Supporting Breastfeeding

La Leche League Canada

Breastfeeding Triplets

My breastfeeding journey began when I gave birth to my first daughter, Tayla. I was 21 years old and completely naive about breastfeeding. I had no role models, support or information, I just somehow knew I was going to do it. My nipples were inverted and I had no help or advice with latching so ended up with severely cracked nipples. I called La Leche League for help with latching, then expressed milk for a week or so until my nipples were healed and then carried on with breastfeeding. She selfweaned at 13 months, which I was sad about, but I was pregnant with number two and I thought I would breastfeed her forever. I had no problems at all with feeding the second time round but Dyani too self-weaned at 13 months.

Fast forward 21 years and I met my husband, Jason, who hadn’t ever had children but still hoped that he could, so I agreed (to just one!). We were understandably terrified when we found out I was pregnant with triplets, but again the idea of doing anything other than breastfeeding never crossed my mind. We found out that triplet mums can access a year’s free supply of formula but I still wasn’t interested.

After a problem free pregnancy I made it to 34 weeks. Two days before I was booked for a Caesarean, my body had other ideas and I went into labour that night. Our babies were born via Caesarean on the 22nd of November, 2011. Willow was 2kg, Connor 2.5kg and Summer 2kg. They all went straight into the NICU but were actually really healthy and big for triplets. I got to cuddle Connor the next day, Summer the day after that and Willow the day after that.

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I don’t think anyone at the hospital expected me to breastfeed because I had to ask someone 12 hours later, if they were able to get me a pump or show me how to get started expressing colostrum. A nurse then showed my husband and I how to express colostrum into tiny 1ml syringes. We got our first 1ml and I said “but there’s three of them, we can’t make them share 1ml!” So I expressed two more for that day, the next day I got 9ml, the next day 15 little syringes made their way into the NICU! Then I began pumping, every three hours day and night and within two days I was pumping about a litre a day, which became two litres within another week.

After a week I got to try breastfeeding Connor, who was the biggest and strongest. To breastfeed, a baby needs to co-ordinate sucking, swallowing and breathing all at the same time and this reflex doesn’t usually kick in until about 35-36 weeks gestation, but I wanted to at least be putting the babies to the breast, even if they weren’t latching at first.

My nipples seemed huge next to their tiny mouths and I wondered how they would ever get the hang of it but one by one, they all did. I would nurse them while they were getting a feed of expressed breastmilk through their NG tube, so they would learn the feeling of a full tummy and associate it with sucking. Gradually each of them started getting a full feed from me. After two weeks and four days, all the babies were taking a good feed from me and so we were allowed to graduate to the parent room. It’s like a motel room where you have your babies with you day and night and you do it totally on your own before going home…but with the nurses just down the hall.

The babies had to gain weight before we were allowed to go home and on just the second morning we had gains of 40g for each of the girls and 60g for Connor. So although it felt like a lifetime, after just three weeks we all went home.

My husband and I had no idea how we were going to do this – feed three babies all day and night – so we had to come up with a plan. For a start, I know that breastfeeding is all about supply and demand so we went against all the triplet parent advice and had no schedule for feeds. I refused to wake them for feeds if they slept longer than three hours and I refused to leave anyone to ‘self-soothe’ if they wanted feeding more often. Our first plan was that we would both get up to all of the babies all through the night, Jason would change and burp and I would feed.

After only four nights we realised that neither of us was getting any sleep so we switched to Plan B which was hubby took the 9pm to 2am shift and I did the 2am to 7am shift. I would pump so that he could have milk to feed them during his shift, and I would just breastfeed. Soon we realised that the 9pm to 2am was the ‘screaming’ shift and it wasn’t working again so we moved to Plan C. This was where I took Connor into our bedroom and co-slept with him and breastfed him all night (and pumped after every feed). Jason slept in the nursery with the girls (it was big enough to fit three cots and a queen bed), and would give them my expressed breastmilk.

This plan is still the one that we use now, the girls are better sleepers than Connor and wake much less frequently for feeds and I can do dream feeds with Connor so we are all getting as much sleep as possible. During the day all the babies are breastfed, and I get a break from feeding two of them between 9pm and when they wake at about 5am.

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Before I had the babies, I talked to another mother of triplets who breastfed for six weeks and she suggested either breastfeeding two and giving the third a bottle of formula, then rotating who got the formula each feed, or feeding one baby one side, the next baby the second side and by the time you get to the third baby the first side is full enough again. I decided I would try the second option. I have always had a great milk supply, and after reading about wet nurses in Victorian times who would feed up to six babies I figured I could definitely do three!

When the babies first came home they had no awake time, they woke for a feed and then went straight back to sleep. Each baby would take around 20-30 minutes for a full feed, so by the time I got to the third baby, the first breast was full again. Then as they got older, their feed times got shorter but my body was already in the swing of how much milk was needed so I’ve never had problems with supply. In the evenings they often cluster feed and I could do 12-15 feeds in three hours! An average day of feeding would be 24 feeds, add in cluster feeds AND growth spurts and some days I was doing upwards of 33 breastfeeds!

I can and have done tandem feeds but I find that it’s nice to have at least SOME one-on-one time with each baby, and also a tandem feed with another feed straight away gives me no time to get full again. Because they are all demand fed it’s not very often that all three are hungry at the same time anyway so it’s actually easier than what you might think.

In the beginning there were eight bottles in the fridge that I had to fill each day for that nights feeding and now the girls may only need one or two feeds each, so I only have to pump once a day to get the 500- 600mls needed for that which also saves me time.

It’s wonderful to be able to do this for my babies and I get a lot of supportive comments from people but it is hard to find support with other triplet mums doing the same thing because no-one is breastfeeding. I have asked around in our triplet circles and none of them breastfed past six weeks (if at all), and they were all supplementing with formula from the beginning. So I get my support for multiples from the Multiple Birth Club, and breastfeeding support from various breastfeeding pages/ groups on Facebook. I do get out quite a bit with the babies but only for short walks, it is nearly impossible to meet up with other people face to face so online support is awesome. Also, as there is always another baby to feed/change/entertain, anything that is online is easy to stop and restart, as opposed to a phone call.

