Supporting Breastfeeding

La Leche League Canada

Breastfeeding Success after Cesarean Section

Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.

This statement from La Leche League philosophy encompasses all births, whether medicated or unmedicated, vaginal or cesarean section. Due to the surgical procedure, mothers who have a cesarean birth may face challenges unlike those who have a vaginal birth.

The Womanly Art of Breastfeeding (8th edition) states on page 57:
The effects of medications and IV fluids, and the difficulty in finding comfortable positions for breastfeeding when your abdomen is tender from surgery, can make breastfeeding more difficult. And it’s challenging to recover from major surgery and look after a new baby at the same time. This doesn’t mean that you can’t breastfeed after a C-section—many, many women do…

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Here are a few tips for getting breastfeeding off to a good start after having a cesarean birth:

Breastfeed as soon as possible after delivery. Because of the nature of Cesarean delivery, it may not be possible to breastfeed immediately following delivery, but as soon as you feel comfortable doing so, try to nurse. Nursing soon after delivery stimulates the release of hormones, which will help your body first produce colostrum followed by your breast milk. Whether a mother went through labor or had a cesarean birth, her milk supply may take longer to come in and vary if she received medications or other circumstances at the time of delivery. Your milk will come in anywhere from two to six days (usually two to three days) after delivery, and colostrum will provide exactly what your baby needs until then.

Take advantage of an extended hospital stay. Room in with your baby if possible so that you can bond and offer the breast as frequently as every two hours. Concentrate on nursing and bonding with your new baby. Encourage your partner to snuggle and bond with the baby when visiting. This gives you time to rest.

Try different breastfeeding positions to avoid discomfort at the incision site. If holding your baby across your belly is uncomfortable, try the football hold, where baby is tucked under your arm on the feeding side. Another position to try is side-lying. With the baby parallel to your body, lie on your side with pillows to support your back and incision.

Stay well rested. Eat nutritious, protein-rich meals and stay hydrated by drinking plenty of water. When you were pregnant, you likely heard, “If I can do anything for you, just let me know,” from friends, family, and neighbors. Take them up on their offers. Allow people to bring over food, walk the dog, do the laundry, or help clean the house.

Ask for help. Don’t assume that just because the act of breastfeeding is a natural function of your body that it comes naturally. If you are having an issue, reach out to a La Leche League Leader, lactation consultant, or your health care provider. They may be able to answer questions and provide insights to help you overcome many breastfeeding struggles.

Gather the things you will need while feeding your baby in one place or put them all in a basket that you can carry with you. Having your supplies together will minimize the number of times you have to get up and allow you to focus on nursing. Have a water bottle, some reading material (or the television remote), your phone or tablet, baby wipes, snacks, and burp cloths handy at your nursing station.

Try to relax. Establishing your breastfeeding relationship while learning how to be a mother and recover from surgery may be stressful for you. Take a few minutes here and there for a hot shower (or a bath once your doctor gives the go-ahead), go for a walk, or have someone rub your back and shoulders. Snuggle time and skin-to-skin time with your baby can relax you.

Rule out other issues. If you are having problems getting started, don’t be too quick to associate them with the surgery. Contact a La Leche League Leader, lactation consultant, or your health care provider to discuss concerns that may be related to latch, inverted nipples, or other issues.

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For more information about getting breastfeeding off to a good start and breastfeeding after a cesarean birth, please click on the following links:

How to Get Your Milk Supply Off to a Good Start  www.llli.org/nb/nbjulaug05p142.html

Is it possible to breastfeed after a cesarean birth?  www.llli.org/faq/cesarean.html

Establishing Your Milk Supply http://www.lllc.ca/Information-sheets

Can I breastfeed after having a Cesarean (C-section) birth? http://www.lllc.ca/faq-page

Breastfeeding After a Cesarean Birth https://supportingbreastfeeding.wordpress.com/2014/06/23/breastfeeding-after-a-cesarean-birth/

 

By Kendra Atkins-Boyce
Used with permission from New Beginnings
http://www.lllusa.org/set-yourself-up-for-breastfeeding-success-after-cesarean-section/

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

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Breastmilk as Medicine?

If you have hung out with a group of breastfeeding mothers for any length of time, you will have heard someone suggest using breastmilk as a cure for rashes or eye infections or any number of other childhood maladies. Is this just crazy talk or is there science to back up using breastmilk as medicine?

The most common suggested “medicinal” use of breastmilk is to treat children’s eye infections. This is not a new idea as an 18th century quote, referring to human breast milk said: “It is an emollient and cool, and cureth Red Eye immediately.” Studies show that most conditions that cause gunky eyes in babies (blocked ducts and the common cold) will resolve on their own without any treatment. For bacteria caused pink eye, evidence shows that mother’s milk is unlikely to be effective against the bacteria that cause this infection. And certainly, in a newborn, genuine pink eyes need to be evaluated by a physician because there is the potential for long term irreversible eye damage.

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So what did the studies say?

