Supporting Breastfeeding

La Leche League Canada

Becoming a Mother

Along with the birth of a baby comes the birth of a mother – you will learn together.
How many of us, before becoming mothers ourselves, have looked upon a screaming child at the grocery store and sworn, with misguided certainty, that it would never happen to us. The same judgment was there in many situations I observed before motherhood: overhearing another parent use an overly harsh tone for a child’s behavior, too much television, idle parental threats….the list goes on and on. Before I was born into my motherhood role, I had all of the answers. Since then, I have been on a road fraught with humility and pitfalls. Luckily, the road has also been rich with many, many gifts that make it all worthwhile.
When my first baby was born, I was well read. I didn’t focus only on the birth and forget about the postpartum period. I was a postpartum nurse in the newborn nursery; I taught mothers about baby care and breastfeeding. I was certain I had the whole mothering thing in the bag. When my beautiful baby girl arrived three weeks early, I wasn’t worried; I couldn’t wait to put my skills to the test.

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Then, we brought her home. We settled in for a few hours, and the downfall of my misplaced confidence began. She cried and cried and cried. As midnight loomed, I called the pediatrician because surely my lovely baby was sick; there must be something wrong with her because I didn’t know how to solve the problem. The pediatrician patiently asked questions to determine if there was something physically wrong, and we checked her temperature and examined her. The pediatrician had just examined our baby a few hours prior at our hospital discharge, so the next step was my first lesson in becoming humbled as a mother: the pediatrician gently explained that sometimes babies cry. She explained that sometimes babies even cry all night. Rationally, I knew this of other people’s babies, but somehow I was naively sure I would be able to circumvent all discomfort for my daughter if I just loved her enough and read the right books.
My world crashed down a little in that moment on the phone with the pediatrician. I began to grasp the magnitude of my role as a mother. The physical birth of the baby was powerful and painful, and now I was beginning to understand that growing into my potential as a mother was going to be painful too. I had to let go of all of my misguided and overconfident preconceived ideas and begin fresh. I had a lot to learn. My daughter and I cried together quite a bit that night and through the difficult colicky weeks that followed.
Slowly, I learned that by watching my baby, and having a “back pocket” full of comfort measures to try, I could solve the problems. I learned that the solution was often found in offering the breast. With my baby in my arms and at my breast, I was empowered. I admired and gazed at her tiny, perfect self. I watched her sucking patterns; I learned many subtle behavior cues. I learned about being the mother to this wonderful, already decisive baby girl as she learned about the world. Slowly, and with a lot of support from family, friends, and La Leche League, I became the authority as her mother. Nobody could take care of that baby as well as I could. Nobody. My mothering confidence was born again.
With each new phase, new trials and triumphs are born: toddlerhood, adding a sibling, adding another sibling, the elementary school years, which flowed right into the tweens and teens. There have been some stages where I have had a lot (a really, really lot) to learn, while I have rolled right through others. There is still more to come—more lessons for all of us. We are learning together.

1LeaderMother

 

Used with permission from LLL USA http://www.lllusa.org/ New Beginnings http://www.lllusa.org/becoming-a-mother/

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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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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Supporting Teen Mothers

Teen mothers are somewhat less likely to decide to breastfeed than women over 20 and can encounter some additional challenges. La Leche League Canada breastfeeding groups for young mothers can provide appropriate support for those young women who choose to breastfeed.
In 2009, a group of La Leche League Canada volunteers in Calgary responded to a need in their community and started LLLC meetings especially for young mothers. “We started this group because we felt there was a need to help teen mothers in their own environment. Teen mothers often have different issues than other mothers”. The Calgary teen group met at a Calgary organization that provides housing and support to teen mothers while they are pregnant and after the birth of the baby for up to a year. Most young women who live there attend school, are working, or seeking employment. The LLLC volunteers visit the school day care centre twice a month at lunchtime and are available to answer questions. The volunteers find that the informal atmosphere helps the mothers to feel more comfortable. Usually about ten mothers attend the sessions. The babies range in age from newborn to about nine months.  The topics discussed follow the La Leche League Canada series meeting topics but are specifically tailored to respond to issues and questions raised by the young mothers. Volunteers also share LLLC Information sheets and website resources with participants. The location and informal nature of the meetings has helped to make LLLC’s mother-to-mother support accessible and relevant to the needs of the young women who attend high school. The program is making a difference in the lives of these young mothers and their babies.

