Tag: breastfeeding advice

Why should I see an IBCLC or lactation consultant

- Julie Matheney

If you broke your foot you wouldn’t go to your local nail salon to have your pedicurist look at it. Yes, they work with feet. I just wouldn’t trust their expert opinion on whether I need a cast or some physical therapy. If my car engine was making smoke and my gauges were outside the appropriate ranges, you wouldn’t go to the car wash to have it looked at. Yes, they work with cars. I just wouldn’t trust their expert opinion on whether my engine block is cracked or not. So why when we’re having lactation problems do we turn to mom groups or even pediatricians? Yes, moms have babies. Yes, pediatricians work with babies. But neither are the experts in lactation (ok, occasionally a pediatrician will seek additional training, but honestly it’s rare). To become a board certified lactation consultant, you need to take advanced college level coursework specifically in human lactation. You need to spend hundreds to thousands of hours being directly mentored by someone who already is board certified. And you have to pass a FOUR HOUR board exam. To be board certified. IBCLCs spend thousands of dollars and years of their lives training to become experts in breasts, babies, and feeding. If you’re struggling, please find the correct help. There’s a lot of bad information out there that may inadvertently sabotage your breastfeeding journey without you even being aware.

Nipple Damage

- Julie Matheney

Nipples and penises have a lot in common. From an anatomical, cellular level, they are both made of the same elastic, erectile tissue. They erect and evert with stimulation. They can crack, bleed, and blister, but they can never toughen up or callous. And neither one should ever crack or bleed.

Babies mouths have two areas: the hard, bony palate up front and the soft palate at the back, just in front of where that little hangy downy uvula is. One of the reasons a nipple erects, everts, and stretches is to help to get it in the safe zone where the palate is soft.

When a baby is latched correctly, the nipple tip stretches back to where the palate is soft, then the tongue massages the nipple to express milk. If baby has a shallow latch, the tongue pinches the nipple tip against the hard roof of the mouth and causes damage. This also happens when there is a tongue tie where the tongue is restricted in its movement. Instead of the middle of the tongue massaging the nipple, the the tongue is anchored to the floor of the mouth and it flicks the nipple, or the middle of the tongue where the restriction is pinches the nipple against the bony palate.

Nipples are perfectly designed to withstand breastfeeding. Other than temporary tenderness in the first few days, there should be no pain or damage. If you do get damage, they should heal quickly (within 24-48 hours) if you can get a consistent deep latch.

Moist wound healing is most effective to heal a nipple. Tips to heal a damaged nipple:

💡Keep breast milk on the nipple. Using a washable breast pad can help keep milk on the nipple

💡Nipple balms/butters, coconut oil and lanolin can help keep the nipple from sticking to clothing and feel soothing

💡Breast gels

💡A 20 second saline rinse once or twice a day

💡Soak the nipple in an Epsom salt bath, either in a bowl or Haakaa filled with warm water

💡A prescription for Dr Jack Newman’s All Purpose Nipple Ointment for severely damaged nipples

💡Silverette cups for persistent damage

💡Temporarily use a nipple

💡Schedule a lactation consultation time get to the root of the damage

Silverette Cups to heal moderate to severe nipple damage

Where did my milk go?

- Julie Matheney

What can cause a late onset decreased milk supply?

1.The mother is pregnant again. Milk supply decreases during pregnancy. Domperidone will not work when the mother is pregnant.

2.The mother is taking some hormonal birth control method (pill including progestin only pill, IUD, etc)

3.The mother is breastfeeding on only one side at a feeding or “block feeding” (several feedings in a row on the same breast, used to treat “overabundant milk ejection, “overabundant milk supply”). I have posted on “block feeding” previously.

4.Some medications other than hormones can decrease the milk supply (antihistamines for example).

5.Can an emotional shock decrease the milk supply? Possible but unusual in our experience.

6.Blocked ducts/mastitis as well as any febrile illness may decrease the milk supply.

7.The use of bottles more than occasionally can very much decrease the milk supply.

8.”Overdoing it”. It’s time that others do most of the usual chores that fall on women’s shoulders.

9.An “abundant milk supply” associated with a less than “ideal” latch. In this situation, the milk flows into the baby’s mouth with little participation of the baby. The baby may often choke while breastfeeding, especially when the mother has a milk ejection reflex. A tongue tie is a common cause of a baby having a less than “ideal” latch and can be a significant cause of late onset decreased milk supply even if neither the mother or the baby had problems early on.

