Beyond The Logistics
In the past few weeks I've had a handful of past patients email me about breastfeeding woes. I was armed with my handy-dandy handout (I have handouts for lots of things), but before I could hit send I felt the need to say something more. Yes, there are logistical things you can do - position changes, frequency, duration, guided imagery, herbs, sufficient hydration and calories, etc. But there is something so much more important than all this - your mindset! I am grateful these women sought me out, because it pushed me to put this into words. I hope it can help others too!
3 Breastfeeding Tips For All Moms
Do what you can.
Any breastmilk is amazing. Every ounce has specific custom antibodies that you make for your baby based on the environment around you. It changes with the time of year, where you are, even your baby's age and gender! Even if you get one bottle of breastmilk a day or a feeding in the morning and night in person in and the rest is formula you are doing an amazing and healthy thing for your little one and you should feel proud and good about it. Instead, what happens is many women feel like it's only one bottle a day and like they are a failure. Nothing could be further from the truth! It's all in your mindset and my mindset is that this is a WIN and you should be proud and know it's a big deal. Breastfed babes (and more or less doesn't matter) have fewer allergies, asthma, illnesses, are less likely to have weight issues in life. Of course, babies who do not breastfeed can have all these things too and there is still no failure if you can't do any level of breastfeeding, but breastfeeding does help tip the scales!
Do what you need to.
My midwifes came to me one week in and I hadn't slept more than 30 minutes at a time for days because my baby was nursing for 2-3 hours at a time and would scream bloody murder if I didn't have my nipple in her mouth and I wouldn't give her a pacifier. When I said I didn't want to give her a pacifier because I was afraid it would mess up nursing they gave me the best advice for parenting (and life I think). SANITY over IDEOLOGY. If you are doing what you think you need to do and it's driving you crazy, something has to give. So let it be the thing you are doing, and avoid you going crazy. :)
Avoid black and white thinking.
This is such a cultural thing. I'm breastfeeding vs I'm not breastfeeding is not an all one or the other thing. It's not an I'm a success vs I'm failing thing. It's more complicated than that. Nor is it a It should be like this vs It should not be like this thing as neither is actually 100% true. It's much healthier and easier to be in the world knowing it's much more complicated. You are doing well. Even if it isn't 100%, you can do both. You can succeed at your breastfeeding goals (or life) and have it look differently than you thought it'd look.
And if you listen to this advice, it will at the very least help you feel less stressed ... which segues into my handouts. Stress isn't the only factor, but it is a factor, especially when it comes to pumping. So if you can be less freaked out about it, it might help in and of itself. It's a crazy thing how powerful that is.
So here's what my handouts say.
- Confidence and relaxation matter! I have had MANY instances when I focussed on pumping (because I was on a schedule, was worried about getting enough, etc.) and after 20 minutes or more only had drops of milk in the bottle. After relaxing and working on visualizations or distraction during the very same pumping session the milk would start to flow and I’d get plenty! I was SHOCKED no one ever told me how much this mattered! The more you worry and focus on whether or not you can nurse and provide enough milk, the more difficult it is.
- Try to do everything in your power to build your confidence AND relax. For each woman this is different. It may mean gathering information ahead of time, reading, watching videos, talking to others, going to LLL meetings, etc. It may mean guided meditations or visualizations prior to or during nursing/pumping, or, it may even mean distractions such as playing a computer game, watching a movie or reading a book while nursing/pumping. Experiment with what works for you!
- Ask for a lesson... right away, in the hospital. There are nurses or lactation consultants that can help you hands on with YOUR nipples and YOUR baby. You don’t need to be struggling to ask!
- If you need further help ask ask ask... other nursing moms, le leche leagues, lactation consultants, postpartum doulas. The more hands on and in person, the better. You will get varied advice. Choose what really works for you.
- It is very normal to worry about your baby getting enough milk and most moms really do make enough! The best way to tell is by a) watching numbers of wet diapers and common sense.
- Frequency and duration are NOT the best indicators of your milk supply. Although the books tell you how babies “should” nurse, some babies like to suck longer, more frequently, power nurse, etc. Don’t worry if your baby doesn’t fit the mold! Again, do what works for you & your baby.
- Each mom’s milk is different. Some mom’s make fattier milk. This may be more filling... the opposite may also be true. Don’t get attached to the amount your baby “should” be drinking. Pay attention to their health & spirit (an alert and thriving baby is what matters).
- In the first week, your baby will be monitored for weight loss. Keep in mind that the smaller your baby is at birth the more narrow margin he or she will have of an acceptable amount of weight loss. 10% of a 5 1/2 lbs baby is just a half pound, while a 9 lb. baby has a pound. Don’t be discouraged or frightened and keep this in mind.
