Perspectives on breastfeeding

PERSPECTIVE

“My hospital nurse told me to feed baby every 2 hours with 15mL and my pediatrician told me to feed baby every 3 hours with 30mL.”

“My IBCLC told me there is a tongue tie but the ENT said there wasn’t one.”

“One consultant told me to use a nipple shield as lo as needed. The other said get off as quick as possible”

“They said don’t let baby feed more than 10 minutes per side, but my baby won’t stay latched that long.”

I hear this all the time in my practice and it can be confusing for families. Why did I get different advice from different people? Perspective. Doulas, midwives, pediatricians, even lactation consultants all come from their own training, education, clinical practice and personal experience. When in doubt, the best person to get lactation advice from is an IBCLC. They have had to go through extensive training and mentoring to become certified in the study of human lactation. But remember: even lactation consultants come from different perspectives.

A hospital based IBCLC typically only works with babies in the first 2-4 days after birth and may see dozens of babies in a week, getting only a short amount of time with each family. A private practice IBCLC may have more time to spend with you but experience and expertise may vary. An IBCLC who is also a nurse will approach breastfeeding differently than one who is also a feeding therapist or who started out as a mother who struggled to breastfeed and became passionate to help others going through what she went through. My best advice is find some one who listens to you, educates on why they want you to do something, and supports you in your journey. Because you have a unique perspective, too.

Lauren Archer, Love of a Little One doula, takes a picture of my midwife and newborn
This is the same image from Lauren’s perspective

My baby mouth breathes: when should I be worried?

Babies are obligatory nose breathers. They should be breathing through their nose all the time. This is how they can have their mouth full with a nipple during breast or bottle feeding and still breathe. Mouth breathing isn’t as efficient as nose breathing — especially when it comes to oxygen absorption in the lungs. And breathing through the nose helps to filter out bacteria and irritants from entering the body. Babies should be breathing through their nose all the time, especially during sleep. And snoring with mouth breathing is NEVER normal.

Mouth breathing as an infant can indicate several things:

🤢Nasal congestion from an illness or allergies

😛Tongue tie

👀Large tonsils/adenoids

👃🏽Deviated nasal septum

🧠Learned habit

Prolonged mouth breathing can cause:

Atypical development of the mouth, nasal passages and face

• Poor quality sleep

ADHD

• Increased risk of asthma

• Swollen tonsils

• Dry cough

• Inflamed tongue

• Teeth issues, like cavities and bad alignment

• Foul-smelling breath

If you notice baby mouth breathing regularly (other than when sick), please make an appointment with a health care provider to help figure out the root cause.

• Stay away from your baby’s known allergens

• Gently push the chin upward to close baby’s mouth when sleeping

• Consult with a doctor as soon as you notice baby breathing through their mouth consistently

• Put a humidifier in their room to prevent their mouth from drying out

• Have tongue tie revised and work on suck training exercises, tongue posture, and body work for proper body posture to correct habits baby made from compensating for the tie

Paced bottle feeding

Paced bottle feeding (meaning you’re setting the pace for how fast/slow baby drinks) helps prevent over feeding baby: it takes 20 minutes for the stomach to tell the brain that it’s full. If a baby takes a bottle too quickly, the mouth can still be “hungry” and wanting to suck when the stomach is actually full. Like going to an all you can eat buffet and eating a lot of food quickly and then realizing half hour later you ate way too much. A baby that happily sucks down too much milk from a bottle can make you think you don’t have enough breast milk even if you make a normal amount. It can also make baby frustrated by the flow of milk from the breast and inadvertently sabotage breastfeeding

These pictures are the same baby in two different positions for paced feeding: semi upright and side lying. Side lying is my favorite position to use as it puts baby in the same position as breastfeeding. Many parents feel baby is more supported in this position. Baby is supported by your leg or breastfeeding pillow.

Tips:

🍼Never feed baby on their back

🍼Keep the bottle parallel with the floor with about half the nipple filled with milk

🍼Use the slowest flow nipple baby will tolerate

🍼Rub the nipple gently on baby’s lips, allow baby to latch at their own pace, don’t force it into their mouth

🍼It should take 15-20 minutes to finish the bottle

🍼Watch the baby and not the bottle, stop when they show signs of being full

🍼Resist the urge to finish the bottle, even if there is only a little left, when baby is showing signs their tummy is full

🍼Take short breaks to burp and give the tummy time to fill naturally

🍼If baby is gulping or chugging, slow down

🍼If baby has taken a good volume of milk (2-4oz) in a short amount of time and is still acting hungry, offer a pacifier for a few minutes to help them digest and give the tummy to to tell the brain it’s full. If they’re still hungry, slowly offer more in 1/2oz increments

Dropping breast milk supply

Feel like your breast milk supply is dropping? It may be normal. The uterus doesn’t tell the breasts how many babies came out. Immediately after birth, hormones cause the breast to go into overdrive to try to figure out how many babies were born…to feed them ALL.

