This week was one of many times where I have been helping a mom with lactation and the issue was her nipples. Nipples? you ask! We need to start encouraging women to look at their breasts- specifically their nipples during their pregnancies. If they can find out that their nipples are flat or inverted, they can do something about it long before they have their babies! Instead this is what is happening.

types of nipples

Women are being handed nipple shields like they are candy. I have even had one mom offered them before they were able to even attempt nursing- before the baby was in her arms (a few weeks early so off to the nursery to be evaluated) and even before the nurse looked at her nipples. It was ridiculous! In fact the mom nursed just fine and did not accept it! So what is the problem with nipple shields?  Research on the use of nipple shields has revealed reduced milk transfer of up to 58 percent. In fact La Leche League stated:| “Often, with use of rubber shields, infants are not able to compress the maternal milk sinuses, which can lead to long-term milk production problems and increased nipple soreness and damage. Since the infant has to rely on suction alone to transfer milk, nipple shields can drastically reduce his milk intake, potentially causing slow or inadequate weight gain. There are reports that even the thin silicone nipple shields cause reduced milk intake and present a potential for reduced maternal milk supply and nipple damage with improper placement.” And my favorite breast authority Jack Newman reports on it’s misuse as well. Nipple Shields.  shield

So what can women do during pregnancy to help? Dr Sears discusses the use of breast shells for inverted and flat nipples. Putting a simple shell into a woman’s bra during the day or evenings. with the smaller hole insert, helps to pull the nipple out over the last few months prior to birth. Often women use them with the large hole setting to help if there are sore nipples. I personally think fixing the latch issue so that the mom does not have sore nipples is the best option.

nipple shells1latch assist 2

 

 

We also sell a product that is like a small plunger that easily fits in your purse. It helps to pull the nipple out gently to protrude a bit more, especially if any engorgement occurs when your milk arrives. It is called a Latch Assist. We sell it in our store. So, midwives and doctors, start looking at the mom’s nipples during the pregnancy. Doulas and lactation educators, offer to look to see if there is a possible issue. Moms start asking for help in identifying an issue before it becomes a problem. Don’t risk a baby not being able to latch well – especially once your milk comes in and there is a bit more difficulty. If your headlights don’t come on when you are in the frozen food section, there is a chance you have flat or inverted nipples. It is fixable! Easily!

inverted nipple

inverted nipple                        flat nipple

flat nipple

There is a lot of misinformation about co-sleeping out there. For most breastfeeding moms, co-sleeping is a fabulous way for everyone to get their must needed sleep and also not interrupt the breastfeeding dyad! So here are some wonderful links for great information to help you be successful and SAFE!Co-sleeping

How Babies Sleep

USC Co-sleeping Pamphlet

Safe Sleeping

Dr William Sears:

Dr Jay Gordon:

Mercola on the Family Bed

Benefits of Co-sleeping Past Infancy

Family cuddling.

Needs vs Habits, Tine Thevenin

Rediscovering the Family Bed, Tine Thevenin

Transitioning Out of the Family Bed

 

Recently I had a mom have her baby at a Forsyth County hospital. The baby nursed some after the birth and then did very little. The next day they had an IBCLC (International Board Certified Lactation Consultant) come in and get the baby latched again. But she mentioned there may be some issues with needing to help her train her tongue for a better latch. I received a call from the parents enlisting my help and they asked if I could come back to help them.

Upon my arrival the mom was emotional and felt like such a failure- her words. She felt she was starving her baby- a word they had planted in her mind. I reminded her that we had gotten the baby to latch and this was fixable. I tried getting the baby to latch and she would suck a few times and then quit. I looked at her tongue and asked them if they had noticed if her tongue ever crossed over the bridge of her lower gum line. They said no. (more…)

What is the first pacifier? No, it’s not the rubber pacifiers that began to be manufactured in the early 1900’s or the use of a corncob prior to that.   Wait for it……Yes, it’s the breast.  Since the dawn of time, breasts have been used as pacifiers and they have done a magnificent job.  Always available, always soft, always smelling like mom – never lost, never being chewed on by the dog, never waiting to be cleaned.   the pacifier

I believe that almost everyone at this point is educated about the benefits of breastfeeding.  We all know that nursing is the best way to feed your baby and breast milk is a super food with immune fighting properties equal to none.  However, why don’t we tout the comforting qualities of the breast just as frequently and that it’s okay to use them for that purpose?  A doula friend of mine was at a hospital recently where the L&D nurse actually told the mom not to let the baby use her breast as a pacifier and plopped a rubber “dummy” in the baby’s mouth.   That’s what artificial pacifiers are called in England..hmmm.

I was recently working as a postpartum doula with a client when she told me the “baby can’t possibly be hungry again, should I put him back on the breast?”  I explained that the baby may want to comfort nurse and that’s absolutely fine – soothes the baby, helps the milk come in etc.  She was more than happy to oblige the baby, she just hadn’t heard of this and didn’t know that her breast could be used to comfort as well as feed.   I realized that day that many women don’t know this.

Dr. Harvey Karp discusses “suckling” as a comfort measure in his book, “The Happiest Baby on the Block.”  However, the other four comfort measures are more widely known: swaddling, swaying, shushing,  holding the baby in a side lying position. (In fact Dr. Karp says that in other cultures where there is no such word as colic, the moms put the baby to the breast as many as 100 times per day! He suggests the use of a pacifier only after breastfeeding is well established.)11924breast_feeding

 I also want to say for the record – I’m not a rubber pacifier hater.  I think they can be a fine soothing tool when used appropriately (after breastfeeding is well established) and judiciously (don’t plop it in constantly without trying other alternatives).   There are times that mom may not feel like offering up her breast one more time and that’s perfectly fine.  Try some of the other soothing techniques noted above from Dr. Karp.  A clean pinky finger can also be used to the delight of a baby that loves to suck.   Let’s just not forget the original pacifier – the wonderful multi-tasking breast.

