Posts Tagged ‘latch’

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.


My Baby Won’t Latch!

September 19, 2010

I hear this phrase several times a week. It troubles me because it implies that the baby is unwilling breastfeed. Nothing could be further from the truth.

You baby was born to breastfeed! She is hard-wired to seek comfort and nutrition from you breasts. This is, after all, how babies survive! When a baby is unable to latch and breastfeed it simply means that she is unable to latch and breastfeed—not that she is unwilling!

If your baby does not breastfeed right away, you may feel that there is something wrong with your breasts, or your baby doesn’t want to breastfeed or even that your baby doesn’t like you. None of these things are even remotely true, however. Your baby is most comforted by you—the scent of your skin, the sound of your voice and the rhythm of your heart and breathing.

There is no need for panic if your baby doesn’t latch immediately after birth. Let your baby snuggle skin-to-skin on your chest. Let her nuzzle against your breast. Encourage her as she scoots around searching for your nipple.

If your baby is attempting to latch on and is unable to grasp the breast or maintain her latch, she may be having some simple coordination problems. Seek the help of a lactation consultant. These things usually work themselves out over time, but you will need support and guidance to ensure your baby gets plenty of your milk while she’s learning to breastfeed.

See also, “Your Baby is a Mammal”

“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”

A Perfect Latch

June 21, 2010

Perfect Latch in Football Hold

Here is a beautiful example of a football hold latch. This baby is just 5 days old, but he knows exactly what to do!

How do we know this latch is perfect?

His nose is tilted away from mom’s breast.

His chin is tucked in firmly to the underside of the breast.

Baby’s top lip barely covers mom’s nipple.  Baby’s mouth is assymetrical in relation to mom’s areola. The areola is clearly visible above the top lip but the lower part is covered by baby’s mouth.  (Note:  The appearance of the latch will differ slightly with each mom due to anatomical variations.)

Baby’s mouth is open wide.  The corners of his lips are not touching.

Most importantly, baby is drinking and mother is comfortable!  Click here to see this baby in action and hear the swallows!

Claire’s Breastfeeding Story

June 14, 2010

The mother in the video contacted me when her baby was 5 weeks old. Her first week of breastfeeding resulted in cracked, bleeding nipples and a bacterial infection. Her nipples were so sore, she had to stop breastfeeding. She did, however, pump regularly to preserve her milk supply. Breastfeeding was important to Claire. She had fond memories of nursing her first daughter. She desperately wanted to nurse this new baby as well; but was afraid to try again.

Claire told me her story and asked for help to breastfeed her newborn daughter without pain. She was concerned that, after 4 weeks of bottle-feeding, her baby may not want to breastfeed. She was also concerned about her milk supply—she was not able to “keep up” with her baby—needing to supplement with some formula each day.

Needless to say, Claire was nervous about trying breastfeeding again. The memories of that first week of pain were still vivid. We worked on getting the latch just right—making sure baby’s mouth was open wide enough. Claire had lots of guided practice to help her baby latch deeply onto the breast well behind the nipple. Her baby daughter was happy to cooperate.

To view a video clip of one of Claire’s practice sessions, click here. But first, read on for a brief description of what you will see.

As you watch the clip, notice the position of the baby relative to Claire’s breast. The baby is slightly under the breast and her upper lip is lined up with the nipple. When baby opens wide, Claire quickly brings the baby all the way to the breast. Baby’s top lip barely covers the nipple. In her effort to help her baby to latch deeply enough, she goes just a bit too far, but she adjusts her baby’s position accordingly when she knows the latch feels right.

Claire generously provided this video in hopes of helping other breastfeeding mothers. She and her infant daughter are now a happy breastfeeding couple. Her milk supply increased when she started breastfeeding again and her baby is thriving without supplements.

See also, “Cross Cradle Latch with Claire” for video.

Cross Cradle Latch with Claire

June 14, 2010

Notice the position of the baby relative to mom’s breast.  The baby is slightly under the breast and her top lip is aligned with the nipple. Mom waits for the baby to open wide.  When latched correctly, baby’s top lip barely covers the nipple.   See “Claire’s Story” for more detail about this video clip.

