Archive for the ‘sore nipples’ Category

Guest Post–When Nursing Makes you Sick

October 8, 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!

When a woman thinks of birth and breastfeeding she expects it to be the happiest time of her life. Occasionally, to a mother’s dismay, she finds that breastfeeding brings on new challenges, feelings and experiences. She may experience feelings of pain with breastfeeding, or an unexplainable twist in her gut when her milk lets down. Unable to justify or validate what she is feeling leaves her at a loss and feeling confused. These feelings may be the result of a condition known as D-MER. D-MER stands for Dysmorphic Milk Ejection Reflex and it is treatable.

D-MER is caused by a drop in dopamine activity when oxytocin rises which creates a feeling of dysphoria in the mother (D-Mer.org). It is a physiological disorder, not a mental disorder. To understand D-MER better I have interviewed Renee Beebe, IBCLC. Renee Beebe is an International Board Certified Lactation Consultant who works with mothers who may be exhibiting symptoms of D-MER.

A mother asked Renee the following questions:

Q. “Dear Renee, when I nurse my baby I feel nauseated and a dull ache. What is causing this pain and what can I do about it?”

A. Renee’s answer is “
First of all let me assure you that you are not causing this situation.  It can be very disturbing to a mother to feel sick, sad or otherwise uncomfortable when breastfeeding or pumping.  After all, breastfeeding is supposed to be pleasant, right?  Various hormones increase and drop dramatically during the process of breastfeeding–particularly during the milk ejection reflex (commonly known as the let down).  Most mothers feel wonderful when the milk ejection reflex or MER occurs.  A few mothers, however, feel awful.  The good news is, the nausea or sad feelings usually dissipate after the MER is finished and it usually dissipates over time during the course of breastfeeding.  Some mothers may need to be on medication temporarily until the condition improves.  Others may find relief with breathing exercises or other coping methods”.  Please see www.d-mer.org for more information and support. You are not alone!

Q: How can I reach Renee Beebe, M. Ed., IBCLC for help if I think I may have D-MER?

A. “Mothers may call or email if they’d like support.  Most mothers call because it ensures I can answer them sooner.  I would encourage women to call before they have the baby to make a connection.  After the baby is born, if things aren’t going absolutely smoothly, call as soon as possible.  I can usually see mothers within 24 hours.  Often the same day.  I take calls 7 days/week till 9 pm.” Renee can be reached at 206-356-7252 or you can go to her website  http://www.second9months.com/.  This entire blog is now located at my new website!

Q. What is an IBCLC?

A. The International Board of Lactation Consultant Examiners (IBLCE) is the certifying body for lactation consultants.  It is the only certification available.  The exam is given once a year all over the world on the same day.  A lactation consultant should have the letters IBCLC after her name.  That is the only way you can ensure that she has achieved this minimum competency required by IBLCE.  The terms “breastfeeding specialist,” “lactation educator,” or “lactation specialist” really don’t mean much.  Usually those people have taken some valuable coursework, but don’t have the clinical hours required to actually sit for and pass the certifying exam.

Q. How did you become a lactation consultant?

A. After the birth of my first baby, I became involved with La Leche League for support.  where I was living at the time, breastfeeding was not the norm and La Leche League provided me with mommy wisdom and role models.  Soon I was helping other mothers and became a La Leche League Leader myself.   It was clear I had found my calling!  6 years later I had accumulated enough “helping” hours (2500!) to become certified as a lactation consultant.  I first took and passed the certifying exam in 1997.  I’ve been working as a lactation consultant ever since.

If you are experiencing negative feelings, pain, or nausea when you nurse your baby please know that you are not alone. Conditions such as D-MER are not caused by the mother. They are physiological in nature and beyond your control. Treatment is available for mothers with D-MER. Please visit www.D-MER.org for more information.

Written by Trina Baggett, Certified Birth Doula and Childbirth Educator.  www.atranquiljourney.com

My Baby is Tongue Tied?

October 1, 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!

“My lactation consultant told me my baby is tongue tied and she needs to get her frenulum clipped so she can breastfeed. What is a frenulum? Why does my baby need this procedure?”

The frenulum is a (usually) thin, fibrous band that connects the underside of the tongue to the floor of the mouth. The mere existence of a lingual (tongue) frenulum is not an indicator of a problem. The important thing is whether the frenulum restricts the movement of the tongue in a way that interferes with its normal functions.  If it does, your baby has a condition known as tongue tie or ankyloglossia.

