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Breastfeeding Specialist, 

Mobile Lactation Services

Help With Breastfeeding is Just a Phone Call Away!

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Preventing Sore nipples

Posted on December 13, 2018 at 4:34 PM Comments comments (88)
What is normal nipple pain?
Normal is, not painful on day one, a little soreness on day two, with no cracking or bruising, pain beginning to subside by day three.
Severe pain with latch, cracking or bruising on day 1 maybe a sign of a problem. Quickly identifying what is causing the problem is crucial to reducing pain, preventing bruising and cracking, as well as improving milk transfer. Think about it, if latch is painful on day one, it will only get worse by day two.
(Bleeding not associated with cracking that comes from inside both breast while pumping or breastfeeding in the first few days is considered normal and the milk is safe for the baby to drink).
Painful latch can be caused by the baby not being ready therefore not opening the mouth wide enough. The baby’s tongue maybe up blocking the breast from going deep into the baby’s mouth. Perhaps the shape of the breast or the nipple are making it difficult for the breast to get in deep enough to prevent pain and trigger suck.
Possibly the positioning of the baby may be unstable causing the baby to slide down to the nipple after being latched on or the baby’s mouth maybe latched onto the nipple only and not the areola. Often times a finger maybe in the way of the baby getting passed the nipple or a finger is being used to pull the breast away from the baby’s nose for breathing room causing the baby to again slide down to the nipple. Some babies may have a slight oral cavity issue like a tongue tie or a bubbled palate.
The goal of latch is still the same! Open mouth, tongue down, deep latch. Identifying an issue a can be very helpful to improve technique. However when the oral cavity issue is mild or moderate it maybe be difficult to identify. In the case of a mild tongue tie or a bubbled or high palate for instance, there isn’t a fix available clinically, therefore you need to learn how to accommodate what cannot be fixed at this time. Therefore understanding what is happening and what needs to happen to get a good latch can really be helpful in working through it. Tweaking your hold, yours and your baby’s position, using tools like; pillows and foot stools to find a good effective, comfortable latch. It is extremely important to wait for a baby to root and open his mouth wide with the tongue down, so that the breast goes in above the tongue and deep into the baby’s mouth.
The baby should not be sucking on the nipple itself. The lips should be wrapped around the areola passed the nipple, so that the nipple is actually deep inside to where the hard and soft palate meet. In order for the breast to trigger suck it must get in deep and up near the palate.
Pain is often caused because the baby has not yet opened wide and the tongue is up, pointing to the roof of the mouth, blocking the breast from going in deep enough
In order to get the baby to root and open the mouth, you must tickle the lips to trigger the rooting reflex, but back away a bit until the baby actually says Ahh.  If the baby doesn’t open wide tickle and back away again. If after a few attempts the baby doesn’t open wide. Wait a few minutes. The baby may not be ready.
When attempting to latch and the baby is not ready and not rooting, the baby will move around and often pull away from the breast and get fussy. This may seem as if the baby does not want to breastfeed.
Sometimes babies will want to be close to the breast but not actually eat. Trying to feed at this time can cause confusion. Since the baby is not ready, the baby will respond but not open wide enough to get a deep latch. Constantly trying to latch will cause the baby to get fussy and even go to sleep to conserve energy.
So take a moment calm the baby and let the baby regroup.
When an infant is ready to eat, touching around the baby’s mouth will cause the baby to root: turn to the breast and open the mouth. But, it is important to wait for the right open mouth to latch.
I use what I call the tickle back away technique with an anatomical latch. Which is also known as chin to breast, nose to nipple. First, place the baby’s chin to the breast, hold the breast in a C or U shape with fingers away from the nipple, and rub with the nipple downward from the nose to the chin rolling out the bottom lip. Back away slightly so the baby can open for you. Repeat a few times until the baby opens wide and allows the breast to land deep inside the mouth above the tongue. Again if the baby doesn’t open wide or gets fussy, stop to calm before attempting latch again.
Lay the baby’s cheek against the breast and cuddle a moment to see if the baby wants to eat or just cuddle skin to skin. On a side note some baby’s won’t eat when they have a wet diaper so if you feel you are getting the breast deep into the mouth but the baby is still fussy, check the diaper.
There are several kinds of nipples; flat, everted, inverted, retractable, etc., a mother’s breast can be firm, taught, pliable, round, tubular, triangular, there are so many variations no one hold or position will work for everyone. So, don’t focus on the nipple! The milk is behind the nipple. Focus on getting the breast itself deep into the baby’s mouth.
I often find that some mothers really are hard on themselves and when latch is difficult they blame themselves. When often there is something unforeseen or simply unexplained. Remember Rome was not built in a day. Take your time with latching. Mom needs to be in charge of when the baby latches, slow it down look into the mouth if possible to make sure the tongue is down.
Reattaching is painful! So it is better to slow down and get a good deep latch the first time. Then don’t be stiff, but don’t move a lot once the baby is latched. Readjusting your position will cause the baby’s mouth to slide down.
 

