Breastfeeding Success

How do you prepare for Breastfeeding?

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There is a lot of things you can do Prenatally to be successful in Breastfeeding. 

Step one

Did you know that your determination is a key component to how well you will traverse the challenges of breastfeeding?  

 

 remember Yoda, answer yes I'm going to breastfeed.

remember Yoda, answer yes I'm going to breastfeed.

 Step two

One key tip is to educate yourself.  A breastfeeding class can help you understand how this breast and baby latching thing works.  Also the teacher of the class can answer questions you may have.  You can find free breastfeeding classes at Women Infant and Children supplemental nutrition program or WIC.  Even if you aren't eligible for WIC.  Hospitals and birth centers also have Breastfeeding classes.  Some Home visiting International Board Certified Lactation Consultant or IBCLC teach private classes which are great for busy families or situations that may be very individual.  A simple web search or Facebook search should help you find what is available in your area.  

Step three

The next step is finding out your resources for help after the baby is born.  There are a lot of groups to help new mom's with breastfeeding.  I went to La Leche League while pregnant.  It was a wonderful place to watch other women breastfeed.  As a WIC peer counselor I also was able to facilitate groups.  Reach out to friends who are breastfeeding and ask what groups they found helpful.  Attending a Breastfeeding or moms group prenatally will help you gather friends for after you have the baby. 

Family and partner support is also helpful.  Your partner or support people could also benefit from the breastfeeding class. 

Call IBCLCs prenatally to find a good fit.  Ask friends and family who they used for some great recommendations.  Some times the best support post partum is in your own home.  Research and save for a home visit by your local IBCLC.  The best time to call an IBCLC is at the first sign of trouble. Even better if you spoke to them prenatally. Save phone numbers for support in you and your support person or partner's phone.

 Step four

The baby is here.  The best way to getting off to a great start with breastfeeding is skin to skin.  You naked from the waste up and baby just in a diaper.  This helps both of you get to your instincts and is where your baby naturally wants to be.

Ask for help at the first sign of pain or stress.  Dr Google is not your friend.  A peer supporters and or an IBCLC can help you make sense of the noise in your search returns.

The worst thing as a professional helping families breastfeed is when they wait till a problem is huge before getting help.  Sometimes by the time I see a family there long term milk supply is permanently compromised.  The sooner you get help the better

Follow these steps prenatally for breastfeeding success   

Why is Breastfeeding Hard? part 1 predatory marketing of formula

Why is breastfeeding hard? 

Part 1 predatory marketing of formua

DREAMLAND

Breastfeeding should not be hard.  It should be an intergenerational behavior that we see daily.  We should see it daily in person, on TV, and on social media.  Breastfeeding should be as normal as diaper changing or burping a baby.  Breastfeeding should be natural.  It should be easy.  It should be accessible to all.

We know what breastfeeding should be like.  What does breastfeeding in our American culture look like?

perception vs reality

My perception of many moms feeling breastfeeding is hard comes from my professional experience working with families as an International Board Certified Lactation Consultant aka Infant Feeding Specialist.  I see the problems; So naturally I see Breastfeeding being hard or not easy.  I also have met many women with no issues with breastfeeding who find it easier than bottle feeding for many reasons.  This is about the perception and or reality for many that breastfeeding is hard.  

If it were as easy as the promotional public health posters or the woman who posts a pic of 8 oz pumped bottle in a moms group.  Than our duration and exclusivity rates would be higher. If our statistics are showing that people aren’t doing it because it's hard, why do we not change our promotion campaigns to really address the issue.   Is it because the why of our statistics is complex? 

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The Why isn't straightforward

There is more than one blog post worth of commentary.  This will be an ongoing theme that I will be revisiting.  This is because it is a complex subject.  In the coming weeks Ill explore the different issues that make breastfeeding hard. 

  • Predatory marketing of artificial infant milk or formula,
  • our health care system, insurance,
  • lack of culturally competent trauma informed care,
  • breastfeeding support alphabet soup,
  • Pump culture,
  • education of other health providers,
  • lack of support by qualified professionals
  • families’ own perception and expectations of newborn infant care all effect mother’s perceptions
  • Got any others I'm missing, let me know

Lets start with Formula and their Predatory marketing

Years of predatory marketing of formula has set us up for a culture of women having to navigate and overcome numerous obstacles to be successful at breastfeeding. 

