are the symptoms of pertussis? 

Symptoms generally appear nine to 10 days after infection and can vary based on age. 

Pertussis usually starts like a cold with a runny nose, red watery eyes, mild fever and cough. 

After a few days, the cough may worsen with coughing spells that are followed by a “whoop” sound before the next breath. The cough is usually severe for two to three weeks before it starts getting better.  

Your child may cough so much that they: 

  • throw up 
  • have trouble breathing 
  • become exhausted 

Check out this video from the Mayo Clinic to hear what a whooping cough sounds like.

Note: Other videos may be recommended by the host channel (e.g. YouTube, Vimeo).  These suggestions may be based on your personal search history and other factors. The Manitoba Government does not control these suggestions and is not responsible for and may not endorse the content.

How do you get pertussis? 

Pertussis is very contagious. It is easily spread from one person to another though the air when a person with pertussis sneezes or coughs. This can happen when spending time with someone with pertussis 

How can I protect my child? 

The best way to protect you or your child is to be immunized with a pertussis containing vaccine.   

Did you know? 

If your child is exposed to pertussis and is not vaccinated or up to date, you should get them vaccinated right away.  If your child gets pertussis the vaccine, it may reduce the severity.

What should I do if I think my child has pertussis?  

If you suspect your child has pertussis, take them to:  

If you do not have a health-care provider, Family Doctor Finder can help. 

How is pertussis diagnosed? 

  • To diagnose pertussis, your health-care provider will take a swab from your child’s nose and test it.  
  • A health-care provider will contact you if you or your child tests positive for pertussis and will provide further information on prevention of exposure to others. 

How is pertussis treated? 

  • Treatment with appropriate antibiotics can help to shorten the length of symptoms and prevent the spread to others. 
  • If antibiotics are prescribed, your child should take all the medication, even if they seem better. 

Do I need to keep my child home? 

  • If your child has pertussis, your child is contagious. They need to have antibiotics for five days before they can attend daycare or school. 
  • After being treated for five days with appropriate antibiotics, only send them if they are feeling well enough to attend.  
  • Avoid contact with infants under one year of age, pregnant women and those who are unvaccinated until considered no longer infectious.   
  • A public health nurse will contact you if you or your child tests positive for pertussis and will provide further information on prevention of exposure to others. 

Tips for comforting your child: 

  • Keep your child hydrated by offering plenty of fluids or breastfeeding/chestfeeding on cue. 
  • Let your child rest .
  • If your child is over one year old and does not have an allergy, offer them honey. 
  • If your child has a fever, dress your child in light clothing and remove any extra blankets. 
  • Acetaminophen (Tylenol®, Tempra®) or ibuprofen (Advil®, Motrin®) are the medicines that can be used to reduce your child’s aches and pains from the fever and illness.
    • How much you give is based on your child’s age and weight. 
    • Follow the medicine’s directions for how much and how often you can give the medicine to your child. 
    • Do not give any medication if your child is allergic to it. 

Safety Tips

To avoid giving your child too much medication: 

  • Use only the measuring syringe or cup that comes with the medicine. Kitchen spoons are not all the same and can cause overdosing. 
  • Make a note of the time and amount you gave. Tip: your calendar or phone works great for this. 
  • Write clear instructions for other caregivers about your child’s medicine – what medicine, how much and when. 

To keep your kids safe

Choose the right medication for your child

  • Do not give acetylsalicylic acid (ASA, Aspirin®) to children because it can cause a rare and dangerous disease called Reye’s Syndrome. 
  • Do not give ibuprofen (Advil®, Motrin®) if your child is dehydrated, vomiting or has diarrhea because it can harm the kidneys. 
  • Do not give over-the-counter cough and cold medicines to children less than six years old. 
  • Check with your pharmacist if your child is taking two or more medications to make sure it’s safe. 

Call your local pharmacist or Health Links-Info Santé (Winnipeg 204-788-8200, toll-free 1-888-315-9257) for information.  