 

10 Points of Positioning

Posted on December 13, 2018 at 4:24 PM Comments comments (34)
When you talk about positioning there are actually a lot of things to consider. I always say positions are a guide you have to tweak a position to make it work for yourself rather than trying to perfectly mimic a position that you saw someone else do or that you read in a book or something you saw on the Internet. It's very important that you actually tweak the position to work for you specifically you and your baby. People have often said to me " oh the cradle is my favorite position or the cross cradle or football is my favorite position". But I have found over the years that there are many things to consider when positioning a baby.
1. The position and comfort of the mother. Did mom have a c-section and she is laying on her back. Does she have a 3rd degree tear, an episiotomy or hemorrhoids that prevent her from sitting straight up.
2.The size of the baby. Large , Small, Long?
3.The size and shape of the breast. Round, Tubular, Triangular?
4. The type of nipple and its location.  Does it point downward? Does it retract?
5. What side you are breastfeeding on. Oftentimes you may even have to use a different position on one breast than the other. 
6. There may be an oral cavity issue like a tongue tied or bubble palate.
7.Where you're sitting or laying.  What type of furniture you are using. Does your chair have arms? 
8.You may need to consider the comfort of the baby in a special way, for example if the baby has a fractured shoulder or a twisted neck or clubbed feet or a circumcision.
9. The size of mom's fingers. The distance from her thumb to her index finger determines how well she's able to hold her breast during breastfeeding and how well she's able to position her baby. The amount of space from the wrist to the elbow  makes a big difference, because if she has very large breasts she will not be able to use a cradle position, because she'll lose the stability of the baby's head as it moves further towards the wrist area. 
10. Does Mom have a very long torso or is Mom obese and her breast lean to the side.  Does Mom have a large tummy therefore eliminating the lap space that a pillow would have sat on.  

 My advice is be open-minded. Be comfortable, start with basic positioning and tweak it according to where you are and what works for you. The baby should always be tummy to tummy with Mommy no matter what position. You should start positioning with Mom's comfort. Once mom is comfortable and in a secure position, then you start to secure a position for the baby. But what you don't want to do is put Mom in a position or Mom get yourself into a position and then once you position the baby readjust your own position. You want to stay in the position that you start with during a latch so get comfortable. Get the baby into a good position  right in front of the breast. Don't hold the baby by the neck. Support the baby's head. Don't lay the baby on the pillow, hold the baby and use the pillow for support. Don't hold the baby's arms behind them, no one wants to eat with their hand twisted behind them. Try to get the hands around the breast as if giving the breast a hug if possible. Some people like to swaddle the baby. But swaddles usually work more when babies are younger. And some babies just don't like being covered up. Try to give the baby a little skin. Skin-to-skin is always great and has continuous benefits for mom and baby. Once mom and baby are in a comfortable position. Hold the breast in a C or U shaped hold with fingers away from the nipple and areola complex, therefore not blocking the baby from getting a deep latch. Use an anatomical latch technique by positioning the baby chin to breast nose to nipple. Use the nipple to tickle from the nose downwards rolling out the bottom lip therefore causing the breast to land above the tongue and deep into the oral cavity.
I also teach what I call tickle back away which is; tickling the lip or nose area of the baby with the nipple to trigger rooting, yet, slightly backing away, and coming back to allow the baby to open wide.  Once the baby actually gives you a nice wide open mouth with the tongue down allow the breast to land deep into the mouth above the tongue and get up to the pallet to trigger the suck reflex.

