Saturday, January 22, 2011

Breastfeeding is a piece of cake

The title of this post is not necessarily true for most people. Someone once told me, "How hard can breastfeeding be? you just put the baby on your boob and poof....you're breastfeeding." There are a few, and I do mean few, who have experienced such easy nursing. And to you all I say that I am jealous and that I'm happy it worked out so easily for you. Please do not take that for granted. But for the majority of nursing mothers, it takes some work. It truly is a learned art. No two nursing pairs are alike and each pair must learn on their own.

This post is not to discourage any from breastfeeding. On the contrary, I encourage you to not only do it, but to not give up when its most difficult (in the first few weeks). It is most definitely the best thing you can do for your baby and for yourself as it lessens the chance of you getting certain types of cancers among countless other benefits. And I promise you, the pay off is huge when you succeed. But this post is to tell you the truth about breastfeeding and the obstacles you may encounter. Id rather you to be prepared for anything and succeed than for you to be caught off guard with a complication you have never heard of, feel confused, disappointed, frustrated and then quit.

So here are a few complications that you may or may not encounter:

  • bad latch
  • nipple pain
  • cracked/chapped/bleeding nipples
  • engorgement
  • plugged duct
  • nipple confusion
  • candidiasis
  • mastitis
  • overactive letdown
  • lip/tongue tie
These are just a few of the most common complications. Don't let this list or any other complications intimidate you. You can and will overcome these should you encounter any. First off, I highly recommend doing three things if you are expecting and planning to breastfeed (no matter how long). First, contact your local La Leche League office and start attending meetings during your pregnancy. I know we all lead very busy lives but these meetings will be for the greater good. If your schedule doesn't allow for it, then at least have their information such as phone number and address and LLL Leader info readily available for any breastfeeding questions and concerns. Second, I highly recommend choosing a location to birth you baby at that has a lactation consultant on hand. Now just because they have one on hand doesn't mean your are going to have everything work out. I personally have experienced horrible treatment from the lactation consultant where my children were born and I think it may have lead to me not being able to breastfeed all my kids. So I encourage you to meet the lactation consultants before hand. Get a feel for the type of support they offer. They should have a personal interest in you and want to see you succeed. If you don't get a good vibe from them or would like additional support for when you are discharged, I encourage you to find a local lactation consultant and at least have a consultation with them (either over the phone or in person) and have them ready to go on speed dial should you need their help once baby is here. These steps might just save your breastfeeding relationship with your baby. And last but not least, I encourage you to find a comfortable and easy to use nursing bra. I highly recommend looking at La Leche League nursing bras and Medela nursing bras. I personally have had great experiences with both those brands. I have also tried your generic nursing bras from Walmart, Target, Motherhood Maternity and the such... and have found that you get what you pay for. You buy cheap you get cheap. So investing in a good great bra will pay off in the long run and is totally worth the investment. I promise you.

Now getting back to the complications. For those of you birthing in a hospital let me give it to you straight. They say they are pro breastfeeding, but actions speak louder than words. Approximately 75% of the hospitals that I have supported at here in the Los Angeles area that I have supported at, are hardly acting in line with what they say. Almost everyone I have known that has given birth in the hospital was forced into giving their child formula. Myself included. Milk takes a few days to come in. 3 days for some, 5 days for others and even as many as 7 days or more for others. A typical stay in the hospital is 2 days. So for the majority of mothers, your milk will not have yet come in during your stay. You will have colostrum in small amounts. This is perfect for baby, don't see the small amount and feel discouraged or like there is something wrong with you. Babies loose as much as 10% of their birth weight in the first week. Totally normal. (Let me add a disclosure that in some rare moments it may be necessary to supplement due to a condition mom or baby has, so follow the advice of your doctor) So my first suggestion is let the staff know you plan on breastfeeding. Have this in your birth plan in bold and underlined. Have multiple copies of your birth plan for not only your doctor but for all the staff taking care of you. That includes different shifts in both the maternity and postpartum ward. Print a total of at least 10 copies of your plan to give out. I strongly suggest avoiding all artificial nipples as this may lead to nipple confusion in your infant (trust me, I am speaking from experience here). Some may even tell you there is no such thing as nipple confusion. And to those I pity how ignorant they are that they are not knowledgeable in a field that has failed so many breastfeeding relationships. Print out a sign such as this one:
onesie or hat. Very cute ideas. Be prepared for the staff to tell you that you must supplement for various reasons ranging all the way to weight loss, jaundice and dehydration along with any possible medical conditions, again there are some rare conditions in which it is necessary. If you are forced to feed your baby formula fear not. There are alternatives. First off I encourage you to ask if they have an SNS (supplemental nursing system) you can use. Here are examples of some types of SNS.
This is an example of finger feeding using an SNS
If you are anything like me, I purchased an SNS for cheap on eBay to have on hand at the hospital if I needed it. Luckily I didn't need it and it is a small price to pay for breastfeeding success. If you are unable to buy one ahead of time and your hospital doesn't have any readily available for you there are still options for you. You could ask for a small cup, usually the same cup they dispense medication with, to cup feed your baby. Though this can be a bit messy. Babies will usually lap it up like a little puppy does. I highly recommend asking for a syringe to feed the baby (needle-less of course). This is a fantastic way to not letting baby get used to sucking from an artificial nipple, I know this from experience. All the while I encourage you to first put your baby to the breast and ask for a breast pump to help stimulate milk production. {A HUGE tip upon being discharged: DO NOT TAKE ANY SAMPLES OF FORMULA WITH YOU! it is way to tempting to use it if you have it. I have seen higher breastfeeding success rates among mothers who leave the free formula samples than those that take it. Fight the urge. In this case, free isn't good} I personally had to syringe feed one of my children for the first 2 weeks or so. I was adamant to breastfeed and not give my child an artificial nipple. Syringe feeding isn't the most convenient especially when you are not home or in a moving car. And it is a bit time consuming. My baby still had not really grasped how to do a deep latch yet. So I settled on Adiri bottles to maybe help making feedings easier. The Adiri bottles actually helped teach my baby how to latch on my breast and we have been nursing perfectly ever since. She just needed to be shown how to latch onto something. And using the Adiri bottle that simulates a breast was the perfect thing for us. So if you are having these same problems you may want to try this.

If you find you continue to have latch/ sucking problems with not getting a deep enough latch, I encourage you to check if your child has a lip/tongue tie.

I have heard countless stories of problems with lip and tongue ties and simple snip can fix the problem. Check with your local lactation consultant if you believe your child has a tie. You can also find great resources on this here, here, here, here and here. Also I wanted to let you know that sometimes a snip is not needed at all to fix the problem. One of my children had a lip tie (shown on the top photo) and we were able to nurse just fine without doing a snip.

If you find that nursing is very painful, causing your nipples to crack and bleed or if you hear a clicking sound coming from the baby, these are signs of a bad latch and I encourage you to seek a lactation consultant asap before you add more trauma to the breast. To ease pain on cracked/bleeding/sore nipples I recommend using Lansinoh Lanolin Cream. It really works wonders.

I recommend Kelly Mom as the #1 online reference to everything breastfeeding. Please know that no online reference, Kelly Mom included, replaces a lactation consultant. If you think you have any of the listed complications or any others, please, please, please... call your local LLL Leader and a lactation consultant. Plus if you are a WIC participant, they offer breastfeeding support as well.

If I can leave you with only one golden rule to breastfeeding, it would be to not give up. Keep going, keep trying, you will and can get it.