How to prevent the spread of pertussis 

When to seek emergency care 

Call 911 or your local emergency number if: 

  • your child is having severe difficulty breathing or is turning blue 
  • your child is having a seizure 
  • you cannot wake up your child 

Go to the emergency department, nursing station or health centre if your child: 

  • is coughing so hard and for so long that they cannot breathe or stop breathing 
  • has had a seizure today (child passes out and is stiff or has jerking movements) 
  • has difficulty breathing or is wheezing 

References

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Got Too Much Milk?

Posted on by Lan

Sometimes a parent may make far more milk than their baby needs. Extra pumping, taking herbal supplements or prescription medication (e.g., domperidone) that increase milk supply can lead to oversupply. Parents with too much milk may have frequently engorged breasts/chest which could lead to mastitis or plugged ducts. So how do you know if you have too much milk? And what can you do about it? 

You may notice: 

  • Your breast/chest size growing more than two cup sizes. 
  • A strong or painful “letdown” of milk once or many times when baby is feeding. 
  • Milk sprays from the nipple if baby unlatches. 
  • It is very easy to express your breastmilk/chestmilk. 
  • The other breast/side of the chest leaks when you are feeding on the opposite breast/side. 
  • Your breasts/chest feel very full or hard most of the time. 
  • Frequently blocked ducts or mastitis. 

Your baby may: 

  • Gulp quickly, cough, choke or sputter while feeding at your breast/chest. 
  • Bite the nipple to try and slow down the milk. They may come off the breast/chest often or not able to stay latched. 
  • Stiffen their body, arch their back or scream. 
  • Spit-up and be gassy. 
  • Have green or watery poop and lots of heavy, wet diapers. 
  • Gain too much weight quickly. 

Did you know? 

If you are unsure if you have too much milk, you can check in with your health-care provider or public health nurse. 

“I have so much milk and yet my baby still seems hungry” 

If you have too much milk, you may be surprised that your baby: 

  • is hard to settle 
  • seems unsatisfied 
  • wants to feed often 

This is because your baby is filling up on the foremilk that contains more milk sugar (lactose), which doesn’t keep them feeling full. This also causes a gassy baby and green poops. For more information on foremilk and hindmilk, see Le Leche League’s information on oversupply. 

What can help? 

Adjust your breastfeeding/chestfeeding position to one that allows baby’s head to be level with or above the breast/chest. This way: 

  • Gravity won’t have as much effect on your milk flow. 
  • Choking is reduced, since milk is directed away from the back of baby’s throat. 

Laid-back Nursing 

Do the cradle, cross cradle or football hold and then lay back. 

hree breastfeeding/chestfeeding positions demonstrated by a person wearing a hijab: Cradle position showing the baby supported on one arm with the head in the crook of the elbow; Cross-cradle position showing the baby supported with the opposite arm while the hand cradles the baby’s head; Football hold showing the baby tucked under the parent’s arm on a pillow, with the head supported by the hand.
A person breastfeeding/chestfeeding a baby while reclining back on a couch.
  • Get comfortable with your back supported either in bed, on a couch or in a recliner. 
  • Latch baby using whatever hold you choose (cradle, cross-cradle or football), then lay back so that baby’s head is either at the same level as the breast/chest or above it. You can use pillows to support baby as well. 

Side-lying 

an adult lying in bed on their side while breastfeeding/chestfeeding their baby and demonstrating the below four points.
  • Lay down on your side. Use cushions or pillows to support your back, shoulders and neck. Be sure none of these supports are covering or near your baby’s face or head. 
  • Place baby on their side facing you with their ear, shoulder and hip in a straight line. Pull your baby in close, tummy to tummy. Your baby’s nose should be lined up with your nipple. 
  • Place a rolled-up towel or baby blanket behind your baby for support. Remember to remove it after you finish feeding. 
  • Latch baby to your breast/chest. 

Baby sitting upright in front 

An adult breastfeeding/chestfeeding a baby while sitting cross-legged on the floor with the baby sitting upright on adult’s knee.
  • Find a comfortable position. You may want to support your back and use a footstool for your feet. 
  • Position baby so they are sitting upright, straddling one of your legs as close to your body as possible. You may need to use a pillow under baby to get them to the level of your nipple. Latch baby to your breast/chest. You may choose to lay back or stay sitting upright. 

