Author Archives: reneeb

Guest Post: Choosing the Right Bottle for your Baby

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This is a guest post from my esteemed colleague, Amy Peterson, BS, IBCLC.  I know it will be helpful when choosing a bottle for your baby.  Thank you, Amy! Photos in the post (as in all posts on this site) are copyrighted and are used with permission from Peterson & Harmer, Hale Publishing 2009.

Which bottle is most like breastfeeding? That’s the million, make that billion-dollar question! The baby bottle industry in the United States is enormous. And not surprisingly, many of the bottles claim to be most like breastfeeding to win your dollar. Continue reading →

Bottle Feeding: Your Baby Sets the Pace!

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Dad pacing the feeding for baby.

Dad pacing the feeding for baby.

You may wonder why I have written a post about bottle feeding. After all, I am a lactation consultant. My job as a lactation consultant is, first and foremost, to help mothers and babies breastfeed comfortably and enjoyably for as long as they both desire. One hundred percent breastfeeding is often the goal. The reality is, however, that most of my clients use bottles as well—either to supplement an inadequate milk supply or as an alternative means of feeding for times when mom is separated from baby. In addition, many babies I see have challenges that make breastfeeding next to impossible until the challenges are resolved. If a baby cannot get adequate nutrition at the breast, a bottle may be a temporary solution. Bottles are a fact of life in the western world. Continue reading →

Erin’s Story: A Tongue Tie with a Happy Ending

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This story was sent to me by an incredibly determined mom. Thank you, Erin B. for sharing with the world!

My daughter had been nursing exclusively until she was 4 months old. She was always colicky, hard to nurse, and would arch her back and scream during feedings. My nipples were constantly sore. She was diagnosed with acid reflux and put on medication, but it never really helped. We had to start her on solids early at 4 months because she always seemed hungry. Then, at 5 months, she flat out refused to nurse. This time, I knew it was more than just “reflux,” and decided to go digging.

I searched high and low and came across some information regarding tongue ties and lip ties.  I immediately made an appointment with our pediatrician to have our daughter checked. He told us that she did not have a tongue tie, and that her lip tie shouldn’t affect feeding, but I had a gut feeling about it and talked to other moms and eventually found Renee–an experienced lactation consultant. (IBCLC)  

Even though Renee practiced in another city, an hour away, I made an appointment and went to see her as she has experience in identifying ankyloglossia (tongue tie). It was a wonderful experience.  Finally someone listened to me!  She was able to diagnose my daughter’s lip and tongue ties, and help me figure out how to nurse her comfortably, without pain, while waiting to have her ties revised. Renee also contacted my OB and our daughter’s surgeon to fill them in, and helped us find a wonderful body worker (Michael Hahn) to take our daughter to after her revisions.  (Note: Body work is often needed after the ties are revised to resolve any residual tightness in the jaw and other areas.)

We had both the tongue and lip ties clipped. We saw an immediate difference. A few days after the procedure we took our baby for a session of body work with Michael which helped our baby even more.  I can’t even begin to describe the difference in my baby since her ties were released, but the short of it is that she is a much more settled, content, happy baby who is gaining weight and growing much more efficiently. For the first time, I have seen her content to nurse and know what “milk drunk” looks like. Her reflux and spitting up have also vanished.

I am forever grateful to have found someone to listen to me and help me figure out how to continue to breastfeed my sweet girl. I will not hesitate to seek help again with any breastfeeding issues, and when we have our next baby, I am absolutely hiring Renee to come to the hospital!

 

Is This Medication Safe for Breastfeeding?

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“Infant formula is almost always more hazardous for the mother and baby than is breast milk with a tiny amount of medication.”

The vast majority of medications, whether over the counter (OTC) or prescription, are considered safe for breastfeeding. Still, many mothers wean unnecessarily when taking a medication. Why is this the case?

Continue reading →

Eating for Milk Supply

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Milkmakers Cookie.

