Getting some reassurance from an IBCLC
You have just had a baby. You’ve always known you would breastfeed, but things are not going well. Perhaps your nipples are sore. Or you’re struggling with engorgement. Maybe you’re worried about milk supply. Or your baby has hard time latching. Or maybe you just have a lot of questions. In any case, you and your healthcare provider have decided you need the help of an expert. It’s time to call a lactation consultant. Continue reading
A new mother called me last week worried about her baby. He was struggling with latching and seemed generally unhappy with breastfeeding. She was terribly engorged and in a tremendous amount of pain from childbirth as well as her breast and nipple pain. When I arrived she was teary, confused and doubting her abilities as a mother.
Engorged breasts and nipple shields
In the process of hearing her story, I learned that she had been told several times by nurses and doctors that it was important to pump after each feeding to make sure the milk would come in. She was also told to feed her baby every 1.5 to 2 hours day and night. . She wanted to do everything right. She wanted to make sure her tiny newborn got plenty to eat.
So she did as she was told. When he was too sleepy (or too full) to wake up, she called her pediatrician. How could she feed her baby when he wouldn’t wake up? As per his advice, she stripped him to his diaper, tickled his feet and used cool washcloths when necessary. She continued to pump after feedings—terrified that her baby was not getting enough to eat. She even hand-expressed milk into his mouth—so worried he wasn’t eating enough. She was also concerned about her baby’s very frequent, mucousy stools.
Unfortunately, no one had bothered to ask about her health history. If they had, they would know she had a late miscarriage a few years prior. They would have known that after the miscarriage she had a full milk supply for several weeks and had a terrible time with engorgement. They would also have know that she has PCOS—which can result in copious milk supply. (Mom’s with PCOS can also have issues with low milk supply.)
When her milk came in she was in trouble. She felt she had to keep pumping because she had so much milk. Her baby was choking and gagging. He would only nurse for 3-5 minutes–and it was a struggle. Then she would pump 6 additional ounces!
I showed her how to help her baby to the breast, letting him “take the lead” and latch in a way that worked with his reflexes. He nursed beautifully through her strong let down and handled her supply with no trouble. When the milk came too quickly, he cleverly let go and she helped him regroup and burp a little. He ended up nursing on both breasts contentedly for about 15 minutes. When he decided he was full, he was relaxed and happy. His mother was amazed at the difference!
I saw this mom a week later and she was a new woman. Now she lets her baby decide when he wants to eat. She used cabbage leaves to reduce her swelling and milk production and stopped pumping after feedings. Her baby’s stools are normal and he is happy and growing well.
If you find yourself with an oversupply brought on by pumping, gradually decrease the pumping over time. Cabbage leaves (green) rinsed and placed under your bra a few times/day will help reduce engorgement and may reduce your supply somewhat. Some foods may help you reduce supply as well. Your baby may be more comfortable nursing side by side in bed. You can also try leaning back and letting your baby nurse prone.
Many mothers worry about not having enough milk. It’s natural for a you, as a new mom, to have doubts. But try to keep in mind that the vast majority of mammals—including humans– have plenty of milk for their babies. It’s relatively rare to be unable to produce adequate milk. If you feel you have too little milk, or too much, please contact a lactation consultant and get help as soon as possible. The sooner you get help, the sooner you can relax and enjoy your baby and breastfeeding.
What now?
So you are pregnant. You are planning to breastfeed. You know that it’s normal, natural and that all other mammals breastfeed. You’ve heard about breastfeeding classes, but why should you take one? Isn’t this something that mothers and babies just do?
Breastfeeding parents and babies are equipped with very helpful instincts* and, in the case of babies, strong reflexes to ensure successful feedings. A baby’s survival depends on their ability to find the breast, latch on* and suckle with just a little help from their parent. But here in the United States, and many other industrialized societies, birth practices and our very culture can mask and even undermine what comes naturally.
New parents often assume that they will get breastfeeding help in the hospital. There may be excellent lactation consultants on staff, but many are only available during the week day—not at night or weekends. Even if you are one of the people who will see a lactation consultant, it is likely your “visit” will be 15 minutes or less. In addition, it is highly unlikely that the consultant will be able to time their visit for the moment you are actually attempting to feed your baby.
Families usually leave the hospital less than 2 days after giving birth. Will a lactation consultant be visiting you on day 3 or 4 when your breasts are swollen*? Will anyone be automatically checking on you and the baby to make sure that baby is hydrated*, gaining weight* and your nipples are healthy*?
“I always tell people that taking a class before the baby came was the best thing I did. I’m so glad that my husband was there, too! He remembered tips and tricks we learned and was also super supportive after learning how beneficial it is!” Cathy Y.
If you are lucky enough to be surrounded by family and friends who have nursed multiple babies, it probably doesn’t matter that you are not provided with a lactation consultant to ensure all is well. You will likely have all the help you need. But, honestly, this is a very rare occurrence in the U.S. and many other parts of the world.
It’s likely that you have never seen a baby breastfeed up close and personal. If you’re like most of my clients, you have seen babies breastfeed from across the room, maybe under some kind of shawl. You probably averted your eyes. That is normal in our culture. We know it’s happening, but it is not ok to look! How can you possibly learn any new skill without seeing it happen and asking questions about it?
A prenatal breastfeeding class will provide you with information, a safe, encouraging place to ask questions and see pictures and videos of babies breastfeeding.
“It’s important to know at least the basics: latch*, hunger signs*, what’s normal in your infant and from our body. All good to know this before you are overwhelmed.” Audrey L.
Here are some topics that are typically covered in a breastfeeding class:
Basic physiology of lactation
Basic information about the content of human milk
What to expect in the first hours and days after birth
How to know if your baby is getting enough milk
Normal newborn behavior and reflexes that assist with feeding
How to help your baby with feeding
Signs that everything is going well
Common challenges and how to avoid them and/or overcome them
How to identify when things are NOT going well
Who to call for help
“What I loved about the class was seeing videos of real babies breastfeeding. They really helped me to understand breastfeeding.”
A breastfeeding class can’t prepare you for every eventuality, but it can give you confidence and information that can make all the difference after your baby is born.
*You will learn about these things and much more in your prenatal breastfeeding class!
For a private, prenatal breastfeeding class in the Seattle area, contact Renee to arrange it! If you’d like to take a class in the comfort of your own home without scheduling an appointment, register for my virtual Breastfeeding 101!
I just wanted to take a moment to say thank you so much for everything you have helped us accomplish this past year. Today is my son, Robbie’s, first birthday, and I am happy to say we are still pumping, and strongly committed to at least 18 months.
After three years of heart-breaking infertility, I often found myself wondering why I couldn’t be a Mommy. I continually came back to the thought I was going to be a horrible mom. The day my son was born, I was terrified I wouldn’t be able to give him everything. We left the hospital when he was five days old. Breastfeeding was not successful. I tried and tried, but Robbie couldn’t latch. I diligently pumped my milk for him, but it was difficult and I never made quite enough. When he was a couple months old, my Dr. suggest the Mirena IUD for birth control. After having it inserted, my supply dwindled even more—down to just an ounce and a half a day. I was met with discouragement and urgings to stop pumping from family and friends. They kept telling me how much more time I would have during the day if I stopped. Continue reading
It’s rainy in Seattle today. It’s rainy in Seattle a lot. All this rain and hanging around indoors can give a person a lot of time to think. Lately I’ve been thinking about the word “breastfeed.” I can’t get it off my mind. Oh yes, it is one word. You see, you can’t separate the word “breast” from the word “baby.” They just go together. Which is my point. But I’ll get to that in a minute. Continue reading