Safety Tip

When using pillows or rolled up towels or blankets to position yourself or your baby, make sure that none of these supports are covering or near your baby’s face or head. When your baby is finished feeding, place them in a crib, cradle or bassinet for sleep.  

How to reduce oversupply if you have too much milk 

  • Feed your baby based on their hunger cues: Feed your baby as soon as they show signs of hunger (licking their lips, opening and closing the mouth or sucking on their hands/fingers). This is when babies are more likely to suck gently. If you wait until your baby is very hungry, crying and frantic (late hunger cue), they are more likely to suck harder. 
  • Avoid any extra pumping.  If you are separated from your baby or are exclusively pumping, aim to produce only the amount of milk your baby needs and not more. 
  • Express only a little milk to get relief if your breasts/chest are full. 
  • Talk to a health-care provider to discontinue any medications or overthe counter supplements that you are taking to increase milk supply. 
  • Feed with one breast/side of the chest each time. Offer only one breast/side of the chest until baby is satisfied. Switch to the other side on the next feed. 
  • Block feeding is meant to be a short-term strategy. How to do it:
    • Use only one breast/side of the chest to feed baby for a block of three hours. If the other breast/side feels uncomfortable during this block of time, express only enough milk to relieve the pressure. 
    • After this three-hour time has passed, switch to the other breast/side of the chest for the next three hours. 
    • Because this reduces your milk supply, you don’t want to continue this for too long. If you have questions or need support, speak with your health-care provider or public health nurse. 

If you have a strong letdown:

Express before feeding

Express some milk for one to two minutes before putting baby to your breast/chest. This can help release the first big rush of milk and help slow the flow to an amount that baby can handle. 

Un-latch baby when coughing, choking begins

Allow this rush of milk to spray onto a towel or into a sterile container. Re-latch baby once the flow of milk has slowed down. Repeat if it happens again. 

Use the scissor-hold on your breast

Use the first and second fingers of your free hand to push the area just above and below the edge of the areola (the darker area around the nipple). Your fingers will look like a pair of scissors. The pressure should slow down the flow of milk. Change the position of your fingers around the areola to avoid blocking the milk duct. You can stop doing this when the flow of milk slows down. 

Burp Baby Often

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Burping Your Baby

Posted on by Lan

Babies often swallow air while feeding, which can make them uncomfortable. This happens with breastfed/chestfed and bottle-fed babies. Burping helps get rid of air that the baby has swallowed. Burp your baby: 

  • Part-way through the feed and then again after feeding. 
  • When they seem uncomfortable. 
  • When breastfeeding/chestfeeding when/if you switch sides during feeding. 
  • More often if the baby has problems with gas or spitting up. 

Signs that your baby may need to burp: 

  • arches the back 
  • gets fussy or cranky 
  • pulls away from the bottle 
  • slows or stops sucking 

Did you know?

Crying babies swallow a lot of air which can cause discomfort and spitting up. Watch your baby for hunger cues and feed before they are hungry to prevent crying.  

To Burp a Baby

  • Place the baby in an upright position. See the pictures below for good burping positions. 
  • Gently rub or pat baby’s back with a cupped hand. The baby will not always burp each time you do this. Wait a few minutes and try again. 
  • Sometimes formula or breastmilk/chest milk comes up with the air when the baby burps. A clean face cloth, cloth diaper or bib can help keep you and the baby clean during burping. 

To help the baby swallow less air during bottle feedings: 

  • Make sure the formula is not too hot or too cold. 
  • Sit the baby upright in your arms when feeding. 
  • See our page Bottle-Feeding 101 for tips on bottle-feeding. 

Most babies burp on their own after two months of age. 

Try These Positions to Burp Your Baby

Hold your baby upright over your shoulder 

an adult holding a baby upright on their shoulder while burping them.

Place your baby on their stomach across your lap. 

An adult holding a baby on their lap, with one hand supporting their jaw and the other hand on their back.

Hold your baby in a sitting position on your lap. Your baby should be leaning slightly forward with your hand supporting the jaw.

an adult holding a baby across their lap with the baby on their stomach.)