One of the vital roles of the tongue for a baby is for feeding. Your baby depends on her tongue for creating a vacuum, sustaining a vacuum, moving the milk to the back of her mouth and swallowing. These things are important whether a baby is breastfeeding or bottle feeding. But when a baby is breastfeeding, the function of the tongue is more critical because incorrect tongue movement/placement equals sore nipples for mommy!

How do you know if your baby is tongue tied? Take a minute to observe your baby with this questions in mind:

  • Does your baby have a hard time latching on?
  • Do your nipples looked creased or flattened after breastfeeding?
  • When your baby cries, does the center of his tongue look “’stuck” to the floor of his mouth with just the edges curling up?
  • When your baby sucks on your finger, do you feel the lower gums either constantly or intermittently?
  • Does your baby seemed stressed with a fast flow of milk?
  • Do feedings take a long time? Or is baby feeding very frequently and never seems satisfied?
  • Does your baby have symptoms of reflux?

If the answer to any of these questions is yes, Your baby may be tongue tied! Check with an experienced lactation consultant to be sure. She will examine the baby—paying particular attention to assessment of tongue function. She will also observe the baby feeding. After a thorough evaluation, the lactation consultant may recommend that the baby have the frenulum clipped.

The clipping—called a frenotomy—is usually performed by a doctor or dentist. The doctor will assess tongue function, may observe a feeding or ask you detailed questions about feeding. You should be given instructions to stretch your baby’s tongue periodically after the procedure to ensure that it heals properly. Sometimes a topical anesthetic is used, but not always. The pain the baby experiences is mild and brief (similar to biting your tongue) and bleeding is minimal. After this very quick procedure (it literally takes about 1 second!) most mothers and babies notice an immediate difference in breastfeeding.

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!

Breastfeeding Help Long Distance

February 5, 2011

This young mother called me at the urging of a friend who already knew and trusted me. Breastfeeding was very important to Marissa, but she didn’t know how she could go on with so much pain. Normally, I would have seen this mom and baby in person. She lives in another city, however, and she felt most comfortable working with me. I gave her guidance over the phone several times over the course of a few weeks. Since her baby was gaining weight and she had a great milk supply, she just needed some minor adjustments to make breastfeeding comfortable.

Here is a portion of her story:

After a few weeks of breastfeeding, I felt defeated. My nipples were cracked and bleeding. Each nursing was becoming more painful, and I was beginning to dread feeding my baby. After every feeding my son would spit up blood. I was beginning to accept this as my breastfeeding fate when I decided to call Renee. On the phone, she was able to describe in detail the way my son should be properly latching on. While we were talking, I could hold him in the positions she was describing to me, and get a complete visual understanding of how to get him to latch on properly. She also recommended that I visit her blog and watch a video of a baby getting a good latch. Within a day or two my nipples were healing, nursing was no longer painful, and I was able to finally enjoy these beautiful moments with my son.

Five months later, Marissa and her baby are still happily breastfeeding!

Note: Lactation help in person is optimal for helping mom and baby breastfeed. It is often necessary in order to complete an accurate assessment. If Marissa’s pain had not quickly resolved after our phone conversation, I would have recommended lactation consultant in her area who could have helped her face to face.

You don’t have to live in Seattle to receive expert guidance from a lactation consultant. I am available for phone consultations for moms anywhere. You may reach me at www.second9months.com.  Send me an email and I’ll call you the same day to set up a “meeting.”

Breastfeeding Challenges-Andrea’s Story

October 30, 2010

This story is generously shared by Andrea and her daughter, Ainsley.  Thank you both for your story and your determination to breastfeed!

When I was pregnant, I worried about everything. Everything, that is, except for whether I’d be able to breastfeed. Since many of my friends and my own sister had breastfed their children, it was a given that I would do the same. I pictured myself breastfeeding my daughter Ainsley, sitting on the beach in front of my house with her tucked inside a sling, contentedly drinking while we enjoyed a special bond.

To my relief, Ainsley latched on within minutes of being born, awake, alert and happily feeding. My heart soared, relieved that we were on the path to having the breastfeeding relationship I’d envisioned. The second time she latched, though, it hurt. The nurses said, “It’s supposed to hurt.” I knew this wasn’t true and it quickly became clear something was wrong. Very soon my nipples were bleeding and the pain was intense. My confidence faltered. I developed fear about feeding, dreading whenever the clock — or my baby — suggested it was time to feed. Sometimes I’d even let her sleep an extra hour or two beyond what was suggested, just so I could give my nipples a break.