My babies are now ten and a half months old, they have two or three meals of solids a day and are still having six to eight breastfeeds as well. At nine months they all weighed in around 8kg so they have grown exceptionally well. Given that we started out with a fair amount of disbelief, little support, a c-section, separation from my babies, unable to actually breastfeed for two weeks, and of course the fact that there are three of them…it’s amazing how far we have come!

It’s now my mission to let other mums know that it is possible to exclusively breastfeed triplets, and while it is a full-time job, it is very rewarding!

By Davina Wright
Used with permission from LLL New Zealand, Aroha: Three Babies, Two Breasts http://www.lalecheleague.org.nz/Websites/laleche/images/PDF_Downloads/Aroha_articles/Aroha_vol_14_iss_5_Three_babies,_two_breasts.pdf

 

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. Your donation is essential and very much appreciated to help LLLC cover the cost of producing breastfeeding resources: https://www.lllc.ca/donate or become a LLLC Friend http://www.lllc.ca/join-lllc-friends

 

PLEASE REMEMBER LA LECHE LEAGUE CANADA ON GIVING TUESDAY NOVEMBER 29, 2016

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Breastfeeding With Diabetes

 

My first daughter, Katharine, was born four-and-a-half years ago. She literally kicked her way out of my womb, and my husband says when he saw her face for the first time, as she screamed at the top of her lungs, he felt a sense of fear: she was a force to be reckoned with. Katharine was demanding in every way, not the least of which was nursing. I was determined to nurse her exclusively for as long as possible. I have been an insulin-dependent diabetic for 15 years, and I knew that nursing her would reduce the risk of her getting diabetes but it was a challenge from the start.

Katharine wanted to be at my breast all the time. She rarely napped for more than half an hour. Like many needy babies I’ve learned about since then, she wanted to be held, comforted, and nursed most of the time. It seemed as if I never had enough milk for her. I remember one day when she was three weeks old, I had had her on my breast for five hours without more than a couple of 15 minute breaks all afternoon. At 5:30 PM, my husband, Lazaro, walked through the door and I burst into tears. I was exhausted, mentally, emotionally, and physically. We decided to give her a bottle of formula. After four ounces, she was finally contented and peaceful and she slept for the first time all day. I felt so inadequate as a mother. That day was truly a low point but, luckily, things became easier after that. I persevered, determined to nurse Katharine exclusively. Slowly but surely, my milk supply began to increase to the point where, at three months, she was satisfied and happy.

Katharine weaned at eight months, earlier than I wanted but I was happy that it was her decision. Today, Katharine is an incredibly bright, healthy four-year-old who speaks fluent Spanish and English and is a joy to behold. She is (and always will be, I’m sure) demanding, energetic, and often difficult.

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My baby, Elizabeth, is just the opposite. She was born just over a year ago and her laid-back disposition was evident at birth, just as Katharine’s fiery personality was. Elizabeth has always been easy but when she was four days old I feared she was too easy. She was simply sleeping too much and not as alert as she should be. I knew something was wrong but I didn’t know what. My LLL Leader, Faith, was the one who noticed Elizabeth’s jaundiced appearance. Faith told me not to worry but to be sure and wake her frequently for feedings. I was worried and called my pediatrician, who was my husband’s cousin and godmother. When I described the jaundice, she said immediately, “Stop the breast. She has breast milk-induced jaundice. Give her formula. If you insist on breastfeeding, give her lots of bottles of water.” I knew from reading baby-care books that that type of jaundice was extremely rare and didn’t appear until two weeks and my baby was only five days old. My mothering instinct told me that what my baby needed was more of my milk, not less. I had read that giving her bottles of water would make her jaundice worse by starving her of the calories she needed. I decided to take my baby out into the sunlight and breastfeed her as much as possible. To my husband’s family’s horror, I decided to find a new pediatrician, one who would support my commitment to breastfeed my baby exclusively.

Elizabeth improved and within a few days was healthy and gaining weight like crazy. She did not have a drop of formula from the day she was born until she was ten months old. Even though I went back to work part-time when she was six months old, I had built up a supply of frozen milk from the early weeks by pumping every morning.  Elizabeth began to wean last month (at thirteen months) and is incredibly healthy.  I am so grateful that I had Faith’s support and counsel and that I had the determination to do what I knew was best for my baby – to give her my milk.

 

By Lauren Priegues

Used with permission from LLL USA http://www.llli.org/nb/nbmayjun00p84.html

Readers should remember that research and medical information change over time.

 

NOVEMBER IS DIABETES AWARENESS MONTH

 

 

 

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. Your donation is essential and very much appreciated to help LLLC cover the cost of producing breastfeeding resources: https://www.lllc.ca/donate or become a LLLC Friend http://www.lllc.ca/join-lllc-friends

 

 

 

 

 

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Second Time Around

As I sit here breastfeeding my second daughter, Niamh, I am so thankful that I became a part of my local La Leche League group. Without the support, information and contacts of the group, my second breastfeeding experience may not have been so positive.

Like my first, my second pregnancy was hard won, though took less time to achieve than my first (two years to conceive as opposed to five for my first). As my older daughter was born prematurely at 30 weeks, we were thinking this time would be similar; the reason for the premature birth was due to my uterine anomaly (Uterus Didelphys) and reduced kidney function, as I only have one kidney and less room in my uterus for the baby to grow. So as soon as I found out I was pregnant again, I started taking low dose Aspirin pills and calcium pills daily. I found an independent midwife who had experience with high risk pregnancies, and was referred to the Obstetric team at Waikato Hospital, who wanted to see me when I got to 20 weeks gestation. From 24 weeks gestation, I was injecting myself daily with blood thinners (Clexane); my impaired kidney function (resulting in protein in my urine) and my age made me higher risk for blood clots in pregnancy. I had to continue this until six weeks after Niamh was born. It wasn’t something I’ve done before, and not being that fond of needles, I certainly didn’t enjoy it, but I tried to shut my brain off and “aim and stab”.