The breast makes milk by being emptied and learns your babies habits and how much milk it needs to make with time and experience. In the early weeks your breasts have extra blood and fluid support to help your breast tissue make milk. This is what makes you aware of the filling and emptying of milk. This extra fluid support goes away around 6-8 weeks and you’ll no longer feel that full/soft feeling. By 10-14 weeks your breasts become more EFFICIENT and only want to make what is routinely emptied. Your breasts will go back to prepregnancy size. You may stop leaking (if you leaked) and not be able to pump as much. That’s NORMAL.

Your body doesn’t want to make milk that isn’t needed. You biological body doesn’t know what a freezer is or that you’re trying to collect that leaking milk for later. Your body wants to be as efficient as possible and make only what is being routinely removed from the breast. It costs your body energy to make milk: about 20 calories per ounce of milk made. Your body doesn’t want to burn calories to make milk that’s not being regularly emptied so it can use those calories for things like your brain function. Because mom brain is real.

So before you reach for formula thinking you don’t have enough milk. Realize that when everything is going normal your milk supply is supposed to regulate and your breast aren’t supposed to stay engorged and full forever. Your body is efficient. As long as baby continues to make good wet and dirty diapers, has a pain free latch where you’re hearing baby swallow, feeding baby in demand and not to the clock, and baby gains weight over time, you body is just doing what it’s supposed to do. You can always increase supply by feeding or pumping more often and decrease supply by feeding or pumping less.

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🤱🏻🤱🏼🤱🏽🤱🏾🤱🏿

#normalizebreastfeeding #normalizenormalbodies #postpartumbody #milksupply #milksupplyissues #makingmilk

How much milk should I leave my breastfed baby?

How many ounces should I leave if I’m exclusively breastfeeding but need to leave my baby a bottle?

The answer is: that depends. Some babies are grazers. They like smaller, more frequent feedings to keep their tummy from being too full or uncomfortable. Their feedings can range from 1-3 ounces and they may feed 10 or more times a day. Other babies are bingers. They like a big, full tummy and may take 3-5 or even occasionally 6 ounces but not as often. They may feed only 6-8 times a day and have longer sleep stretches. Their tummy doesn’t mind being stretched fuller and their bodies tell them it’s ok to go longer between feedings.

The question is: how many feedings do they get in 24 hours? From one month to one year, babies take between 19-32 ounces of breast milk a day. The average is 25 ounces in 24 hours. There’s a range because babies eat more or less depending on the activities of the day, growth spurts, teething, and even babies emotionally eat sometimes. In general, take 25 and divide it by the number of feedings they average in any given day. Also take into account that growth slows between 6-12 months and baby should be eating table foods, so you don’t need to increase the ounces in the bottle during that time. If your baby took 4 Oz bottles at 4 months, 4 Oz bottles are still appropriate at 9 months because they’re also begging for the food right off your plate in addition to what you’re putting on their tray.

How can I make more breast milk?

The best way to lose weight is to be in a calorie deficit. Choosing the right foods, protein, fruits and vegetables with moderation of carbs, sugars and starches is guaranteed for most to lose extra pounds. Sure, exercise helps. It helps burn calories, again contributing to calorie deficit. But exercise alone won’t help you lose weight if you’re still eating a high calorie diet. Sure, going vegetarian or vegan or doing Weight Watchers or Atkins or any other “diet” helps. It helps you monitor intake to be in a calorie deficit. But even on any diet plan, if you’re not following it correctly and still eating high amounts of foods you won’t lose weight. Certain people do better on certain diets or with specific exercise programs because of how their specific body handles and processes food, vitamins, stress, movement, and all of the other factors like environment and genetics. Finding a nutritionist, weight loss coach, or personal trainer helps you look at your specific body and goals and helps you reach them. You can absolutely get there in your own, having someone counsel you through often gets you quicker results from their experience and wisdom. But the principle remains: calorie deficit is the number one way to lose weight.

The best way to make breast milk is to empty breast milk. Whether that’s your baby or a high quality breast pump, moving milk multiple times a day tells the body to make more milk. The more often milk is removed, the faster it is made. Sure, supplements help. They support your thyroid and blood with the extra nutrients and hormones needed to produce milk. But supplements alone is no replacement for moving milk. You can take the best lactation bars and drink all the tea you want, but without emptying the breast every few hours routinely I wouldn’t expect the majority of us to make enough milk to feed baby. Sure, hydration and nutrition are important. It takes calories to make calories and hydration help with that process. But even the research shows women who are malnourished in famine torn countries make plenty of milk for their babies when baby is allowed unrestricted access to the breast. Yes, adding in chia seed, flax seed, oats, nuts and nut butters, and coconut water helps make milk. Certain people do better on certain herbs and foods because of how their specific body handles and processes food, vitamins, stress, hormones, and all of the other factors like anatomy and genetics. Finding a lactation consultant, peer counselor, or trained doula helps you look at your specific body and goals and helps you reach them. You can absolutely get there in your own, having someone counsel you through often gets you quicker results from their experience and wisdom. But the principle remains: emptying milk from the breast is the number one way to make breast milk.