Undeterred The Story of Carlette Edwards

Posted on April 29, 2017 at 2:54 PM Comments comments (29)

While working on her Master’s degree Carlette Edwards was diagnosed with breast cancer. At this time she only had 5 classes to go and a red headed two year old son Christian.  In bed one night her husband accidentally brushed against her left breast and she felt pain. Since she had heard there is no pain with cancer she thought it was an aggravated hair follicle. Unfortunately it was actually a pea size lump. 5 months later she was diagnosed with stage 3 breast cancer.  1st round of treatment was a mastectomy and 2 months of chemo therapy and radiation. Taking Andromyacin and Cytoxin were the hardest because it made her so ill. Zofran helped her feel better but there was a $75 co pay for one pill.  When she didn't have money to pay for the last pill, she was very sick for several days and it was the only medication on the market that helped her. Luckily her doctor found a sample he could give her. 

 

Last thing was to finalize the capstone project. Dr Timothy Goedde was a co-creator of a machine that could do a biopsy so good you could walk out with a band aid afterwards, so he made her feel safe. Since she had very large breast, she wore a 5 pound prosthesis on her left side. After 7 years they did a tram flap reconstruction, where they removed fat from her abdomen and used it to create a breast for the left side where she had the mastectomy. Then they did a breast reduction on the right to reduce the size to match. This was literally a weight lifted for Carlette. The Medical Group Community Health Network in Indianapolis awarded her a $500 gift card, other gift cards, a nail treatment and a photo opportunity. 

 

She never told the professor at her school what she was going through because she didn't want special treatment. She finished and graduated with a 3.5 GPA and Masters Degree in Business Administration. She finished her treatments with Taxil and Herceptin which had reduced side effects. Interestingly she graduated the very next day after treatment ended. The doctors told her she had to wait 5 years before having a baby, so in 2013 she had her IUD removed and got pregnant in 3 days with her 2nd child Evan.

 

When I met Carlette in 2017 she was having her third baby a pretty little girl. After she had the baby she was very fatigued and the baby was crying a lot so the Newborn Nursery decided to give the baby some formula. Once she got to the Mother and Baby floor and into her room Carlette began breastfeeding. Since the right breast was really only fatty tissue and did not have a nipple or an areola, we could only use the right breast and remember the right breast had a reduction.

 

Colostrum was visible, in small amounts of clear liquid on the first try. Horaay! mom I said you do have milk, now we have to build the supply. So we used a lot of stimulation through warm compress, hourly massage, latching on demand and pumping. Latch was difficult since the right breast had nipple reconstruction. Even though the nipple appeared everted, it was actually retractable. Therefore the areola complex seemed to collapse when the baby tried to latch, this also proved to be a problem for hand expression. We used a 20 mm Nipple Shield to facilitate latch which did also allow us to visibly check for milk transfer.  After a few minutes of suckling mom was able to remove the shield and the baby could latched well.

 

Once the edema or swelling of fluid overload kicked in on day two, things got touchy.  Mom could get out 2 ½ ml of yellow thick sticky colostrum with the pump which we fed by syringe after breastfeeding. The baby lost 9.3% of birth weight. 7 % weight loss is normal during the hospital stay. 10% is a medical indication to supplement. Also the blood sugar level wasn’t low but it wasn’t high. Therefore we had to offer formula supplement after feedings and the doctor insisted it was given by artificial nipple.

 

By day 4 the volume of milk was increasing and it turned white or into what we call mature milk. Now the scary part was over. Mom left the hospital mostly breastfeeding. I gave her a referral for a pump from her insurance company and suggested she breastfeed on demand, pump to empty afterwards. I also suggested she drink mother’s milk tea.  

 

It is strong determined women like Carlette Edwards who stand in the face of adversity and are unmoved. Most people would have thought breastfeeding was not possible, and would have just opted for Formula from the start. But Carlette is a fighter. She did not let cancer stop her from being a career woman, a breastfeeding mother and a powerful example that you can do anything you put your mind and your heart to. Don’t look at obstacles but at the goal in front of you, Remembering, when you’re determined enough nothing can stop you.

Shirley Morales Copenhagen 1973

Posted on December 16, 2016 at 11:53 PM Comments comments (23)
Shirley Morales who used a blue bicycle horn manual breast pump in Copenhagen in 1973 and such got such a surplus of milk that she sold it to the Childrens Hospital for premature and sick infants. A Milkman who come 4 mornings a week and pick up the milk. She would sell the milk in 1/2 liter bottles and she was paid $2.50 per bottle. Now Human milk is sold in milk banks all over the world for $3.85 per ounce.