When the pregnancy got to, and past 30 weeks, I was almost just waiting for something to happen. I was having fortnightly blood and urine tests to monitor my kidney function. The levels were worsening, but so far manageable. I noticed on the weekend when I was 33 weeks pregnant, that my face/neck looked a bit swollen and puffy. It became more noticeable the following day. So I contacted my midwife and she got me in for a blood pressure check. My blood pressure was fine, but she wanted me to have a blood test done along with my fortnightly kidney function tests which were due that day. My midwife phoned that evening and said my kidney function results had deteriorated in the past two weeks, so I needed to go to Women’s Assessment Unit to be admitted for observation.
I was admitted to hospital on the Monday night. On the Tuesday my Obstetrician came to see me and said she wasn’t happy with the test results, and that she would rather deliver my baby now to preserve the kidney function I had. The Renal specialist wasn’t quite so concerned, but after much consultation between the two specialists, it was decided that my baby would be delivered by elective Caesarean section first thing Wednesday morning.

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Fortunately this time I was awake for the delivery (my older daughter was born by emergency c-section with me under general anaesthetic), so it was quite a surreal experience having open abdominal surgery while still awake. It was all very leisurely and relaxed, even though I felt on edge. I got to see my baby briefly as she was taken across to the resuscitation table, then again as she was taken out to the Neonatal Intensive Care Unit (NICU). I got to see her properly for the first time two hours later, when I’d been given the all clear from recovery. I was wheeled on my bed down to NICU and Niamh was taken out of her incubator to have a skin-to-skin cuddle with me. She was on Continuous Positive Airway Pressure (CPAP) to help her breathe. Even though I had been given steroid injections a week before to help mature her lungs for a potential premature arrival, because it wasn’t her that initiated labour, her lungs hadn’t had time to start adapting to life outside.

As I had been through the premature baby experience before, I knew I needed to start hand expressing colostrum for Niamh to be fed through her feeding tube. My midwife helped with the hand expressing on day one, I think the first syringe was only 0.1 ml of colostrum. Most of the rest of that day was a blur as I was dosed on pain medication. By day two, my hand expressing was getting a bit more volume. On day three I started using the electric pump.

Niamh was being given small amounts of my milk as it was available. She was also on a glucose drip to keep her blood sugar up. As she tolerated the milk, her volumes were increased, and the glucose reduced until she was only on breastmilk by nasal gastric tube.
She was able to come off CPAP on day five, and was put onto high flow oxygen to give a little bit of assistance. Day six was a milestone day, I was discharged from hospital, (which is one of the hardest things I’ve now had to experience twice, with each of my children, leaving my baby in the hospital), Niamh went off any breathing support and was maintaining her body temperature, so could come out of the incubator and into a cot (and into clothes!).

With my first daughter, pumping every three hours in the day and once overnight didn’t result in enough volume, so this time I was pumping every three hours in the day and twice overnight, setting an alarm to wake me to pump. The amount I was expressing wasn’t great, but was slowly increasing every day. While Niamh was in NICU I was only just keeping up with her scheduled feed demands, which put stress onto the expressing, and needing to get enough to feed her. I was also getting incredibly painful nipples from expressing; the breast pump fittings didn’t seem to fit me properly. A Lactation Consultant let me have a different type of fitting, and we bought another one the same so I could double pump, which helped immensely. I also hired a hospital grade double pump for using at home, to try and maximize the output and speed up the pumping sessions.
I knew from my time expressing with my older daughter, that I got a larger volume of milk after I’d had skin-to-skin cuddles with her. After reading up on the topic during my second pregnancy, and having a midwife who was very pro active in getting her clients to do skin-to-skin, I made sure that every day I spent at least an hour with Niamh skin-toskin. I only had to justify it once to a NICU Nurse, who suggested that Niamh would be “better off back in her cot”. I explained to her that I needed to have skin-to-skin cuddles with my baby, as it helped build my supply.

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When she was a week old, I tried our first breastfeed (she was 34 weeks gestation corrected age). She didn’t latch at all, and fell asleep at my breast, which wasn’t a surprise but I continued to try each day during our time spent skin-to-skin. One of the nurses gave me a nipple shield to try; they said that she was probably struggling to latch on because her mouth was so small. This made no sense to me, as my older daughter, who was more premature, had launched herself at my nipple when she was 32 weeks gestation corrected age, and started sucking. So I knew if a smaller baby could do it, then it was definitely possible. But I tried it, and it did seem to allow Niamh to have a deeper latch so we started using the nipple shield for every breastfeed attempt. I did notice that she had a dip in the end of her tongue, that made it kind of heart shaped, and remembered that being mentioned in a book one of my group leaders had lent me, called Making More Milk*, in relation to tongue ties, but I thought nothing more of it. I guess I assumed the NICU nurses would identify if there were any reasons why feeding wasn’t happening as it could be.

To be discharged from NICU, Niamh needed to be fully suckle feeding (breast or bottle), and gaining weight. So that became my goal. At just over two weeks old, I asked the charge nurse if I could try demand feeding Niamh when I was at the hospital, at my breast only without giving any expressed milk through her nasal gastric tube (NGT), and then see how long she went before waking for her next feed. We’d give her a top-up after the last feed I was able to be there for, to try and ensure she would last the three hours till her next scheduled feed (which the nurse would do).

She agreed that we could try this for two days, and if she had gained weight in that time, then we could room in. So I would feed her at the breast when she woke, which would be around every three hours, then pump, and then be back beside her for when she next woke. I was able to be there for four of her scheduled feeds on both of those two days, and she had gained weight during that time, so on the Saturday we were allowed to room in. Rooming in is where you stay in the hospital (they have dedicated rooms for mothers of NICU babies) and have your baby with you 24/7, and you do all the feeds and cares. If the baby gains weight during that time, you are discharged.