By the time we were home, it seemed like all we did was feed. I would breastfeed, painfully, and she would cry—not satisfied. Knowing that the early days of breastfeeding were critical ones, I called a recommended lactation consultant, Renee Beebe, for a home visit. Seeing the damage already inflicted on my nipples, she urged me to exclusively pump until my nipples healed. I hoped for smooth sailing from that point forward.

Pumping was difficult—I barely got enough milk. Furthermore, when I began breastfeeding again, I noticed Ainsley’s fussy behavior at the breast was getting worse. Sometimes she’d scream and cry until I removed her; other times, she’d fall asleep the minute she latched on. I called Renee back for help. It soon became clear that the latch problem was exacerbated by another underlying issue — low milk supply.

I had to supplement with formula, as my pumping output couldn’t keep up with her demand. The first few times I made the formula, I cried. I felt like a complete failure as a new mother.

I ate and drank everything I could to help boost the supply. I ate oatmeal every day, and snacked on Milkmakers cookies. I took a variety of herbs in many forms. Everything helped a little, but still, I didn’t have enough milk. I knew I had to try everything in my power to make this work before calling it quits, and I so persevered.

In the following weeks, I saw other specialists, including an occupational therapist trained in newborn feeding issues. No one could find any sucking or anatomical problems. Clearly, supply was the main issue. To preserve the breastfeeding relationship as best as I could, I began supplementing at the breast using a supplemental nursing system. The SNS was awkward the first few times, But soon I became a pro at taping the tube to my breast and latching her on. Over the next few days, Ainsley became more content at the breast, getting the milk flow she needed to feel satisfied.

At the same time, I started a medication to help boost milk production. Within just a few days, I noticed an increase. One night I pumped 4 oz in one sitting, and I was so proud that I took a picture of the milk I pumped! Slowly but surely, Ainsley took less and less milk from the supplementer. The formula became a thing of the past, and pretty soon, the supplementer as well.

Today, Ainsley is nearly three months old, gaining weight at an excellent pace, and thriving. I am so proud that we made it this far with breastfeeding. Was my supply low because of our struggles in the early days? I may never know. I still worry that I won’t be able to keep up with her as she grows. But for now, I am going to enjoy every moment of our breastfeeding relationship. I am going to sit on a park bench facing the beach, nursing and nourishing my daughter, relishing the moment.

Why do we Need Lactation Consultants?-Video

August 31, 2010

Do you really need a lactation consultant?  Why hire a board certified lactation consultant?  What does IBCLC really mean?  Watch this to find out!

Emma’s Breastfeeding Saga

August 27, 2010

When I was pregnant, I had lots of thoughts about my future breastfeeding life. I was planning on being one of those out-on-the-town moms–baby nursing happily while in a sling or sitting together under a tree in one of Seattle’s local parks. My biggest concern was how long to breastfeed–not if I could breast feed. But things turned out differently.

Solomon was a sleepy baby and didn’t breastfeed regularly. When he did breastfeed, it was very painful. The nurses told me pain was normal. The pain was so bad I would make my husband stand on my feet during feedings to counteract the nipple pain Still, I was determined to breastfeed.

At the first pediatrician visit, we learned that Solomon was jaundiced. He needed to be on a light bed. After one day on light thereapy, his jaundice was worse and we had to start supplementing with formula. We met with a nurse “lactation specialist” and she suggested supplementing at the breast with a feeding tube. She showed me how to feed Solomon with a tube taped to my breast. The temporary supplementation helped Solomon gain weight and eliminated the jaundice problem so we stopped.  Breastfeeding was still excruciating.

After a week of exclusive, frequent breastfeeding, my nipples were badly damaged AND we learned that Solomon wasn’t gaining weight. I was so discouraged! Finally, at the urging of our doula and pediatric clinic, we hired a lactation consultant to help us. Renee noticed tension in Solomon’s jaw and neck. She pointed out that his jaw was slightly asymmetrical. She suspected that he was tongue tied and explained how all these things contribute to poor feedings. Finally, after watching Solomon breastfeed, she determined that my milk supply was low and that he wasn’t doing a great job of taking the milk that I had. No wonder he wasn’t gaining weight!

Renee urged me to temporarily stop breastfeeding and use a pump to allow my nipples to heal and increase my milk production. She referred me to a Dr. who specializes in helping babies who are tongue tied. In addition, she recommended a physical therapist to help Solomon with his tight jaw and neck muscles. I fed Solomon as much breast milk as possible and took a combination of herbs and medications that support milk production.