Formula is a tool.  It is a tool that has saved babies lives and made babies sicker.  This isn’t a post about how if you formula feed you are a bad parent or if you breastfeed you are a saintly parent either.  This is not an anti Formula post. My issue is not with the tool. It is about the innerworkings of how the tools promotion interact with our ability to breastfeed and how it continues to undermine our cultures breastfeeding.   

Here is an example of the issue with formula marketing.

I went to get a nipple shield, a silicone tool that can help moms that are healing from severe nipple trauma, can help transition baby off bottles and or that can make breastfeeding bearable till you can address other issues, for a client at Walgreens. I think I'll have a whole other post about breastfeeding tools.  Well, I used my Walgreens card. Now every other time I buy anything at Walgreens for the past 2 years, I have gotten a large formula coupon. 

Imagine being the mom having to use a nipple shield to breastfeed constantly reminded that formula is always there, and if your struggling here is an 8 dollar discount so you can have it around, just in case you can’t breastfeed.  How would you feel if it was you?

This is just one of the PREDATORY MARKETING techniques.  

Here are some links to more about the World Health Organizations guidelines on formula marketing and predatory marketing. 

http://www.who.int/nutrition/publications/code_english.pdf

https://binged.it/2iUNQIa The Politics of Breastfeeding

http://ibfan.org/about-ibfan

http://theleakyboob.com/tag/formula-marketing/

http://www.slate.com/articles/double_x/doublex/2015/06/a_century_of_formula_advertising_it_s_always_gone_straight_for_the_new_mother.html

Got any experiences or stories of how formula was marketed to you and how it effected you breastfeeding experience?

My personal experience as a mom was that formula was every where much more accessible than adequate support.  

I wish all families had the prenatal and postpartum support I did.  For instance I went to La Leche League groups while pregnant. I saw breastfeeding work up close and personal, I heard women overcome struggles.  I was told to hide the free formula samples or even give them away cuz formula is only a store drive away at any time. Only use it if you absolutely have to.  Supplementing is a slippery slope, that all to often winds up with premature weaning.. I also read breastfeeding and baby care books   I got that Breastfeeding was important but not always easy. Something I wish everyone in our culture could understand.

Breastfeeding isn’t all or nothing. Some women can still reach their duration of breastfeeding goals with some usage of formula.  My son got maybe 10 bottles of formula in his first year. My supply was established for him.  I could make milk while direct breastfeeding, but I could not pump effectively.  I had an adequate direct breastfeeding supply and no Pumping milk ability.  Formula was a tool I used sparingly and cautiously.  I have also worked with families that give a bottle of formula once a day for whatever reason and breastfeed past a year.  There is a wide way of making breastfeeding work for your family.  

My role in all this is to help make breastfeeding work for your family.  If Breastfeeding is feeling hard please reach out.  

 

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Why does breastfeeding hurt?

Ask other women about breastfeeding in the first few weeks and a common story you will hear is how much it hurts. 

“Oh my, it hurt so bad but I muscled through it and after a few weeks it went away”

“I just tried everything and it never stopped hurting so I had to stop because my baby just didn’t like breastfeeding.”

I’ve heard this from so many women. Breastfeeding hurting is common but not normal.  What does that mean?  It means breastfeeding shouldn’t hurt but due to many reasons it often does.

So If pain isn’t normal why is it common?

Reason #1 

It’s all about the latch, baby.

Take your tongue and run it up the roof of your mouth, this is the palette, feel where the hard part ends and the softer palette begins.  Feel that, this is how far back in your baby’s mouth your nipple should fall.  If your nipple doesn’t fall into this area while breastfeeding than your baby’s hard palette will rub against and pinch your nipple which hurts.  So a really deep latch is necessary for comfortable breastfeeding

Another way to know your baby has a deep latch is look at the corner of your baby’s mouth while latched on to your breast.  It should be open bigger than 140 degree angle.  This angle should be from the corner of where the baby’s lips meet.  I have seen shallower latches be pain free but to effectively drain the breast the optimal angle should be over 140 degrees. Youtube Ameda Latch on for a simple animation to show what I am describing. 