Verd, in 2007, published an account of his clinic’s switch from treating infants with blocked tear ducts with antibiotic eye drops to mother’s milk drops. The study is retrospective and descriptive rather than quantitative, but it suggests that routinely using mother’s milk is probably safe. Blocked tear ducts, we know, get better without any therapy at all. But if you want to do something, instilling mother’s milk seems safe.

In 2012, Baynham and colleagues published a letter  in the British Journal of Ophthalmology, looking at the in vitro inhibitory effects of donated fresh breast milk against common ocular pathogens. (Translation: they squirted milk into petri dishes of eye germs to see what would happen.) They found that 100% of their donated milk samples contained bacteria (including, in some cases, bacteria that could cause human disease). Though there was some inhibition of bacterial growth against some bacteria, the inhibition wasn’t strong, and the authors concluded that “… human milk is unlikely to be effective against the most common causes of paediatric conjunctivitis.” There was one interesting finding: of all the bacteria tested, human milk was most effective against the bacteria that causes gonorrhea, which is the same bacteria that causes most serious neonatal eye infections, world-wide. Now, it wasn’t as good as an antibiotic, but for resource-poor communities in the developing world, human milk may be much better than nothing.

Ibhanesebhor, in 1996, also did an in vitro (in the lab) study  looking at the effects of human milk against bacteria. He found that while colostrum had some inhibitory effects, mature milk did not—presumably because colostrum has a much higher concentration of antibodies. In any case, even colostrum was effective against only some bacteria, and it wasn’t nearly as effective as an antibiotic.

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Another commonly suggested use of breastmilk is to treat ear infections. Most ear infections are middle ear infections, that is to say they are behind the ear drum. Breastmilk in the ear canal will not cross the barrier of the ear drum to reach the bacteria. Breastmilk in the ear canal may be effective against bacteria if the infection is in the outer ear canal such as a “swimmer’s ear” infection. Most inner ear infections clear up on their own. The American Academy of Pediatrics recommends waiting 48-72 hours after diagnosis before trying antibiotics. Warmth is soothing to an inflamed ear so mothers who have tried putting breastmilk in baby’s ear may have found that it gave some relief. Warm compresses or warmed oil drops or ear drops will also have the same effect.

Infant atopic eczema is a skin condition that affects about 50% of infants in the first years of their lives. Mothers often try breastmilk as a treatment. One study looked at the short-term efficacy of breastmilk versus hydrocortisone 1% ointment in infants with mild to moderate atopic dermatitis (AD). There were no significant differences between these two groups at days 0, 7, 14, and 21, and the interventions of both groups were found to have the same effects. As breastmilk and the hydrocortisone 1% ointment provided the same results in the healing of AD, the study’s authors support using breastmilk to treat infant atopic eczema because of low cost and accessibility.

Need help sorting out the myths from facts about breastfeeding? La Leche League Leaders are available by phone, e-mail and at group meetings.

http://www.lllc.ca/thursdays-tip-breastmilk-medicine

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.
If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

 

LLLC Spring Appeal Campaign for the support of breastfed babies: Help LLLC Grow – If you, or someone you know, has benefitted from the support of LLLC, a donation is one way you can “pay it forward”.

Donate Today

Over 385,000 babies are born in Canada each year and we want to ensure every mother has access to La Leche League Canada support whenever she needs it. We are working hard to grow and we need your support. Every donation helps us provide more support to more families!

Thanks to past donations, we have been working hard to grow our services:

Our volunteer Leaders are the cornerstone of LLLC and the support we provide. We have increased our Leaders by 10% in the past year and Leader Applicants by 40% over the past 2 years!

More than 13,000 mothers attend LLLC meetings and another 20,000 receive one-to-one phone support from Leaders.

We have doubled our community and health professional outreach in just one year!

5 new Information Sheets in various languages were made available free of charge to mothers and health professionals

A new Communication Skills program was developed to strengthen health professional and breastfeeding peer support skills and our Best for Babies pre-natal program continues to grow.

Our Leaders are a vital part of LLLC’s breastfeeding foundation. They freely devote their time to help other parents give their children the optimal start in life. You, the donor, make up the other part of the foundation on which the LLLC breastfeeding services rest. Your gifts mean that our Leaders can carry out the valuable help families need. Frankly, we would be unable to deliver services to families without you or our Leaders so please take a moment to consider how valuable your support is and make a donation, either online or by using our pledge form. If a one-time donation is not suitable for you, perhaps spreading your gift over a year would make sense. Our pledge form has the monthly donation option for your convenience.

We are proud of our growth – but we want to do so much more! We need your support to help us serve even more mothers. Please donate today so we can grow to serve the mothers and babies of tomorrow.

Thank you for taking the time to consider supporting La Leche League Canada and our continued efforts to support all breastfeeding families who need us.

 

 

 

 

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Engorgement: Cabbage leaves and Other Treatments

Engorgement is the tender, full, larger feeling that many women get in their breasts between day 2 and day 6 after giving birth.  Some women describe it as feeling like they have Barbie Doll breasts.  The change in size and sensation is caused by increasing milk volume and increased blood and lymph flow to the breasts.  The increase blood and lymph flow supports milk production.

