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  1. #1
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    Default Breastfeeding Help and Support Part XIII

    Time for a new thread! The previous one is here: http://www.constantchatter.com/forum...pport-Part-XII
    mama to Joey (01/20/04) and Teddy (04/29/08)

  2. #2
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    Many thanks to all the moms over the years who helped put these together.

    Links for Quick Tips and Getting Started:
    Dr. Sears' BFing Webpage
    http://www.kellymom.com/
    Mothering.com's Breastfeeding discussion forum
    Info from the Great Dr. Jack Newman
    Promom.org
    The Notorious LLL (La Leche League)
    Page on What Medications are "Safe" While BFing
    WHO Child Growth Standards


    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.
    mama to Joey (01/20/04) and Teddy (04/29/08)

  3. #3
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    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


    Politics, Controversial Issues, and BFing/Activism:
    How to Be a Three Minute Activist
    The free gifts given by formula companies, and how they effect BFing.
    National Center for BFing Advocacy
    Breastfeeding Education in K-12 Schools (New York State)
    The controversy over the marketing of BM substitutes (this is why many boycott Nestle).

    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.

    Mothers Grieving Lost Breastfeeding Relationships thread:
    http://www.constantchatter.com/forum...ad.php?t=21398

    Where to Buy Nursing Bras:
    (Feel free to suggest others or offer reviews!)

    Bravado Bras
    Medela Bras
    Leading Lady
    Motherwear



    Please let me know if there's anything else we should include in these first few posts!
    mama to Joey (01/20/04) and Teddy (04/29/08)

  4. #4
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    Welcome to lucky number Thirteen! Thanks again to all of the friends who have helped along the way, these last SEVEN YEARS or so! Please let me know if you'd like to include anything in the main info posts here on page one.

    And post away!
    mama to Joey (01/20/04) and Teddy (04/29/08)

  5. #5
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    Thanks, Marisa! Even though I haven't been nursing seven years, I think I've been lurking in the thread for that long, way back to my TTC days, then pregnancy days.
    My Projects - House stuff, sewing, gardening, etc....
    #1 - Andrew Wyatt, our angel #2 - Nora Grace (8/06) - our VBAC rainbow baby, #3 - Joshua Edward (9/08) - another VBAC, #4 - Charlotte Jane(2/11)

  6. #6
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    Malala - Please don't beat yourself up!

    First some questions:
    When was the last time you had your thyroid checked?
    How is your bleeding? Does it have an odor?

    Next, in addition to Marisa's notes on fenugreek, I'll just say that you should be prepared to smell like maple syrup when you pee, sweat, etc. Other things that you can do to help boost supply:
    Mother's Milk Tea
    Almonds
    Brewer's Yeast
    Water to thirst

    There are a few things you might want to avoid, as they are mentioned to moms looking to wean or decrease their supplies:
    Oregano
    Parsley
    Peppermint/Menthol
    Sage
    Spearmint
    Thyme
    My Projects - House stuff, sewing, gardening, etc....
    #1 - Andrew Wyatt, our angel #2 - Nora Grace (8/06) - our VBAC rainbow baby, #3 - Joshua Edward (9/08) - another VBAC, #4 - Charlotte Jane(2/11)

  7. #7
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    Does anyone have a rec. for a good nursing sleep bra? My ladies get huge (H or higher cup) and I leak a ton. I need something to hold my nursing pads in place in the very beginning. We co-sleep so I prefer something in a cross over style to avoid fumbling with hooks/snaps in the middle of the night.

  8. #8
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    Thank you ladies for your support, it does mean a lot.

    Things are not going very well on the breastfeeding front here. DD's latch and the intensity of her suckling are getting worse at each feeding. And I'm not really sure that my supply is increasing.
    I've been taking 5490 mg of Fenugreek, drinking mother's milk tea 3 times a day, drinking lots of water and eating a bowl of oatmeal.
    The few times I'm able to, I pump on the side DD just ate from, while feeding on the other side.
    I'd love to be able to pump after each feeding to empty the breast, but it's impossible being by myself.

    It's hard to do more with DH being out of town since last Thursday and having to also care for my 5 y.o. DD.
    All I know is that I have to give it my best try, to be able to come to terms with whatever will happen.

