Posts Tagged ‘Breastfeeding’

Tongue Tie: More than “Just” a Breastfeeding Problem

October 2, 2011

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

Let’s assume for a moment that breastfeeding is not important. That the oral development that breastfeeding provides is inconsequential. We will ignore, for just a moment, the fact that the act of breastfeeding helps develop the baby’s jaw, his facial muscles and properly shapes the palate to make room for his future teeth. We’ll ignore all of that so that I can give you a few other reasons to agree to have your baby’s frenulum clipped. Just in case the possibility of pain free, effective breastfeeding is not a good enough reason for you.

The reason I’m being just a bit sarcastic is because there are plenty of health care professionals out there who do not “believe in” freeing a tongue tied baby’s tongue “just” so he can breastfeed. “After all,” they say, “..you can just feed your baby pumped milk or formula from a bottle.”

Let’s say you are pondering that question yourself. And you don’t want to put your baby through even a second of pain—however minor—if you don’t have to. And, up until the moment your lactation consultant told you your baby is tongue tied, you’d never heard of such a thing. Why should your baby have a frenotomy (clipping the frenulum) when it’s only going to help with breastfeeding and breastfeeding is such a short time in your baby’s life? I’ll tell you why. Because freeing the tongue with a quick clip now may help your baby avoid health problems in childhood and even into adulthood.

The tongue is a very strong muscle and that frenulum is an inelastic cord that is constantly pulling on the floor of the mouth and/or the lower gum ridge (called the alveolar ridge) when the tongue tries to move normally. Without normal tongue movements the oral cavity does not develop properly and since one body part is connected to the other, problems can occur in the rest of the body as well. Here are some effects of tongue tie that are not breastfeeding related.

  • Ineffective oral hygiene
  • Tooth decay
  • Crowding of teeth—especially lower teeth
  • Orthodontia
  • Lisps and other speech impairments
  • Excess saliva production–frenulum pulls salivary glans to unnatural position.
  • Fatigue with speaking
  • Shame, embarrassment with speaking
  • High, arched or “bubble” palate
  • Choking
  • Reflux
  • Snoring
  • Sleep apnea
  • Headaches

So now you know. If your baby is tongue tied and you have been wondering if a frenotomy is “just” for breastfeeding, wonder no more. Your baby will thank you some day!  

See also, “My Baby is Tongue Tied?”

Breastfeeding Diet Quiz

September 16, 2011

This is a test! Please read the following statements and respond “true” or “false” to each one.

1. If I breastfeed, I have to eat a bland diet.

2. If I eat broccoli, my baby will have gas.

 3.  If I have a glass of wine, I have to “pump and dump.”

4.  I cannot drink coffee while breastfeeding.

5.  If I eat chocolate, my breastfed baby will get diarrhea.

6.  I have to drink lots of milk to produce milk for my baby.

7.  I can’t eat spicy foods and breastfeed my baby.

If you answered false to each question, congratulations! Your score is 100 percent!

1. Babies love a varied diet. One study demonstrated that babies nurse longer after their mothers ate garlic.

2. It is a rare baby who doesn’t like nutritious vegetables. On the other hand, if your baby seems to be gassy after a particular food, try avoiding it for a few days and then re-introduce it just to be sure.

3. Drinking alcohol when breastfeeding is NOT the same as drinking while you’re pregnant. An occasional drink is just fine while breastfeeding.

4 and 5. Caffeine and chocolate in moderation are fine for mom and baby.

6. When was the last time you saw an adult cow or any other adult mammal drink milk?

7.  Spicy foods? Mothers all over the world breastfeed and enjoy the foods of their culture.

So, indulge in the nutritious foods you love. Enjoy the occasional pleasure of a glass of wine or some yummy chocolate. You deserve itImportant notice:  

This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

Nipple Confusion…Really?

September 7, 2011

I have never, in all my years of breastfeeding help, seen a case of nipple confusion. There, I said it. For many years I thought I saw it. I bought the whole concept that introduction of bottles too early would cause a baby to reject his mother’s breast. That somehow the baby would get “confused” and suddenly not know how to breastfeed.

So what made me change my tune? The babies themselves. They proved to me over and over again that the idea of nipple confusion is nonsense. They showed me that they are infant mammals and that mammals are hard-wired to do this thing we call breastfeeding. And they showed me that they are born to be adaptable and perfectly capable of adjusting to a wide variety of challenges that life doles out on a daily basis.