Pumping while away from baby helps maintain your supply

Cluster feeding

CLUSTER FEEDING. Two words when paired together that drive fear and trembling to parents. Cluster feeding is NORMAL for ALL breastfed babies. It has nothing to do with your supply. It has nothing to do with the clock. It has nothing to do with what you’re eating or drinking or those supplements you just took. It may not even have anything to even do with being hungry. Babies typically cluster feed in the afternoon/evening. When your milk supply naturally and appropriately dips. When your milk is a smaller water concentration with a higher fat content. As long as baby is happy to feed the rest of the day, is making plenty of wet and dirty diapers, is content and sleeping routinely between feedings, and gaining weight over time, DON’T BLAME THE BOOB!! Even if baby seems like they want to feed constantly. Cluster feeding is normal. It typically happens MORE when baby is going through a growth spurt (body growing), developmental leap (mind/skills growing), or teething/illness. Why does baby want the breast more?

• Preparing for a longer sleep: Some babies just prefer to fill up on milk for a few hours before a longer sleep.

• Milk flow is slower at night: Some babies nurse longer to fill up due to the slower flow.

• A growth spurt: they usually occur around 3, 6, and 8weeks of age.

• They need of comfort. Breast milk has hormones to develop baby’s circadian rhythm. At nighttime baby may just seek comfort to help them sleep.

• Developmental leap: Mental and emotional growth spurts when they acquire new skills.

• Baby is sick, thirsty, or teething: breast feeding is a pain reliever, medicine and hydration all in one

Know that it’s normal. Be patient through the process. Be prepared with snacks and water for yourself, a comfy spot, a good pillow for support and the remote and your phone charger close by to get you through. You’re not alone and it doesn’t last forever!!

Best Parenting Advice

Put them in water or take them outside. This is the best parenting advice I’ve ever been given. When breastfeeding has been established (baby is making good wet and dirty diapers, generally pain free latch, and gaining weight), there will be times when baby will be super fussy and refuse the boob. Many misinterpret this as having low milk supply or something wrong with the breast. Don’t be so quick to blame yourself or to supplement with a bottle. I guarantee you there will be times when you have no idea what to do to stop your baby from crying. The boob won’t work. Changing the diaper won’t work. Burping and rocking and shushing won’t work. I guarantee you there will be times when you will cry right along with your baby and feel helpless to soothe them (or yourself).

When the breast doesn’t work: put them in water or take them outside. It works. When your baby is falling to pieces for no apparent reason and the usual tricks don’t work, go outside or get in water. It works on adults, too!!

Cabbage for engorgment

Cabbage is not just for Cole slaw. Did you know that cabbage leaves have been used for decades to help reduce breast engorgement? A handful of studies have shown that placing a chilled green cabbage leaf against the breast has been effective to reduce breast swelling and pain. It is suspected that the compounds found in the plant leaves have strong anti-inflammatory properties that help improve blood flow, decrease swelling, and allow milk to flow more freely.


Using Cabbage Leaves for Engorgement:

✏️Chill the cabbage, green cabbages are best

✏️Wash off one or two inner leaves, be mindful to remove any dirt, pesticides or residue

✏️Gently pat dry with a towel

✏️Crush the center stem for maximum potency

✏️Wrap a leaf around the affected area of the breast, exposing the nipple when possible.

✏️Use a bra or lose wrap to hold the leaves in place

✏️Leave for 20 minutes

✏️Discard the leaves

✏️Cautions:20 minutes seems to be for most the right amount of time

✏️Repeat no more than 1-2 times a day for engorgement, as cabbage leaves used more often can actually decrease milk supply!

✏️This process is also used for weaning breast milk, such as when quick weaning is needed or when mothers are done breastfeeding.

Sunflower lethicin and plugged ducts

Lecithin is used in food to provide a smooth, moist texture and to keep ingredients from separating. Lecithin can naturally be found in green vegetables, red meat, and eggs. Commercial preparations are often made from soybeans, egg yolks, or animal products. It is also commonly used in eye drops, skin moisturizers, and food emulsifiers (agents that keep ingredients from separating).

Sunflower lethicin, a specific kind of lethicin, is often taken during breastfeeding to reduce plugged ducts or to help increase milk flow. Sunflower lethicin is thought to reduce the “stickiness” of breast milk by thinning out the fats in the milk and keeping them from clumping together. There are no known contraindications for breast-feeding, and lecithin is “generally recognized as safe” by the FDA. However, people with a preexisting tendency to depression may become depressed if taking high doses of lecithin. While very rare, if you begin to have a fish-like odor while taking high doses of lethicin, stop taking it immediately and notify your physician, as this is a serious sign of liver damage. As there is no recommended daily allowance for lecithin, there is no established dosing for lecithin supplements. Different brands might have different amounts of lecithin in each pill or capsule, so be sure to read labels very carefully before taking lecithin or any other dietary supplement. Per Kellymom.com, the maximum dosage recommended for recurrent plugged ducts is 4,800mg/day. As always, consult with your doctor before trying any dietary supplements while pregnant or breast-feeding.