Our first day of rooming in, Niamh kept pretty much to three hourly feeding, at the breast with no top-ups. She was weighed the next morning, and had only gained 9 grams. My midwife said they like them to be gaining a minimum of 20 grams a day before they allow discharge. The second night we roomed in was pretty hectic. Niamh wanted to feed constantly, would scream if not feeding, screamed when trying to feed, and we both hardly slept. In desperation, I went to the nursery and got one of the NICU nurses to make up a 20 ml bottle of my expressed milk for her. I wanted to solely breastfeed, so was very upset at having to resort to a bottle at this point.

The weigh in after the second night was exactly what we needed; she had gained 22 grams so we were allowed to take her home. She was two weeks and five days old (36 weeks gestation corrected age) weighing 2,041 grams.

That should have been the end of the challenges, if my older daughter was anything to go by. I was expecting to come home, and just have her needing to feed and grow. But it wasn’t to be that straight forward.

My midwife came to see us on our first day home, she weighed Niamh, and while it was a “gain” in numbers, when she factored in Niamh’s vest and nappy and different scales to the NICU ones, the “gain” was actually very minimal. She then checked in Niamh’s mouth and said that she was fairly certain there was a tongue tie and that we should consider whether or not to have it snipped. I took her to the hospital the following week, where the Lactation Consultant confirmed a type 3 tongue tie, and she snipped it.
My midwife came to see us at home over the next few days. Niamh continued to gain, but incredibly slowly, with barely 10 grams a day, which my midwife was concerned about. So she suggested that we start supplementing with my expressed milk, and that I pump after as many feeds as possible to build up supply. The hope was that once her tongue tie was snipped, feeding would improve, and supply would improve.

So I started pumping after every feed, I was already taking several different herbal supplements, taking the medication Domperidone, and doing breast compression while pumping. We re-hired the double pump for a month, and I would double pump, then single pump each side while doing compressions, after every breastfeed. Yet the amount I was expressing didn’t seem to be increasing.

Since I wasn’t producing enough extra milk to meet the amount suggested by my midwife, I had to make a decision on what to do; Niamh wasn’t gaining weight well, though she wasn’t quite deemed “failing to thrive”. Our options were to use either donor breastmilk or formula to make up the shortfall for top-ups, until my supply increased and Niamh got stronger at feeding. I wanted to avoid using formula this time, as I had used it for one bottle a day with my older daughter, and wanted to trust that my body would do it this time. I discussed milk donation with my husband, and we decided we’d try. Through some contacts we found two mothers who were happy to donate milk to Niamh. I didn’t need much as the potential shortfall was only around 20-50 ml a day but it was a massive relief to have the donor milk available. I could now focus on trying to build my supply, knowing I had a back-up option ready and waiting if needed. In the end, I only needed to use 100ml of it; with a frequent pumping schedule I managed to just keep my expressing (and Niamh’s weight gain) on track.

 

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During all of this, I was still pumping after every feed. We decided to do the night feeds solely by bottle to try and maximize sleep. My husband would feed Niamh, and I would pump. We had to set an alarm to wake us up so we could feed her, as she wasn’t waking on her own, and with minimal weight gain, she couldn’t afford to go too long without feeding. I was getting increasingly concerned about my supply, as I was struggling to get 50 ml in total during these night time pumping sessions. When I was doing the same for my older daughter, I was getting 100 ml. I continued on with the galactogogues, Domperidone, and herbs, which had helped before, but nothing seemed to be working this time. It was then that my group Leader asked me what medication I was on, so I said only the blood pressure medication, Enalapril. That was our Eureka moment. My group Leader had consulted with Alison Barrett (IBCLC, Obstetrician), who found information which stated that when post-partum women were put on Enalapril (an ACE inhibitor) in the first 12 weeks, their breastmilk production could be impacted, with prolactin levels being reduced by 20%. The studies she looked at suggested this would happen at a dose of 20 mg/day, which is what I was on. So I then swapped my medication back to the pregnancy safe Labetalol, and the change was incredible. The day after I stopped taking Enalapril, I got 80 ml during my night time pumping sessions, then the next night I got 100 ml, then 120 ml. The blood pressure medication was the cause of my shocking supply. It also explained why I could pump the most volume in the late afternoon, but very little overnight, as I was taking the pill at night before bed, and by the afternoon it had worn off.

That wasn’t the only challenge we faced. Two weeks after Niamh came home, she started showing signs of Gastroesophageal reflux. My older daughter had had reflux, and was on medication for it until she outgrew the need so I recognised the symptoms immediately. We were checked at the hospital to make sure there were no physical issues at play, and were given the all clear.  So in addition to pumping after every feed, I now had a baby with reflux who would scream in pain after every feed, didn’t like to lie down flat, and had to be held upright after every feed for 20-30 minutes to try to keep the milk down.

I knew that in many instances reflux could be a result of physical issues, so I had my Osteopath treat her. She helped with realigning her body, though it didn’t appear to help the reflux. The Osteopath did however improve her breastfeeding. Even after her tongue tie was snipped Niamh still couldn’t poke her tongue out. But once the Osteopath treated her tongue, she instantly poked it right out, and could latch without a shield.

I then wondered if the reflux may be caused by food sensitivities as I had discovered while pregnant that I had sensitivities to certain foods. After keeping a food diary for a week, and noting what foods I’d eaten, and any symptoms I experienced, then what symptoms Niamh had, I was fairly sure that wheat and dairy were issues. When she was two months old I took her to my Naturopath, who tested her, and identified all the foods she is sensitive to, which along with my suspicions of wheat and dairy, were; gluten, soy, beef, pork, peanuts, cashew nuts and yeast. So I then cut them out of my diet, and within a few days, she was no longer screaming in pain after every feed, and we stopped medicating her for reflux.