Solomon’s latch got better immediately after the frenotomy (clipping the frenulum to release the tongue) but it was still slow progress. The body work helped relax his jaw. And, gradually, my milk supply increased to meet my baby’s needs. Finally, at 2 months, I was ready to breastfeed full time, but every time I did, the pain increased.

At Renee’s suggestion, I began to feed Solomon at the breast one feeding a day, then two, and so on until I was totally able to completely breastfeed without pain. I still have worries about losing my milk but so far, into month three, he’s gaining weight and I’m beginning to store milk for when I return to work.

Looking back, I wish I would have hired Renee right after Solomon’s birth. I know we could have gotten off to a better start. We could have identified his challenges and resolved them sooner. I would have been able to focus on being a mom and enjoying my baby.

I’m so happy that we persevered through those early, dark days. Thank you, Renee, for helping us become a success story!

“Cures” for Sore Nipples

August 1, 2010

It’s no surprise that there are dozens of “cures” out there for sore nipples. In my lactation practice, nipple pain is the most common reason that mothers seek help. The only real way to “cure” sore nipples, however, is to fix the underlying cause. It’s usually a faulty latch that causes the problem in the first place. Once the latch is corrected, nipples feel better. Usually the results are immediate.

Some antibiotics and prescription medications can be helpful for badly damaged nipples, but nothing can eliminate the pain completely until the latch problem has been resolved. In your efforts to find relief, you may find remedies promising to cure sore nipples. Often these remedies are useless—or even harmful.

Please avoid these commonly recommended but ineffective strategies for healing sore nipples:

Tea bags—Often recommended by nurses and lactation consultants, research has shown that tea bags can actually increase soreness.

Hydrogen peroxide—It is painful and irritating.

Topical Vitamin E—Vitamin E can be toxic for baby.

Restricting time at the breast—This just makes your baby hungrier. He may be more aggressive at the breast and less likely to be patient enough to latch correctly.

Cabbage leaves—Recommended to reduce swelling of engorged breasts, but not helpful for sore nipples.

Nipple creams and oils—Although sometimes soothing, they can cause more problems by making the nipple area so slippery that the baby can’t maintain his latch. Many are not safe for baby.

Using a blow dryer on nipples after feedings—This practice is drying and irritating to an area that is already tender.

Pulling baby’s chin down after he’s latched on– It’s what’s happening inside the baby’s mouth that’s important!

Remember, there should NEVER be pain with breastfeeding. Pain is a signal to the body that something is not right. If you have any pain with breastfeeding, contact a lactation consultant immediately. This is one issue where a “wait and see” approach can have severe consequences.

See also:  “Breastfeeding Myth: Sore Nipples”

Breastfeeding Myth: Sore Nipples

March 17, 2010

Myth: It’s normal to have sore, cracked nipples the first few weeks of breastfeeding.

One of the most common reasons women give for not initiating breastfeeding is “I’m afraid that it will hurt.” Breastfeeding is not supposed to hurt! Ever! Think of all the mammals who nurse their babies. Are they grimacing? Are they trying to avoid breastfeeding because of pain? Absolutely not. They look peaceful and relaxed. We are mammals too! Breastfeeding is a normal process that is meant to be enjoyable for mother and baby.

So, what are normal sensations when breastfeeding?

There should be no nipple tenderness at all in the first 24 hours. For the first few days your nipples may feel slightly tender when the baby latches on, but feel fine as the baby continues to nurse. What’s the difference between tenderness and pain? The tenderness is fleeting and mild. It doesn’t make you cry out or gasp. You look forward to breastfeeding. Your nipples look healthy.

Pain, however, often lasts throughout the feeding. You feel tense. You dread breastfeeding because it hurts. You also may find yourself ending the feeding before the baby is finished. Your nipples may look creased or flattened after feedings. There may be bruising. You wonder how long you can continue with this.

When the baby is latched on correctly, you will feel some gentle, rhythmic tugging. Some women feel the milk-ejection reflex (let down). It is often experienced as a tingly sensation around the areola or a mild ache in the breasts. Experienced mothers welcome this feeling–it means baby is getting lots of milk!

If breastfeeding is painful, enlist the help of a lactation consultant. She’ll help you breastfeed comfortably so you can truly enjoy nursing your baby.

www.second9months.com

See also: “Cures for Sore Nipples”


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