If you’re concerned about milk supply, you probably already know that there are herbs, medications and even foods that can help. Herbs and medications often come with risks and side effects. But foods that help boost supply are simply foods! Foods have basically no risk and have an added benefit of increasing your nutrition and overall health!
Continue reading →

Bodywork for Baby Leah

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I got a massage this afternoon. I told the massage therapist that my shoulder and neck felt “stuck” and there were certain every day activities that I couldn’t do comfortably because the movement in my shoulder was restricted. After an hour of skilled touch, I could move again–without pain.

Sometimes babies are “stuck.” Developing in a small space, the baby may grow with a shoulder pushed up against her jaw. Or with her head turned to one side. When that baby is born, she may continue to tilt her head to one side, or her jaw may look asymmetrical. I pay attention to this because all that muscle tension and asymmetry can interfere with normal infant feeding. Continue reading →

Squeaker: A Story about a Tongue Tie Release

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Baby with tight frenulum. No tongue elevation present.

I met a darling baby last week who was obviously tongue tied. By obvious I mean that his tongue was not only visibly anchored to the floor of his mouth, but the mobility of his tongue was severely restricted. All signs indicated tongue tie. He cried frequently through the day with severe gas pains. He could not move his tongue side to side and there was almost no elevation when he cried. When he nursed, his tongue “snapped back” repeatedly. The snap back prevented him from keeping a strong vacuum at the breast, leading to noisy breastfeeding, slipping off the breast and sore nipples for mom. He was so noisy with smacking sounds and squeaky swallowing that his mom nicknamed him “Squeaker.” Continue reading →

The Lactation Consultant is Coming! How do I Prepare?

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Getting some reassurance from an IBCLC

You have just had a baby. You’ve always known you would breastfeed, but things are not going well. Perhaps your nipples are sore. Or you’re struggling with engorgement. Maybe you’re worried about milk supply. Or your baby has hard time latching. Or maybe you just have a lot of questions. In any case, you and your healthcare provider have decided you need the help of an expert. It’s time to call a lactation consultant.

You’re happy to hear that the lactation consultant (IBCLC) your doctor recommends will come to your home to help you. You make an appointment with the consultant, and then you wonder….”What should I do in preparation for her visit?” Continue reading →

Oversupply: Too Much of a Good Thing?

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A new mother called me last week worried about her baby. He was struggling with latching and seemed generally unhappy with breastfeeding. She was terribly engorged and in a tremendous amount of pain from childbirth as well as her breast and nipple pain. When I arrived she was teary, confused and doubting her abilities as a mother.

Engorged breasts and nipple shields

In the process of hearing her story, I learned that she had been told several times by nurses and doctors that it was important to pump after each feeding to make sure the milk would come in. She was also told to feed her baby every 1.5 to 2 hours day and night. . She wanted to do everything right. She wanted to make sure her tiny newborn got plenty to eat.

So she did as she was told. When he was too sleepy (or too full) to wake up, she called her pediatrician. How could she feed her baby when he wouldn’t wake up? As per his advice, she stripped him to his diaper, tickled his feet and used cool washcloths when necessary. She continued to pump after feedings—terrified that her baby was not getting enough to eat. She even hand-expressed milk into his mouth—so worried he wasn’t eating enough. She was also concerned about her baby’s very frequent, mucousy stools.

Unfortunately, no one had bothered to ask about her health history. If they had, they would know she had a late miscarriage a few years prior. They would have known that after the miscarriage she had a full milk supply for several weeks and had a terrible time with engorgement. They would also have know that she has PCOS—which can result in copious milk supply. (Mom’s with PCOS can also have issues with low milk supply.)

When her milk came in she was in trouble. She felt she had to keep pumping because she had so much milk. Her baby was choking and gagging. He would only nurse for 3-5 minutes–and it was a struggle. Then she would pump 6 additional ounces!

I showed her how to help her baby to the breast, letting him “take the lead” and latch in a way that worked with his reflexes. He nursed beautifully through her strong let down and handled her supply with no trouble. When the milk came too quickly, he cleverly let go and she helped him regroup and burp a little. He ended up nursing on both breasts contentedly for about 15 minutes. When he decided he was full, he was relaxed and happy. His mother was amazed at the difference!