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Fiona, a LLLC Leader in Edmonton Alberta, agrees. She has been coordinating a noon-hour breastfeeding drop-in for young mothers since 2002. Teen mothers often have a hard time admitting when they are struggling with breastfeeding or parenting issues. They are oriented to their peers and therefore much of their information about breastfeeding and babies can come from people who are equally ill-informed. One of the interesting side effects of holding these group meetings in a common room, is that girls who do not plan to attend the meeting are in the room and find themselves drawn into the discussion. Often they will speak about how their experience of breastfeeding did not go well, leading to discussion about how to prevent and overcome problems and where to find support and information for breastfeeding. Their experiences can encourage the expectant mothers to do some forward planning to improve their chances of successfully meeting their own breastfeeding goals. Girls who have struggled with breastfeeding and given up, gain some knowledge about the circumstances that created the challenges, the information that could have helped turn things around, and the support systems that could have helped them through the challenging times. They come to realize that their bodies did not fail them and they become better-informed peer supporters for the other teen mothers around them.
The issues that young mothers deal with are often different from those of adult mothers. For example, they are required to be back at school two weeks after giving birth. For many of them, this requires over an hour on the bus with at least one change. Some have no qualms about breastfeeding in public but for most in those early weeks, it is hard to handle any additional strange looks beyond what they are already getting as a teen with a baby in tow. Helping them figure out how to manage the trips can make the difference between continuing to breastfeed while at school and at home or giving up completely.
Alcohol use, smoking, street drugs and birth control are other issues that come up far more often in the teen group. Fiona finds that reading straight from the Breastfeeding Answer Book provides the information they seek without any hint of judgment creeping in. She has noticed that the girls are often far more openly judgmental of each other’s choices in these areas than adults would be but the perception of adult judgment will shut down communication very quickly.
“Working with young mothers is a privilege. They are as determined, passionate, funny, self-absorbed and energetic as any other teens.” Fiona concludes. “They are also caring concerned mothers who want the best for their children just as adult mothers do.”

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Adapted from the LLLC Tree of Life Summer 2010 http://www.lllc.ca/donor-newsletter-tree-lllife

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!

 

Other links:  https://supportingbreastfeeding.wordpress.com/2015/04/13/teens-and-breastfeeding/

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Green breastmilk and Green Baby Poop

As a new mother, you may find yourself extraordinarily interested in the colour of things that you never imagined that you would spending any time considering: breastmilk and poop! In honour of St Patrick’s Day this week, let’s look at the colour that causes mothers the most concern.

Occasionally mothers who are pumping their milk are startled to discover it has a greenish tint. Generally breastmilk would be described as clear, white, bluish, tan or yellow. But at some point during the course of your breastmilk pumping experience, you may be surprised to find that your milk can be other colors as well.

Green milk can show up after the ingestion of green foods or foods containing green or blue dyes. Drinking green or blue coloured sports beverages can pass the dye into your breastmilk. Eating spinach, other deep green vegetables or seaweed may give your breastmilk a greenish cast. Some herbs and supplements can also turn breastmilk green. The Womanly Art of Breastfeeding (WAB 8th edition page 307) reminds us: “Don’t worry about the colour of your milk. It can change after you eat certain foods, but that doesn’t harm the milk at all. Just tell yourself, “If I were nursing, I wouldn’t be seeing this.” Most parents will change a diaper and find a greenish poop at least once during the diaper years.

natural weaning

Eating green food

 

If the baby is within the first few days of life, the poop will be transitioning from black meconium to the yellow colour that is usual for a breastfed baby. During that transition phase there can be some poops that could be described as greenish. The colour should continue to change over the next few diaper changes and is nothing to be concerned about.

As baby gets older, an occasional greenish diaper is also nothing to be concerned about as long as baby is happy, eating and gaining well and there is no sign of blood in the diaper.

Some babies have green, frothy poops. These can be a result of baby receiving more foremilk than hindmilk. “Foremilk” describes the breastmilk at the beginning of a feeding. It is lower in fat and higher in lactose than the milk at the end of a feeding which is known as “hindmilk”. The lactose, when it isn’t balanced with fat, moves through baby’s digestive system very quickly and can result in green poop. Sometimes this happens when mom has an especially forceful letdown or she has an overabundant supply of milk and baby isn’t getting the higher fat content hindmilk. If baby is otherwise healthy, happy, and gaining weight, nothing needs to be done. If baby is having trouble latching or staying latched, or isn’t gaining weight as expected then talking to a La Leche League Leader or other lactation specialist can help you find a solution to balance your supply and baby’s intake.

Green mucousy poop is a sign that baby’s intestines are irritated. If baby is still happy and eating and sleeping normally, then you can probably wait a day or two to see if things get better. If the poops return to their previous colour and frequency, probably baby had a mild virus or a reaction to something in mom’s diet. Teething may also be the culprit: When baby swallows a ton of drool, it can irritate the intestines and cause some mucus in the poop.

Green watery poops with a foul odor can be a sign of diarrhea, especially if they are much more frequent than usual. Baby diarrhea can be caused by a virus, infection, stress or food intolerance. Babies can get dehydrated quickly when they have diarrhea. In this scenario evaluation by a doctor is a good idea.

