7 Ways to Tell if Your Baby is Getting Enough
The number one reason women stop breastfeeding is “Misperceived low milk supply syndrome,” in other words, over thinking. The more information you have at your fingertips, the more you doubt your own instincts. Before technology, women would ask friends, mother, sister, aunt, cousin, grandmother for guidance through pregnancy-birth-breastfeeding & parenting. Putting that into numbers, she may have received advice from 30-40 women. Fast forward to today’s techno savvy mothers who are soliciting feedback online and she would have 10x the amount of input. So how does a new mother with sensory overload undoubtedly know her baby is thriving?? Here I will explore methods to help unravel the web of confusion. Ask yourself these questions before turning to your online companions: Based on a baby in the first 4 months of life Is your baby gaining weight? After the initial 7-13% weight loss Is your baby eating a minimum of 8 times per day? Including cluster feeding Does your baby have the appropriate amount of output? Minimum of 6 wet diapers and 2-3 stools every 24 hours (after day 2) Is breastfeeding comfortable? Tender for a minute in the first 2 weeks can be normal. Did you notice changes to your breasts after delivery? Fuller, heavier, engorged? Can you notice when baby is swallowing? Audible? Is baby content after feeding, most of the time? It is normal for baby to have fussier times of each day. Cluster feeding can fall under this time as well. If you can answer yes to numbers 1-3, your baby is getting enough!! Even if you answered no to 4-7. You should seek out advice from breastfeeding support groups (with trained help) or a professional lactation specialist (IBCLC), to help fix 4-7. If you answer yes to all 7 questions, congratulations- you are doing excellent!! If you answer no to any of the first 3, you need a professional lactation specialist (IBCLC) to help get you on track. Remember, tune into your “mothering instincts”, seek out supportive-tangible-successful breastfeeding moms-have a professional IBCLC on hand for critical questions, find a pediatrician trained in breastfeeding and keep it simple. Most important, relax and enjoy your baby. Please seek the advice of a Healthcare Professional if your baby is not meeting weight and output goals! Happy Parenting!
Breast Pain
When breast pain doesn’t go away it can leave a mother to feel defeated and distraught. Especially for those that felt breastfeeding was going well and her achy breast was not much of anything to worry about. Clearly, having a plan to resolve the issues quickly can bring peace back to the symbiotic relationship. Breastfeeding is an intricate exchange between a mother and her child. The mother relies on her offspring to take the milk from the breast while the child expects to find a quality bounty while suckling. Now and again the communication between the breast and infant goes awry for one reason or another and a “back-up” in the breast occurs. A firmness that makes the mom feel full and uncomfortable can become rather troublesome. Despite all the tips and tricks, she does to alleviate engorgement, the breast pain doesn’t go away. This situation is oftentimes a surprise to a mother that wakes up one morning in breast agony, unsure how she ended up here. Or possibly the mom who missed a feeding or two and has been behind since. Whatever her scenario, the quicker she gets it under control, the less damage will be done. Usually, the first sign of trouble is a sore lump in the breast, called a plugged duct. If mom can spend a few days being more mindful of emptying the breast well, with heat & massage, she’ll nip it in the bud. If the breast pain doesn’t go away, seeking help is her next step. She also needs to focus on how she got to this point to avoid recurrent issues. Mastitis If this “sore lump” doesn’t go away, or she isn’t able to empty the breast efficiently enough, this may move on to the next stage called mastitis. She may find herself with some or all of these symptoms: a very achy breast pain that won’t go away sore to the touch red & inflamed flu-like symptoms fever 101 or more chills exhaustion body aches She should call her obstetrician and lactation consultant to help her navigate this slippery slope. If the mother recognizes these signs early and reacts swiftly, she may be able to avoid antibiotics. Although it is still essential to have a caregiver or two to work with during this time. Using the suggestions for engorgement relief, along with these tips, can assist in a speedy recovery: Tips to Heal Mastitis Breast Pain Mom should take her baby and go to bed immediately. Treat herself as though she has the flu (no other chores). Feed baby often and effectively on both sides, starting with the affected breast first. If latch is not great, get help ASAP. Use breast compressions to be more effective at emptying the breast. Along with warm compresses and massage, put breasts in the bowl of warm water a few times per day (you can use Epsom salt in water). Dangle breasts over baby while feeding. Take hot showers. Stay braless