Women who have had intravenous fluids during labour are at an increased risk of having an extended period of engorgement while the body rids itself of the excess fluids.  If the baby is latching and nursing well the normal postpartum levels of extra fluid generally don’t cause any breastfeeding difficulties.  As the pregnancy and childbirth hormone levels decrease over
the next few weeks, mother’s breasts feel softer in-spite of the increased milk volume of established breastfeeding.

Several studies have shown that when babies feed more frequently in the early days mothers are less likely to experience engorgement.  An Australian study which compared mothers who were told to let their babies nurse as long as their wanted on one breast before offering the second breast found those mothers had less engorgement than the mothers who were told to be sure their babies took both breasts at a feeding.

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Treatments for postpartum breast engorgement have not been well studied so mothers will get lots of opinions and advice.  The ideas we know work well are those that get the baby nursing effectively and emptying the breast:

-Breastfed as often as baby is willing (at least every 2-3 hours) and allow the baby to stay on the first breast until he comes off on his own.  The second breast can be offered if the baby is interested.  If baby isn’t interested in the second breast right away make sure to offer that side at the next feeding whether that is 10 minutes or two hours later.

– Get assistance sooner rather than later from La Leche League or another trained breastfeeding support person if baby is not latching well.

– Cold compresses between feedings can help reduce the swelling and the often feel good.  A soft gel Ice packs or a bag of small dice frozen vegetables works well to sooth an engorged breast.  Protect the skin with a layer of cloth between the ice pack and the skin.

– Pain medication may be helpful while waiting for the increased breastfeeding and cold compress to be effective if a mother is experiencing a lot of discomfort from engorgement. Discuss appropriate pain control medication with a health care provider.

– Express some milk if baby isn’t able to latch on well due to the swelling.  Some mothers worry that by expressing milk they will increase their milk production and create a bigger problem. Draining the breast helps to decrease the congestion of extra blood and lymph in the breast tissues.  Milk volume is unlikely to increase beyond baby’s needs with the amount of milk expression needed to regain comfort and make it easier for baby to latch on.

– Gentle breast massage before feeding or expressing may help to make the milk flow more easily.

-Cabbage leaves have long been recommended as a treatment for engorgement.  The small amount of research that has been done shows they don’t prevent engorgement.  Another study showed that they don’t appear to be any more effective than frozen gel packs but mothers preferred using cabbage leaves over the frozen gel packs.  If mothers want to try using cabbage leaves as a treatment for engorgement, choose green cabbage not the red/purple variety (it stains skin and clothing!).  Take a rinsed, room temperature or refrigerated, cabbage leaf and cut out the heavy vein out of the middle of the leaf.  The leaf or leaves are laid over the breast directly on the skin.  Putting on a bra or snug top over top of the leaves will keep them from falling off.  Remove the leaves when they are wilted and soft (usually within a few hours) or when the baby wants to feed again.  Fresh leaves can be applied after a feeding or when the first ones are wilted.

La Leche League Leaders can help you work through engorgement and other breastfeeding challenges.

http://www.lllc.ca/thursday-tip-cabbage-leaves-and-other-treatments-engorgement

More information about engorgement can be found by clicking here.

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

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Newborns Have Small Stomachs!

It should be self-evident that very small people will have very small stomachs.  However, many adults are surprised when they learn about the limited capacity of a newborn’s stomach.

Here are some facts that may help you (or those around you) better visualize what baby’s tummy can hold:

Before birth baby never feels hunger as he is fed constantly via the placenta. After birth small frequent feedings help baby transition to an intermittent feeding pattern. To make this transition easier for baby mother’s breasts provide small amounts of milk (colostrum) on day 1.

Newborn stomachs don’t stretch. Zangenet al (2001) found that on day 1 a newborn’s stomach wall is firm and doesn’t stretch. By day 3 the stomach starts to expand more easily to hold more milk. Interestingly, day 3-5 is when the milk volume starts to increase for most mothers.

When breastfeeding is going as expected, each day baby feeds more effectively. In response, mother’s milk production increases and baby gets more milk, which encourages her to feed more effectively. Supply follows demand.

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Day 1:  baby’s stomach holds 5-7 ml (1 – 1.4 teaspoons) at a time. The mother will produce about 37 ml (one ounce) of milk/colostrum in the first 24 hours. The capacity of a newborn’s stomach is influenced by birth weight however the differences are not substantial.

1st week:  with frequent feedings milk production increases to about 280 -576 ml (10-19 ounces) per day by day 7. Baby’s stomach can now hold 30-59 ml ( 1 -2 ounces) at a feeding by the end of the week.

2nd & 3rd week:  with frequent feedings mother’s milk supply continues to build. Now baby’s stomach can hold 59 – 89 ml (2-3 ounces) at a feeding and baby is taking in 591-750 ml (20-25 ounces) per day.

4th & 5th weeks:  babies will now be taking an average of 89-118 ml (3 -4 ounces) per feeding and daily milk intake will be in the range of 750 – 1035 ml (25 – 35 ounces) per day.

