First Things First!

For many expectant moms, this is a happy, exciting time, but it can also be overwhelming. If this is your first child, you may feel overwhelmed by all the things you need to know about having a baby. There’s a lot to learn. But you don’t have to know everything right away. You can choose to read as much as possible about your pregnancy now, or you can learn about each stage as you go along. The great thing is that your maternity care nurse will be with you every step of the way!

Maternity care

Early and regular prenatal care is essential to help keep you and your baby healthy and decrease your chances of premature delivery. You should see your health care provider once a month for the first 24 weeks of pregnancy. As you move further along in your pregnancy, you will visit the doctor more frequently. Expect weekly doctor visits for the last four weeks of your pregnancy.

It’s important that you go to every prenatal visit. These visits may seem simple and routine, but they are very important. The sooner an issue is identified, the better

your chances of getting it under control. Throughout your pregnancy, your provider will perform a variety of tests to keep a close eye on you and your baby’s health. You also get to experience the exciting moment when you hear your baby’s heartbeat and see your baby for the first time with an ultrasound. It’s equally important to schedule a postpartum visit four to six weeks after your baby is born. The postpartum appointment allows your doctor to check how you’re recovering, both physically and emotionally, from childbirth.

If you need help with prenatal care, find out about free or low-cost services in your area:

• Call 800-311-BABY (800-311-2229). This toll-free telephone number will connect you to your local health department.

• For information in Spanish, call 800-504-7081.

Add your baby to your policy

Add your newborn to your insurance as soon as possible. Contact the employer of the person in your family who will add the baby to his or her policy within 30 days of the birth. Whether you choose to enroll your baby with us or with another insurer, the sooner you enroll your baby, the sooner your baby’s bills will be paid!

Congratulations on your pregnancy!

Healthy habits to last TWO lifetimes!Now more than ever, it’s important to make healthy lifestyle choices part of your daily routine. Get regular exercise, eat a healthy diet, drink lots of water, get plenty of rest and reduce or eliminate caffeine. You also need to avoid alcohol, tobacco and illegal drugs. These substances can create lifelong health problems and can even be fatal for your baby.

Exercise during pregnancy is perfectly safe. In fact, it’s recommended! Unless your provider cautions against it, you should exercise 30 minutes a day for at least five days a week. Be sure to drink an extra 8-ounce serving of non-caffeinated beverage for every hour of activity you do. As with starting any new exercise regimen, talk to your provider about which exercises are best for you.

Get moving!

Nutrition — you are what you eat … and so is your baby!Having a healthy diet is one of the most important things you can do for yourself and for your baby’s long-term health.

Pregnancy experts recommend that you only add 300 calories a day to your diet when pregnant. You may need to add more calories if you are expecting multiples. Talk to your provider about your specific nutritional needs.

You should also drink at least eight to 10 8-ounce servings of non-caffeinated, non-alcoholic beverages each day. Avoiding dehydration can prevent many discomforts of pregnancy. Too little fluid intake can also cause preterm labor.

Weight gain — do the math!Talk to your health care provider to find out the amount of weight you should gain during pregnancy based on your pre-pregnancy weight. Here are some guidelines:

• Average weight before pregnancy: Expect to gain about 25 to 35 pounds.

• Underweight before pregnancy: Expect to gain about 28 to 40 pounds.

• Overweight before pregnancy: Expect to gain about 15–25 pounds.

Generally, you should gain about 2 to 4 pounds during your first trimester and 1 pound per week for the rest of your pregnancy. You can expect to gain more weight if you are carrying multiples.

• Fever greater than 100 degrees for more than three days

• Vaginal discharge with foul odor or leaking of fluids

• Burning or pain with urination

• Contractions with your abdomen tightening like a fist every 10 minutes or more often

• Cramping like your period

• Pelvic or rectal pressure

• Low, dull back pain despite position change

• Abdominal cramps with or without diarrhea

Nutritional supplements — read the label!Getting the proper amount of nutrients is vital at every stage of life. It’s especially important during pregnancy. Your health care provider may prescribe a prenatal vitamin to supplement your diet. You should make sure you are getting the recommended amounts of certain nutrients every day, especially if you are a vegetarian.