This problem of late onset decreased milk supply and accompanying symptoms is typically the problem of the mother who once had an abundant milk supply and milk supply may still be quite good, but less than it once was.

Breastfeeding and lactose, dairy, food intolerances and allergies

- Julie Matheney

Lactose is the number one sugar in breastmilk. It is the protein in cow’s milk that is difficult to digest for some babies. Human milk has human protein. It is easily digested by the stomach and absorbed in the intestines. The protein of cow’s milk is shaped different and not easily absorbed by the stomach and intestines as it’s designed to be absorbed by calves. It can sometimes make babies gassy or have poops that have bloody or mucous in them. Cow’s milk sensitivity or allergy can cause colic-like symptoms, eczema, wheezing, vomiting, diarrhea (including bloody diarrhea), constipation, hives, and/or a stuffy, itchy nose. Which can also be signs of other things. You could always try decreasing your dairy intake. Baby’s symptoms will usually begin to improve within 5-7 days of eliminating a problem food. Baby may not improve immediately, however, especially if the reaction is to a food that has been a regular part of your diet. Sometimes symptoms get worse before they begin to improve. It usually takes 2-3 weeks to see an improvement.

If baby is sensitive to dairy, it will not help to switch to lactose-free dairy products or put your baby in formula, which is cow protein based.

While culture may dictate what you can and cannot eat while breastfeeding, science does not. Most babies have no problems with anything that you eat. It’s generally recommended that you eat whatever you like, whenever you like, in the amounts that you like and continue to do this unless you notice an obvious reaction in your baby.

There is no list of “foods that every nursing person should avoid” because most of us can eat anything we want, and because the babies who are sensitive to certain foods are each unique – what bothers one may not bother another.

Babies’ guts are also constantly developing. So what bothers them as a newborn may not bother them the closer they get to a year.

Unless there are known food allergies in your family history or your baby is having severe reactions to what you think you may be eating, there’s no need to restrict what you eat. Remember: fussiness and gas is normal for a young baby, and is not usually related to foods you eat. If your baby is sensitive to something you are eating, you will most likely notice other symptoms in addition to fussiness, such as EXCESSIVE spitting up or vomiting, colic, rash or persistent congestion, crying inconsolably for long periods, or sleep little and wake suddenly with obvious discomfort. Other signs of a true food allergy may include: rash, hives, eczema, sore bottom, dry skin; wheezing or asthma; congestion or cold-like symptoms; red, itchy eyes; ear infections; irritability, fussiness, colic; intestinal upsets, vomiting, constipation and/or diarrhea, or green stools with mucus or blood. Fussiness that is not accompanied by these other symptoms and calms with more frequent nursing is probably not food-related.

Comparison will steal your peace

- Julie Matheney

Too often we look around to see what everyone else is doing and it makes us feel incomplete, incompetent, like we’re doing something wrong or not doing enough. We see the success of others in parenting, sleep training, their milk supply, pumping, whatever, and it makes us feel like we’ve failed. Comparison is the number one way to have your joy and peace stolen. Stop looking at Becky over there with her oversupply and thinking your normal supply is inadequate for your content and growing baby. Stop looking at Gina over there whose baby has slept through the night since two months and thinking there’s something wrong with your happy child. Stop comparing your tiny but mighty that looks like the rest of your flock to my giant giraffe babies that look like the rest of my herd. You’re not getting a grade. Breastfeeding is not a pass/fail activity. Trust your baby. Trust your body. You’ve got this.

Oxytocin

- Julie Matheney
Positioning tools and devices

Oxytocin is a hormone produced by the pituitary gland in the brain. It increases relaxation, lowers stress and anxiety, lowers blood pressure, and causes muscle contractions. Oxytocin, also called the mothering, cuddle or love hormone, is involved in social relationships, bonding, trust, and love. Breastfeeding stimulates the release of oxytocin from your brain.  When your baby latches on to breastfeed, the nerve cells in your breasts send a signal to your brain to release oxytocin. The oxytocin causes the muscles around the milk-making glands in your breast to contract, squeezing the breast milk into the milk ducts. The milk ducts then contract to push the breast milk through your breast, out of the nipple to your baby. This is called the let-down reflex. As baby continues to breastfeed, more oxytocin is released and milk continues to flow. You may experience 2-14 let-downs in one breastfeeding session! The release of oxytocin while you're breastfeeding may make you feel sleepy and relaxed. It can raise your body temperature and is one of the reasons you may feel so hot while nursing. It might also make you feel thirsty or even give you a headache!