At one month most mothers will be producing nearly as much milk as their baby will ever need. Because the rate of growth slows as babies get older, they continue to need about the same amount of breastmilk per day from one month to six months of age. The nursing pattern will change during that time even though the volume of intake over the day remains much the same.

Some people have trouble visualizing stomach capacity so using common objects can help make the capacity clearer:

Day 1:  5-7 ml is about the size of a large marble or a cherry

Day 3:  22-27 ml is about the size of a ping pong ball or a walnut

One week:  45-60 ml is the size of an apricot or plum

One month:  80-150 ml is about the size of an large chicken egg

 

Adult stomach size is equivalent to a soft ball or the size of your own fist clenched at rest and has a capacity of 1-4 liters.

When someone asks you why your newborn is nursing at least 10-12 times in 24 hours and suggests that your milk might not be filling up her tummy, you now have some information to help them understand that frequent feedings, on baby’s own schedule, is exactly what her tummy and your milk supply need.

 

http://www.lllc.ca/thursday-tip-newborns-have-small-stomachs

 

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

 

 

 

 

 

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Jaundice and Breastfeeding

Infant jaundice is a yellow discolouration of a newborn’s skin and eyes.  It is a fairly common condition caused by an excess of bilirubin.  In utero, the baby has extra red blood cells to transport the oxygen he receives from his mother via the placenta.  Once baby is born and breathing on his own, these extra blood cells are no longer needed and they break down.  Bilirubin is a yellow pigment that is a by-product of the breakdown process.

In the early days, bilirubin is excreted by being bound to water-soluble proteins in the blood which are processed in the liver where bile takes them to the intestines and the bilirubin is excreted in the stools.  If it is not eliminated quickly, the baby starts to absorb bilirubin back into the blood stream.  As the bilirubin levels rise in the blood stream, it can enter the skin, muscles and mucous tissues causing the yellowing of the skin and eyes.

 

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Breastfeeding early and often encourages the rapid elimination of the meconium stools and decreases the opportunity for the bilirubin to be reabsorbed.  A study by Yamauchi & Yamanouchi (1990) showed a clear correlation between fewer breast feedings in the first 24 hours and rates of bilirubin levels over 14mg/dl on Day 6 (28.1% of the babies who fed two or fewer times compared with 0% of the babies who fed nine or more times).

Mild jaundice generally takes a few days to appear and the levels rise slowly usually peaking between day 3 and 5 at less the 12 mg/dl.  Jaundice that appears within the first 24 hours, rises quickly, and reaches higher than 17 mg/dl in a full term baby is indicative of a more serious problem.  Pre-term babies are at greater risk of brain injury from excess bilirubin.  Safe bilirubin levels are determined individually based on gestational age, weight and baby’s overall health.

Mild jaundice usually resolves without treatment.  Effective breastfeeding and adequate milk intake helps baby clear the bilirubin from the blood stream.  Some babies will have mildly elevated bilirubin levels for as long as 15 weeks.  In the past, there was a belief that prolonged jaundice was caused by breastfeeding and weaning was often recommended.  “The proven benefits of breastfeeding far outweigh any theoretical advantage of reducing mild to moderate levels of  jaundice” Gartner & Lee 1999.

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Because the majority of bilirubin (98%) is eliminated in the stools, supplementing the baby with water or glucose water does not prevent jaundice or bring down bilirubin levels and should be avoided.  Feeding the baby water with a bottle may compromise breastfeeding by causing the baby to feel full and by altering the sucking pattern.  Water or glucose water supplementation puts baby at an increased risk of absorbing excess bilirubin back into the blood stream.

Treatment of severe jaundice may involve separation of mother and baby so that the baby can spend time under phototherapy lights and/or supplementation if baby has not been getting enough breastmilk.  Both of these can be upsetting and discouraging to the mother.  Resolving the high bilirubin levels is the most important issue and generally only takes a few days.  Once the baby’s bilirubin levels are dropping resolving any ongoing breastfeeding issues can again be the focus.

Skin to skin contact between mother and baby, while baby is not under the phototherapy lights, can encourage the instinctive feeding behaviours.  Leaning back in a semi-reclined positon with baby resting tummy down on mum’s chest is comfortable and comforting even if baby is asleep.  As baby wakes, she may shift herself into a feeding position.

If baby is not emptying the breast effectively breast, compression may help her get more milk with less effort, which in turn will keep her more interested and actively nursing.

Mum may find pumping, while baby is having a phototherapy treatment, helps to stimulate her milk supply.  The pumped milk can be used for supplementation if needed.

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http://www.lllc.ca/thursday-tip-jaundice-and-breastfeeding 

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

 

 

 

 

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Diabetic or Insulin Resistant Breastfeeding Mother

Women who have Type 1 or Type 2 diabetes or who are considered insulin
resistant or “pre-diabetic” can breastfeed and doing so is good for mother and baby.

Breastfeeding has a positive effect on a mother’s insulin response.  For Type 1 diabetic mothers, this can decrease their need for insulin during the breastfeeding period.  Mothers who have Type 2 diabetes may find they require less hypoglycemic medication while breastfeeding.  Good control of your insulin levels is important while breastfeeding.  You may need to do some additional monitoring and be in close contact with your health practitioner during the early weeks until your hormones and your milk productions stabilize.