I saw this mom a week later and she was a new woman. Now she lets her baby decide when he wants to eat. She used cabbage leaves to reduce her swelling and milk production and stopped pumping after feedings. Her baby’s stools are normal and he is happy and growing well.

If you find yourself with an oversupply brought on by pumping, gradually decrease the pumping over time. Cabbage leaves (green) rinsed and placed under your bra a few times/day will help reduce engorgement and may reduce your supply somewhat. Some foods may help you reduce supply as well. Your baby may be more comfortable nursing side by side in bed. You can also try leaning back and letting your baby nurse prone.

Many mothers worry about not having enough milk. It’s natural for a you, as a new mom, to have doubts. But try to keep in mind that the vast majority of mammals—including humans– have plenty of milk for their babies. It’s relatively rare to be unable to produce adequate milk. If you feel you have too little milk, or too much, please contact a lactation consultant and get help as soon as possible. The sooner you get help, the sooner you can relax and enjoy your baby and breastfeeding.

Breastfeeding Classes: Are They Necessary?

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What now?

So you are pregnant. You are planning to breastfeed. You know that it’s normal, natural and that all other mammals breastfeed. You’ve heard about breastfeeding classes, but why should you take one? Isn’t this something that mothers and babies just do?

Mothers and babies are equipped with very helpful instincts* and, in the case of babies, strong reflexes to ensure successful feedings. A baby’s survival depends on his ability to find the breast, latch on* and suckle with just a little help from his mother. But here in the United States, and many other industrialized societies, birth practices and our very culture can mask and even undermine what come naturally.

New parents often assume that they will get breastfeeding help in the hospital. There may be excellent lactation consultants on staff, but many are only available during the week day—not at night or weekends. Even if you are one of the mothers who will see a lactation consultant, it is likely your “visit” will be 15 minutes or less. In addition, it is highly unlikely that the consultant will be able to time her visit for the moment you are actually attempting to feed your baby.

Mothers usually leave the hospital less than 2 days after giving birth. Will a lactation consultant be visiting you on day 3 or 4 when your breasts are swollen*? Will anyone be automatically checking on you and the baby to make sure that baby is hydrated*, gaining weight* and your nipples are healthy*?

“I always tell people that taking a class before the baby came was the best thing I did. I’m so glad that my husband was there, too! He remembered tips and tricks we learned and was also super supportive after learning how beneficial it is!” Cathy Y.

If you are lucky enough to be surrounded by family and friends who have nursed multiple babies, it probably doesn’t matter that you are not provided with a lactation consultant to ensure all is well. You will likely have all the help you need. But, honestly, this is a very rare occurrence in the U.S.

It’s likely that you have never seen a baby breastfeed up close and personal. If you’re like most of my clients, you have seen babies breastfeed from across the room, maybe under some kind of shawl. You probably averted your eyes. That is normal in our culture. We know it’s happening, but it is not ok to look! How can you possibly learn any new skill without seeing it happen and asking questions about it?

A prenatal breastfeeding class will provide you with information, a safe, encouraging place to ask questions and see pictures and videos of babies breastfeeding.

“It’s important to know at least the basics: latch*, hunger signs*, what’s normal in your infant and from our body. All good to know this before you are overwhelmed.” Audrey L.

Here are some topics that are typically covered in a breastfeeding class:

Basic physiology of lactation
Basic information about the content of human milk
What to expect in the first hours and days after birth
How to know if your baby is getting enough milk
Normal newborn behavior and reflexes that assist with feeding
How to help your baby with feeding
Signs that everything is going well
Common challenges and how to avoid them and/or overcome them
How to identify when things are NOT going well
Who to call for help

“What I loved about the class was seeing videos of real babies breastfeeding. They really helped me to understand breastfeeding.”

A breastfeeding class can’t prepare you for every eventuality, but it can give you confidence and information that can make all the difference after your baby is born.

*You will learn about these things and much more in your prenatal breastfeeding class!

For a private, prenatal breastfeeding class in the Seattle area, contact Renee directly. Or you can register for Breastfeeding Fundamentals if you’d rather have a group class.