Good Books for the BFing Mom:
"The Womanly Art of BFing" by LLL (general reference, can be preachy)
"So That's What They're For!" by Janet Tamaro (funny, light read)
"The Ultimate Breastfeeding Book of Answers" by Jack Newman (good information, presented clearly, and by a wonderful doctor)
"The Breastfeeding Book" by William and Martha Sears (can be a bit simplistic for women with serious BFing issues, but generally very informative)
"Nursing Mother, Working Mother" (as the title says, it's for the working mom)
"Mothering Multiples: Breastfeeding and Caring for Twins or More"
"Mothering Your Nursing Toddler" (for Extended Nursing)
"Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond" by Hilary Flowers
"Breastfeeding the Adopted Baby"
"The Nursing Mother's Companion" by Kathleen Huggins
Nursing Holds:
This site has both pictures and a description of some different holds
Here's One On Nursing Twins, which is totally doable, by the way (but very hard and admirable!)
The Correct Latch On: http://www.breastfeeding.com/helpme/...s_latchon.html
Basically, the baby's mouth should as be as open as possible and he should have both his upper and bottom lip "out," not tucked in, if that makes sense. Make sure your baby is supported by pillows, a sling, or a Boppy. You do not want to be leaning forward or hunching. You could hurt your back or strain your shoulders. You want as much areola in baby's mouth as possible. If the baby just sucks on your nipple and not the darker part of the areola, your nipples can crack and the baby will not get enough milk. To delatch, slip your finger in the baby's mouth and break the suction before pulling him away.
You may feel some pain, but it shouldn't be excruciating. That probably signifies something wrong, be it thrush, a plugged duct, a bad latch, or something else.
Leaking:
Leaking, for MOST women, goes away within the first few months PP. Until then, invest in good nursing pads. If you suddenly stop feeing full around 3-6 months, it is probably not a cause for concern. Your body is most likely just adjusting to your baby's needs.
Plugged Duct:
Characterized by deep pain in the breast, and a red bump or pimple like thing (technical term). This can be a precursor to mastitis. To help, nurse as much as possible. Try different positions so the baby can drain all the different ducts. Warm compresses/showers will help drain the breast. Massage the area as you nurse to unplug the duct. Try pumping after nursing if the baby isn't too hungry. If white clumps or pus or blood comes out, don't freak, it's okay. The baby can still drink this milk, as long as there is only a little blood. Get a lot of rest. If you are prone to plugged ducts, the supplement lecithin can be helpful if taken regularly.
Mastitis:
Characterized by flu symptoms, such as fever, fatigue, vomiting, chills, etc. The breast is sometimes red, warm or hot, and extremely painful. Can happen when you skip feedings or wean too quickly. The breast does not drain fully, engorgement happens and an infection develops. Treatment is typically antibiotics. Nurse as frequently as possible, even if it is uncomfortable. Draining the milk is good for the infection.
If you cannot nurse, then pump if possible. Drink lots of water and take OTC pain relievers and anti-inflammatories, such as Ibuprofen. Try not to wear anything that will restrict the breast, such as tight bras or underwire bras. Warm showers will help get the milk flowing out of the breast, and cold packs will relieve swelling and pain.
Thrush:
Is a yeast infection of the breast and of the baby's mouth. On your baby, it may look like white patches on the tongue that persist after a feeding and that are not easily scraped off, or could manifest itself as a diaper rash with raised, sometimes open sores (or you could see both, or neither).
In your breasts, it feels like a deep burning pain. It is frequently accompanied by stinging in the nipples and persistent pain. It is usually treated by a combination of Nystatin, Diflucan, and other prescriptions. If you would rather use something more natural, Gentian Violet and grapefruit seed extract are good, too.
Taking a probiotic supplement (acidophilus) at the first sign of discomfort can help your body begin to combat the yeast quickly and bring relief sooner. When you have thrush, you should try to avoid sugar and yeast in your diet, as well as caffeine.
Low Supply (or suspected low supply)
The truth is, somewhere between 90-97% of women can physically produce breastmilk to feed their children. Those women who cannot BF should be treated with respect and kindness. One's commitment to Bfing should not be questioned if she says she had low supply.
Most cases of suspected low supply in new moms are just normal variations in how much milk is produced in the newborn period. As the baby settles into a bit more of a routine, the breasts produce more or less milk to suit the child's suckling patterns and nutritionl needs. If your newborn (<4 months) is acting very huingry and fussy when offered the breast, the solution is not to offer EBM or Formula. The child is sucking more to increase your supply to meet his needs. If you do not let him suck, he will not improve your supply, and both of you will be in a cycle of needing to use more supplements. Try as hard as possible to not offer formula (if you are committed to BFing, I mean), as it will almost certainly be destructive to the BFing relationship. link on supply
Nipple Confusion:
Introducing a bottle too early can cause nipple confusion. The baby can get much more milk faster from a bottle, and so if a bottle is given before BFing is well established, he might lose his desire or ability to suck from the breast. This is not a rare occurance. The prevalence of unnecessary supplementation in hospitals greatly adds to this problem.