But, please… don’t listen to what I have to say about this. Listen to the babies. They taught me. Maybe they can teach you too!

Here are the stories of just a few of the many, many babies who teach me every day:

Case 1–Baby could not latch on to breast. Nipple shield was given to mom to help with latch and milk transfer. Baby used nipple shield for 4 months. By 5 months of age she had completely transitioned from the shield and was happily breastfeeding all by herself.

Case 2– Twins born prematurely. Neither could breastfeed at birth and needed a lot of help to suck at all. Eventually they learned to bottle feed well. Mom pumped for 3 months so these babies could have her milk. At 3 months, as mom was bathing with one of the babies, he rooted and latched and suckled. Encouraged, she tried to nurse the other twin and he did the same thing. They never looked back.

Case 3– Mom pumped and bottle fed for 3 months because baby was unable to breastfeed after birth. She was told the baby probably never would. She called me as a last resort. I showed her how to hold the baby and support her breast, and baby latched on and breastfed like she’d been doing it all along.

Case 4—Baby born tongue tied and unable to latch. The parents were referred to a Dr. who clipped the frenulum, but didn’t clip enough so the tongue was still restricted. By the time the mother had called me, her milk supply was severely compromised. She worked on her milk production, finally got her son’s tongue properly released and continued to pump and bottle feed. Another lactation consultant told her “your baby has learned to like the bottle better” and he would never breastfeed. The baby and mom had other ideas. At 11 weeks this baby was 100% breastfed.

Case 5–(My favorite). This baby girl had been born with a cleft palate so she was unable to breastfeed or even use a regular bottle. Mom pumped for 4 months until the palate was repaired, hoping to breastfeed after her baby had healed from surgery. But she wasn’t successful. Finally, she called me at 7 months. When baby was sleepy, mom was able to coax her baby to the breast using a nipple shield. She suckled a bit then came off. I suggested she keep trying—that she had proved to us she could do it. A few months later I received an email from an elated mom telling me her baby had figured it out and at long last really breastfeeding!

I have many more stories of mothers and babies who persisted and triumphed. What about you? Do you have a story to share? Feel free to let us know by commenting here!

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

Breastfeeding and Work: New Research

July 27, 2011

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

It is commonly understood that breastfeeding mothers returning to work face multiple challenges. Balancing work and motherhood, carving out time to pump at work and maintaining adequate milk production are all topics that any employed, lactating mother can discuss at length. Studies have shown over and over again that employment outside the home reduces breastfeeding duration.

A new study just published in the Journal of Human Lactation (August, 2011) has shed some new light on this topic. It sought to understand the relationship between breastfeeding and occupational type (professional, administrative, service, sales, etc.) and postpartum employment status. The researchers asked about initiation of breastfeeding as well as duration of breastfeeding. The subjects in the study included thousands of women in the U.S. from all walks of life.

Instead of boring you with all the statistics and methodology, I’ll just summarize the results. This study found that neither postpartum employment status or occupational type was a significant predictor of duration of predominant (mostly) breastfeeding. However, and this is big, full time workers were less likely to initiate breastfeeding in the first place! There was no significant difference in breastfeeding initiation between part time workers and mothers with no postpartum employment.

Mothers who were employed full time and chose to continue breastfeeding were also less likely to continue breastfeeding beyond 6 months compared to part time workers and “stay at home” mothers. Again, there was no difference in breastfeeding duration between part time workers and non-employed mothers.

Even when mothers have part time jobs that enable pumping breaks, access to lactation consultants, and other amenities, milk production can still be a problem when relying on a breast pump for a large part of the day. Other research has demonstrated that the strategy associated with the longest duration of breastfeeding after returning to work was breastfeeding the baby during the work day. Access to the baby is the number one strategy for maintaining breastfeeding for the longest amount of time.

How does all this relate to you? If you’re breastfeeding and plan to return to work, the following strategies will help you continue your breastfeeding relationship until you and your baby are ready to wean.

  • Don’t go back to work for as long as possible.
  • When you start back to work, just work part time if possible. Even if it’s only for the first year. Consider job sharing.
  • If you must go back full time, find a way to work from home part of the day or a day or two per week.
  • Does your employer offer onsite day care? If so, go for it!
  • Get childcare close to your job so you can have access to your baby.
  • Find a care provider who will bring your baby to you at lunch so you can breastfeed.
Obviously not every mom can enjoy all of the above options.  You can only do what you can do! But if you apply some creativity to your work situation, you may be able to improve your situation somewhat–which may be just enough to make long-term breastfeeding easier!