- Breastfeeding any amount is one of the best things you can do for your baby. Don’t worry about having to do it perfectly. If you even do ONE feeding a day with breastmilk it is well worth it!
- Breastfeeding a newborn takes roughly the equivalent amount of time as working full time (not to mention the work it takes your body to make the milk). Remind yourself and your partner of this and have realistic expectations on what you’ll be able to do while nursing your new baby. It does get easier and is well worth the effort.
- Support does matter! An invested and supportive partner and social network has been shown to be statistically significant in promoting longer and more successful nursing.
If You Need More Milk
- Supply is based on frequency not duration. Try increasing frequency if possible. If your baby isn’t interested don’t hesitate to pump between feedings (just be sure not to sacrifice your sleep or sanity to do so-that cancels itself right out!).
- Sufficient calories are needed to make milk, try increasing your food intake, especially naturally red foods (beets, berries), as well as dark leafy greens, nuts (trial mix is great!), eggs, and some meat (es- pecially soups made with soup bones and slow cooked meats with bones like roasts). You need more calories to nurse than you do while pregnant!
- Drink sufficient amounts of fluids (watch your urine color not the ounces your drink to tell - urine should be pale yellow).
- Keep baby as close as possible (baby wearing/slings, sleeping with baby, holding baby, especially skin on skin) this will stimulate more milk. Try taking baths with baby and nursing in the bathtub or taking naps with baby snuggled up to your chest.
- Try herbs: Mu tong is a very gentle Chinese herb that is helpful for most women. If you are interested in trying it, please ask me or a trained TCM herbalist! You might also try fenugreek tea or mother’s milk tea which you can buy online.
- If you had blood loss or taxation with your birth consider adding an extra iron supplement (I highly recommend Floradix Iron & Herbs) to build back up your blood (which will also increase milk).
- Avoid drying foods and drugs (spicy foods, antihistamines, decongestants). Hormonal forms of birth control can also decrease milk supplies.
- Lifestyle matters! If you are exercising more than your body can handle right now, sleeping too little, or working (mentally or physically) too hard you may have too little left to make more milk.
- Revisit the stress/confidence suggestions. It is a slippery slope as the more you focus on milk amount, the less it will freely flow!
Avoiding Issues (Blocked Ducts / Mastitis)
- Nurse, nurse nurse. Unrestricted feedings for 2 - 3 weeks after birth is essential for establishing milk supply and keeping it moving. Routinely feel your breasts to check for painful areas or lumps (especially if you have an extra abundant milk supply), should you find them nurse your baby with his/her chin pointing towards the lump to help drain that area of the breast (get creative with positions if you need to!), use hot compresses or aim the shower head at any areas that feel full or blocked and massage them out.
- Stimulate the MER (milk ejection reflex) in the shower or before/during pumping by leaning forwards and gently shaking your breasts from side to side. This helps the milk let down and come out freely.
- Put cooked cabbage leaves over any red, blocked areas should other preventative techniques not work. Get medical help if you get a fever or feel flu-ish. If you do need antibiotics be sure to supplement with probiotics with and after you take them.
If You Have Too Much Milk
- Be sure to follow the avoiding issues section! Although it is better to have too much than too little this can be stressful. Get support and do what you need to take care of yourself. There are some wonderful places you can donate your extra milk. Google breast milk donation or milk share for programs including milk for adopted babies, babies of mother’s with AIDS, etc. Check out human milk for human babies hm4hb.net.
Thrush (Yeast Infection)
- If your baby has a thick white coat on her/his tongue or a clearly defined very red diaper rash or your nipples are red and irritated or you have stabbing inner breast pain with your milk letting down there is a good chance you have thrush (you may have some or all symptoms). Thrush is especially stressful because it passes from mom to baby and back and must be treated in both to be corrected. Try as many of the following for at least 10 - 14 days for the best chance at naturally correcting the situation. Wash all affected areas with a very dilute vinegar water (preferably unpasturized cider vinegar) 1 T. vinegar to 1/2 gallon water. Put this on nipples before nursing to get some in baby’s mouth too. Wash all things that come in contact with affected areas in vinegar water (1/2 cup per load), use topical anti-fungal cream on nipples and diaper area as needed (be sure to wash off before nursing) or use gentian violet (be careful it stains!!!), boil all pump and bottle parts each time you use them. Change nursing pads and diapers frequently, yeast thrive in hot moist environments, expose affected areas to sunlight if possible as yeast doesn’t like the sun. Take probiotics and give baby probiotics too. Decrease your sugar intake including fruits, dairy and simple carbs as well.