 

Patti Schultz, Postpartum Doula

I went to a musical on Sunday. Sat next to a woman who commented she had kept her grandkids for a week that previous week. The youngest was six months old. I commented that I would not have been able to feed my six month old grandkids. She then proceeded to tell me that her six month old granddaughter is fine if fed on her schedule that the mom had provided. Seems at five months she was weaned from being breastfed since the mom was starving her baby according to the grandmother. She wanted to eat all the time and was not sleeping through the night. So this grandmother had encouraged her to wean her to a bottle. She then proceeded to tell me how this six month old was 20 pounds- would get a bottle every three hours, would eat also- so I guessing that means solids – then told me she would get cereal at 6pm, a bottle at 6:30pm and would then proceed to sleep for twelve hours straight! I just wondered if the grandmother knew the harm she was doing in encouraging her daughter to wean this baby so young. I wondered if she understood how a little bit of support could have gone a long way. It makes me sad when the very women who need to be supporting and encouraging their daughters are sabotaging a breastfeeding relationship. I just kept my mouth shut and was happy the musical was about to start. People don’t know what they do not know.

Then for some reason I stopped on the Baby’s First Day television show today. There was a mom with her first who had decided to go natural. She was ten days postdates and her midwife was fine with that. But induction was planned for that day. Does anyone see that as an antithesis? Anyway the mom was already five centimeters. After a few hours of not feeling anything really from the induction on Pitocin, the midwife decided to break her water. This mom did not want intervention.  Her aunt on webcam asked, “are you still not going to do an epidural?” And the mom said no she was still hoping for a “painless delivery.” But once her water was broken she wanted to be in the tub but no touching and no talking. The camera person interviewed her mom in the hallway stating, “I thought she may not want her husband touching her or talking, but not me, the mom. I can’t speak around her!” She seemed quite put off that she could not do what she suspected she could do. Previously she topped off her comments by saying that she was concerned when the “real pain comes” she will panic and not know what to do.” This laboring mom stood, swayed a bit, got in the tub (the Pitocin was unhooked) , demanded the nurse to not monitor her during a contraction once- really seemed to believe in the process. Then the fear arose within the mom. I wondered if this statement of fear she would repeat several times was something she had heard. “I am exhausted and nervous about the fact that now I have to put in work.” The midwife then says that usually a first time mom even non-medicated pushes for about an hour. I thought, what? Only an hour?  We hear nurses and docs say all the time, “Get the epidural because you could be pushing for hours and will need the rest before pushing.” And I wonder how all the other women in the world seem to get the energy to do this.  13 hours into lab, or and only one hour of pushing, the mom says she is afraid of the energy it will take to push. She then pushes out a 9# 14 ounce baby girl. Although in the bed for the pushing, she did give birth on her side. I hope her mom saw her in a different light when this was done. I hope she will see her daughter did know what to do when “the real pain” came!

I just wish grandmothers to the baby would consider their words carefully. Birth and breastfeeding can be sabotaged so easily by those words. My daughters grew up believing in birth and understanding the wonderful aspects of breastfeeding. Don’t speak about that which you have no knowledge. Realize your daughters need your support not your doubts. The mom who birthed said she now knows “she can do it! ” I think this is great since her mom had her misgivings. Grandmothers, Mothers- support your daughters in the decisions that they find are right for them. Believe in them!

What is normal?  How do you set yourself up for success in breastfeeding? Have you seen another mom with a new baby nurse their baby? I don’t mean under a blanket– I mean really see a baby nursing? Attend La Leche League meetings to actually learn from moms who are doing it! And attend a great breastfeeding class. A couples class is best since your partner being on board is one of the primary things that can make or break your success. Take a class that has you practice positions holding a baby- a hands on class helps you gather great skills you will need.  You will learn what is normal.

For instance, one of the biggest misinformation myths out there is that if a baby is nursing more than five minutes and more often than every three hours, they are using you for a pacifier only. Not true! A good latch should never cause a sore nipple- nursing frequently with a good latch should not make you sore. And if we are trying to get a baby to double their weight in three months,  giving them a pacifier instead of nursing them is like giving them worthless non-weight gaining activities. A pacifier in the first six weeks can cause latch issues for most moms. (more…)

Our facebook fans put together a list of the reasons they love to breastfeed. I wanted to share it here with you! There are some near duplicates but I figured it was because it was worth repeating!

  1. Often overlooked reason, it relaxes the mama!
  2. Because it’s what’s normal. It’s using your body in the best way possible…exactly how it was meant to be used.
  3. Because your breast milk will never be recalled
  4. Because there will never be beetles or cockroaches in my breasts
  5. My favorite reason is because breastmilk comes in such nice packages! 😉
  6. No preparation needed, which means I don’t have to stumble out to the kitchen at 1 in the morning
  7. Source of comfort for my nursling.
  8. Nothing like having your child look up at you and smile.
  9. THE BEST boo-boo remedy. Better than a bandaid. (more…)

Folks come to me all the time talking about their baby being separated from them to go under bilirubin lights. Occasionally someone insists on bringing their baby home and they use light therapy there or even use the bilirubin blanket. I wanted to share what is actually the issue with bilirubin levels in an infant and some protocol that has been shared with me. I just feel you need to know the facts- know the Pediatric Guidelines and know what you can do to help your baby and your breastfeeding relationship not be interrupted. 

jaundice_in_newborns_e (more…)