• Folic Acid — 600 mcg (micrograms) to help prevent birth defects in your child and possibly protect you from cancer or stroke.

• Iron — 27 mg (milligrams) for muscle development and to prevent anemia, preterm birth and low birth weight.

• Calcium — 1,000 mg (milligrams) for healthy teeth and bones, and nervous, muscular and circulatory systems. If you don’t get enough calcium in your diet, your baby will take it from your teeth and bones.

• Omega-3 fatty acids (DHA) — 200 mg (milligrams) for your baby’s developing brain and eyes.

Discuss with your health care provider any supplements you are taking. Some supplements are not safe during pregnancy. Just because it is “natural” doesn’t mean it is harmless. For example, taking too much vitamin A can cause certain birth defects.

When to call your health care provider — be on the lookout

19084MJGP-8-2016

Pregnancy and dental healthDuring pregnancy, your body undergoes hormonal changes that can affect your dental health. These changes can increase your risk of developing gum disease and affect the health of your baby.

After pregnancy• If you experience any dental problems during your pregnancy, see your dentist after delivery to have your mouth,

teeth and gums examined.

Pregnant women tend to have more acidity in the mouth, which increases the risk of tooth decay. Vomiting can aggravate the problem by exposing the teeth to more gastric acid. The hormonal changes of pregnancy can also cause gum disease. Women who have gum disease are more likely to have a premature or low birth weight baby. Signs of gum disease include: red or swollen gums, bad breath that won’t go away, pain when chewing, tender or bleeding gums, loose or sensitive teeth and receding gums. The good news is, there are steps you can take to prevent gum disease. Brush your teeth at least twice a day, floss at least once a day and use a soft-bristled toothbrush.

During your pregnancyAlso follow these steps for better dental health:

• If you are experiencing morning sickness or frequent vomiting, rinse your mouth with water or a mouth rinse. You can also rinse with a solution of one teaspoon of baking soda and one cup of water.

• Always tell your dentist you are pregnant so he or she can take steps to keep you and your baby safe.

• Avoid any dental treatment during your first trimester and the second half of your third trimester, if possible.

• Any dental procedures that are not urgent should be postponed until after delivery.

• Avoid dental X-rays if possible. In case of emergency, your dentist will know how to protect you and your baby.

• Avoid frequently eating sugary snacks, because they increase your chance of developing tooth decay.

• If you develop any dental problems, see your dentist right away.

Your Second Trimester

Don’t skip the doctorOngoing prenatal care continues to be vital for your health and your baby’s. You will continue to see your provider once a month during the second trimester. You also will begin routine lab testing and measurement of your baby’s growth and development.

To track your baby’s growth, your provider will likely take a measurement of your abdomen. Typically, this measurement (in centimeters) is a close match to your weeks of pregnancy — for example, you’ll measure about 30 centimeters during your 30th week. One of the more exciting moments may come during the second trimester, when you can listen to your baby’s heartbeat. You may also begin to feel your baby move at around 20 weeks. Be sure to tell your provider when you start noticing your baby moving.

Here’s a look at some of the lab tests you might undergo during your second trimester:

• Blood tests. Blood tests might be done to screen for a number of conditions, including gestational diabetes. To check for gestational diabetes, your provider will ask you to drink a sugary drink. After a period of time, he or she will draw a blood sample and measure the amount of sugar in your blood. This is called a glucose tolerance test. Your doctor may also test for conditions such as spina bifida and Down syndrome.

• Fetal ultrasound. An ultrasound is another way your provider can check your baby’s growth and development. It also allows you to see your baby.