Breast Engorgement and Cabbage Leaves?

July 25, 2011

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

Let’s be honest. Overly full, engorged breasts are uncomfortable and sometimes downright painful. Fortunately, under normal circumstances true engorgement can be prevented with frequent breastfeeding in the first few days/weeks after the birth of your baby. Some breast fullness and tenderness is to be expected in the first week postpartum as your breasts prepare to provide nourishment for your baby or babies. It may feel like you have enough milk to feed the entire neighborhood, but keep in mind that much of the swelling you are experiencing is simply that—swelling. It’s not just milk “coming in” that is making your breasts feel so full. After the birth of your baby; water, blood and lymphatic fluid rush to your breasts in preparation for breastfeeding. With adequate breastfeeding, the discomfort usually passes in a day or 2. Many mothers don’t experience anything but mild fullness.

Currently, however, many mothers in the U.S. experience births that are anything but “normal.” Epidural anesthesia requires that mother receive an IV of fluids. Inducing labor with pitocin requires extra fluid. C-sections require IV’s. If a mother receives any extra fluids via IV, she will continue to retain the fluid for some time even after the birth of her baby. That extra fluid often results in swollen ankles, fingers and even breasts!

The edema in the limbs may be noticeable right away; but the breast swelling will probably not be apparent until day 3-5. When breasts are full in a normal way as the milk “comes in,” your baby will still be able to latch on and breastfeed. The breasts will feel full, but the areola will be soft and compressible. True engorgement is very different. Your breasts are hard. The skin is stretched and shiny. The areola is hard and taut. There is no way a baby can latch on to your breast. Pumping is usually ineffective since the tissue is not malleable. It’s like trying to use a pump on a wall!

So what can you do if your breasts become so engorged that you feel like you have 2 bowling balls on your chest? Try using cabbage leaves to relieve the swelling so that milk can be removed by the baby or a pump. Cabbage? Really? Yes! This is one of those times when folk wisdom can be helpful.

Green cabbage contains sulfa compounds which pass through the skin, and constrict vessels–relieving inflammation. This reduction of inflammation and swelling allows the milk to flow. To use the cabbage to relieve engorgement, rinse the leaves thoroughly in cold water (leaves should not be cooked). Place a leaf or two on your breasts under your bra. Change the leaves as they wilt. Most mothers notice immediate relief using this method.

A couple words of caution: This technique is not recommended for women who are allergic to sulfa or cabbage. It’s also important to not over-do the cabbage cure. There are reports of decreased milk supply with excessive cabbage use.

If you find yourself in the difficult situation of clinical engorgement, you need help! Contact an experienced lactation consultant right away. In the meantime…try some cabbage!

Alcohol and Breastfeeding

July 3, 2011

It is well known that alcohol consumption during pregnancy can harm the developing fetus. The placenta is not a barrier for toxic substances and even moderate drinking can cause devastating brain damage. But what about breastfeeding? Does that glass of wine you enjoyed with dinner pass into your breast milk? Do you need to be cautious about drinking alcohol?

The short answer is “yes.” The alcohol you consume enters your bloodstream almost immediately and, therefore, is in your milk rather quickly. Even though the alcohol does transfer to your milk, the amount of alcohol your baby experiences is much less than the amount you drink. Unlike the placenta, the breast provides some protection from most toxins in your bloodstream. According to Dr. Thomas Hale, the dose of alcohol in milk is less than 16% of the mother’s milk.

The amount of alcohol in your milk will peak 30 to 60 minutes after you enjoy your drink. After that time, the milk alcohol level decrease rapidly as long as you don’t have another drink. Alcohol is not stored in your milk. It quickly dissipates as your blood-alcohol level decreases.

There is no need to “pump and dump” (how I hate that phrase!) if you enjoy an occasional alcoholic beverage. But it is a good idea to time your drink for just after a breastfeeding session. That way most of the alcohol will be out of your bloodstream by the time your baby wants to breastfeed again.

After 40 weeks of abstaining, you may be excited about that first glass of wine. A note of caution from someone who has been there. Be careful! Many sleep-deprived mothers find alcohol packs a much bigger punch than before the pregnancy. If you choose to imbibe, take it slowly. Start with 1/3 to ½ of what you used to drink.