Mothers who are diabetic are at an increased risk of pre-term birth and their babies may develop prolonged low blood sugar levels shortly after birth (a dip in blood sugar levels one to two hours after birth is normal with blood sugar levels starting to rise again within 2 to 4 hours). Planning ahead with your birth team to manage these potential events can be helpful so everyone is prepared and not making decisions in a stressful situation.  If at all possible, plan to breastfeed within the first hour after birth and at least once an hour until the baby’s blood sugar levels stabilize.  Skin-to-skin contact has been found to decrease the risk of hypoglycemia in newborns and it helps trigger the hormones that drive breastfeeding.
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A mother who is diabetic or insulin resistant may find that it takes a bit longer for her milk volume to increase after giving birth.  Colostrum is providing all the nutrients (vitamins, minerals and fats) that baby needs through the early days.  Frequent effective feedings will speed up the body’s ability to increase the milk volume.  In the event that supplementation is required during the first few days, human donor milk is the best option.  A non-cow’s milk based formula is the next best option of donor milk is not available.  Early introduction of cow’s milk is considered a risk factor for later development of diabetes.  Talk to a La Leche League Leader or lactation professional if you have concerns about your milk supply.

Breastfeeding may make your blood glucose levels harder to predict.  To prevent blood sugar dips:

Plan to have a snack before or during nursing
* Drink enough fluids (plan to sip a glass of water or a caffeine-free drink while nursing)
* Keep something to treat low blood glucose nearby when you nurse, so you
* don’t have to stop your child’s feeding
* Developing a meal plan with your health care provider or dietitian will allow you to achieve stable blood sugar which will help you meet your breastfeeding goals.

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Most medications used to treat diabetes or insulin resistance can be safely used during nursing, but be sure to check with your doctor.  The insulin molecule itself is too large to pass from your blood stream into your breast milk and it would be digested in baby’s stomach if any did pass through.  If you are considering taking herbs, like fenugreek, which may have an effect on blood sugar levels, discuss this with your health care provider.  Mothers with diabetes have an increased risk of thrush and mastitis, which is why it is important for them to look after their nipples and drain their breasts regularly.  Make sure that your baby is latched on properly and get help if you are experiencing sore nipples or sore breasts. When weaning, a diabetic mother should do so very gradually, so her body can adjust to the changing insulin requirement.  Close monitoring and medication adjustment may be required at the end of breastfeeding as it was at the beginning.

For a detailed look at Insulin resistance and lactation insufficiency by Diana Cassar-Uhl, MPH, IBCLC check out this link.

For information and breastfeeding support if you are diabetic or insulin resistant or facing any other breastfeeding challenges please contact a La Leche League Leader.

 

http://www.lllc.ca/thursdays-tip-breastfeeding-if-you-are-diabetic-or-insulin-resistant

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

 

 

 

 

 

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Why Does My Baby Cry?

All babies cry, and some cry a lot.

When it’s your baby who is crying a lot, it can be very frustrating and upsetting for you, too.  You try burping him, rocking him – and he’s still wailing. What’s wrong?  You might be worried about making enough milk to fill him.  Or think that your milk is not good enough. Or maybe you are worried that something you are eating is upsetting his tummy through your milk.

You’re not alone in these concerns.  Many mothers worry about these things.  But most of the time, your baby’s crying has nothing to do with the quality or amount of milk in your breasts.

The truth is that there are many reasons babies cry. Crying is one way your baby communicates with you, but at first it can be a challenge to figure out what he’s trying to tell you.

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In the first few days:

Your baby is adjusting to life out in the world.  He’s been through some big changes!  When he fusses or cries, offering the breast can easily comfort him.  At first, your breasts produce small amounts of colostrum, but your baby is soothed by sucking, by being held skin-to-skin and by hearing your familiar voice and heartbeat.  His frequent feedings also signal your breasts to make more milk.

He’s not likely to follow a firm pattern or schedule for feeding.  He might breastfeed very frequently for a few hours and then sleep for a longer period of time.  Or he might just have an irregular pattern with his feedings.  Some babies will feed 8 or 9 times a day, others will nurse more than 12 times a day. That’s all normal.

Crying and breastfeeding problems:

It can be very frustrating when you try to breastfeed, but the baby just cries and can’t seem to find the nipple or suck properly.  It might help to just cuddle your baby against your bare skin with her head near your shoulder for a few minutes, until she calms down.  Then try again. Maybe try a laid-back position so she can feel your skin and start to move to the breast on her own.

Remember, she’s learning to do something brand new, so it may take her more than a few minutes to latch on to the breast.  Be patient with your baby, and ask for help (from a La Leche League Leader, lactation consultant, midwife or nurse) if you are worried.

After day three or four:

At this point, the amount of milk in your breasts will increase significantly.  Your baby may have trouble latching on to your fuller breasts, and that might cause more crying. Try to express a little milk to make your breasts softer and help him latch on. If that doesn’t work, ask for some help.

