By Lindsey Shipley, RN, IBCLC
Some women come to me for consultations after a few days or several weeks of things not going well. They’ve experienced pain, exhaustion and lost that picture of what they thought new mommyhood would be like. I started Lactation Link after working as a Labor and Delivery RN for 5 years and seeing an immense need for prenatal breastfeeding education. I saw too many women leaving the hospital disappointed in their breastfeeding experience. Due to poor education and lack of support, they weren’t equipped to “weather the storm” that is certainly going to arise sometime during our breastfeeding experience. Maybe they thought it would come naturally to them. Maybe they received conflicting advice. Perhaps a complication arose. How do we prepare ourselves for such a time? There are so many things to remember, some women feel defeated before even getting started. So, what should we focus on to ensure our success? Today I’d like to share my “5 Breastfeeding Tips Your Baby Wants You to Know” to give you a starting point.
Stimulating Milk Production is key in the first 24 hours
You may have heard a lot of talk about the baby’s latch. While latch is important, it shouldn’t be your sole focus in that first day of your newborn’s life. Despite proper instruction on how to latch your infant, some babies just take a little longer than others to master this skill. You’re learning, baby’s learning. However, frequent breast stimulation cannot wait. It’s a little like store inventory. The inventory computer will only be alerted to set out more if the item is removed. If the item isn’t removed frequently enough, the store will eventually discontinue the item. It’s the exact same with breastmilk supply. So if baby is having difficulty latching early on, continue practicing while removing your milk another way. A combination of hand expression and an electric breast pump has been proven to be the most effective form of milk removal (second to the baby, of course) (1). Mohrbacher and Stock tell us, “The amount of breast stimulation in the first three days has a direct correlation with milk supply at three months” (3). The point is, latch can be improved with proper guidance and practice, but there is no reversing time and making up for inadequate breast stimulation in those early hours and days.
It’s good to know alternate feeding methods in case you hit a snag
Like I said above, not all babies latch right away. If you don’t have a plan B in place, often times the first recommendation by family or hospital personnel may be to supplement with formula in a bottle. However, introducing a bottle in the midst of breastfeeding issues may make matters worse. In the meantime, your baby wants to eat! The ways I teach my clients to deliver their expressed milk is through a spoon, medicine cup, or a syringe. Sometimes just a bit of colostrum (early breastmilk) on a spoon is enough to coat the infant’s tongue and stimulate them to latch to the breast. Other clients have used these methods for a longer duration until the infant was able to latch properly.
Pain is not normal
I’ve seen so many new mamas try to muscle through nipple pain, cracks, blisters, and bleeding because they felt it was their “motherly duty”. Or perhaps they heard someone else tell them breastfeeding was going to hurt. I teach my clients to differentiate between the pressure and sensation of a proper latch and the pain associated with an improper one. When checking for a good latch, you should ensure your baby is “breast”feeding, not “nipple”feeding. This means they are attached deeper onto the breast tissue, not just sucking on the end of the nipple.
You’ll feel some tenderness in those early days and during latch you may feel what some Moms describe as a “tugging and pulling” sensation. What you should not feel is pinching pain that makes your toes curl. Your baby doesn’t want you in pain!
This is most likely a signal of a poor latch and you need to break the latch (roll baby’s top lip toward their nose) and start over getting a good latch.
Weight gain is just one piece of the well-‐baby puzzle
I have many clients who call me after their 2-‐week well baby checkups, seeking help when their infant didn’t regain their birth weight. Many of them are torn between their goal to exclusively breastfeed and ensuring their infant’s needs are met. After consulting with them, I find a variety of things that have contributed to a slower weight gain. Some of these things could be: not breastfeeding frequently enough, using a nipple shield, not feeding from both breasts, poor latch, insufficient breast emptying, etc. I want to be clear that if the physician has ruled out an underlying health condition, slower weight gain does not necessarily indicate a sick baby. It’s useful to remember all the other signs of well being including wet and messy diapers, good skin tone, good muscle tone, temperature stability, good head and length growth and the ability to be active and alert at times. My recommendation here would be close breastfeeding management with an IBCLC trained consultant and your pediatrician. Working together to increase calories through breastmilk is a reasonable way to increase weight gain and foster continued breastfeeding.
Your inside circle can make or break your success
Research has shown that the opinions about breastfeeding of those close to you (including the baby’s father and your mother) affect the duration of breastfeeding overall (3). It is so important to have support when it comes to breastfeeding.