Its mothers like Shirley who set the pace for the future of Human Milk Banking

Nipple Shield Dependant

Posted on August 20, 2014 at 5:10 PM Comments comments (48)
When using or recommending the use of a nipple shield, it is important to remember not become too dependent on the shield. A nipple shield is a wonderful tool for a mother when she is experiencing difficulties with Breastfeeding. However, it was always intended for temporary or occasional use. It is not a permanent solution. The long term use of a nipple shield will not only reduce your milk supply, and reduce milk transfer during nursing, but it can mask the true problem, create the need for supplementation and lead to premature weaning. I worked with a mom who was told she had flat nipples and was given a nipple shield. When I met her, her infant was 71/2 weeks old and she did not breastfeed without a shield. During our first home visit, I noticed her nipples were not flat. I also noticed her babies frenulum was a little short. But clipping it was not an option. I recommended we try latching without the shield and mom said " nope, I'm fine to just use it forever" On our second visit I offered again "she said no". I explained extensively how to properly latch without it. I also suggested to her that she try it when ever she felt good and her infant wasn't too hungry and she felt like it was a good time for her. I also suggested she get herself mentally ready to let it go. By our third home visit, mom had not used it for two days. nipples did start to get a little sore by the third day. We worked on latching without it to improve technique a little more. Shortly after that visit, she no longer uses the shield, her milk supply has improved and she is even breastfeeding in public.
 
I also met a mom who was given a nipple shield due to pain with latch. Her baby was already 7 months old when I met her and she had never breastfed without a shield, not even at night or away from home. Her complaint today was that her infant will not latch to her breast without a shield. It was not about pain anymore. This infant has gotten a custom to the shield. He has never used a bottle and even uses a sippy cup for water, but won't breastfeed without a shield.
Before using a shield, seek clear answers as to why the problem exist. Look for and plan for resolve. Most problems related to latch can be improved with better technique. For example: better positioning, that offers comfort and a good vantage point. A calm mother who is aware and patiently looking for an open mouth with the tongue down.
 
Cracked nipples can be painful and a nipple shield can help for a few days to allow some healing to take place. however,  if technique is not improved the problem will just reoccur.
Of course, some issues are not fixable today. For example: an infant who has a tongue or lip tie ( see blog post the uncuttable frenulum ). With these moms the problem can go on for many months. Initially a nipple shield can be used to allow healing and give mom time to gain confidence and perfect her techniques. She will really need some tips on latching with a tongue tied baby. She will need to learn to adapt to what cannot be immediately fixed.  She needs to Always work to get a deep latch and may still get a little sore from time to time. When latching the tip of the shield still needs to get up over the tongue and deep into the center of the mouth or the infant will fuss with it but not suck.
 
When things improve she can choose to use a shield occasionally but should work to not need it anymore. For some moms it still hurts even with the shield on. It is important to give instructions on how to use it. If it is not on properly and it's sliding around, it will limit the amount of milk the infant gets based on the the lack of negative pressure created by the sucking. Make sure the size of the shield is accommodating also, some women use two size shields one that is more comfortable and one that gets more milk. Even with a shield an infant needs to learn and be reminded to open wide and put its tongue down to achieve a deep latch. If not, the infant will only be on the nipple. If just on the nipple, he will be gassy and fussy and he will get considerably less milk.

UndiagnosedThrush

Posted on May 20, 2013 at 7:37 PM Comments comments (64)
I have been noticing that severalcases of thrush (Candida) are going undiagnosed. I truly believe that this isaffecting the success and duration of breastfeeding for many mothers. Because the symptoms can so easily go without being recognized, they are often misjudged as some other problem or mistaken as a normal part of a different issue. Even when it is noticed, some feel it is common and harmless so they just let it run it's course. Other people clean the infant’s mouth with a solution like hydrogen peroxide, baking soda or thieves’ oil so it looks better. Often times they have recently seen a doctor so they feel that the infant has already been checked for it. The problem is so many mothers and babies suffer through preventable symptoms and often time’s breastfeeding is stopped or its planned duration is greatly reduced.
 