Oxytocin can cause your milk to let-down when you're not breastfeeding. Hearing a baby cry, thinking about your baby or even smelling something that reminds you of your baby can trigger oxytocin flow and make you leak!! While oxytocin is responsible for the let-down reflex and the release of breast milk from your body, it has nothing to do with the amount of breast milk that you will make. Prolactin is the hormone that does that. 

Some people feel the oxytocin release (aka Let-Down) and others don’t. Both are totally normal!

Signs of let down include:

  • Tingling or a pins-and-needles sensation in your breasts. It could be a light sensation or even an electrical shock feeling.
  • Hearing baby swallow while at the breast.
  • Leaking milk from the other breast
  • Uterine cramps when breastfeeding, especially the first week.
  • Feeling happy and relaxed after you feed your baby.

Factors that inhibit oxytocin release and let down include: pain, breast surgery or trauma, stress, illness, fatigue, fear, embarrassment, drinking or smoking. 

Some mothers may breastfeed and let-down milk just fine to baby but struggle to release milk to an electric pump. A quality double electric breast pump will have two modes: a quick cycle/light suction or "stimulation" mode, and a slow cycle, hard suction of "expression" mode. By alternating several times between these modes in a pump session, you can trick your body into thinking baby is feeding to stimulate more let-downs of milk. When pumping, you can also help stimulate your body to let-down more often by:

  • Watching videos or looking at pictures of your baby
  • Smelling something that reminds you of your baby (a onesie, your baby shampoo or soap, lavender)
  • Listening to calming music
  • Using heat before and during pumping
  • Massaging your breasts before and during pumping
  • Eating a snack or drinking water while pumping

 

Breastfeeding advice from social media: Buyer beware

- Julie Matheney

Asking for medical advise from social media forums, especially mommy groups, is like asking a mother who’s had a baby to deliver yours. Just because she has experience in the field does not make her qualified to give technical advice in that area. She can give you her opinions or share her experience, but she did never be relied on as a trustworthy source when providing care to YOUR child.

 

Breastfeeding is especially one of those areas that we need to tread wisely into when asking for help and advice. Or culture has hidden breastfeeding from the norm and made it this mysterious, murky action where myths and misunderstandings abound. So much of the information found in quick Google searches are anecdotal, antiquated, or based off formula feeding data which is completely distinct and sometimes totally opposite of true breastfeeding. We should be seeking community support for breastfeeding, but not when medical advice is being solicited.

When mothers give out advice on social media platforms, they are not taking into consideration the whole breastfeeding picture and may inadvertently give advice that could care harm or actually negatively impact breastfeeding. For instance, when a mother of a two month old asks for advice on increasing her breastmilk supply and mother start giving advice on herbs, lactation cookies, or teas, they may not be considering WHY she is needing to increase her supply. Is her baby in the NICU? Is she going back to work and stressed with the pumping process? Does she have. History of sexual abuse that she actually needs to work through? Did her pediatrician have her supplement which impacted her supply? Is she trying to sleep train and sabotaging her own supply? Is she ALLERGIC to the herbs in those teas and supplements? How often is she feeding? Does she have a metabolic or hormonal disorder impacting her supply? Does she have enough glandular breast tissue to even produce sufficient milk supply? Does her baby have a tongue tie? Does the baby simply have a poor latch? These are the questions that are crucial in giving appropriate breastfeeding advice to protect the breastfeeding relationship. The best advice a mother can give on the social media platform is to have the questioning mother contact a lactation consultant.

The gold standard for breastfeeding advice is the International Board Certified Lactation Consultant (IBCLC). There are other forms of lactation consultants that teach and serve out of a variety of backgrounds. The IBCLC is the top most coveted professional because of the extensive education and rigorous testing they need to go through in order to be able to assist lactating mothers. In order to sit for the FOUR HOUR board exam, candidates must have extensive education in specific health science subjects, like nutrition, psychology, and childhood development; 90 college level credit hours of education in human lactation and breastfeeding, and hundreds to thousands of clinical practice in providing care to breastfeeding families. They must also maintain a high level of continuing education courses and continue to sit for the board exam every 10 years.

So when you see moms with questions related to breastfeeding in social media forums that are beyond opinions or personal experience, the best advice is professional advice.