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How to Express and Store Breastmilk

Posted on by Lan

Feeding your baby early and often at the breast/chest is helpful to establish your milk supply and breastfeeding/chestfeeding relationship with your baby. Expressing your milk stimulates your body to make more milk. There may be times when you want to give your baby expressed breastmilk/chest milk. 

Do I need to pump to breastfeed/chestfeed?

If your baby is growing well and you do not have to be away from them, don’t feel like you have to pump. If you are pumping because you are worried about your breastmilk/chestmilk supply, check out our breastfeeding/chestfeeding resources and reach out for help. 

What do I need to know about exclusive pumping?  

Exclusive pumping is another way to provide breastmilk/chestmilk to your baby. If you decide to exclusively pump, express milk at a frequency that mimics how often your baby feeds. Initially, this could mean pumping every one to three hours for a newborn. As your baby gets older, they would go longer intervals without feeding. Use the most comfortable pressure setting and pump for 10 to 15 minutes. It would also be important to check if the flange size of your breast pump is a good fit for you. 

Ways to Express your Breastmilk/Chestmilk 

Expressing by hand

Expressing by breast pump/chest pump

  • You can rent or buy different types of breast pumps/chest pumps. Ask your midwife, public health nurse, lactation consultant or pharmacy for more information. 
  • When you are choosing your breast/chest pump, try and find one that meets your needs and you feel comfortable using.

Did you know? 

If you have health care benefits, you may have coverage for a breast/chest pump. It may be listed under special medical devices and you might need a doctor’s prescription. 

Types of Breast Pumps/Chest Pumps

Manual (hand-held) breast pumps/chest pumps

A manual breast pump and bags of breast/chest milk.

Single electric breast/chest pump

A single electric breast pump latched onto a breast.

Double electric breast pump/chest pump 

A double electric pump latched onto both breasts.
 

How should I store my expressed breast milk?

How should I store my expressed breastmilk/chestmilk? 

  • Freshly expressed breastmilk/chestmilk is safe to use at room temperature for up to four hours. 
  • Breastmilk/chestmilk must be stored in a sterilized bag or container.
    • You can buy sterile milk storage bags designed for freezing and storing breastmilk/chestmilk. 
    • If you are using a container, you must sterilize it. See below for information on how to sterilize.

a stainless steel refrigerator

In a refrigerator for 3-5 days. In a fridge freezer for 3-6 months.

A white deep freezer with the door opened.

Store your milk in a deep freezer for six to 12 months

Did you know?

You can freeze your milk in two-to-four-ounce (60-120ml) quantities so you can thaw and warm it quickly. You can label the stored milk with the day, month and year.

How to Clean and Sterilize Your Equipment

Step by step instructions on how to sterilize, with corresponding images. 1. Wash and clean your hands and countertops with soap and water. 2. Wash all items in warm, soapy water and make sure nipple holes are not clogged. 3. Use a bottle brush that is only used on your infant feeding equipment. Scrub the inside of the bottles and nipples to make sure they are clean. 4. Rinse all items in hot water. Place on clean surface. Now you are ready to sterilize. 5. Put items in a large pot. Fill the pot with enough water to cover all the items. Bring water to a rolling boil for two minutes. 6. Let water cool. Remove items with tongs and place no clean towel.)

How do I use frozen breastmilk/chestmilk? 

  • Place frozen milk under cold running water until thawed or thaw frozen milk in the fridge for several hours before it is needed. 
  • To warm breastmilk/chestmilk, place container in a bowl of warm water. Never heat breastmilk/chestmilk in the microwave because it can cause hot spots that can burn the baby’s mouth and affect the quality of the milk. 
  • Thawed breastmilk/chestmilk should be refrigerated and used within 24 hours. Do not refreeze. 
  • Frozen milk can separate when thawed, so shake the container gently. 

Safety Tips

When purchasing bottles look for ones that are BPA free. 

It is recommended to sterilize all your equipment for the entire time your child is bottle feeding. 