Thrush is basically a yeast infection in the baby’s mouth. We all have yeast naturally on our bodies, but when there is an overgrowth it becomes and infection.
 
Why is it so easily mistaken or over looked? Let’s take a look at the basic symptoms:
 
For the Mom:
 
·       White patches on mom’s nipple and areola area
 
·       Nipple pain not improved with better latch and positioning  
 
·       Sharp shooting pains deep within the breast
 
For the Infant:
 
·       White patches – may appear on the tongue, cheeks and lips
 
·       Latch difficulty
 
·       Short frequent feedings
 
·       Diaper Rash
 
The white patches characteristics of Thrush often occur only inside the buccal pads (cheeks) of an infant’s mouth so they go unnoticed. These white patches are easily seen on the infant’s tongue but are often mistaken for leftover milk. A mother’s nipples and areola may take on a shiny appearance which can be overlooked, unless a mom knows to look for it.  Especially if she is using a nipple cream, she may think the shine is from the cream or the Lanolin she is applying. Latching can become difficult, the infant’s mouth may be sore therefore he may nurse only when hungry and desire short frequent feedings. He may be fussy while trying to nurse or suck on a pacifier. This behavior is often mistaken as bottle nipple confusion, breast refusal or even a desire ofthe infant’s to no longer want to breastfeed. This is especially a hint if the infant has been nursing with no problems for several weeks or months and all of a sudden latch becomes difficult.
 
The mother may experience burning pain on the nipples during and after nursing. If a mother is not aware of thrush being present she may think it is a latch problem or that her infant is a really aggressive sucker and she has to decide to take the pain or give up nursing. Some mother’s will choose to stop latching and pump only for the duration of their breastfeeding experience to avoid the pain. This mother didn’t know that the situation was temporary and that even without treatment the pain would have most likely subsided as soon as the thrush improved. Even though pumping only and offering breastmilk in a bottle is still breastfeeding, pumping only does tend to decrease the milk supply and again reduce breastfeeding duration. Not to mention it’s a big commitment and a lot of work.
 
The sharp shooting pains in mom’s breast are often confused with a strong milk ejection reflex (letdown). In the later stage of thrush, an infant’s diaper area may get a raised patchy bright or dark red diaper rash with distinct borders. However, especially depending onthe age of infant, the origin of the rash may be assumed to be related to urine or feces left on the skin too long, an allergic reaction to the brand of diapers being used or maybe mistaken as an allergic reaction to a new food or askin care product. Thrush is contagious and often time’s thrush is shared back and forth between a mother and baby. That is why it is important to treat them both simultaneously.
 
It is important to not diagnose yourself or take remedies you get off the internet or from other people.Contact your physician for diagnosis and treatment. Replace or sterilize everything that touches your infant’s mouth, nipples, pacifiers, toys, breastpump parts, bras and nightgowns. Change nursing pads often. Wash hands frequently.
 
Be on the lookout for symptoms of thrush if;
 
·       Mom has had a yeast infection during pregnancy or in the postpartum period
 
·       If a mother is given antibiotics after surgery
 
·       If the infant has been given antibiotics
 
·       If you suddenly get an onset of nipple pain after several weeks or months of pain free breastfeeding
 
 
 
Sandra Davis-Hathaway, IBCLC
 
The Breastfeeding Specialist
 
 
 

The Un-Cuttable Frenulum

Posted on December 2, 2012 at 4:47 PM Comments comments (447)
 
The Un-cut-able frenulum
 
A shortfrenulum or a tied tongue can present true challenges for a nursing mother;sore nipples, low milk supply, a fussy gassy baby and even mastitis. Somefrenulum’s can be so short that they are immediately noticeable almost at birth.The tongue never really comes out past the lips and it curves into a U or Vshape whenever the infant cries. For this family the answer is obvious, thedoctor says “this infant needs a frenotomy.” A very simple procedure where thefrenulum is clipped to give the tongue more mobility. Unfortunately, someinfants have a frenulum that is not so short that it needs to be cut, but notso long that it allows for comfortable breastfeeding. It is not just importanthow short the frenulum is but also where it attaches to the bottom of thetongue, close to the base of the tongue or closer to the tip.  The problem with this is that a doctor doesnot cut frenulums just because it hurts to breastfeed. Frenulums are cut toprevent speech & dental problems later in life. Therefore this family is ina difficult situation. Though this is not considered a medical emergency, itwill present special implications for breastfeeding. For some they end up pumpingonly, supplementing or they stop breastfeeding altogether.
 