Reason # 2

Engorgement sucks, or more accurately doesn’t let baby suck effectively

Another reason still related to baby latching is engorgement.  Imagine trying to bite a basketball.  That is what it is like for a baby to try to latch on to an engorged breast. 

Like the nipple pain being common but not normal, the same can be said for engorgement.  If during your delivery you have any IV fluids your engorgement can be worse.  Fluids in your body get in-between the milk making cells, fat, ducal tissue, and ligaments to further exacerbate the issue.

Light breast massage all over and Reverse pressure softening can be very helpful to prep your breast for a less painful latch while letting your baby aid in relieving the engorgement.  Reverse pressure softening is where you push fluid and tissue away from the nipple and areola to loosen the tissue ensuring enough tissue to allow the latch to happen. If reverse pressure softening doesn’t help pumping and or hand expression can loosen up the nipple and areola to make latching easier. 

# 3 Oral anatomy

If its still hurting search for answers

If after trying all the tricks and seeing an experienced lactation professional it still hurts, then it might be compromised oral anatomy. 

Common issue under the oral anatomy umbrella is a tongue or lip tie.  Even though I do an oral exam at every consultation my hope is always that I don’t notice a tight lip or tongue frenulum.  (This is also known as lip or tongue tie, you thought it was just a saying huh?)

It’s important to know this may be an issue and seek out assessment and referral from an experienced lactation professional.  FYI most pediatricians are only going to notice or see obvious ties and down play the need for a referral to an experienced provider for assessment and possible revision.

Pain and Discomfort, what’s the difference?

In the first 2 weeks of breastfeeding discomfort is common and normal. What do I mean by discomfort?

On a scale of 1 to 10:  10 being you are about to die from pain and go to the ER and 1 being hmm I feel something but it definitely doesn’t hurt.  3 would be discomfort. 3 or below when breastfeeding is normal and common when latching especially the first few weeks. 

If on a scale of 1 to 10 your breastfeeding experience is above a level 3 for pain than you need to get help.  You need to get help.  Pain = Get Help.  Even if lactation professionals see your latch and say it looks great but it still hurts than you need to get help. One more time if you didn’t catch it,

PAIN = GET HELP NOW

 pain scale 

pain scale 

Muscling through pain at the breast does no one any good.  Why?  Babies that cause their mothers pain at latching don’t drain the breast well and can possibly not be getting enough milk.  Mothers that breastfeed through pain also can be damaging their nipples which can cause issues with milk flow and supply. 

I totally understand why women prematurely wean when suffering with nipple pain.  I don’t do martyrdom.  I wouldn’t to continue to do something 8 to 12 plus times a day that hurt.  There is a way to avoid premature weaning.  See someone to help you figure out how to make it stop being painful.  Do this immediately at the first signs of pain.

Breastfeeding is not like lifting weights.  No pain, No gain does not apply. 

Nipple pain is common not normal.

Latch is the number one reason that you experience nipple pain.

Engorgement and compromised oral anatomy can cause and or exacerbate latching difficulties.

Discomfort in the early weeks can be common and normal, but pain is not normal.

PAIN = GET HELP NOW

remember you are more than just the breast 

Cat Halek IBCLC

My favorite videos on Youtube for my clients

This is you on you tube. Searching for videos to help you feed your baby.

you on dr google

Information over load from Dr. Google can be intense.

There is so much information out there how do you know what to follow or go with.  I am going to share a two videos that I show my clients.  I'll also explain what I like about each video and possibly what I don't like about it.  

First Ameda Latch On

Why i like this video:  It has an awesome animation of where your nipple should fall in your baby's mouth.  It also shows a very mom directed latch cross cradle.  The most helpful part of this video is the animation.  Second is watching a baby latch.  It is short and sweet too.  This is best to watch prenatally

What don't like about it 'is that who has perfect perky breasts.  Also that it only really shows one position.  Third its from a pump manufacturer.  

Pace-feeding the Breastfed Baby

I like that it is so straight forward.  I like that it gives you the option to either drop the nipple down or remove the bottle nipple from the baby's mouth.  I dislike that it isn't an actual baby actually taking a pace-fed bottle

I plan on doing my own videos and adding more great videos for you. 

Hope this cuts down on a little clutter

Cat