Your baby lost weight in the first few days (as he got rid of the dark-coloured poop called meconium that was previously in his gut) but now he will start gaining. Between 5 and 8 ounces or 140-250 grams each week is typical. That means he is getting plenty of milk – one worry you can cross off your list!  In between weight checks, just watch to be sure he has at least 6 heavy wet diapers and 3 or 4 poopy diapers every 24 hours. (He may poop less often after one month.)

If your baby is not gaining weight as expected after day four, talk to your doctor or midwife. There are things you can do to help your baby get more milk at the breast.

Does your baby cry a lot in the evenings?  Many mothers find their babies are extra-fussy in the evening hours.  If you can, just relax on the couch or in a rocking chair and let the baby nurse as much as he wants.

Worried that something you are eating or drinking is bothering your baby?  Most babies aren’t bothered by anything their mothers eat or drink, but some are.  You could talk to a La Leche League Leader or lactation consultant about this if you think it is a problem for your baby.

In the first two months:

Many babies have “growth spurts” or “frequency days” as they grow.  This happens around 3 weeks and 6 weeks. You’ll notice that suddenly your usually happy baby will start to cry a lot and want to nurse much more often – sometimes all day long!  This is normal.  Usually after two or three days your baby goes back to his previous pattern of breastfeeding and seems more content.  Those days of frequent feedings have boosted your milk supply to meet his needs.

What else could it be?

Most of the time a baby’s crying or fussing has nothing to do with breastfeeding.  Babies are all different: some are more sensitive and intense than others.  One baby might not wake up if a dog barks; while another will wake up crying and keep crying.  Crying is the loudest way your baby can communicate. He’s not trying to drive you crazy or manipulate you; he’s trying to let you know “something is wrong!”

How do you know what’s wrong?  Sometimes your baby cries because he wants to be close to you, hear your voice, and feel your warmth, just as he did before he was born.  Over time, you’ll get to know your baby and understand his unique cries and signals.

Some things to try:

  • Offer the breast, even if your baby nursed a short time ago. He may just need a little dessert!  Even if he is not very hungry, breastfeeding might calm him.
  • Hold him close to you – perhaps undressing him so that you can be skin to skin. That contact often helps the baby stop crying.
  • Take a walk with him. Babies love to move, and they love the rhythm of an adult walking.  Use a wrap or soft baby carrier if you have one, or just carry him as you stroll around your kitchen or around the block.  You can also rock in a rocking chair.
  • Talk or sing to her. Your baby has been listening to your voice for months before she was born, and she loves the sound of it.
  • Take a bath together. If your baby is feeling tense, snuggling with you in warm water might just be the relaxation she needs.  A helper can place the baby in your arms once you’re in the water.
  • If nothing is working, try offering the breast again. She might be ready to latch on and nurse a bit more now.

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A helping hand

Sometimes all you can do for your baby is to be there while he cries.  He will be reassured by your touch and closeness, even if he continues to cry. If your baby cries a lot, and you are getting frustrated, ask someone to help you out.  Perhaps your partner or a friend or family member can hold or carry the baby while you have a break.

Here’s the good news:  even babies who cry a lot tend to do less and less crying as they reach two or three months of age.  Your love and support will help him learn that the world is a caring place and that he can trust you to be there for him.

Why Not Formula?

Baby cries > Anxious parents > Feed Formula > Baby breastfeeds less > Breast milk production decreases

http://www.lllc.ca/Information-sheets This La Leche League Canada Information Sheet Why Does my Baby Cry? is available on our website in several languages including English, Spanish, Chinese, and Arabic.

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/ so we can continue to help others breastfeed. Thank you!

 

 

 

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What if I Want to Wean my Baby?

Breastfeeding your baby for even a day is the best baby gift you can give. Breastfeeding is always the best choice for your baby.  If it doesn’t seem like the best choice for you, these guidelines may help.  Talking to a La Leche League Canada Leader or Public Health Nurse may help you sort out your options or resolve any challenges which are leading you to want to wean.

IF YOU WEAN YOUR BABY AFTER A FEW DAYS, your baby will have received your colostrum, or early milk.  Packed with optimal nutrition and antibodies, it helps get your baby’s digestive system going and gives him his first – and easiest – “immunization”.  Breastfeeding gives your baby, by far, the best start and helps your own body recover from the birth, too.  Since your only job in the first week should be to get to know your baby, it just makes sense to nurse while you’re getting to know each other!

IF YOU WEAN YOUR BABY AT FOUR TO SIX WEEKS, you will have eased him through the most critical part of his infancy.  Breastfed newborns are much less likely to get sick or be hospitalized, and have many fewer digestive problems than artificially fed babies.  After 4 to 6 weeks, you will probably have worked through any early nursing concerns, too.  Make a serious goal of nursing for a month, call La Leche League Canada or a health professional if you have any problems or questions, and you’ll be in a better position to decide whether continued breastfeeding is for you!

IF YOU WEAN YOUR BABY AT 3 OR 4 MONTHS, her digestive system will have matured a great deal, and she will be much better able to tolerate the foreign substances in commercial formulas.  If there is a family history of allergies, though, you will greatly reduce her risk of allergies by waiting a few more months before adding anything at all to her diet of breastmilk.  Breastfed babies do not need juice or water.