The 1step is recognizing that the frenulum is a little short. A mother may not knowthat the frenulum is short and she believes that she is doing something wrong.Especially since the doctor may have already told her that the frenulum wasn‘tshort. It is usually a little later when these moms figure out something justisn’t right. All the pillows and positioning are still not working and their breastare still sore.  Nipple shields can helpbut are a temporary solution, they reduce milk transfer and for some mothers,it still hurts even with a nipple shield on. Once the determination is madethat the frenulum is a little short, she can turn her efforts to accommodatingit, instead of thinking it’s her fault or that the baby doesn’t want it. Thiscan reduce a lot of pressure on mom and point her in the right direction. Thedegree of breastfeeding difficulty maybe proportionate to the tightness of the frenulum.
 
 
 
It is commonto find that with a short frenulum one breast is sorer than the other. Thatbreastfeeding is more difficult on that one side. Positioning can be a key toolto finding comfort. Mom’s position as well as the infant’s position is really important.I find that the traditional cradle position and cross cradle positions are notalways the most comfortable for that sore side. Football, lying down, laid backbreastfeeding and a sitting up facing the breast position seemed to offer themost comfort. These infants work really hard to latch and often fall off thebreast frequently. Sucking is harder so they are more likely to nurse longer, fallasleep at the breast and wake still hungry. Therefore scheduling is really notrecommended.
 
It isimportant to target the middle of the tongue when latching, be very patient andremember,  touching the lips will promotethe rooting reflex which says open your mouth, but, to operate the sucklingreflex, the infant needs to have the nipple at least into the mouth about tothe middle of the tongue before he will suck. Think about it, if you put yourfinger in your mouth, you will have to stick it an inch or two in before you triggeryour brain to suck.  I also find that thetongue is often in the way instead of lying down, so remember to look for andwait for that target in the middle of the tongue. It is better to take the timeto get a good deep latch the first time instead of having to keep re-latching. Re-latchingfrustrates the infant and promotes nipple soreness. These infants also tend to bitedown a little on the nipple in an effort to hold on to it and not slide off thebreast. Again positioning, pillows, foot stools are all useful tools.
 
I wouldrecommend if breastfeeding is not going as well as planned for now pump to helpmaintain your supply. It is also important to help your breast heal. So continueto use your lanolin when needed. Expose the breast to fresh air to promote healing.When really sore a nipple shield can provide a barrier to reduce healing time.
 
The frenulummay give a little as the infant grows making breastfeeding more comfortable inthe later months.
 
 
 

Let the Experts Do What the Experts Do

Posted on August 12, 2012 at 6:45 PM Comments comments (171)
Write your  
 Be an advocate for your own healthcare. Be an educated informed participant in all areas related to the health and welfare of you and your baby. Be an active key decision maker, but don’t diagnose yourself or your baby. Self-assessment can be dangerous. Collect the facts open-mindedly. Don’t look for something that’s not there. Ask questions and do your research. Narrow down possibilities using obvious facts, not what ifs. Then take all the information to an expert. Don’t take remedies you find on the internet, always seek a doctor’s advice. Talking to people, searching the internet, books, chats, are all great tools that are essential for seeking information, researching, and getting an idea of what might be going on. You can find out what remedies have worked for other people and make some comparisons, eliminate options and narrow down possibilities. But ultimately you need a professional doctor to determine the correct steps to take. Stick to your doctors recommendations. Don’t take remedies, medicines, herbs, or homeopathic supplements unless approved or prescribed by your doctor. Always let your doctors know what you are taking or when your routine’s change in regards to your health care practices. It takes a village to raise a child and it takes a health care team to live healthy.
 
 
post here.

It takes a few days to get sore nipples….

Posted on July 11, 2012 at 6:26 PM Comments comments (321)
Write your post her
 
Before leaving the hospital most moms will get help from a Lactation Consultant or a Nurse to latch the baby on. Often times when I talk to a mom the same day she has her baby or even the next day she will say “the baby is latching on and were doing fine”.  But, by the time she gets home from the hospital things begin to change. Now her nipples are sore and her baby is not getting full. Translated, this means that she is in pain and not getting sleep, her baby is fussy and gassy and continues to seem hungry after breastfeeding. This means mom is probably beginning to feel stressed and maybe even be concerned that she may need to supplement.
 