Make sure to jot down any questions or concerns you have so you can discuss them with your doctor. No question is too big or too small, even if it seems silly. Your provider and your maternity care nurse are happy to help.

Maternity care

Here are some of the changes you may see in your body:

• Growing belly: Your uterus becomes heavier and begins to grow more rapidly to make room for your growing baby.

• Braxton Hicks contractions: Think of these as sort of a warmup for labor. They are typically weak and come and go unpredictably. If your contractions become more painful or regular, contact your provider immediately. This could be a sign of preterm labor.

• Leg cramps: These are fairly common as you move further along in your pregnancy. To help prevent leg cramps, try stretching your calf muscles before bed. And make sure you drink plenty of fluids and stay active.

• Fuller breasts: The milk-producing glands inside your breasts begin getting larger during the second trimester in preparation for breast-feeding.

Your changing bodyAt this point during your pregnancy, you’re probably noticing a number of changes in every area, from changes in your body to emotional changes. Many women are more upbeat during their second trimester, as they are adjusting to pregnancy and begin to feel less tired. If so, take advantage while you can! Now may be a great time to get a jump start on finding a childbirth class, a health care provider for your new baby and looking into day care options if you plan to return to work.

Where does all that weight go?Eating right during your pregnancy is one of the best things you can do for yourself and your baby. Finding a balance between getting enough nutrients while maintaining a healthy weight is important for you and your baby’s future health. Expect to gain about one pound a week during this trimester. It may seem like your weight gain is going all to your belly, but during the average pregnancy it looks more like figure to the right.

Total weight gain

Your breast growth 2-3 lbs

5-9 lbs

8 lbs

2-3 lbs

2-5 lbs

2-3 lbs

4 lbs

25-35 lbs

Stored fat for delivery and breast-feeding

Baby

Placenta (the baby sack)

Your womb

Amniotic fluid*

Blood supply

*Amniotic fluid is the water around the baby

Breast-feed for the best startHow you choose to feed your baby — breast, bottle or both — is an important decision. The American Academy of Pediatrics recommends breast milk for the first six months of an infant’s life. No matter what decision you make, your maternity care nurse is here to help.

Protects against:

• Ear infections

• Diarrhea and other stomach problems

• Allergies

• Asthma

• Bone loss later in life

• Reduces risk of SIDS, diabetes and obesity

• Provides all the nutrition your baby needs for the first six months of life

• Stronger bones and teeth

• Develops higher IQ and improves brain development

• Promotes lower blood pressure and cholesterol later in life

Reduces risk of:

• Cancer, including breast and ovarian

• Postpartum depression

• Low iron

• Helps return uterus to its normal size

• Promotes weight loss (burns up to 500 calories a day!)

• Reduces health care costs because babies are healthier

• Develops a special bond between you and your baby

For your baby For you

Here are a few of the benefits of breast-feeding:

19082MJGP-08-2016

Do’s and don’ts for a healthier pregnancy

High Blood Pressure/Pre-Eclampsia

• A headache not relieved by over-the-counter medication

• Vision changes

• Sudden swelling of your hands and face

Infection

• Fever greater than 100 degrees for more than three days

• Vaginal discharge with foul odor or leaking of fluids

• Burning or pain with urination

Preterm Labor

• Contractions with your abdomen tightening like a fist every 10 minutes or more often

• Cramping like during your period

• Pelvic or rectal pressure

• Low, dull back pain despite position change

• Abdominal cramps with or without diarrhea

Baby May Be Sick

• Fewer than five “kicks” from your baby each hour

Improve your chance of having a healthy baby by making some important lifestyle changes today.

Is something wrong?

If you have any questions about how to have a healthy pregnancy, please call your maternity care nurse. He or she will be happy to discuss them with you. Or, talk to your health care provider about any concerns or questions you may have.

Call your health care provider if you notice any of these symptoms, as they may be caused by a serious complication:

Do:

• Keep all your scheduled prenatal care appointments.