Link to: Some Common Concerns When Storing Human Milk  http://www.lalecheleague.org/nb/nbjulaug98p109.html

 

http://www.lllc.ca/thursday-tip-explaining-green-breastmilk-and-green-baby-poop

 

 

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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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!

newborn

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Easier Breastfeeding the Second Time Around

There are many women who will tell you their early breastfeeding experience was easier with the second baby. In particular, they will say that they had better milk production. Some of this ease of breastfeeding the second time around is undoubtedly due to mother being more relaxed, already having experience recognizing baby feeding cues and knowing how to get baby to latch on well. New research indicates that these anecdotal stories may also have a scientific basis to back them up.

Camila dos Santos of Cold Spring Harbor Laboratory in New York and her colleagues looked at the mammary tissues of mice prior to pregnancy, during and after first pregnancies, and again during and after subsequent pregnancies. In their research, they confirmed that pregnancy is the key change agent for the mammary gland.

During the first pregnancy, as any pregnant woman can tell you, there is a tremendous expansion of cells within the breast tissue. The pregnant and lactating breast has alveoli (hollow cavities, a few millimeters large) lined with milk-secreting cells and surrounded by epithelial (surface) cells. The alveoli join to form groups known as lobules. Each lobule has a duct that drains into openings in the nipple. The results of the dos Santos study showed that many of these cellular changes to the alveoli and epithelial cells created during the first pregnancy are maintained after the first period of lactation has ended.

When the test mice became pregnant for the second time the mammary tissues responded to the pregnancy hormones more quickly than during the first pregnancy. The mice were also seen to create additional alveolar structures and additional epithelial cells during the second pregnancy. This increase in cellular structure enhances the body’s ability to produce mature milk and produce it more quickly. The researchers suggest that the cellular “memory” from the first pregnancy primes the body for mammary function in the future.
family and newborn


Looking at this “lactation cellular memory” from a human evolutionary
perspective, it has a clear advantage. The mother with her first baby has more time available to spend feeding the baby. When baby #2 (or more) comes along the mother needs to be able to feed the baby and keep up with the needs of older children. Those mothers who had the ability to produce a greater milk supply for subsequent babies had the greatest likelihood of their genes being passed on to the next generation.

This study gives hope to mothers who struggled with milk supply with their first babies and provides another layer to the explanation why there was more breastmilk the second time around for mothers who have already had a second baby.

Even though your breasts will be primed for increased milk supply with baby #2, there is always value in getting encouragement and information from a knowledgeable breastfeeding supporter if you are currently struggling with breastfeeding or if you are expecting a second baby and struggled the first time around.

http://www.lllc.ca/thursday-tip-factors-may-make-breastfeeding-easier-second-time-around

 

 

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.

Birthnewborn

 

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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Our Christmas Baby

Our Christmas baby was born 34 yrs ago.  She was premature by a little more than two weeks and having a baby come early was definitely not in our plans.  We were going to celebrate Christmas with my parents and family in Edmonton then Grandma and Grandpa would come down to help get ready to greet our new baby.

However, during the night my waters broke.  By then, our 2 1/2 year old son was cuddled in with us and he heard me tell his dad that it was time.  I was amazed how he woke up in a flash, reminding me just how intensely a soon-to-be older brother/sister waits for this moment to arrive, too.  When I worried about how this can’t be happening so soon, that we weren’t ready, he rolled over gave me a big hug and patting my back said, “It’s OK Mom; everything will be OK.”  That comforted me so much.  I was able to refocus, pack our bags and find someone to take care of him while we went off to the hospital.  As has happened many times during our 36+ years of parenting, a friend from my LLLC Group came to our rescue.  She had 4 young boys and one more staying over was just fine for them. Our brave little trooper, who had never been away from us overnight, cuddled up with her on the couch reading stories, napping and spent the day happily playing until his new baby sister was born.  She arrived in the birthing room just before sunset.  The soft winter sunlight coming in through the window at that time of day always reminds me now of those peaceful moments after birth with her, her dad and me snuggled up in bed.

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We didn’t get to rest too long, though, as the hospital was discharging anyone who wanted to leave in order to reduce staff over the holiday.  What were we going to do now?  I really wanted to go home but the house was not ready nor food in the fridge to celebrate Christmas.  I totally surprised my husband when I asked him to pack up the car, bring our big down comforter, emergency kit plus snacks and we were on the road heading to Edmonton.  Our precious two slept all the way there.  We arrived much to everyone’s surprise on Christmas Day morning with our newborn.  My family pampered us for the entire holiday week with lots of care, attention and food to eat.  It was perfect and truly “everything was OK”.

Happy holiday!

 

http://www.lllc.ca/christmas-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/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.

BF family

 

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.

skin to skin-cropped

 

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.

Newborn

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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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.

Leave a comment »

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