It is important to take the time to get a deep latch from the beginning. Infants do not nipple feed, they breastfeed. It is not important if you have nipples that poke out or ones that don’t. What matters is how much actual breast tissue goes into the mouth along with the nipple. Sucking on a nipple only, can cause a world of problems like sore cracked nipples, low milk supply, plugged ducts. In order for the milk to be stimulated the nipple needs to be inside the infant’s mouth deep to about the middle of the tongue. He should have a mouth full of breast tissue. The infant’s lips should be flanged out like a fish and his breathe, suck, swallow motion he does will stimulate the ducts and help to bring down the good fatty milk. This means your milk supply will grow, he will get more satisfied, he won’t be gassy and you can get some rest!
1.     Your Position-You need to be comfortable, use pillows a foot stool, support your back and relax your shoulders. Take a deep relaxing breath for the next few minutes let it all go. Clear your mind and connect with your baby. Get into a position where you can comfortably stay in once you latch the baby on. Anything you may need should be within arm’s reach. I.e. a glass of water, the remote.
2.     The baby’s position- It is important that you use positions that feel comfortable to you. The baby should be close to the breast, and the head shoulders and hips should be in a straight line. Again use pillows to give extra support and bring the baby up close to the breast. Once you latch stay in the same position and don’t change hands.
3.     Tummy to Tummy-The baby’s body should be turned tummy to tummy with you, directly facing the breast.
4.     How you hold the breast-Hold your breast in a “C” or “U” shaped hold. Make sure that your fingers are far enough away from the nipple on top and bottom of the areola to allow the baby to have a clear target and enough breast tissue available to latch on to.
5.     Offering the breast- tickle the baby’s lips with your nipple to encourage him to open his mouth. Be really patient and you be in control of when the baby actually latches on. You don’t want the baby to grab your nipple, and you don’t want to put the nipple into the baby’s mouth. You need to wait until the mouth is open wide and the baby’s tongue is down. You should be able to see into the baby’s mouth. Remember the middle area of the baby’s tongue is where you want the nipple to end up. When you see the mouth open wide allow the baby to latch on. If it hurts stop and start back over at step 1. To properly remove the baby off the nipple; use your index or baby finger, run it alongside of the baby’s cheek, stick it between the baby’s gums to break the suction and remove baby off the nipple.
e.

Every time I put my baby down he wakes right back up and wants to eat again…….

Posted on June 15, 2012 at 5:28 PM Comments comments (246)
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Lactation consultant
 
      This a very common concern I hear from mothers. When they breastfeed their infant he seems to be done eating and he falls asleep. They burp him and put him down and he wakes right back up and wants to eat again.This can be very frustrating for parents, it makes a mother feel as if she does not have enough milk and it makes it difficult to get rest. I have found in my work with mothers that for an infant breastfeeding can be a lot of work.Therefore it is very common for infants to get tired and take rest breaks during a feed. This can really give the appearance that the baby is done eating on that side, he is sleeping, or he doesn’t want to eat right now, especially if you hold him in your arms. I call it playing Possum. They look sleep but there not! I would recommend that when the baby stops sucking, but is still latched and you keep talking to him and trying to get him to eat, let him rest for a moment. You may find a couple of moments later he will start sucking again. If he appears to be done and sleeping lay him down next to you (not in your arms). He will probably rest for a few moments and wake back up. When he does I would put him back to the same breast for a while to make sure he finishes that side before switching. Also when switching breast, I would allow a few moments in between breast so he can wake up and be ready to eat. Otherwise if you switch right from one breast to the other you will get a sleepy baby who latches and stops eating right away. If you let him rest a few minutes and wake he will latch and eat better from the second breast. If you have to hold him to keep him from waking, he is not sleep. If he still seems hungry go ahead and latch him back on. Remember that some days he will eat more than others. The best way to increase your milk supply is to empty the breast. If you feel you are not making enough milk pump to empty after breastfeeding. If you get an ounce or two more out you know the baby could have eaten more. If you do not get more out pump for a few minutes anyway to send a message to your body to increase your supply. And call me!