Her growth has continued to be in the realms of “slow and steady”, with a predictable 20 grams a day. She is happy and healthy in all other respects, and developing in line with her corrected age.

I later discovered that she had an upper-lip tie, and that some of her tongue-tie had either come forward or reattached, as she regained the dip in her tongue. Breastfeeding was becoming uncomfortable as she was not able to latch properly and couldn’t flare her lip out. We subsequently had it revised by laser and her latching and feeding is greatly improved.

It has been an interesting and stressful learning curve, and while some of the aspects of our journey together are similar to the experience I had with her older sister, there are many more that are different. My husband was a wonderful support, and he took over a lot of things like doing the pre-school run with our older daughter on the two days she went, and keeping the house running.

With the difficulties that we’ve experienced, if Niamh had been my first child, I do wonder if I’d have been able to overcome them or find the support to work through them. I only discovered my local La Leche League group when my older daughter was 13 months old. Through the information I’ve gained (from the group meetings and group library books) and the support of the Leaders and other group members, I am pleased to have overcome our difficult start, and gone on to have another rewarding, loving breastfeeding relationship with my child.

* The Breastfeeding Mother’s Guide to Making More Milk, by Diana West, may be in your local LLL group’s library, and is also available through lllc.ca on Chapters Indigo.

 

by Alison Stacey
Used with permission from LLL New Zealand http://www.lalecheleague.org.nz/Websites/laleche/images/PDF_Downloads/Aroha_articles/Aroha_vol_15_iss_4_Second_Time_Around.pdf

 

 
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. Your donation is essential and very much appreciated to help LLLC cover the cost of producing breastfeeding resources: https://www.lllc.ca/donate or become a LLLC Friend http://www.lllc.ca/join-lllc-friends

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Weaning

I have often heard the definition of weaning as ‘to be satisfied’ and in my experience I think this is true. With my first baby, Matthew, I was an exhausted new mother trying desperately to do everything right. He had latching trouble that even experts struggled to identify, and because of my split bleeding nipples, he spent a week drinking expressed milk.

 
Twelve years on I still bear the scars. When Matthew had just turned one, we went out of town to visit family. On one occasion his cousin who had just turned five was present, and as the evening wore on, his mother took him on her lap, breastfed him, and he fell asleep. Until then, my point of reference for nursing duration was two years, as this is what had been the norm when my mother breastfed my brother. I was not shocked, but I was surprised. And several things went through my head – one being that I wouldn’t do that, quickly followed by a reminder that I probably shouldn’t rule anything out.

 
Matthew and I enjoyed a happy breastfeeding relationship for over four years. I became pregnant with baby number two when Matthew was thirteen months old, so embarked on a journey into nursing when pregnant and then tandem nursing. Aidan was an enthusiastic feeder, and we experienced none of the troubles I had the first time. Tandem feeding worked well for us, as it meant that while the newborn fed, I also knew exactly where the toddler was.

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When the boys were four and two years old respectively, I found I was pregnant with their sister. This time around, breastfeeding while pregnant was a bit too much. It was painful, and I decided that the boys should wean. I discovered that weaning a four year old and weaning a two year old are quite different experiences. When Matthew was four and a half, we exploited the idea of this ‘half birthday’ to bring our breastfeeding relationship to an end. We made it an event. He had a special dinner to celebrate that he was moving onto the next step. This situation showed us that although the child didn’t make the choice about weaning, he was old enough to participate and cooperate in someone else’s decision about him. Breastfeeding is a relationship, and the fundamental shift in it meant something had to change, a compromise had to be reached, and an effort made for everyone to be protected.

 
And we succeeded.

 
A few months later I found breastfeeding Aidan (then aged two and a half) was too painful, and I felt that he, too, would be old enough to handle weaning. I was wrong. He became upset, toilet training regressed, and he was not a happy boy. All I could do was make the best decision I could at the time, and my levels of physical discomfort with continuing to feed him overrode his distress. I had to find ways of ‘other mothering’ – and fathering; this was a point where his father came into his own with comforting. Looking back now, I do regret weaning him at that stage. During this time we moved house, and he would have had a vague knowledge that big changes were afoot with my growing belly. But I can only acknowledge that at the time I thought it was best for all of us, and use the experience to learn from.

 
In October 2006 we welcomed our first baby girl, Fiona. Breastfeeding went smoothly and she enjoyed it for many years. In 2008 we found we were expecting another baby in February 2009, and so embarked yet again on a tandem feeding journey. Breastfeeding while pregnant was fine, and tandem nursing turned out to be a real bonus.

 
Joel had lots of problems latching, and would simply drink milk from my initial letdown, and then fall asleep. He would take in adequate quantities of milk to keep hydrated, but not enough to put on weight. Days and weeks of stress blurred together as we tried all sorts of techniques to get volumes of milk into him, and to get him feeding at the breast again.

 
The real bonus in all this was that Fiona (two) was still an enthusiastic feeder, and she aided in keeping my supply up. Even through the fraught early days with Joel, it was comforting to be able to nurse her to sleep in the middle of the day.
By six weeks old, Joel was back on the breast, his weight gain had picked up and everything was going smoothly. Our tandem feeding relationship carried on for several years without event.

 
In 2010 we were approached by the makers of the TV series 20/20 to participate in a piece about ‘extended’ breastfeeding. Knowing that features about extended breastfeeding often lurch into sensationalism, it was a risky move. But the producer and presenter were reassuring, pleasant, polite and non-judgemental. We spent several days having our family filmed and I did an interview to camera. At the time Fiona was three-and-a-half and I talked about her weaning in about a year. Of course this again came back to my own cultural references. I had pushed past my original social norm of two years old, and created my own.