if you are in bed. Reduce any constrictive clothing or positioning (don’t lay on belly). Stay hydrated. When prescribed, it’s crucial to finish the medication. Pump to drain breasts after feedings, using hand massage as well. Take anti-inflammatory medications as needed. Put cold compresses on the affected breast between feeds. This mother needs to keep her guard up even when she feels better. She is more susceptible to recurring plugged ducts or mastitis. Mom should not skip feedings or pumpings. Be sure the pump fits appropriately, and it is working effectively. Get help, if this happens again. Most important, DO NOT try to wean at this time. The process of drying your milk up could take days, weeks, months, or years in some cases. If she tries to do it too quickly, a larger infection can settle in and cause more problems. She needs to work with a healthcare provider and lactation consultant to find the best course of action for her situation. When Infection Goes Deeper than Breast Pain If a mom does not take mastitis seriously, a deeper infection may form-called a breast abscess (a localized area of pus). This is very serious and should not be taken lightly. She should talk to her HCP if she is not feeling any improvement with mastitis treatment after three days. The doctor may order an ultrasound of the breast to be sure she does not have an abscess. If the test confirms it, the mother will need to have it drained. This process can be done with surgery or fine-needle aspiration. Either way, she will need to keep emptying the breast during this time to avoid other problems. Working with a lactation consultant in conjunction with her physician can expedite the healing process. Keep in mind that the milk volume and taste (it’s saltier) will change during these conditions. Some babies outright refuse to feed on the affected side, and the mother will have to use a quality breast pump to keep emptying appropriately. She shouldn’t take it personally if she pushes past these issues breastfeeding can go back to normal in time. She needs to be patient and vigilant about treatment as well as working with professionals to avoid future complications. Here is the recap on the breast pain timeline: Manageable engorgement-breast pain eases with feeding or pumping. Challenging engorgement-breast pain that won’t go away regardless of efforts. Manageable plugged duct-lump in the breast that eases with feeding or pumping. Takes a few days. Challenging plugged duct-a lump that is not changing despite efforts even after a week. Manageable mastitis-red swollen, inflamed breast with mild flu-like symptoms, that improve with OTC or Keflex treatment. Challenging mastitis- red swollen, inflamed breast with flu-like symptoms, that despite antibiotic is not improving. Breast abscess-never manageable on your own. Seek care from a physician expert in breast care. Whatever the reason for her breast pain, there is a light at the end of the tunnel. If she promptly reaches out to the right professionals and follows all the suggestions
Milk Coming In
Milk-coming-in is part of the changes you experience after the delivery of your progeny. Your body has been making all the necessary preparations since egg and sperm met. Possibly you’ve even seen a discharge from the nipple occasionally during pregnancy. Remember you’ve spent 40 weeks creating life and now you need to sustain that life. At first, women worry whether milk will come in but after a few days, they realize how bountiful their yield is. Engorgement is when the breast tissue overfills with milk, blood, and other fluids. It may cause your breasts to feel very full, to become hard and painful, and your nipples to flatten and tighten. Engorgement is a temporary stage to the milk-coming-in part of breastfeeding. Milk-coming-in is part of the changes you experience after the delivery of your progeny. Your body has been making all the necessary preparations since egg and sperm met. Possibly you’ve even seen a discharge from the nipple occasionally during pregnancy. Remember you’ve spent 40 weeks creating life and now you need to sustain that life. At first, women worry whether milk will come in but after a few days, they realize how bountiful their yield is. This phenomenon is called engorgement. “Engorgement is when the breast tissue overfills with milk, blood, and other fluids. It may cause your breasts to feel very full, to become hard and painful, and your nipples to flatten and tighten. Engorgement is a temporary stage to the milk-coming-in part of breastfeeding. Most women have heard the stories of nipple pain, but some may not have anticipated “breast” pain. To wake up one morning about 2-5 days after delivery, and find you have “rocks” as breasts can be quite overwhelming. You’ve likely just left the hospital or birth center and have yet to settle in at home when you feel such intense changes to your breast. If you’re lucky you experience these changes while still in hospital and you get as much help as possible to navigate milk-coming-in. My memory of milk-coming-in the first go-around was quite pronounced. Baby and I took