Reference

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Breastfeeding/Chestfeeding – Common Questions

Posted on by Lan

You may have some questions about breastfeeding/chestfeeding. Find the answers to some frequently asked questions below.

What is triple feeding?

Triple feeding is when you do three things to feed your baby – feed at the breast/chest, express milk by pumping and feed the expressed milk or formula to your baby. It is meant to be a temporary measure to increase breastmilk/chest milk supply and help babies gain weight. If you are looking for more information read our breastfeeding/chestfeeding resources.

Why is paced feeding important?

Paced feeding is a method of bottle feeding that mimics feeding at the breast/chest. Holding the baby upright and the bottle parallel to the ground ensures a slower milk flow out of the bottle. If the baby pauses to breath or because they are full, you can tilt the bottle down.

Paced feeding:

  • protects direct breastfeeding/chestfeeding
  • prevents using up more breastmilk/chest milk stash or formula than needed
  • prevents overfeeding the baby.

Watch this video to learn how to feed your baby with a paced bottle.

Do I need a special bra?

  • On average, you can expect to go up one cup size, and one band size, by the time you are breastfeeding/chestfeeding.
  • Not everyone finds that a maternity or nursing bra is necessary. Some breastfeeding/chestfeeding parents just use an inexpensive and comfortable sports bra.
  • Nursing bras have clasps or panels that allow easy access to your breasts/chest for breastfeeding/chestfeeding.
  • For comfort, choose a bra with wide straps, extra hooks and eyes on the band and comfortable breathable material (such as cotton).
  • Wear a comfortable and supportive bra that is not too tight. Avoid underwire bras as they can block your milk ducts.
  • If you were binding prior to pregnancy, you may already have stopped due to increasing chest sensitivity while pregnant. While you are breastfeeding/chestfeeding, wearing something less restrictive with more flexibility than a chest binder can be helpful in milk production and lower the risk for mastitis.

Did you know?

You may leak breastmilk/chest milk in between feedings. Breast/chest pads can help absorb the milk. You can find breast/chest pads in the baby section at most stores.

Be sure to change wet breast/chest pads often so they don’t grow bacteria which can lead to thrush. See below for more information on thrush.

breast pad

Are sore nipples common?

It’s common to feel some pain when your baby latches on for the first few days. This happens because your baby stretches your nipple deep into their mouth while breast/chest feeding and your body is not used to this sensation. The pain happens when the baby first latches on and should go away within a minute with a good latch.

You should no longer feel this pain with latching by four to seven days.

What you can do:

  • You can get some relief by rubbing colostrum or breastmilk/chest milk on your nipples and letting it dry.
  • If your nipples continue to be sore, try changing how you hold your baby while breastfeeding/chestfeeding, and get help with the latch.
  • Pure lanolin products can also help heal nipple pain.

Did you know?

If your nipple pain continues throughout the entire feed- you should get help with your latch. Contact your Public Health Nurse, Health Care Provider, nursing station or health centre. Check out our breastfeeding/chestfeeding resources.

Should I take medications to help increase breast milk?

Get breastfeeding/chestfeeding support if you are having trouble breastfeeding/chestfeeding. Personal help can make all the difference. For a list of places that can help, see Breastfeeding/chestfeeding resources.

Domperidone is a prescribed medication that can increase breastmilk/chest milk supply. It is generally safe and can be effective in increasing breastmilk/chest milk supply, along with adequate breastfeeding/chestfeeding or expressing breastmilk/chest milk. Speak to your health care provider to see if this medicine is right for you.

  • Domperidone can react with other medications so be sure to tell your health care provider that you are using it if you are being prescribed other medications.
  • This drug can have some side effects so take only as prescribed. Be sure to taper slowly if you want to stop taking the medication.
  • Seek help if you experience mood and or anxiety symptoms anytime before, during or after pregnancy.

Why do my breasts feel like they are going to explode?

In the early days of breastfeeding/chestfeeding it is common for your breasts/chest to swell up with milk. This is called engorgement. Your breasts/chest may feel full, heavy and at times be painful.

