Sunday, February 3, 2013

Common Booby Traps & Troubleshooting

Our society is fraught with "booby traps" or traps that impede women's breastfeeding attempts. I am going to choose a few select common booby traps to explain and troubleshoot for you.

Tips and Troubleshooting to Ensure Breastfeeding Success


1. Read, Read, Read & See, See, See

Read as many books as you possibly can on it. The more you know about what is normal and what isn't, you will be able to troubleshoot most of your own problems at home or consult a Lactation Consultant who you can help by eliminating problems with them. It gives you a starting point.

Avoid books written or funded by formula companies. Many of the breastfeeding pamphlets and books supplied by hospital staff (whether it be in a hospital breastfeeding class, a birthing class, after birth, etc) are written or funded by formula companies. They will sweet talk you and attempt to come off neutral...but why bother? They sell formula. Who buys formula? People who don't breastfeed. They are not trying to get you to breastfeed, no matter how well-meaning or "factual" they come off.

See? See what? See breastfeeding in action. Go to La Leche League meetings while you're pregnant. Take a class (I highly recommend non-hospital associated), meet breastfeeding mamas. Ask questions, watch closely. Go to Mommy Cafes in your area, if any. Many have meeting for breastfeeding moms. It helps to take away the "unknown" in breastfeeding when you see others succeed. It takes away the "fear" of failing.

2. Have A Mama/Baby-Friendly Birth

What does this mean? This means, be as informed about birth as you possibly can. This doesn't mean you have to go without an epidural or pain relief if you wish (although it is ideal). It means, if you choose to get the epidural, know that it's best to wait to get it as long as you possibly can, and that getting it before active labor (5cm) can stall or slow your labor and require more interventions. Having a M/B-Friendly Birth just means to reduce the interventions as much as possible. Epidurals, C-Sections, and other such measures are known to cause lower breastfeeding rates. The baby does sometimes come out far to sleepy to suckle (this effect can last up to two weeks, which is THE most important period in establishing supply) and you want to avoid that. If you do have to have a c-section for whatever reason, ask for only the epidural, and make sure they give you skin-to-skin immediately and do not take your baby (of course, barring complications). It is your baby, and they do not get to tell you no.

All in all, the less interventions - the better the breastfeeding outcome.

2. Check and Check Again

Check what? Check your baby for lip and tongue ties, even the smallest one can impede breastfeeding. Many nurses and pediatricians will say "Oh, it's only a small one, no need to worry" or play it off as if there isn't one. For most ties (2nd Degree +) they will need to be clipped by a pediatric dentist or ENT. If the tie is even a 1st degree, you need to know anyways, as some can still cause problems. I don't advise doing anything for 1st degree ties except to know they are there, so you know what the problem is if it still needs to be clipped if problems arise later.

Check latch. Don't follow the nurse's instructions. Nurses are well-meaning most of the time, and yes they see many many women who breastfeed, but most are not experts and not trained on the matter. If you have the smallest hint of a problem, or just feel like it needs to be checked, ask for the lactation consultant. If there is none, you can call La Leche League and usually they will be able to help you.

3. Avoid Formula Samples and Breastfeeding Pamphlets/Books with Ties to Formula Companies

This means, do not keep formula in your house. If it is gifted to you or you get samples in the mail...give it away or donate it. If the temptation is there, you are more likely to take it. This means, when you're in the hospital, make it clear you are breastfeeding. Do not let the baby go to the nursery (it is shown that regardless of parents' wishes, NICU staff often force-feeds newborns formula without regard). See the above information about why those Pamphlets and Books are bad. ^^

4. Have Support

It sounds so obvious - but some women really feel they don't need support, and then end up needing it. Breastfeeding can be hard, especially in the first few weeks post-partum. It takes dedication, time, sometimes pain, and lots of love. For a while it can feel like you can't get out of bed to pee without a milk-vampire screaming for you. It can make a mom desperate and lonely and frustrated. Having a supportive partner, friend, or relative can really help. Someone who encourages you or soothes the baby while you take a shower is sometimes all a mom needs. Seriously, even if you feel you can handle it - why deny that shower to yourself? You will feel so much better when you take care of yourself (and feeling better will help you succeed). It's been proven that women who feel they have no support - oftentimes stop breastfeeding before reaching the 6 week mark.