• Contact your provider with any problems or concerns.

• Take a daily multivitamin containing 600 micrograms of folic acid.

• Eat a well-balanced diet that’s divided into small, frequent meals each day. This includes:

– Six to 11 servings of whole grains

– Three to five servings of vegetables

– Two to four servings of fruits

– Four to six servings of dairy products

– Three to four servings of meat and protein

• Limit fatty foods and sweets.

• Drink at least six to eight glasses of water, fruit juice or milk each day.

• Avoid caffeine, including coffee, tea and chocolate.

• Avoid saunas, hot tubs or steam rooms.

Don’t:

• Take any prescription or over-the-counter medication without your doctor’s advice.

• Use alcohol or street drugs.

• Smoke cigarettes.

• Handle used cat litter.

• Eat undercooked meat or unpasteurized cheese.

Your Third Trimester

Don’t skip the doctor

The need for additional tests will depend on any risk factors you have. Extra tests may be ordered if:

• You have high blood pressure.

• You have diabetes.

• You have kidney or heart disease.

• You are pregnant with more than one baby and there are complications.

• Your pregnancy has gone past your due date.

• Your baby has growth problems.

• You have too much or too little amniotic fluid.

Maternity care

If your blood type is Rh negative and you haven’t had your Rhogam injection yet, you may receive one during your doctor visit between your 28th and 30th week of pregnancy. The Tdap vaccine is also recommended beginning at 28 weeks to protect you and your baby from whooping cough, tetanus and diphtheria. Don’t forget to get a flu shot if it is flu season!

You will probably have lots of questions as your due date approaches. Jot them down and make sure to discuss them with your provider and your maternity care nurse. If you have specific desires for labor and delivery – such as laboring in water or avoiding medication – be sure to discuss them with your provider before delivery.

Ongoing prenatal care continues to be vital for your health and your baby’s. You will continue to see your provider at least twice a month until around 36 weeks. After that, you will go in every week until delivery.

These doctor visits will be fairly routine. You can expect to have your weight and blood pressure checked, as well as your baby’s heartbeat and movement. You may also have a simple test to check for bacteria called Group B strep, which can be treated early before delivery, if needed. Group B Strep test checks for a common bacterium that is harmless, and is often found in your intestines or lower genital tract. Most babies born to women with Group B Strep are healthy, but a few who are infected during labor can become critically ill. Group B Strep can be treated early with antibiotics, before delivery, if needed. Your provider may also do a pelvic exam to check your baby’s position.

There are times when you should call your doctor immediately. Don’t wait until the next day to call if:

• You do not feel 10 movements within two hours.

• You notice a drastic change in the amount of kicks or type of movements your baby is making.

• You have not felt your baby move all day.

Kicks count

Here’s how:

• Start counting your baby’s kicks during your 28th week of pregnancy. Try to do the kick count at the same time each day.

• Choose the time of day when your baby seems to be most active. For many women, this is right after eating a meal.

• Get into a comfortable position. You can lie down or sit in a chair with your feet up.

• Use a chart to write down the time you start counting. Each movement counts as a kick. That could include a kick, twist or a roll.

• Count until you reach 10 kicks. Write down the amount of time it took to count to 10 kicks. For most moms, this takes less than 30 minutes, but it can take as long as two hours.

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Date 9/4/16

Start Time 7:15 p.m.

Stop Time 7:50 p.m.

Minutes to reach 10 kicks

35

Research shows that counting your baby’s kicks may help reduce the risk of stillbirth. Most providers recommend counting fetal kicks beginning at the 28th week of pregnancy.

