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?

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.

More about Milk Supply

 

This mamma has plenty of milk.

This mamma has plenty of milk.

You probably already know that certain foods and herbs can increase milk supply. Oatmeal, fenugreek* and blessed thistle* and many others all have a reputation for helping mothers overflow with milk.

But many people don’t know that some foods can actually decrease milk production. There is no need to worry about small amounts of any of the following foods, but if you’re struggling with low milk supply already, avoid ingesting large quantities of the following. On the other hand, if you are one of those mothers with an over-abundance of milk, or if you are in the process of weaning, you may find the following foods helpful! Continue reading

Breast Engorgement and Cabbage Leaves?

Let’s be honest. Overly full, engorged breasts are uncomfortable and sometimes downright painful. Fortunately, under normal circumstances true engorgement can be prevented with frequent breastfeeding in the first few days/weeks after the birth of your baby. Some breast fullness and tenderness is to be expected in the first week postpartum as your breasts prepare to provide nourishment for your baby or babies. It may feel like you have enough milk to feed the entire neighborhood, but keep in mind that much of the swelling you are experiencing is simply that—swelling. It’s not just milk “coming in” that is making your breasts feel so full. After the birth of your baby; water, blood and lymphatic fluid rush to your breasts in preparation for breastfeeding. With adequate breastfeeding, the discomfort usually passes in a day or 2. Many mothers don’t experience anything but mild fullness.

Currently, however, many mothers in the U.S. experience births that are anything but “normal.” Epidural anesthesia requires that mother receive an IV of fluids. Inducing labor with pitocin requires extra fluid. C-sections require IV’s. If a mother receives any extra fluids via IV, she will continue to retain the fluid for some time even after the birth of her baby. That extra fluid often results in swollen ankles, fingers and even breasts! Continue reading