a much-needed nap after being discharged from the hospital on day 3. I woke up 5 hours later with “Dolly Parton” breasts and a screaming newborn. In truth, I couldn’t get her to latch due to their enormous size and flattened nipples. My husband and I spent hours trying to console and feed my baby to no avail. We thought she was ill and returned to the hospital. The nurse in the emergency room put us in a dark, quiet room and latched her right away. It had been 12 hours since she had eaten and my breasts were emptied. What a relief it was to have more comfortable breasts and a content baby! I hope the information you learn from this blog, prevents you from experiencing the extreme situation I was in. Engorgement Expectations & Treatments Lactogenisis is the period when the breasts start to produce transitional milk. At the start of this phase, the breasts may feel warm to the touch, lumpy, and you may have a low-grade fever (under 101). The more medication and fluids you have in labor, the more engorged your breasts will be. Your nipples are an extremity, and fluid builds up in all extremities. Think of how tight your hands and feet feel and imagine the same thing happening to your nipple area. You can use reverse pressure softening to reduce the discomfort in your breast. Most healthy, normal, uncomplicated births of healthy mothers should notice a change to their breasts within 48-72 hours — the more complicated the delivery, the slower the transition from colostrum to transitional milk to mature milk. If you do not notice any changes to your breasts by day five, please call your lactation consultant. Your breasts can feel like they will burst at times when you’ve gone too long between feeds. This feeling can also be felt up in the armpit and be uncomfortable to put your arms down. Use warm compresses before feeding and ice after feeding on those sore areas. You should feel relief or softening after feeding. If you don’t think there is any change to your breast after the feeding (and baby is not content), use a warm compress and massage before trying another feeding. If baby transferred milk (and is content), but you are still uncomfortable use warm compresses and hand-expression to help soften. Pumping is a last resort. The more you feed on demand from birth (minimum of 8-15 times per day in the first week), the less uncomfortable this phase is. When you feed on a schedule, the more painful and long-lasting the changeover will be and the less milk you will make. If the baby is unable to go directly to the breast to feed or is not emptying well due to health concerns, you must pump both breasts 8-15 times per day for 15 minutes by electric pump. If you are not getting relief with the pump, consider troubleshooting pump pieces and or a new, improved pump. Your breasts will feel sore to the touch, and you will not want to touch them, but this will give you relief the fastest. If you can spend a few minutes massaging the breasts in the shower and feed quickly after exiting, you can remedy the pressure build-up in the breast. Don’t be shy, use gentle pressure in a circular, top to bottom motion as often as possible to keep engorgement from intensifying. Wear a supportive but not compression bra. Sports bras and underwires are generally too restrictive! Make sure the fit is appropriately-sized for your changing body. You may need a new one, get yourself sized by a professional. Along the same lines, do not put any undue pressure on breasts-sleeping on them or holding the breast too tight, like a vice grip. This pressure may impede overall milk supply and or “dry up” your milk. Use buoyancy when all else fails. Float your breasts
Quick Tips to Help with Painful Nipples
These quick tips to help with painful nipples can be used in conjunction with or without lactation support. There is no shame in asking for help. Many times we just need someone to tell us we are doing everything right. Please seek the advice of your healthcare practitioner if you are not healing or feeling secure in your feeding. Hopefully, you’ve already asked and answered the questions relevant to understanding pain issues and breastfeeding. You may find you need to get professional help, but in the meantime, you could try a few tips below. The suggestions listed can aid in the healing process of sore nipples. Always check for proper latch first. Change positions. Check for proper fit of your pumping kit/flanges (look on the website of brand you own). Stay topless as much as possible after a feed to air dry your nipples with your milk. Use expressed breastmilk when healing any abrasions. Warm soaks with or without Epsom salt (before a feed). Cold compresses after a feed (unless you have Raynaud’s or vasospasms). Coconut or olive oil can help when mom puts a shirt/bra on. Food grade, not from the beauty section. Silverettes can be placed over nipples to help heal cracks or abrasions. Please make sure they are pure silver for the best effect. Lanolin can be a lifesaver for most if you’re not sensitive to wool or sheep. When allergic, some prefer lanolin-free products. If you have been using