Example: On Sunday, Sept. 4, you begin counting your baby’s movements at 7:15 p.m. By 7:50 p.m., you have felt your baby kick or move 10 times. You would fill in your chart like this:

Breast-feed for the best startAlthough you can’t guarantee your birth experience to be exactly the way you want it, planning ahead and letting your caregivers, family and friends know your wants and needs can make the event more enjoyable and breast-feeding more successful. If you plan to breast-feed, it’s important to get started right away. For the first two hours after delivery, your baby will be alert and willing to nurse. The sooner you start breast-feeding, the more successful you will be.

Here are a few things to make sure you have on hand for baby’s debut:

• Car seat. Guarantee your bundle of joy a safe and legal ride home by buying a rear-facing infant car seat. An infant under 1 year old and less than 20 pounds must be in a rear-facing seat. The back seat of your vehicle is the safest place for your baby to ride. Check your local fire department or police station for car seat inspection events.

• Baby bathtub. A tub specially designed to hold your baby is a great way to get him or her clean after all those diaper changes. Never leave your baby unattended during bath time, even briefly.

• Stroller. Unlike a bassinet or backpack, a stroller is essential parenting gear. But with dozens of styles to choose from, selecting the right wheels for your baby can be challenging. In general, sturdy ones with locking wheels and safety harnesses will keep your baby safe while lightening your load.

• Diaper supplies. You’ll be going through 10-12 diapers a day during the first few weeks. You’ll also need wipes, diaper cream or petroleum jelly for preventing diaper rash and a diaper disposal pail. These are good items to request for a baby shower.

• Baby keepsake book. Preserve memories of your new baby. Don’t forget to take some pictures of you “before” the baby.

Here are a few more tips:

• Limit visitors. This way, you will cut down on distractions and allow plenty of time for breast-feeding. Too many visitors may overwhelm you and your baby during this special time of getting to know each other.

• Room in. Keep your baby in the same room with you at all times. This will help you learn your baby’s hunger cues. Feeding your baby at the first signs of hunger will calm him or her and make it easier to latch on.

• Avoid bottles and pacifiers. Bottles and pacifiers may keep you from having a good milk supply. They can also cause nipple confusion.

• See the lactation consultant. Even if you think breast-feeding is going well, you should still ask to see the lactation consultant. He or she can check and see how the baby is positioned and how well he or she is nursing. The right position and a good latch can prevent soreness and other problems.

• Plan to breast-feed exclusively. Exclusive breast-feeding means your baby will get only your breast milk and nothing else. It is important to breast-feed for the first four to six weeks, so you can establish a good milk supply.

You’re almost thereYour due date is quickly approaching! The past few months have probably been filled with all sorts of emotions, from joy to fear, excitement to anxiety. Now, you’re almost to the finish line. You may be making last-minute arrangements and preparations for your new baby’s arrival.

If you haven’t already done so, now is a good time to find a pediatrician for your baby. Some doctors will even allow you to visit the office to get acquainted with the practice and its services. Don’t forget to add your baby to your insurance policy after delivery; you’ll need to complete this step for your baby’s medical claims to be paid.

In most cases, breast milk is ideal for babies. Sometimes, however, a new mom may be unable to breast-feed. There are a number of infant formulas that can provide the nutrition your baby needs. Talk to your provider if you need help choosing the formula that’s best for your baby.

19083MJGP-08-2016

• Your baby’s brain and lungs are still growing. And babies born after 39 weeks are less likely to have vision and hearing problems.

• Your baby is gaining weight. Babies born at a healthy weight have an easier time staying warm than babies born too small.

• Sometimes, babies born too early can’t suck, swallow and/or stay awake long enough to eat.

The last few weeksThe last few weeks of pregnancy can be a challenge. Let’s face it: You’re uncomfortable when you sit, walk or sleep. But before you request an elective induction or Cesarean section (C-section) for nonmedical reasons, there are some considerations. If you have a choice, it’s best to stay pregnant until 39–40 weeks.

• Your due date may not be exactly right. If your date is off by a week or two, your baby may be born too early.

• Inducing labor may not work. When this happens, you may need to have a C-section.

