When leaving your breastfed baby with a caregiver for short or long periods of time it is important to brief them ahead of time regarding feeding a breastfed baby. Here are some tips to go over ahead of with your caregiver. 

-All caregivers should wash their hands before handling any breast milk or bottles.

-Expressed breast milk (EBM) is a different color and consistency than infant formulas.

-EBM will separate when refrigerated. After warming, try shaking gently to mix the milk.

-A mother's EBM should only be used for her baby.  For health reasons, milk from different mothers should not be shared.

-Frozen EBM can be warmed quickly in warm water, but not in boiling water.  EBM can be thawed slowly in the refrigerator.  To thaw quickly, hold the container of frozen EBM under cool running water and gradually add warmer water until the EBM becomes liquid. Transfer EBM to a sterilized bottle. 

-EBM is susceptible to contamination by bacteria, particularly after freezing and thawing. All bottles, spoons, cups or other feeding equipment should be sterilized.

-EBM should not be frozen or heated more than once. Offer small amounts of EBM at a time to the baby if EBM is limited to reduce waste. 

-Bottle feeding a baby EBM may take some time for the baby and caregiver to adjust. If the baby is fussy and refusing the EBM, try gentle rocking and/or walking motion to help settle the baby.

-Breastfed babies are used to being able to control the flow of milk from the breast as they feed, bottle-feeding is a different feeding experience.

-Try to pace the feeding and add frequent pauses to mimic breastfeeding.

-If the baby becomes unsettled try to comfort baby by wearing in a sling/wrap/or carrier. Many breastfed babies are used to falling asleep at the breast for comfort.  Try wearing the baby and gentle patting motions on the babies back combined with a rhythmic side-to-side movement. This babywearing may allow baby to calm down and try to bottle feed again.

-Breastfed baby’s diapers can look much different from a formula fed babies.  Breastfed stools can be green, brown, yellow or orange.  The stools are very runny and have a curd like appearance almost every time.  Always wash hands after handling dirty diapers.