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Time passed and breastfeeding changed with age and stage. As our children grew we changed our approach. At around two years old I stopped breastfeeding them to sleep and co-sleeping, and we initiated ‘Daddy Intervention.’ This was an approach to get them to fall asleep in their beds, and Daddy would be the one to return them there if they woke in the night. They were still welcome to breastfeed during the day, and there is still nothing like a breastfeed to calm a busy toddler and get them to sleep.

 
In 2012 Fiona turned five and started school – and was still breastfeeding first thing in the morning. This carried on for another year. She and Joel were still both breastfeeding, coming in for morning cuddles and ‘milkies’ every day.

 
In January 2013, we moved house, and found that the dynamics of the household changed with the layout of the house. Our formerly cramped existence had meant more closeness, and our new spacious house lent itself to children heading downstairs and away from their parents’ room. Eventually, the littler ones followed suit, and not long after turning six, sometime into the new year, Fiona stopped coming in for her morning milkies, instead choosing to join her big brothers downstairs watching TV.

 
After having experience with a child who had truly weaned by her own choice, I came to understand the meaning behind weaning and why it meant satisfaction. We had both let ourselves run through the natural course of breastfeeding, and at the end, that course came to a natural close with no feelings of loss or resentment.

 
Not long after, at the age of four, Joel also began to follow his big brothers downstairs, and he didn’t come calling for his morning milk either. Initially I was surprised at this. My reference for normal nursing duration had been pushed out so far that it was almost a little jarring to have a child wean ‘so soon’ – at four years old!

 
Weaning Joel was a time of reflection. I felt I had fulfilled this part of my parenting journey well. I did have some regrets, but overall had done the right thing. And that wasn’t dictated by books or other people – it was by watching my child in the context of his family group and his needs. Breastfeeding started out as a momentous event. Something that took over our lives and our time and our minds, but eleven years later as that time came to an end, it was just a quiet slipping away. A need now sated and an emotional belly now full.

 
It was satisfaction.

 

by Donna Henderson
Used with permission from LLL New Zealand http://www.lalecheleague.org.nz/Websites/laleche/images/PDF_Downloads/Aroha_articles/Aroha_vol_16_iss_1_Weaning.pdf

 

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. Your donation is essential and very much appreciated to help LLLC cover the cost of producing breastfeeding resources: https://www.lllc.ca/donate or become a LLLC Friend http://www.lllc.ca/join-lllc-friends

 

 

 

 

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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.

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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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Low Milk Supply and Breastfeeding

The most common questions La Leche League Leaders hear on phone calls, e-mails and at meetings are about milk supply and generally they are about the mother’s perception that she doesn’t have enough milk for her baby(ies). There are a lot of reasons that mothers may think they don’t have enough breastmilk which are not a low supply problem at all.

Here are some tips to help you sort out what is going on:

  • You don’t necessarily have a low milk supply if baby won’t go the X number of hours between feedings that your baby book, mother, friend or health care professional says they should. Normal babies sometimes feed every 2 hours but they can also want to feed again after 20 minutes or 45 minutes or… if they are having a growth spurt they may want to feed every hour for a few days. They may cluster feed and then sleep for a longer stretch (this often happens in the evening). All of these feeding spacings are normal and a baby might do all of them in one day or over the course of a week.
  • You don’t necessarily have a low milk supply if your breasts aren’t leaking anymore or if they feel softer than they used to. Around six to eight weeks after giving birth, your breasts will no longer have the excess of lymph and blood flow that they had in the early days and they will feel softer. Some mothers never experience leaking and for those who did have leaking, most find the leaking episodes decrease as their bodies get used to breastfeeding.
  • You don’t necessarily have low milk supply because you have small breasts. The size of your breasts has very little to do with the amount of milk making glandular tissue. If your breasts grew during your teen years and grew again during pregnancy then it is very unlikely that you don’t have sufficient glandular tissue to support breastfeeding.
  • You don’t necessarily have low milk supply because your baby won’t stay asleep if you put them down after a feeding. Babies often drift off to sleep at the breast and then wake up the minute you put them down. This happens because babies are happiest in their favourite environment (your chest). Many babies also like to take a short break, have a little nap, and then come back for the second breast. This is normal.
  • You don’t necessarily have low milk supply just because your baby will take milk out of a bottle right after you have breastfed. The sucking reflex is so strong that babies will take milk if a bottle nipple is put in their mouth even if their tummies are full.

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There are two things that may indicate that you that you have a problem with low milk supply:

  • Weight gain problems: Babies almost always go down from their birth weight. Most babies have regained birth weight by two weeks and then continue to put on 150-200 grams per week. There can be some variation so getting support from someone who has a thorough understanding of breastfed baby growth rates and breastfeeding technique is important if you have concerns.
  • Diapers: After the first week, we expect to see 6-8 wet diapers per 24 hours and several poops that are at least big enough to cover about 2.5 cms. If this is not what you are seeing when you change baby’s diapers then it is time to follow up with someone knowledgeable.

If you feel that you might have a low milk supply, or baby isn’t happily feeding, or for anything else about breastfeeding that concerns you, contact a La Leche League Canada Leader to help sort out how to deal with your breastfeeding/caring for a newborn challenge. Breastfeeding isn’t always easy, we’re here to help.
http://www.lllc.ca/thursdays-tip-breastfeeding-and-low-milk-supply

 

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/.