To avoid nipple confusion, it is best to wait until baby is 3-4 weeks old before introducing a bottle or pacifier (once they have passed their first growth spurt, typically at three weeks) -- and only if breastfeeding is well-established and going smoothly.
Jaundice:
The best thing for normal jaundice is a lot of BFing. It may be difficult if your baby is under lights or the bili blanket, but it is good for the baby. Remember that it is your baby, and the nurses cannot tell you what to do. Insist that your baby be taken out at the bare minimum every three hours to nurse. Offer supplementation only after nursing, if you decide with the pediatrician that it really is necessary. Ask more than one doctor.
Jaundice is resolved quickly by baby stooling frequently, and formula supplementation can lead to constipation -- which only makes the jaundice increase.
High Palate or "Bubble" Palate/Physical Abnormalities in the Infant
If you are experiencing persistent, mysterious nursing pain and have been checked for proper latch and thrush, please have an LC assess your baby's mouth to check for palate problems (and also a tight frenulum, under the tongue). The roof of your baby's mouth should feel approximately similar to the back of a teaspoon in terms of its shape and how high its arch is. If the arch is unusually high or goes way up and then slants sharply down again (bubble), it can make nursing very painful, because the baby cannot draw the nipple back far enough back to hit the "soft palate." Many babies do outgrow this problem, some as early as 8 weeks and others not till 6 months or beyond. There are different holds you can use, but basically you will need to concentrate on getting a HUGE amount of breast into baby's mouth, which may spare your nipple. It is best to change the holds you use frequently so that you "spread around" the abrasion to your nipple.
High arches and bubble palates can also cause Reynaud's Syndrome, a condition where your nipples react very painfully to cold and frequently blanch or turn purple. http://mother-2-mother.com/nipplepain.htm#HighPalate
Post Partum AF While Nursing
AF can come back at any time while nursing. "Ecological breastfeeding" -- breastfeeding on demand and exclusively, sleeping with your infant -- is a method of natural child spacing that can be highly effective as birth control for the first six months only. After six months, most nursing mothers find that their fertility may return at any time, regardless of how frequently their child nurses. Still, it is individual -- you may find that she returns at 9 weeks postpartum, 9 months PP, or 19 months PP.
Check out: Breastfeeding and Natural Child Spacing by Sheila Kippley, http://www.llli.org/llleaderweb/LV/L...Jan99p128.html
AF may be heavier or lighter than before. It can take a few cycles for it to become more regular as well, this is normal.
Books to Generally Avoid, If You Want to BF Successfully Anything by Ezzo (babywise)
The "Baby Whisperer" Series and The "What to Expect" Series - (I am not referring to any part of these books except the BFing parts. I make no comment on the non BFing parts. They might be great books otherwise. As with any book, pick and choose the parts you like and don't like)
Links for Advocacy Clothing: our previous list was outdated -- feel free to suggest some! Granola Threads Options from Cafepress stores Little Earth Angels
BC for the Nursing Mama
Generally, the nursing mama should use barrier methods, FAM, LAM, progesterone only birth control pills, copper IUD, or some mixture of the above for reliable BC. Nursing is not reliable birth control on its own. Many women become pg while nursing, and you have no way of knowing whether you are ovulating yet. The hormones in regular BCP are harmful to nursing- they contain estrogen, which can lower milk supply.
The mini-pill is a common option, but it is not foolproof. It must be taken at the same time every day, and it has a lower failure rate than the regular pill. At least 3 women on this board have become pg while using it.
Drinking and BFing
Obviously, use your judgement. You can drink while BFing. Less than 2% of the alcohol consumed by the mother reaches her blood and milk. Alcohol peaks in mom's blood and milk approximately 1/2-1 hour after drinking. Some experts caution against having more than 1-2 drinks per week. Of course, mother's weight is only one of many variables.
There is no need to pump and dump, unless it is for your own comfort. It does not speed up the alcohol leaving your milk.
Gentle/Child-led Weaning:
There are a lot of schools of thought on weaning, which is a deeply emotional and personal decision. The AAP recommends nursing for a minimum of one year, and the World Health Organization and CDC recommend two years minimum.
The LLL's policy on weaning (if initiated by mother) is "don't offer, don't refuse." Generally, you do just that; you never offer the breast and don't say no when the baby asks. This might not work for some kids, who ask all the time anyway.
Many believe in "child-led" weaning, usually meaning that the mother will continue to BF as long as the child so desires. This can be wonderful for some nursing couples, but is difficult for many mothers to do, either practically or emotionally. Most children, if left alone, will nurse beteen 4-5 years. If you choose to nurse this long, know that it's normal and fine, you are not strange!
LLL's book "How Weaning Happens" is tremendously helpful.
Usually a mother tries to cut out nursing sessions one by one, over a period of weeks or even months. Many mothers find that it happens very quickly, and that as soon as they start cutting one session out, the rest quickly follow. It depends on the child.
In order to avoid mastitis (see above), it is strongly recommended that weaning is done gradually, with a minimum of 3-4 days between dropping each nursing or pumping session. In an older infant, following this minimum schedule, complete weaning from the breast would take roughly a month.