Your Baby is a Mammal

May 30, 2010

Infant mammals have one thing in common. They all breastfeed. In addition, they are all equipped to squirm, crawl or swim to the breast and latch and happily suckle without the help of their mothers.

But human babies are different than other mammals, right? Don’t they need someone to “latch them on”?

Yes, human babies ARE different from other mammals. They are smarter and even more capable than their furry counterparts. After some help to get to mom’s torso, a newborn will have no trouble finding the breast and suckling comfortably and effectively. Just like other mammals, your baby has an innate need and an intense drive to breastfeed. To your baby it is not a choice. It is simply survival.

You have probably already noticed the reflexes that help babies find the breast. When your baby is ready to breastfeed, she turns her head back and forth on your chest and moves her body toward one breast or another while her mouth is wide open. She may also bob up and down on your chest with an open mouth. This can be quite comical to observe, but it is serious business for your baby. When your baby does those things, she is looking for your breast.

If your baby has been having trouble with breastfeeding, or if breastfeeding has been uncomfortable for you, you might want to try letting your baby show you how it’s done. Sit in a semi-reclined position bare from the waist up. Place your baby (also shirtless) on your chest facing you. Keep your hands close by to protect her from falling—otherwise, let her move her way. She may scoot down your torso. Or, she may throw her entire body to one side or the other. Be prepared for any movement she wants to make! As she gets closer to your breast, notice how she uses her chin, cheeks and mouth to find the breast, then the nipple. When she gets close enough, she will anchor her chin to the underside of your breast, throw her head back, open her mouth wide and latch on. It may take her a few tries to get it right. You can help her by lifting the breast if necessary.

Letting your baby show you how she wants to postion herself can help you understand how best to help her–even when it’s not practical to remove your shirt!

See also:  “Let Your Baby Lead!

Is My Baby Getting Enough Milk?

March 23, 2010

Wouldn’t it be nice if your breasts were equipped with little gauges that indicated how much milk was removed when your baby ate? Fortunately there are other ways to measure milk intake when a baby is breastfeeding.

Your baby should eat at least 8 times every 24 hours. If your baby is eating and not just sucking, you will be able to observe swallows. Swallows will be infrequent immediately after birth, but will gradually increase to about 1 swallow per second around day 4 or 5.

It is possible for a baby to be at the breast for long periods of time but not get enough milk to grow. If baby’s suck is ineffective or the latch is incorrect, he may not get enough to eat in a timely fashion. For that reason, it’s very important to watch and listen for swallows when you’re nursing your baby.

Swallows are audible and visible. A swallow sounds like a softly whispered “kuh” as air is released from your baby’s nose. Sometimes there will be an audible “gulp” when milk is gushing into your baby’s mouth. You can see a swallow by watching your baby’s chin. When his chin is moving rapidly up and down your baby is not swallowing. When he pauses and drops his chin down, opening his mouth extra wide, your baby is swallowing.

If your baby is nursing well, he will be happy and vigorous at the breast—sucking and swallowing rhythmically. When he is finished, your breast(s) will feel softer and your newborn will look content and a little drunk.

What goes in, must come out! A baby should have at least as many wet diapers as his age. A 2-day-old baby should have 2 wet diapers, a 3-day-old baby, 3 wet diapers and so on. After day 5 your baby needs at least 6 pees per day. The diaper will feel heavy and the urine will be pale yellow or colorless.

Counting poopy diapers is important as well. Newborn poop is called meconium. It’s sticky and greenish-black. It gradually transitions to breastmilk poop which is yellow and runny with tiny white curds. A well-fed baby will have at least 2 big poops each day after day 4. Don’t be alarmed if your newborn gives you a poop with every feeding. That’s completely normal for breastfed babies.

Finally…trust your instincts! Nature gave you powerful intuition to help you with mothering. If you ever feel unsure that your baby is not feeding well, check with your pediatrician or lactation consultant.