What about alcohol and milk supply? Some mothers are told to drink a beer so their milk will “come in” faster. Perhaps your wise, old grandmother advised you that beer would increase your supply. On the contrary, research has demonstrated that alcohol inhibits oxytocin release. Since oxytocin is responsible for your milk ejection reflex or let down, alcohol consumption actually decreases the amount of milk released from the breast during a feeding. Over time this can lead to a reduction in your milk supply.

Drinking during breastfeeding is a personal choice—one of many decisions that you will make as a mother. The bottom line is that alcohol in moderation, keeping in mind the timing of your drink, is probably not harmful. The American Academy of Pediatrics lists alcohol as “usually compatible” with breastfeeding. Excessive drinking while breastfeeding can, however, lead to developmental delays.

In summary:

    • Alcohol enters milk freely, but in lesser amounts than is in your bloodstream.
    • The peak level of alcohol in breast milk is 1/2-1 hour after it’s consumed.
    • If you choose to drink alcohol, time your drink for right after the baby nurses.
    • There is no need to pump and dump.
    • Waiting about 2 hours after having a drink is a general guideline to ensure complete metabolism of alcohol. (Based on a 180 lb. female)
    • Your milk is the best thing for your baby. Planning your alcohol consumption is advised over using formula to replace milk that may contain a small amount of alcohol.

If you’re too tipsy to safely hold your baby, you’re probably too tipsy to breastfeed! Use some previously pumped, alcohol-free milk instead.Important notice:  

This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

 

Breastfeeding Myths Galore!

June 19, 2011

These are things that I see or read every day: From my clients, from professionals and websites focusing on newborn issues. I know that one post cannot squash these myths completely, but if this helps just a few moms obtain correct information, I’ll be very happy! Each one of these statements could be an entire post. As time goes on, I hope to link each myth with a thorough explanation as to why it’s a myth. But for now, read these and remember they are MYTHS!

Breastfeeding is painful for the first few weeks.

Engorgement is normal and is a sign that everything is going well.

There is not enough milk during the first few days after the birth, so most babies need some formula until the milk “comes in.”

Many women do not produce enough milk.

A baby should be on the breast for a certain amount of time.

A mother should wash her nipples with soap before feeding the baby.

Pumping is a good way of knowing how much milk you have.

If your breasts don’t feel full, that means your milk supply is inadequate.

If a mother is planning to breastfeed, she should buy a pump.

Infant formulas are almost the same as breast milk.

Doctors know a lot about breastfeeding.

Some babies are lactose intolerant.

Nipples need to “toughen up” in order to breastfeed.

If you give a baby a bottle, he will not like the breast any more.

If you breastfeed you will sleep less than if you bottle feed.

You can’t eat your favorite foods if you breastfeed.

You can’t have a glass of wine if you breastfeed.

Breastfeeding makes your breasts sag.

Breastfeeding takes a lot of time.

Dads can’t bond with the baby if baby is breastfed.

If you breastfeed, everyone can see your breasts.

After 6 months, breast milk provides no more benefit to the baby.

If you have twins or more, you will definitely need to use formula.

If your baby is gassy or cries a lot, it means he is allergic to your milk.

Your baby will sleep longer at night if you give her a bottle of formula.

If your baby doesn’t breastfeed in the first week, he probably never will.

If you have flat nipples, your baby won’t be able to breastfeed.

If your nipples are too big, your baby won’t be able to breastfeed.

If your breasts are too small, too big, too (fill in the blank), you won’t be able to breastfeed.

Have you encountered any myths about breastfeeding? Have you heard some things that just don’t sound right? Please, post them here in the comments box. I would love to hear from you!

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

Bras for Breastfeeding: Finding Your Perfect Fit

May 14, 2011

Please note:  This blog and all of its content and subsequent content can now be found at www.second9months.com.  Please visit and comment often!