Engorgement can also happen after you have been breastfeeding/chestfeeding for many weeks if feedings are missed. To avoid this:

  • Breastfeed/chestfeed on demand (on baby’s cue) day and night
  • Express your milk if you miss a feeding
  • If you are starting to wean- do this slowly

Tips for easing engorgement:

  • Soften your breast/chest by expressing milk for a few minutes, either by hand or with a breast/chest pump (this will make latching easier).
  • Make sure your baby is latched on well, and feeds long enough until your breasts/chest feel soft.
  • Gently massage your breasts/chest (also called breast/chest compressions) while breastfeeding/chestfeeding. This will keep your milk flowing. Watch this video to learn more.
  • Between feedings, apply cold (cold towels, a diaper soaked in cool water, cabbage leaves) to your breasts/chest for 15-20 minutes. This will help to lessen swelling and pain.
  • If engorgement is not lessened with the above methods:
    • Express your breastmilk until you feel comfortable. (by hand, or with a pump)
    • Use cold compresses to lessen swelling and pain.
    • If necessary, take medications as advised by your health care provider.

Did you know?

  • The good news is engorgement generally only lasts a couple of days. 
  • Feed your baby at least 8-12 times in 24 hours, and at least every 3 hours during the day. Continue night feedings. 
  • As you and your baby learn to breast/chest feed your body will adapt to meet your baby’s needs. 
  • Feeding your baby early and often helps to prevent and relieve this discomfort. Feed your baby whenever they show early feeding cues.

Mastitis (breast/chest inflammation): 

Mastitis is painful inflammation in the breast  tissue/chest tissue which can affect parents who breastfeed/chestfeed or exclusively pump.  Mastitis can cause pain, swelling, warmth and redness on your breast/chest and can make you feel run down and tired. Some parents may consider weaning their baby sooner then they intended. The good news is you do not need to wean. You can continue to breastfeed/chest feed while your mastitis is healing. For more information on mastitis click here.

What is a nipple bleb or milk blister?

  • A nipple bleb forms because of inflammation of the tissue in the nipple.
  • It usually shows up as a painful white or yellowish dot on the nipple or areola.
  • If you squeeze your breast/chest, the bleb or blister will typically bulge outward.

What to do if you have a nipple bleb or milk blister:

  • Do not pick the nipple bleb or milk blister.
  • Continue breastfeeding/chestfeeding.
  • Talk to your health care provider to discuss if you need a prescription for a steroid cream to help with healing.
a baby breastfeeding/chestfeeding

Plugged Ducts

A tender lump that does not go away with breastfeeding/chestfeeding may be a plugged duct.

What you can do to prevent:

  • Breastfeed/chestfeed your baby on demand on both of your breasts 
  • When unable to breastfeed/chestfeed, express breastmilk/chest milk at the same frequency you would breastfeed/chestfeed (with a breast pump/chest pump or by hand)
  • Avoid pressure on the area (wear a comfortable bra, avoid sleeping on the side where you feel pain)

How to treat a plugged duct:

  • Apply cold to your breasts/chest for a couple minutes (a cold towel, a clean disposable diaper filled with cold water, a shower)
  • Breastfeed/chestfeed your baby on demand on both of your breasts 
  • When unable to breastfeed/chestfeed, express breastmilk/chest milk at the same frequency you would breastfeed/chestfeed (with a breast/chest pump or by hand)
  • Gently massage the area with your fingertips while you breastfeed/chestfeed
  • Contact your health care provider as necessary.

Oral Thrush (Yeast Infections)

Cracked nipples or mastitis can lead to a yeast infection on your nipples.

You may have thrush if you have:

  • a shooting, burning pain in the nipple, areola (dark part around your nipple) and breast/chest
  • pain that happens while feeding, even with a good latch, and continues after you breastfeed/chestfeed
  • pinker than usual nipples
  • nipples that are very sensitive to touch
  • nipple cracks that are not healing

Thrush can spread back and forth between you and your baby.

a close up of baby’s tongue with oral thrush. The tongue appears to have a white coating.