• A C-section can cause problems for your baby, such as difficulty breathing. Also, the more C-sections you have, the more problems you may have with your placenta, which poses risks to you and your baby. There are high

risks for you, too, like increased risk of infection and bleeding following the surgery.

• It takes longer to recover from a C-section than a vaginal birth. After a C-section, a woman can expect a three- to four-day hospital stay, and full recovery usually takes four to six weeks.

• Elective C-sections may not be offered due to the risks for mom and baby.

Why the last few weeks are important:

I’m 38 weeks. What’s the big deal?

To learn more about pregnancy and for a list of questions to ask your doctor about scheduling your birth, visit www.marchofdimes.com.

Postpartum

Congratulations!The joys and challenges of motherhood have begun. Remember to take care of yourself, too. Caring for a new baby can be fun, but it is also hard work. You have experienced nine months of changes in your body. Those changes will continue in the next couple of months, as your body recovers from having the baby. It is important to make and keep your postpartum follow-up appointment. Every baby deserves a healthy mom!

Maternity care

Taking care of both of youHave you added your baby to your policy yet? For your health plan to cover any of your baby’s claims — hospital, physician or others — you must enroll your baby and pay your premiums. Be sure to enroll your baby in your health policy if you haven’t already done so.

If you didn’t receive the Tdap vaccination before delivery, you might have received it in the hospital. This will help protect both you and your baby from the very contagious bacteria that causes pertussis, also known as whooping cough. This disease can make your baby very ill. The current recommendations are for everyone age 11-64 to have a booster shot. Babies don’t start this immunization series until around 2 months and might not be fully immune until after the third dose. Ask your health care provider at your postpartum visit about this important protection.

Regaining a healthy weight and shape

If you want to diet and are breast-feeding, it is best to wait until your baby is at least 2 months old. During that time, your body needs to recover from childbirth and establish a good milk supply. Then, when you start to lose weight, try not to lose too much too quickly. This can be harmful to the baby because environmental toxins that are stored in your body fat can be released into your breast milk. Losing about one pound per week (no more than four pounds per month) is a safe amount and will not affect your milk supply or the baby’s growth.

You can safely lose weight by consuming at least 1,800 calories per day with a well-balanced, nutritious diet that is rich in calcium, zinc, magnesium, vitamin B6 and folate. Diets in which you consume fewer than 1,500 calories per

day are not recommended at any point during breast-feeding. This can put you at risk for a nutritional deficiency, lower your energy level and lower your resistance to illness.

Now that you’ve delivered your little bundle of joy, you may be eager to get back to your pre-pregnancy weight. If so, make sure you do it in a healthy way. Consult your doctor before you start any type of diet or exercise plan.

Here are some of the things you can expect:

• You will have spotting or bleeding, like a menstrual period, off and on for up to six weeks.

• You might also have swelling in your legs and feet. You can reduce swelling by keeping your feet elevated when possible.

• You might feel constipated. Try to drink plenty of water and eat fresh fruits and vegetables.

• Menstrual-like cramping is common, especially if you are breast-feeding. Your breast milk will come in within three to six days after your delivery. Even if you are not breast-feeding, you can have milk leaking from your nipples, and your breasts might feel full, tender or uncomfortable.

After the birth of your baby, your doctor will talk with you about things you will experience as your body starts to recover.

Physical changes

Follow your doctor’s instructions on how much activity, like climbing stairs or walking, you can do for the next few weeks. Doctors usually recommend that you abstain from sexual intercourse for four to six weeks after birth. Before resuming sexual intercourse, talk with your doctor about your plan for birth control, since you can become pregnant again. Breast-feeding alone does not protect you from getting pregnant.

According to the recommendations of the American Congress of Obstetrics and Gynecology, you should seek help if you notice any of these symptoms:

• The baby blues do not start to fade after about a week, or the feelings get worse.

• Strong feelings of depression and anger come one to two months after childbirth.