Buying a nursing bra should be fun; but often it’s frustrating.  I recently sat down with Bella Materna‘s Anne Dimond to learn more about finding the perfect fit. She gave me lots of great tips, but first she treated me to a personal bra fitting of my own.   Thank you, Anne, for enlightening me on the intricacies of bra-fitting!  Here is what I learned:

  • Find your band size. This is the measurement around your rib cage-along the underside of your breasts. The band should feel snug and firm, “like a new pair of shoes.” The band should not ride up.
  • Remember that bras lose elasticity over time, so don’t start with a bra that is a bit loose!
  • Expect a 2-cup increase in pre-pregnancy size. So if you were a B before you were pregnant, expect to measure a D when you’re breastfeeding.
  • Did you know that a 36D is the same cup as a 34E and the same cup as a 32F? I didn’t either!
  • The more your bra is worn, the looser it will feel. Tighten the hooks as needed or simply retire that bra!
  • If your straps are digging into your shoulders or back, you probably need a larger cup size.
  • I used to tell breastfeeding moms, “Never use an underwire bra while breastfeeding because it may cause a plugged milk duct.” I stand corrected! An underwire bra is fine for breastfeeding—just make sure it fits correctly. The underwire should fit around and beneath the breast tissue—never on top of breast tissue. Be sure that your breasts are positioned correctly in the bra each time you put it on.
  • Breasts should not bulge or spill out of cups. If you’re experiencing “spillage,” you need a larger cup size.

Of course, nothing beats a personal fitting—especially when you are looking for nursing bras. If you’re lucky enough to be in Seattle, plan to visit Bella Materna‘s beautiful show room for a personal fitting. Otherwise, their expert fitters will be happy to help you find your perfect bra in the perfect size with an email or phone conversation.  

You will definitely want to visit Bella Materna for all of your pregnancy and breastfeeding lingerie needs.  Enjoy!

Is Breastfeeding Good for Business?

March 21, 2011

Are you wondering if health care legislation that includes provisions for breastfeeding is a good idea?  How do you feel about requiring businesses to accommodate mothers who want to pump at work? Consider the following:

Every year, more than 3 million mothers in America breastfeed. These provisions are good public policy for not only the baby and the mother, but also for the business community and our overall economy. Breastfeeding can improve more than 10% of the Healthy People 2020 health goals for the nation.

Promoting and increasing the rate of breastfeeding in the United States can provide upwards of $14 billion per year in cost savings related to just the treatment of several childhood ill- nesses seen in higher rates in those infants who are not breastfed. Research shows that breastfeeding lowers the baby‘s risk of infections, diarrhea, SIDS, obesity, diabetes, asthma, and childhood leukemia. A 2009 study of nearly 140,000 women found that women who breastfed for at least one year were 10-15% less likely to have high blood pressure, diabetes, high cholesterol, and cardiovascular disease compared to mothers who never breastfed. Breastfeeding also lowers the mother‘s risk of breast cancer, ovarian cancer and osteoporosis.

Companies providing lactation accommodations reap a 3 to 1 return on investment and can save hundreds of thousands of dollars every year on reduced health claims, lowered employee turnover, decreased absenteeism, and less money spent on recruitment and training of new employees. At the same time, The Business Case for Breastfeeding, a program created in 2008 by the Department of Health and Human Services, showed that employees whose com- panies provide breastfeeding support consistently report improved morale, better satisfaction with their jobs, and higher productivity.

Excerpt from the United States Lactation Consultant e-newsletter.

Pacifiers and Newborns

March 6, 2011

Nearly every new mother I see asks the question, “Is it ok for my baby to use a pacifier?”  Here is the simple answer: Yes and no!

What these mothers want to know is whether pacifier use will interfere with breastfeeding. I can say with confidence that I have never seen a baby prefer a pacifier over a breast filled with nummy milk! In addition, in over 20 years of helping resolve breastfeeding issues, I have never named the pacifier as the source of the problem.

Even though pacifiers are not necessarily the cause of breastfeeding difficulties, they should be used with caution—especially during the first few weeks of life. Newborns don’t necessarily know when they are hungry or thirsty. Thankfully, they don’t need to figure that out. All they know is they need to suck.  Frequently! When that suckling is at the breast, it ensures that babies get plenty of milk and moms have an abundant milk supply.

Conversely, when a baby uses a pacifier to get her sucking needs met, there is a danger that she will not spend enough time at the breast. My primary concern about pacifier use is this: All that sucking requires energy.  Newborn sucking is actually an aerobic exercise.  A baby exhausted from sucking on a pacifier may not have the energy to obtain nourishment from the breast. In addition, she may “fool” her parents into thinking she is getting enough to eat, as she falls asleep while using a pacifier.

Occasional pacifier use for very brief periods of time will not likely interfere with breastfeeding. But keep in mind that a pacifier is a breast substitute and use with caution. If your newborn baby needs to suck, she probably needs to eat!


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