a cream/oil for longer than a week with no relief, stop! Try something else. All-purpose nipple ointment can be a lifesaver if you have a bacteria or fungus on nipples. Bring this information to your obstetrician or pediatrician to get the prescription. Hydrogel pads– The Ameda brand lasts longer than others. Avoid using soap of any type on your nipples. Feed on 1 breast per feed, if the baby is gaining well. Allow more extended time in between breast use! Take a feeding vacation-Spend 2-4 days exclusively pumping if this is more comfortable and finger, cup, medicine dropper or syringe feed. Some women use breast shells to keep the clothes from rubbing on nipples. Make sure they fit appropriately if you choose to use them. Do not use a nipple shield exclusively to fix the pain. Nipple shields can be a lifesaver in certain drastic instances but are meant for the inverted nipple. Consider being evaluated for yeast. Consider an evaluation for tongue or lip tie with an expert in the field. Talk to your friends who have had their baby’s’ evaluated. Some pediatricians will not advise you on the subject. Consider having the baby assessed by an alternative expert in infant feeding issues (chiropractor, cranial-sacral therapist, speech pathologist, otolaryngologist, etc.). Consider an online evaluation by an expert. Have an IBCLC assess in-home or office visits. You don’t need expensive creams to get through this. Your milk is living microorganisms that can heal almost anything. Be patient, and reach out if you are still suffering. Remember, breastfeeding should not hurt. You can feel sensitive, but cringing through every feed is not appropriate. If you click some of the links I’ve added to this educational information, I may earn a few cents to help keep this operational. There are various pregnancy, birth, breastfeeding, and newborn products that have been tried and true for many mamas out there. I’ve either used these products myself or trust the recommendations from the moms I serve and choose to pass on the great tips. Win-Win
How to Keep Breastfeeding Comfortable
To master how to keep breastfeeding comfortable can take time and patience but feeling pain shouldn’t be part of the equation. It’s hard to know what breastfeeding should feel like if it’s your first time. You’ve probably heard women tell stories of nipple and or breast pain at one time or another. Maybe you’ve witnessed someone wincing or crying out while feeding. Or perhaps you have experienced this yourself. Some women think suffering is part of the natural process of being a successful breastfeeding mother. What no one tells you is that breastfeeding should not be painful. Sure, you’ve never done this, and you may feel “tender” for the first week or two, but that’s it. Typically, in the first minute of the feeding. A strong tugging and pulling sensation is appropriate. A pinching, biting, or burning feeling is not. Statistically, most women with pain throughout feedings are incorrectly latching the baby. Yes, everyone does have a different pain perception, so deciding what is reasonable can be a struggle for some mothers who seem to be doing everything right. Questions to Keep Breastfeeding Comfortable Are you in the early weeks postpartum? Are you supporting the breast and baby’s head with your hands? Has baby turned tummy to tummy? Are his ear, nose, and hip in alignment? Are you bringing the baby to your breast, not leaning into the baby? Is baby opening wide, like a yawn, when bringing him to latch? Do you feel tugging/pulling? Are your nipples intact? Long, but rounded when baby pulls off. Not flat like a pancake. Have you tried different positions? If you answered yes to most of the above questions, then tenderness should be getting better by 2-3 weeks. Otherwise, keep reading: When More Help is Needed Are you fair-skinned with light or red hair? Are your nipples usually sensitive? Some women don’t even like to be touched. Do you have Raynaud’s Syndrome, vascular disorders or fibromyalgia? Have you recently (past few months) had a yeast infection, used antibiotics or corticosteroids (asthma), or have a baby with thrush or diaper rash? Could the baby be tongue or lip tied? Have you ever had surgery to your breast or chest? Do you feel pinching or biting throughout the feed? Are your nipples cracked? Do you take any medicine or herbal supplements? Are you using something on your nipples for comfort? Do you use a breast pump? What type of bra and or breast pads are you using? If you’ve answered yes to any of #1-12, please reach out to your lactation consultant or la leche league leader. A phone consult can be helpful in certain instances, or for a visual assessment, you should go on FaceTime or Skype. Understand that a better perception of the whole picture may take working one on one with an expert in the field to keep breastfeeding comfortable. Make an appointment for a home or office visit with an IBCLC as soon as possible. Most important, know that this is temporary. With help, time, and patience, you could be on the road to a more comfortable breastfeeding journey. Happy Parenting!