An additional benefit to gradual weaning, if you are weaning to whole milk at 1+ year, is that baby will be less likely to become anemic on cow's milk, as opposed to those infants who make a more abrupt switch.
If you wean after 6-8 months, you don't need to wean to a bottle. A sippy is fine for formula. Once a child is past one, whole milk (not 1 or 2%) should be offered after weaning, as it has the proper amount of "good fats" for appropriate brain development.
Nut milks, rice milk, and soy milk are all good options for babies past one year, but consult your doctor about the fat, calories, and nutrients in these milks. Soy and especially rice milk tend to be lower in fat and cholesterol, even when fortified, and you will likely have to balance the remainder of their diet to meet their nutritional needs.
This thread is now open for business! Please do make any suggestions as far as the first two "info" posts -- I removed some dead links and would love to include some new ones!
Marisa: I saw someone had posted in the last thread that her ped suggested increasing solids to increase weight gain, rather than increasing BM. This is also what my ped had suggested to me and now a friend is getting the same recommendation from her ped.
I've seen the info that shows that BM (or even formula) has higher calories than the solid foods would have and it seems to be pretty clear, but why does there seem to be such a discrepancy between what our peds are telling us and that info? I am just curious here because my friend is now really pushing solids and asking me for my advice, and since I am not a doctor I don't really feel right telling her to go against her ped's recommendation.
When DS wasn't gaining weight we saw a nutritionist and she also said to start solids because he was getting enough BM but not gaining and she said that's probably what he needed. When we started them he started gaining again. We did wait till 7 months though.
I think that a lot of doctors push solid foods or formula because it's quantifiable. Short of doing a weigh-feed-weigh every single time, there's no way to know exactly how much milk a breastfed baby is taking in at each feeding, and I think that a lot of doctors dislike that -- esp. when slow gain is concerned. Although it's an old-fashioned idea, it goes along with the notion that formula is scientific and 'better', the concept that made it so popular back in the 50's.
Here's the link with the average fat/calories of human milk: http://www.kellymom.com/nutrition/mi...e-milkfat.html
It's 22 calories per oz. on average, higher even than most formulas, but because of the variables involved (fullness of the mom's breast = more foremilk, for example) it's so hard to pin down and I think a lot of health care professionals want to be able to wipe out the variables and measure these things exactly. Makes it a lot easier for them, though it's not necessarily what's best for baby!
A lot of doctors have only received the most basic of nutrition/breastfeeding training in their school career, and for all we know that could have been 20-30 years ago when different information was available.
Michelle - do you have any LLL groups or leaders nearby, maybe someone who could point her toward a BFing friendly doctor or LC? There may even be a LC at the hospital who can answer a couple of questions over the phone, or a BFing support group/new moms group of some sort (this is what my mom does at her hospital, a lot of places around here offer something like this). I don't like to demonize doctors, but they are only human and have their own biases -- it never hurts to get another opinion, esp. if you can find someone who has more experience in this area.
When DS wasn't gaining weight we saw a nutritionist and she also said to start solids because he was getting enough BM but not gaining and she said that's probably what he needed. When we started them he started gaining again. We did wait till 7 months though.
But do you think he started gaining more because of the solid food, or do you think you started paying more attention to offering food/milk more frequently in general? See, I don't know if it can really be clearly 'cause-and-effect' because a lot of babies slow down their weight gain around the middle of the first year, when they get active and busy and stop 'demanding' to nurse as often or for as long. Couple that with the fact that many babies will start to sleep through the night at 6m or so - it's a common age for many baby books to suggest that they no longer need to eat at night and can be sleep trained as well. A lot of times if mom is just vigilant about offering to nurse frequently, moving to a quiet place where there are few distractions, maybe offering an overnight nursing session or 'dream feed', etc, you get the same results, improved weight gain, without additional foods.
I don't want to come off as anti-solids, I think it's great if baby is interested and all! But it's strange to think of it as the 'answer' to poor weight gain, all things considered it doesn't make sense to me.
Just wondering if this is the end of the road of my BF journey...
I have been BF/pumping DD for 8 months. On her 8-month birthday AF showed her ugly head and I noticed a dip in my supply (which I understand is normal) ... But its almost 2 weeks since AF ended and my supply is fairly low. I also realize DD has been eating her solids regularly. When I BF her she does not fuss and eats as normal. But when I pump, my supply output is much lower than normal. Therefore, I have been forced to use the freezer stash for daycare. I want to know if this is the end of the road or is there anything I could do to increase my supply. I have been drinking my water and try to breastfeed her when we are together as opposed to pumping & giving a bottle.
Granted, I have surpassed my own personal 6 month goal. Which I am pretty proud of for a first time mom
And Baby makes 3...Sydney Brielle is here! June 16, 2009
Thanks Marisa. My friend will be going to her first LLL meeting tomorrow, actually. She is going to the same group I went to so I know they will be able to give her good advice. I don't like to demonize doctors either because I certainly don't doubt that they know what they are talking about.
Thanks for the info. That clears it up a bit. I will pass it along to my friend so she can discuss this with her ped herself.
Breastfeeding Help and Support Part XII
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