 

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IF YOU WEAN YOUR BABY AT 6 MONTHS, she will be much less likely to suffer an allergic reaction to formula or other foods.  At this point, her body is probably ready to tackle some solids whether or not you wean.  Exclusive breastfeeding for at least 6 months helps ensure better health throughout your baby’s first year of life.  Studies indicate that nursing for more than 6 months may greatly reduce the risk of childhood cancers as well as improving lifelong health.  Do not over feed solids.  At this age 80% of his calories should come from milk.

IF YOU WEAN YOUR BABY AT 9 MONTHS, you will have seen him through the fastest and most important development period of his life on the most valuable of all foods, your milk.  You may even have noticed that he is more alert and more active than babies who did not have the benefit of their mother’s milk.  Weaning may be fairly easy at this age… but then, so is nursing!  If you want to avoid weaning this early, be sure you’ve been available to nurse for comfort as well as for nutrition!  Baby still needs lots of sucking time and milk is still a large part of his daily diet.

IF YOU WEAN YOUR BABY AT A YEAR, you can avoid the expense of formula.  Her one-year-old body can probably handle whole cow’s milk as well as most table foods.  Many of the health benefits this year of nursing has given your child will last her whole life.  She will have a stronger immune system, for instance, and will be much less likely to need braces or speech therapy.  The Canadian Pediatric Society recommends nursing for at least a year, to ensure the best possible nutrition and health for your baby.

IF YOU WEAN YOUR BABY AT 18 MONTHS, you will have continued to provide the highest quality nutrition and superb protection against illness at a time when illness is common in other babies.  Your baby is probably well started on table foods, too.  He has had time to form a solid bond with you – a healthy starting point for his growing independence.  And he is old enough that you and he can work together on the weaning process, progressing at a pace that he can handle.

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IF YOUR CHILD WEANS WHEN SHE IS READY, you can feel confident that you have met your baby’s physical and emotional needs in the most natural and healthiest way possible.  In cultures where there is no pressure to wean, children tend to nurse for at least two years.  The World Health Organization strongly encourages breastfeeding through toddlerhood.  Your milk provides antibodies and other protective substances as long as you continue nursing, and families of nursing toddlers often find that their medical bills are lower than their neighbours’ for years to come.  Mothers who have nursed for two or more years have a lower risk of developing breast cancer. Children who were nursed long-term tend to be very secure, and are less likely to suck their thumbs or cling to blankets.  Some studies indicate that they adjust more easily to school.  Nursing can help ease both of you through the tears, tantrums, and tumbles that come with toddlerhood and helps ensure that any illnesses are milder and easier to deal with.  It’s an all-purpose mothering tool you won’t want to be without!  Don’t worry that your child will nurse forever.  All children wean eventually, no matter what you do, and there are more nursing toddlers around than you might guess.

Whether you breastfeed for a day, a few months or for several years, the decision to breastfeed your child is one you need never regret.   And whenever weaning takes place, remember that it is a big step for both of you.  If you choose to initiate weaning be sure to do it gradually and with sensitivity to how your baby is coping with the changes.  Taking it slow also allows your body time to adjust to producing less and less breastmilk which is healthier and more comfortable for you.

http://www.lllc.ca/thursday-tip-what-if-i-want-wean-my-baby

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/ so we can continue to help others breastfeed.

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The Power of Hand Expression

By Diana West from La Leche League International’s Breastfeeding Today.

I was a new mother struggling with low milk production and a baby who wouldn’t nurse when the first effective “consumer grade” breast pumps were invented. I’d been renting a hospital-grade pump to remove my milk, but the idea of owning a good quality pump that was more portable enticed me to buy a double-sided electrical model. It looked so cool! It was in a black bag designed to look like a briefcase so it could be carried to work discreetly. I wasn’t working, but I loved the way it made me feel efficient and smart. I was in the first wave of breastfeeding mothers to flock to this type of pump, and millions have been sold over the years.

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Knowing what I’ve learned since those days, my heart sinks to think I put such stock in a cool looking pump when my own two hands could have done a better job. But expressing my milk by hand never crossed my mind then. My impression of hand expression in those days was as a last resort when a good pump wasn’t available. My mind has changed quite a bit since then.

I now see hand expression as far more powerful than pumping in many ways. Research has shown that it can be more effective at removing milk in the first days after birth when the colostrum is thick and the breasts are swollen. Pumping colostrum leaves only sprays on the side of the bottle that are hard to give to the baby, but hand expression into a spoon saves every drop. Hand expression can also be used as a technique during and after pumping to increase caloric content and remove more milk.  It can be more reliable than a pump when electricity is scarce. It’s quieter than a pump when privacy is needed. It’s certainly less expensive than a pump. But I think the most powerful aspect of hand expression is the way it affects our perception of our breasts and what they can do.

Many young women have an uncomfortable relationship with their breasts before they become mothers. They’re usually aware of the sexual aspects of their breasts before they think about their ability to make milk.  As an erogenous zone, women often feel it’s more appropriate for their partners to handle their breasts than to touch them themselves. There can be a delicate balance between breasts as sexual power and targets of sexual vulnerability.