Your baby may have thrush if:

  • they have small white patchy spots on their tongue, gums and/or roof of mouth that look like milk but do not rub off
  • they are fussy while breastfeeding/chestfeeding
  • they come on and off your breast/chest while feeding
  • they are gassy and cranky and may have slow gain weight

If you or your baby have any of these signs and symptoms, see your health care provider as soon as possible. You will both need to be treated for yeast infections at the same time. Antifungal creams are used to help clear up thrush.

To prevent reinfection:

  • Wash your bras daily and avoid using breast/chest pads if possible.
  • If you are using a breast pump/chest pump, boil the parts that touches the milk daily.
  • A soother can carry thrush back into your baby’s mouth, if possible, try not to use it and/or replace it frequently. Boil it daily.

What is “tongue-tie”?

Tongue-tie is a fairly common condition that runs in families. It occurs when a thin web of skin under the tongue “ties” the tip of the tongue to the floor of the mouth.

Signs of tongue-tie in the infant include:

  • When the tongue looks heart-shaped or notched when stuck out
  • Difficulty sticking the tongue out past the lower teeth or up to the upper teeth
  • Difficulty moving the tongue from side to side of the mouth
close up of a baby’s open mouth, showing a baby with a tongue tie (a tight piece of skin under their tongue

How a tongue-tie may affect breastfeeding/chestfeeding:

  • Tongue-tie is a problem for somebreastfeeding/chest feeding people and babies.
  • This is because your baby uses the tongue to get milk from the breast/chest.
  • The tongue-tie prevents the baby’s tongue from extending far enough to get a proper latch. This is what can cause a person to feel pain during breastfeeding/chestfeeding.
  • Your baby may have trouble getting enough milk out of the breast/chest.
  • Mothers often complain about very sore nipples and the baby may be hungry and fussy.

How to treat tongue-tie?

  • Sometimes a tongue-tie will stretch over time, allowing the tongue to move better as the baby grows.
  • If you have early and ongoing breastfeeding/chestfeeding problems, a simple procedure called a frenotomy may free the tongue and help your baby to feed. This procedure can be done on an out-patient basis with minimal if any bleeding or pain.
  • Your health care provider can assess the tongue-tie and provide information on where to get frenotomy.

References:

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What’s in My Breastmilk/Chestmilk?

Posted on by Lan

At about 21 weeks of your pregnancy, your body starts making milk which you may not notice until after delivery. Breasts/chests of all shapes and sizes can make milk. Your breasts/chest are designed to make as much milk as your baby (or babies – twins, triplets) needs. The more often your baby feeds, the more milk you make (also known as supply and demand). Your breastmilk/chestmilk changes daily to meet the nutritional needs of your growing baby. 

Your breastmilk/chestmilk has three different stages: 

Colostrum: 

  • Your first breastmilk/chestmilk is called colostrum. Your body starts to make colostrum when you are around four months pregnant, and it will last up to four days after you give birth. It is either yellowish or creamy in color. Colostrum is high in protein, fats, vitamins and antibodies. Consider colostrum your baby’s first immunization. This is the first milk your baby will get when you breastfeed/chestfeed. 
  • At this point many parents worry that they are not producing milk, and they are concerned that their baby is not getting enough. 
  • Colostrum provides all the nutrients your baby needs for the first few days of life. Your baby’s tummy is the size of a dime at birth so they will only need a little bit at a time. This is why babies need to feed so often. 

Transitional Milk 

  • Three to four days after you give birth, your breasts/chest will become fuller and heavier. Birthing parents often refer to this as their milk “coming in.” Transitional milk looks like milk mixed with orange juice. It has less antibodies and protein than colostrum but has more sugar, fats and calories, which your baby needs for growth. 

Mature milk 

  • This will come in about 10 days after you give birth. It looks like watery skim milk because it is 90 per cent water. This will keep your baby hydrated. The other 10 per cent is made up of the carbohydrates, proteins and fats your baby needs for growth and energy. 
a closeup of a nipple with milk flowing from it

Our bodies are amazing! They make the right type of milk our babies need as they grow and develop. 

Check out this video!

Note: Other videos may be recommended by the host channel (e.g. YouTube, Vimeo). These suggestions may be based on your personal search history and other factors. The Manitoba Government does not control these suggestions and is not responsible for and may not endorse the content.