Without it, many mothers wean in the first week postpartum! I always tell my clients to have two people they know they can turn to for breastfeeding support. Talk to those around you about your breastfeeding goals. Bring your spouse with you to a breastfeeding class. Join or start a mother’s support group. Just hearing about other Moms obstacles and how they overcame them can be strengthening. In short, if people in your circle don’t support your choices as a Mom despite their own views, you may want to tighten your circle!
To finish off, I’d just like to share some experiences from a few Moms who have utilized some of these “5 Tips”. Like I said, hearing the experiences of others can increase confidence in our ability as mothers.
“I always wanted to breastfeed, and my first experience didn’t go as I envisioned. It didn't come natural to me and I wasn’t able to continue past a few days. So when I became pregnant for the second time I knew I needed to be more prepared. I found Lindsey from Lactation Link www.lactationlink.com and took her breastfeeding basics class. I felt like I had everything I needed to successfully breastfeed.
After 36 hours of labor, my sweet Lincoln was born. I knew I needed to nurse within the first hour of life, as that's when they are most alert. We tried, but he didn’t latch right away. For about 10 days it was the same thing, he wouldn't latch. I never got discouraged because I knew I had all the tools to breastfeed, and that helped me stay calm in the moments of frustration. Even though it took time, I had trust in Lincoln and myself that we would both get the hang of it. Lindsey's class prepared me for the hiccups that came my way and gave me the tools and confidence for overcoming them. I can't stress enough how important it was to have my family's support. I had my husband, mom, and sister constantly telling me I could do it, and how proud they were of me. Surrounding myself with people who were saying, "you can do it" when I wanted to give up was so key to our success. And here we are almost 3 months later and breastfeeding is the most amazing thing I'm doing for my little boy. He's gaining weight and thriving.”
“I emailed Lindsey, http://www.lactationlink.com/about-me/ two weeks after my son was born because he was 9 oz. under his birth weight by his two-week doctor's appointment. My doctor was alarmed and told me to supplement my baby with formula after every feeding. I wanted to make breastfeeding work for us and diagnose the problem so I contacted Lindsey. She talked to me a little bit about my concerns and then helped me latch Jay on correctly. She also taught me about increasing breast stimulation and how to feed my baby the expressed milk. At my next doctors appointment Jay had gained 1/2 an ounce. Two days later he had gained another ounce. The next week he gained six ounces and has continued to gain 6+ ounces a week consistently since then.”
After delivery especially with your first baby things are very overwhelming! You have just experienced one of life's greatest blessings yet one of the hardest things most women do in their life. Emotions are high, you are going on little sleep, visitors are pouring in, and you are just exhausted.
This is exactly how I was feeling after giving birth to my first baby and it did not help the situation when she was having a difficult time latching on. I was able to remain fairly calm and stick with breastfeeding. I feel like that was due to my preparation and support.
When I first got pregnant my husband and I set the goal for me to exclusively breastfeed our baby. We then determined the steps needed to achieve that goal such as education and support system. I believe that setting this goal early on was the reason I was able to stick with breastfeeding through the hard first weeks. I was prepared with the tools like hand expression and proper latch techniques. Without this knowledge I would have had no idea how to feed my hungry baby when latching was not working. I took several classes http://www.lactationlink.com/classes-3/ and knew the struggles that almost all moms face and how to overcome them. I had amazing support from my husband and my lactation consultant Lindsey. I knew I was not alone and together we could get through this.
My advice to other moms would be to decide early on that you are committed to breastfeeding. I don't think it is a decision you can make under the stress that comes post partum. Take classes so you are prepared and establish a support system. Remember you are not alone and you can do it!
Morton, J. (2012). The Importance of Hands. Journal of Human Lactation, 28, 276- 277, doi:10.1177/0890334412444930.
Mohrbacher, N., Stock, J. (2003). The Breastfeeding Answer Book (3rd ed.). Schaumburg, IL: La Leche League International.
Cox, K., Giglia, R., Zhao, Y., and Binns, C.W. (2014). Factors Associated with Exclusive Breastfeeding at Hospital Discharge in Rural Western Australia. Journal of Human Lactation, 30: 488-497, first published on August 19, 2014 doi:10.1177/0890334414547274.
Here are all my links:
Web: www.lactationlink.com Email: firstname.lastname@example.org Instagram: @lactationlink
Don't forget to head over to @lactationlink on Instagram to enter to win a $100 Oilo Gift Card and online breastfeeding course from Lactation Link!"
Lindsey is an RN, IBCLC certified lactation specialist, and mom of 2. She teaches in-person and ONLINE breastfeeding classes, with both group and private sessions available. Also e-consulting through email, phone, and Google hangout video calls. For Utah locals - home and hospital visits are available! For more info, you can visit her on Instagram @lactationlink or online at www.lactationlink.com.