Many women have discovered that learning how to hand express during pregnancy helps them feel more comfortable touching and handling their breasts. I jokingly call this “making friends with the girls” when I suggest the idea to a client. That usually makes her laugh and lightens the mood, but there’s some real truth to it. One study found that learning hand expression during pregnancy increased mothers’ confidence and readiness for breastfeeding. Another study found that it increased not only breastfeeding confidence, but also how long they breastfed. Experimenting slowly with hand expression to figure out what it takes to get drops of milk can be empowering, especially during pregnancy before there’s any pressure to express milk for the baby.

In my experience, there’s no one right way to hand express. When I was nursing my first baby almost 20 years ago, I remember being taught the Marmet Method of Milk Expression, which was developed by Chele Marmet, one of the pioneers of the lactation consultation field. Over the years, there have been several other official methods, many of which are now demonstrated on YouTube. But I think hand expression methods are best used as a starting point to figuring out what works best on your own individual breasts. We’re all different, and what works for you might be different than what works for me. The one movement that I find helps no matter what else you do is to move the skin over the breast tissue instead of sliding your fingers over the skin. You’ll also almost always get milk to spray by compressing just behind the areola where there’s a sort of “sweet spot.”

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Getting to know the landscape of your breasts and the way they work can help you start to think of them as your breasts. You may feel a slowly growing pride as you see that they can feed and soothe your baby. You’ll start to appreciate their superpower. After a few days of nursing, you may realize that your breasts are your connection to this baby with whom you are falling so deeply in love. That’s the power of hand expression.

From Breastfeeding Today, used with permission. http://viewer.zmags.com/publication/46f5a2ad#/46f5a2ad/1

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/ so we can continue to help others breastfeed. 

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Breast Engorgement

What is engorgement?  After you give birth, your body produces the early milk called colostrum which provides your baby with all the nourishment he needs plus important antibodies and other protective factors.  Sometime between the second and sixth day, your body will begin to produce mature milk.  Some women experience such fullness in the breasts that it makes their breasts feel hard and painfully full.  This is engorgement.  This fullness is due to additional blood and fluid travelling to the breasts as your body is preparing to produce milk as well as the actual volume of milk itself.  Some degree of breast engorgement is normal. Usually the fullness subsides within 12-48 hours.

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Engorgement can make the nipples flatten due to the fullness of the breast and make it difficult for the baby to latch on to the breast.  Mothers may experience pain in the breasts due to the fullness.

You can minimize the effects of engorgement by doing the following:

  • Nurse frequently, at least 8-12 times or more a day. Offer both breasts. A newborn should be nursing on each breast at least every two to three hours.  Remember to breastfeed as often as your baby indicates the need.
  • Engage in skin-to-skin contact with your baby.
  • Gentle Breast Massage – with the palm of your hand and starting from the top of your chest (just below your collar bone), gently stroke the breast downward in a circular motion, toward the nipple. This may be more effective when done while you are in the shower or while leaning over a basin of warm water and splashing water over your breasts.
  • Warm Compresses – Some mothers find that applying a warm, moist compress and expressing some milk just before feedings helps to relieve engorgement. Using heat for too long will increase swelling and inflammation, so keep it brief. Cold compresses can be used in between to reduce swelling and relieve pain.
  • Cabbage Leaf Compresses – Rinse the inner leaves of a head of green cabbage. They can be used refrigerated (best) or at room temperature. Between feedings, drape leaves directly over breasts. Change when the leaves become wilted or every two hours. Some authorities suggest twice a day for 20 minutes for a day or two.  Discontinue use if rash or other signs of allergy occur or when the swelling starts to go down.
  • Engorgement can cause the dark area around the nipple, the areola, to become hard and swollen. This can be a problem if the fullness makes it difficult for baby to latch on. A technique that can help is reverse pressure softening. Reverse Pressure Softening softens the areola to make latching and removing milk easier. It is not the same as hand expression. For complete instructions and illustrations click here.

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Contact your La Leche League Leader, International Board Certified Lactation Consultant, or health care provider immediately if:

  • Engorgement is not relieved by any of the above comfort measures.
  • You begin experiencing symptoms of mastitis: fever of greater than 100.6°F (38.1°C), red/painful/swollen breast(s), chills, “flu-like” symptoms.
  • Your baby is unable to latch on to your breast.
  • Your baby is not having enough wet and dirty diapers.

Engorgement of your breasts can seem to you like a huge complication at the time.  It’s a little bump in the road and is very time-limited to a few days.  You can take action to help yourself through this temporary hurdle and continue to enjoy breastfeeding your baby.

 

http://www.lllc.ca/faq-page

http://www.lllc.ca/hp-information-sheets

http://www.llli.org/faq/engorgement.html

https://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/06_hand_expression.pdf

http://www.lllc.ca/tuesday-tip-scoop-poop

 

If you need more information or have a breastfeeding problem or concern, you are encouraged to talk directly to a La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

 

 

 

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