 

https://supportingbreastfeeding.wordpress.com/2014/09/22/establishing-your-milk-supply/

https://supportingbreastfeeding.wordpress.com/2015/03/09/how-to-know-your-breastfed-baby-is-getting-enough-milk/

https://supportingbreastfeeding.wordpress.com/2013/08/19/newborn-feeding-patterns/

https://supportingbreastfeeding.wordpress.com/2016/01/18/newborns-have-small-stomachs/

https://supportingbreastfeeding.wordpress.com/2015/06/08/why-does-my-baby-cry/

https://supportingbreastfeeding.wordpress.com/2014/03/31/crying-and-breastfeeding/

https://supportingbreastfeeding.wordpress.com/2015/03/16/tracking-newborn-weight-loss-in-breastfed-babies/

https://supportingbreastfeeding.wordpress.com/2014/08/04/tips-for-breastfeeding-success/

http://breastfeedingtoday-llli.org/what-your-baby-knows-about-breastfeeding/

 

 

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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Tracking Newborn Weight Loss in Breastfed Babies

 

One of the biggest sources of stress for parents in the first days of baby’s life is wondering how much weight baby has lost compared to his/her birth weight. Most exclusively breastfed babies lose some weight and we know that this is normal. What hadn’t been clearly established was how much weight loss is normal and at what point parents and health care professions should become concerned.

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A new on-line tool for health care providers is available to help them compare the birth and current weights of an exclusively breastfed baby against the information collected from a large study cohort. This comparison will tell the parents and health care team whether the newborn has lost more weight, less weight or an average amount of weight based on how many hours old baby is. The goal of the researchers was to provide a tool that would help identify those babies who are at risk for excess weight loss so that their mothers can be prioritized for additional lactation support. Babies can be checked for problems such as tongue tie and mothers can be assisted to improve latching or encouraged to respond more quickly to early feeding cues before baby experiences any dehydration related problems such as increased effects of newborn jaundice or additional breastfeeding problems. The Newborn Weight Tool (NEWT) is available for free HERE.

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NEWT developer Dr. Ian Paul, a professor of pediatrics and public health sciences at Penn State College of Medicine and a pediatrician at Penn State Hershey Children’s Hospital stated “Although a small minority of babies do need formula, breast milk has many health benefits that have been well-documented. Hopefully by being able to know what the normal amount of weight loss is for exclusively breastfed babies, we can prevent the unnecessary use of formula.”

More information about NEWT and the research behind it is available HERE. Please share this information with anyone you know who cares for mothers and newborns.

http://www.lllc.ca/thursday-tip-tracking-newborn-weight-loss-breastfed-babies

Weight

 

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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Establishing Your Milk Supply

 

A baby’s need for milk and his mother’s ability to produce it in just the right quantity is one of nature’s most perfect examples of the law of supply and demand.  Until the mass production of artificial formula, the survival of the human race depended on mothers’ ability to produce enough milk to nourish their babies.  Establishing and maintaining an ample milk supply can be easy, as long as you understand how it is regulated.  Knowing how to avoid things that upset the balance of supply and demand is important when establishing your milk supply.  A baby who is not gaining well should be checked by a doctor.  However, knowing the following information will enable you to improve weight gain while protecting the breastfeeding relationship.

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Milk is produced almost continuously:  the more often the baby nurses, the more milk there will be.  Frequent nursing and effective sucking signal the mother’s body to produce the amount of milk her baby needs.  These are the keys to an abundant milk supply and a contented baby.  The first milk the baby gets after birth is called colostrum.  It is rich in antibodies and other protective factors.  The small quantities give babies a chance to learn how to suckle without being overwhelmed by milk.  Production of colostrum starts during pregnancy and continues even after the mature milk comes in.

The delivery of the placenta tells the body to start producing milk.  This happens whether a mother is breastfeeding or not.  By day 3-5, mother’s milk comes in and volume increases. Frequent nursing and regular removal of the milk stimulates the breast to produce more milk. Milk changes through a feeding and throughout the day to meet a baby’s changing needs. Foremilk, at the beginning of a feeding session, contains less fat and more water.  Hindmilk, later in the feeding, contains more fat and is higher in calories.  Babies need both foremilk and hindmilk to provide total nutrition

Breastfeeding early and often is one of the most important factors in getting breastfeeding off to a good start.  Babies who are allowed to breastfeed within an hour of birth and then at frequent, unrestricted intervals, help mother establish a good milk supply sooner than those who are put on a strict feeding schedule.  Newborns usually nurse about every two hours, or at least 8-12 times per day; some may nurse even more frequently.  Feeds may not be spaced evenly throughout the day.  Some babies cluster several feeds together and then sleep for a longer stretch.

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Holding the baby skin to skin on your chest calms and soothes him after the journey of birth; it can help baby to regulate temperature and heart rate.  Skin contact also heightens the hormones that naturally produce milk.  Many babies can latch more easily when they are gently welcomed to the mother’s breasts.  In fact, many babies who are held upright between the mother’s breasts respond by squirming and bobbing until they position themselves at the breast and latch on.

Allow the baby to nurse as long as he seems interested, right from the start.  It may take the milk a few minutes to let down, or start to flow, so limiting breastfeeding to a short time frame may mean the baby won’t get sufficient milk.  A baby needs to nurse long enough to get the milk flowing and also to receive hindmilk.

Offer both breasts at each feeding, especially in the early days.  A newborn should be nursing on each breast at least every two to three hours (except for, perhaps, one longer stretch at night) in the weeks when the milk supply is becoming established.  Let the baby stay on the first breast as long as he is actively sucking and swallowing to ensure he gets hindmilk.  When the sucking slows down, it will be easy for you to release the latch, or your baby may come off by himself.

Offer the second breast.  If baby is still hungry he will latch on and suckle, showing signs of active swallowing with deeper jaw motions; if not, that is alright.  At the next feeding offer this breast first.  Offer both breasts at each feed, but let baby decide if he wants the second side.

Be sure the baby is latched and sucking effectively.  Positioning the baby correctly and ensuring a good latch (attachment to the breast) prevents sore nipples and allows baby to get plenty of milk.  The baby should have a large mouthful of breast tissue; babies breastfeed, not nipple feed.  Sore nipples may be a sign of poor latch; consult a health professional or La Leche League Leader for help.  Newborn babies often become sleepy after a few minutes of sucking. Your baby will feed more effectively when stimulated with some tickles or movement closer into the breast.