Make sure your child's pediatrician is supportive of your breastfeeding wishes. An unsupportive pediatrician will often try and get you to stop. They will give you samples of formula, those dreaded booklets we discussed, and use scare tactics on you that will attempt to get you to second guess yourself. Sometimes a pediatrician also doesn't know what is normal for breastfeeding. They use the CDC growth charts (based on formula-fed infants) and don't know that there are breast-fed baby charts (by the WHO). Oftentimes that small mistake can lead them to diagnosing your baby with FTT (Failure to Thrive) or other issues that your baby doesn't have - leading to supplementing - which will eventually lead to full-time formula-feeding. Make sure your pediatrician is either knowledgeable or willing to work with you.

5. Stick it Out! Set goals - or don't!

Oftentimes the first few weeks or months can be so hard. You may face latch issues, tongue or lip ties, allergies, thrush, mastitis, leaking nipples, sore boobies and other such problems. It may seem like forever - but those issues go away really quickly. It will be like the blink of an eye, and you will be SO proud of your achievement.

If it is helpful to you - set some goals. "Let's make it to the 6 week mark." "I will go a year!" Sometimes that doesn't work out - and that's alright. But if you think it will help - set them anyways. Stick to it! It's worth it. If you feel setting arbitrary goals is just going to put on too much pressure - skip them. Do what works for you! Find your inspiration somewhere.




Troubleshooting

1. My milk isn't in!!

Usually it can take 3-7 days for milk to come in post-partum. Until then, you will produce colostrum - and until your milk comes in this will satisfy your baby - even if your baby seems very hungry it is often just the sucking action that is soothing. Put them to the breast as often as you possibly can - this will ensure your milk will come in faster. Giving formula will just impede or destroy breastfeeding. You need your baby to breastfeed as much as possible for the first two weeks to ensure your supply. Breastfeeding is supply and demand. 

2. Why does it hurt??

Sometimes - it just does for a while. More often than not though, there can be an improper latch. Most of the time that is due to a tongue or lip tie, and usually a lactation consultant can diagnose it for you. In rarer cases - it can be caused by Raynaud's Phenomenon which is usually treatable and unconcerning (besides being painful, of course). 

3. What's this white stuff on my nipple and/or in my baby's mouth?

That's usually a sign of thrush, and there are many home remedies for it. In particularly stubborn cases an antifungal may be given to you by your child's pediatrician. Usually, just cutting out most yeast, gluten, and/or sugar in your diet will clear it right up though. Gentian violet is another common remedy.

4. I have shooting pains in my breast. The area is red and sore. What is this??

It could be a clogged duct - massage it and breastfeed often. Apply hot compresses (or take hot showers) to try and loosen it up. If not resolved quickly enough it can lead to mastitis - infection. Mastitis can be really painful, and takes antibiotics to treat. So if you suspect a clogged duct, try and help yourself out by getting rid of it. Your baby will often finally just suck it right out from your breast and you won't know.

5. My baby just eats and eats and eats every 20 minutes. I'm so frustrated!!

This is caused by a lot of things. In the beginning this is normal, a newborn's belly is only so big. And those tiny mouths get tired quick. Be patient - it will pass.

It can be caused by growth spurts - just remember you're giving them liquid gold! They will grow big and strong!

Your little one may be getting sick. Don't worry, her saliva will tell your breast to make antibodies - and you will pass those antibodies right along in your milk to help. Many times your little one will be over that bug before you even realize she may have been getting sick.

It can be teething. All that suction and motion may help relieve the pressure and pain in their tiny jaws. It may be the only thing that helps for a while. Again, remember....it will pass! Don't be afraid of them getting teeth - you can't suck and bite at the same time. Most babies only bite a few times and quickly get over it - they want their milk first and foremost!

Check again for lip and tongue ties. They may be just as frustrated as you because they don't know why their milk-nozzle isn't working right. In these cases they become frustrated with their own limitations and keep trying to satisfy themselves.



Most of all - have faith in yourself. Most women CAN successfully nurse with the proper support and determination. Only a very small percentage of women can't breastfeed due to hypoplasia/insufficient glandular tissue. Chances are - you are NOT one of them.



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