Hidden Hazards of Nipple Shields

March 12, 2010

As I’ve stated many times to anyone who will listen,  nipple shields can be helpful if a baby is having trouble breastfeeding. In the wrong hands, however, they can be downright dangerous. Just today I saw 2 moms who were given nipple shields in the hospital within 48 hours of their babies’ birth.  Their 2 stories had very different outcomes.

Story number 1:  Three -week- old baby. Mom given nipple shield day 2 because baby was having a hard time latching. Baby was able to latch with the shield, but he nursed for 45 minutes to an hour each feeding and never seemed satisfied. Things seemed to go OK the first week, but at a routine check-up 2 weeks later, baby hadn’t gained any weight. The pediatrician told mom to start supplementing immediately and referred her to me. I saw her the next day.

After a little guidance, baby latched on to the breast easily and nursed well. Mom’s milk supply is very low, of course, since baby was not transferring milk well with the nipple shield. Now this mom has quite a bit of work ahead to increase her milk supply. In the meantime, this baby will need to be supplemented with formula.

Story number 2:  Three- day- old baby. Mom was given a nipple shield after the very first attempt at breastfeeding because her baby’s latch was incorrect and her nipple felt pinched. Fortunately, this mom had arranged to see me prior to her son’s birth and I consulted with her in her home.   The baby latched easily after I showed his mom how to help him find the breast. He breastfed happily while his parents watched in awe—surprised that he could do so well without the nipple shield. Mom was absolutely comfortable and delighted that breastfeeding did not hurt!

Story number 2 turned out well. It likely would have had a very different ending, however, if this mom had continued to use the nipple shield.

The lactation consultants who dispensed the nipple shields (2 different hospitals, by the way!) did not attempt to correct the underlying problem BEFORE resorting to plastic.  In addition, they did not teach the moms how to assess the babies’ effectiveness using the shield while breastfeeding. Finally, there was no follow -up offered or suggested to ensure that either of the babies were transferring enough milk to gain weight.

I wish these 2 stories were isolated incidences. They are not. I see more or less the same scenario several times a week. So how can you avoid this very common problem?

  • Know that your baby was born to breastfeed!
  • Avoid nipple shields in the first 24 hours.
  • If you’re having trouble breastfeeding, insist on getting help. If the hospital cannot provide you with timely, knowledgeable, REAL help, ask a nurse for a referral to a private lactation consultant.
  • If you decide to use a nipple shield, make sure someone in the hospital evaluates an entire feeding with you to help you feel confident.
  • Arrange for a lactation consultant visit and a baby weight check as soon as possible after leaving the hospital.

Ten Reasons to Call a Lactation Consultant

March 4, 2010

Breastfeeding should be enjoyable for you and your baby! If either one of you is not having a good time, something is not right. As a new mom, you have instincts to guide you. Your baby has instincts and very strong reflexes to guide him. But neither one of you has ever done this before and, most likely, you have never seen a baby breastfeeding. It’s likely you will need some help.

Contact a lactation consultant immediately if you experience any of the following:

  1. Any nipple pain in the first 24 hours after birth. Breastfeeding is not supposed to hurt—ever! Listen to your body. It’s telling you that something is very wrong!
  2. Bleeding, cracked or bruised nipples that are not feeling and looking better every day.
  3. Inadequate weight gain or inadequate wet/dirty diapers at any time.
  4. Baby cannot latch on to the breast or seems to latch on but “falls off” after a short time.
  5. You have difficulty getting the baby to “latch.”
  6. Baby is at the breast for long periods of times (over 45 minutes of continuous nursing) after day 2 or wants to go to the breast very frequently (every hour or less).
  7. Baby does not seemed satisfied after feedings.
  8. Baby stays on the breast for a very short period of time (less than 5 minutes) or is not interested in feeding at least every 3 hours.
  9. Redness, pain or severe swelling in the breast.
  10. You have twins or more.

If you are in need of a lactation consultant,  you may use the form below to get help.

See also: “Why do we Need Lactation Consultants?”

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