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Breastfeed as often as your baby indicates the need; this is called cue feeding.  Some cues include licking lips, restlessness, rooting (turning head towards breast) or mouthing hands. Crying is a late hunger cue.  Nature intended for babies to feed frequently.  Your baby is used to being fed continuously while in the womb.  Some newborns take time to learn their own signs of hungry and full.  They might suckle for several minutes, then come off, but start fussing or rooting if you try to put them down.  Many factors, such as birth experience, maturity, human contact, and access to the breast can affect the baby’s learning.  Respond to his cues and he will learn to trust that his needs will be met; and you will begin to recognize patterns to your breastfeeding sessions.  It gets easier as you get to know each other.  If your baby regularly sleeps more than three hours between feedings and is not gaining well, he may need to be awakened for feedings at least every two hours during the day until your milk supply is well established.

The law of supply and demand also works in reverse: the less often the baby nurses, the less milk there will be.  This might happen if you try to schedule feeds 3-4 hours apart, or if supplemental feedings with formula or water are introduced.  Pacifiers, which satisfy the baby’s need to suck, can also interfere with milk supply.  However, older babies (2-3 months old) do sometimes space their feedings further apart and/or reduce the time they spend at the breast, but still gain well.  This means that they can get the milk they need faster, and mother’s supply is matching baby’s demand.

How do I know my baby is getting enough to eat?  If the baby has six very wet diapers (more if you use cloth) and three to five bowel movements, each the size of a $2 coin, per day (after 3 or 4 days old) and is not being given anything but your milk, you can see he is getting plenty of nourishment.  An older baby may have bowel movements less frequently, but they should be plentiful.  The baby will also start gaining 115-200 grams (4-7 ounces) per week.

Growth spurts or frequency days occur 3-4 times in the first 3 months as the baby matures. Allowing him to nurse on cue, which may seem like all the time, for two or three days will increase your milk supply to meet his needs.  Trust that your milk supply can adjust and increase as your baby grows.

Newborns nurse for many reasons other than hunger.  Your baby may breastfeed often because he likes the feeling of security and close body contact, because he needs to satisfy his sucking need, or because he finds the sound of your heartbeat and the gentleness of your touch a great source of comfort as he adjusts to his new world.  Meeting these needs will not spoil your baby; it will teach him that there are people he can trust to keep him happy, safe and comfortable.

La Leche League group meeting

La Leche League group meeting

 

Mothers need the support of other mothers.  La Leche League meetings can be one place to find this support; Leaders are here to help you enjoy your breastfeeding experience.  With the support of your health care provider to help you see that your baby is growing well, and the practical and moral support mothers find from other mothers, you can ensure your baby thrives on the milk your body provides.  Find out more at lllc.ca

Quick Tips

  • Breastfeed early (within an hour of birth) and often(8-12 times / 24 hours).
  • Skin-to-skin contact between mother and baby enhances milk supply.
  • Ensure baby has a good latch. (Get help if needed, especially if nipples are sore.)
  • Offer both breasts at every feeding in the early days.
  • Ensure baby is actively sucking and transferring milk while at the breast.
  • Supply and Demand—the more the baby nurses, the more milk you will produce.
  • What comes out must have gone in: 5-6 wet diapers and at least 3 bowel movements the size of a $2 coin per day.
  • Babies breastfeed for comfort as well as food.
  • A supportive network of other mothers can help smooth out the bumps in the road.

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

 

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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Overcoming Difficulties

Today I’m GRATEFUL for being able to breastfeed Melody.  After struggling for the first month I became very empathetic and understanding of each Mom I met knowing that they too had faced what I was facing.

Jacklyn S

 

After a severe case of mastitis, pumping like a poor dairy cow and the scheduling that came with it and crying as I had to give Melody formula in a bottle (this was really hard for me), I was near my breaking point and almost gave up.  Melody was labelled failure to thrive for the first month as we rushed to the hospital 3 times in a month as she wasn’t gaining…it was an awful feeling inside that I wasn’t able to feed my baby.  I was on the herbs and the meds, the cookies, the teas and wasn’t sure what to do anymore.

Thankfully our struggle was only for the first month and a half and I was blessed with a recommendation from my friend and my Aunt to contact my local La Leche League Leader.  I was soon in contact and this woman, who unpaid, came right over *.  Her payment, she says is seeing babies successfully breastfeed.  When Melody really nursed for the first time, I remember that I wasn’t the only one with tears of joy in my eyes.  My LLLC Leader was also tearing up as Melody breastfed independently for the first time.  The nurses will say don’t let them just sit there and eat/soothe but honestly, I don’t care…when I finally got that gift…I just didn’t care.

Since then, we’ve danced the breastfeeding dance everywhere possible and I’m beyond blessed that in our little valley we have so much support for Mom’s.  I just wanted to share my story so other Mom’s know the help that’s available.  My LLLC Leader was invaluable and I think every Mom should have her on call just as you would your midwife or doctor.

VanBC

As a mom, it’s unfair to sit in judgement of other mom’s choices because as I learned sometimes there isn’t a choice to make.  We all do what we can and when it comes down to it, our little ones need us to make the best decisions possible…I soon learned a happy Mom was a happy Baby.

A large number of women stood beside me in my struggles and I wanted to acknowledge all the things they did for me, including bringing me food in the hospital, coming to take me to the doctors, making me lactation cookies, bringing us food at home, going to our house to pick up clean clothes & food, always answering a text, doing grocery shopping, talking over Facebook, bringing me creams and hot packs and listening to me cry, hugging me endlessly and being there when I finally stood up again.

A huge thank you to my Aunt, my good friend for her article, and above all my La Leche League Leader, who helped me reach a goal I believed unreachable.

To all the Mom’s – thank you for sharing your stories with me, needless to say, the biggest thing is knowing you’re not alone and that whatever decision you make is the right one.

Much love, Melody and I.

By Jacklyn Szabo

http://www.lllc.ca/overcoming-difficulties

*Not all La Leche League Leaders are able to make home visits.

 

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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