Need help getting started with breastfeeding/chestfeeding? See Breastfeeding – Getting Started. 

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RSV (Respiratory syncytial virus)-What to Know, When to Get Help

Posted on by Lan

Respiratory syncytial virus (RSV) is usually mild and doesn’t need any treatment. Most children do not need to see a doctor. If you are not sure if your child needs to see a doctor, call Health Links – Info Santé (204-788-8200 or toll-free 1-888-315-9257). 

RSV is the most common virus that can infect the lungs and breathing tubes. RSV infection is most serious in young babies. Almost all children get the virus at least once before they are two years old. Older children and adults also get RSV at least every few years, but do not usually get very sick from it. 

How is it spread? 

RSV is very contagious. The virus is most common between late fall and early spring. RSV spreads the same way as a common cold: 

  • By touching something that has the virus on it, then touching your mouth, nose or eyes with unwashed hands.  
  • By being close (less than two metres apart) to someone with the infection who is coughing or sneezing. Droplets from the infected person can reach another person’s nose or mouth. 

What are the symptoms of RSV? 

Children with RSV have the same symptoms as a common cold, which may include: 

  • coughing
  • runny nose
  • fever
  • decreased appetite and energy
  • irritability

Some children (most often very young babies) may have bronchiolitis – an infection of the tiny airways that lead to the lungs that causes wheezing and difficulty breathing. 

How is RSV treated? 

RSV is usually mild and doesn’t need any treatment. Most children get better within a week or two.  Sometimes children need to be hospitalized so that they can be watched closely and given fluids or oxygen if needed. Because RSV is a virus, antibiotics will not help a child get better faster (antibiotics kill bacteria, not viruses). 

How can I protect my children from RSV? 

Keep babies under six months old away from people with colds, if possible. 

  • Wash your hands and your children’s hands often to reduce the spread of germs. 
  • Breastfeeding /Chestfeeding. Breastmilk/chestmilk contains antibodies and other immune factors that help prevent and fight off illness. 
  • Don’t smoke. Make sure that your children are not around cigarette smoke, especially in the car or in your home. 
  • Make sure your child receives all recommended immunizations. Vaccines won’t prevent your child from getting RSV or other viruses that cause colds, but they will protect your child from some of the complications a cold can cause. 
  • Infants and young children who are at risk of severe RSV infection, such as those with heart or lung disease or those who are born very early, are eligible to receive an antibody medication to protect against RSV through the Manitoba RSV Prophylaxis Program.  

What can I do if my child is sick? 

Keep your child at home and as comfortable as possible. Offer plenty of fluids. 

  • Give acetaminophen or ibuprofen for fever. Ibuprofen should only be given if your child is drinking reasonably well. Do not give ibuprofen to babies under six months old without first talking to your doctor. Speak to a health-care provider if you are unsure of what to take or are unable to use these medications.  
  • If your baby is having trouble drinking, try to clear nasal congestion gently with a bulb syringe or with saline (salt water) nose drops. 
  • Do not give over-the-counter cough and cold medicines to a child younger than six years old. Although these drugs do not need a doctor’s prescription, they are not safe in young children. 
  • If you are using cough and cold medicines for children older than six years, read instructions carefully and give only the recommended dose. 

When should I seek immediate medical care? 

Take your baby to an emergency department if your child: 

  • has trouble breathing or has lips that look blue,
  • is younger than three months old and has a fever 
  • is no longer able to suck or drink and is showing signs of dehydration (dry mouth, less urine output) 

See a doctor if your child: 

  • has had a fever for more than 72 hours
  • is not eating or is vomiting
  • is not having wet diapers
  • is coughing so bad that they are choking or vomiting

If you have questions about RSV, speak with your primary care provider – your doctor, registered nurse, public health nurse, nursing station or health centre , or call Health Links – Info Santé at 204-788-8200 or toll-free 1-888-315-9257.  

For more information on where and when to seek health care, see Cold and Flu – When to Seek Healthcare . 

Reprinted with permission from the Caring for kids (cps.ca)

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