• Feelings of sadness, doubt, guilt or helplessness seem to increase each week and get in the way of normal functions.

• You are not able to care for yourself or your baby.

• You have trouble doing tasks at home or on the job.

• Your appetite changes.

• Things that used to bring you pleasure no longer do.

• Your concern and worry about the baby are too intense — or on the other extreme, you lack interest in the baby.

• You have anxiety or panic attacks. You may be afraid to be left alone in the house with the baby.

• You fear harming the baby. These feelings can be scary, even though most women with postpartum depression never act on them. These kinds of feelings may lead to guilt, which makes the depression worse.

Getting rest The first few days at home after having your baby are a time for rest and recuperation, physically and emotionally. It takes a lot of energy to care for a newborn. Even though you may be very excited and have requests for lots of visits from family and friends, try to get as much rest as possible. Don’t expect to keep your house perfect. You may find that all you can do is eat, sleep and care for your baby. And that is perfectly OK. Learn to pace yourself from the first day that you arrive back home. Try to lie down or nap while the baby naps. Don’t try to do too much around the house. Allow others to help you and don’t be afraid to ask for help with cleaning, laundry, meals or caring for the baby.

Singing the blues?You may have heard the term “baby blues.” Be aware that there is a difference between “normal” blues due to hormonal changes after delivery and more serious postpartum depression. Seventy to 80 percent of new mothers experience anxiety, crying or even anger two to three days after birth. These feelings should go away within a week or so.

Postpartum depression can happen anytime during the first year after delivery, but generally begins one to three weeks after delivery. The U.S. Preventive Services Task Force recommends screening for depression in the general adult population, including pregnant and postpartum women. Your health care provider may ask you to complete a screening for postpartum depression. This allows for early diagnosis and treatment to help you get the care you need and get back to enjoying your new family.

19085MJGP-08-2016

Here are some tips to help make the transition easier:

• If possible, return to work gradually. Perhaps you can work with your boss to create a schedule where you start your return by working 20 hours per week, gradually increasing the amount of time you spend at work and away from your baby. This gives you more time to adjust and helps your body make a good supply of milk.

• Get a quality breast pump. A good, electric breast pump may be your best bet for efficiently expressing milk during the workday.

• Find a private place to express milk. Work with your supervisor to find a private space.

• Follow a schedule to express milk. Express milk for 20 minutes two or three times during a typical eight-hour workday. A sample schedule might look like this: 8 a.m. Begin work 9–9:20 a.m. Use break to express milk Noon Take allowed lunch break to express milk 2–2:20 p.m. Use break to express milk 5 p.m. Leave work

• Storing your milk: Because your milk is full of antibodies that fight germs and bacteria, it can be safely stored and given to your baby later. Breast milk is food, so it is safe to keep in an employee refrigerator or a cooler with ice packs. Discuss with your supervisor the best place for you to store your milk.

Breast-feeding and work?You may wonder if you can continue to breast-feed after returning to work. The answer is yes!

Postpartum checklistAppointments to make sure you and your baby are healthy don’t automatically end at delivery. Make sure you:

• Schedule and keep your postpartum doctor’s appointment. This appointment is sometimes referred to as a “six-week checkup.” This visit allows your doctor to check on your recovery from childbirth, both physically and emotionally. Even if you are seen for an issue or re-check within the first one to two weeks after delivery, you still need to be seen again between four and six weeks after your delivery for your complete postpartum evaluation.

• Schedule and keep your baby’s first well-baby visits. These visits will allow your baby’s pediatrician to monitor his or her health, growth and development. Your baby will also receive a series of recommended vaccinations.

If you have questions along the way, be sure to write them down. Your postpartum appointment and your baby’s pediatrician visit are great opportunities to address any issues or concerns you have about your and your baby’s health.

The most important thing to remember is that communication is key! Work with your boss to figure out a plan that works for everyone without interrupting your responsibilities at work.