    Maybe I should try to EP if I can ever get my supply up? I'll discuss it with the LC on Tuesday

    jennylou I don't know when my thyroid was checked last and I haven't been bleeding for about 3 weeks now, with the exception of some heavy bright red bleeding for 3 days, 2 weeks ago.

    The good news is that she's a completely different baby ever since we started supplementing. She's happy, smiling and cooing and has more alert time.

  9. #9
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    Glad someone else is talking about latch...I have a question since it's looking like that is an issue for us as well. DD has 2 things going on...first she doesn't open wide enough sometimes to get on the breast. She will just suck on the nipple and I have to unlatch and relatch her several times to get her to open wide (yes, I think it's probably my fault for the nipple confusion started by the bottles I pumped from the beginning when the LC told me to start pumping.) But even if that weren't the case the second issue is that she sometimes opens her mouth with her tongue up on the roof of her mouth instead of laying flat so that the nipple/breast can go in. Not sure what's up with that. Even more unsure what caused it (doubt I can blame it on the bottle this time) or how to fix it. As a somewhat *side* note...as much as I hated the nipple shield they gave me at the hospital and told me to use with DS, I actually went out yesterday to BRU and bought a nipple shield thinking this would help DD with her latch. Well, I am glad I did...not because by some miracle the latching is now perfect but because guess what I found out! My BF experience with DS which was made miserable in part due to that stupid nipple shield could have possibly gone better had the darn thing BEEN THE RIGHT SIZE! I honestly don't know why I didn't realize that the thing kept popping off not because it was DS's fault but because it was TOO SMALL! The LC at the hospital never measured me...guess she figured she's been doing this so long she just eyeballed me and gave me the 20mm size small. Well, that's what I went and bought for DD because although I noticed there was a 24 mm medium size BRU was all out. Had the same sucky experience with DD and the 20 mm...so I went to a different BRU and bought the 24mm. Boy what a difference is all I can say!
    At 24w 4d my little boy...became an angel 11/7/07
    Rainbow baby arrived 12/6/09!

    Added a dash of PINK 4/9/11

  10. #10
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    Quote Originally Posted by malala View Post
    Thank you ladies for your support, it does mean a lot.

    Things are not going very well on the breastfeeding front here. DD's latch and the intensity of her suckling are getting worse at each feeding. And I'm not really sure that my supply is increasing.
    I've been taking 5490 mg of Fenugreek, drinking mother's milk tea 3 times a day, drinking lots of water and eating a bowl of oatmeal.
    The few times I'm able to, I pump on the side DD just ate from, while feeding on the other side.
    I'd love to be able to pump after each feeding to empty the breast, but it's impossible being by myself.

    It's hard to do more with DH being out of town since last Thursday and having to also care for my 5 y.o. DD.
    All I know is that I have to give it my best try, to be able to come to terms with whatever will happen.

    Maybe I should try to EP if I can ever get my supply up? I'll discuss it with the LC on Tuesday

    jennylou I don't know when my thyroid was checked last and I haven't been bleeding for about 3 weeks now, with the exception of some heavy bright red bleeding for 3 days, 2 weeks ago.

    The good news is that she's a completely different baby ever since we started supplementing. She's happy, smiling and cooing and has more alert time.
    Have you tried a nipple shield? I'd try that before going to the EP route.

    As for my other questions - I ask because generally, most women can produce enough milk with no issues. Only about 5% of women can't. I've seen women that couldn't make milk, who call us back six months or a year (plus) after they quit nursing to tell us that they had their thyroid tested and it was out of whack. One in particular, we suggested get her thyroid tested and her OB told her it wasn't necessary. Later, she sought out her family Dr for related symptoms and he caught it. If it had been caught early, it could have changed her outcome. The other part I asked about has to do with a retained placenta, but usually that would have heavy bleeding with an odor, which doesn't seem to match with your report.
    My Projects - House stuff, sewing, gardening, etc....
    #1 - Andrew Wyatt, our angel #2 - Nora Grace (8/06) - our VBAC rainbow baby, #3 - Joshua Edward (9/08) - another VBAC, #4 - Charlotte Jane(2/11)

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