Breastfeeding SOS: A Glimpse into a Monday Morning

Breastfeeding SOS

Breastfeeding SOS

I used to facilitate a breastfeeding drop in group.  I never knew what to expect or who would show up. Sometimes clients pop in for a quick follow up, but often I’ve never met the moms before. They are referred to the group by their Drs, their doulas, the acupuncturist or their friends. This is a glimpse into a recent drop in.

After moms straggle in with their babies somewhere between 10:20 and 10:45. They get settled in the comfy chairs and I ask them to introduce themselves and their babies.  They admire each other’s babies. A mother with a 3- month- old marvels at the smallness of another mom’s 8-day-old baby. She congratulates her for making it out of the house to get support with such a tiny baby.. I ask the mothers to talk about why they are here. Here is what I heard last week.

“I just want to make sure I’m doing it right.”

“I want to make sure my baby is gaining weight.”

“My nipples are really sore.”

“My baby has a hard time latching and he’s really fussy at the breast.”

“I’m using nipples shields and I want to breastfeed without them.”

Babies begin to get restless and fussy.  I assure them it’s totally fine to breastfeed in this setting!  A question is asked about latching. All eyes are on me as I  bring out my knitted breast and demonstrate for all to see. I can see mothers trying to replicate the technique I demonstrated.

There is concern expressed about using some formula. Everyone is quick to assure the mom that any amount of breast milk is great and the important thing is to feed the baby.

There is a discussion about milk supply and how to know baby is getting enough.

More questions.. I give general answers. If a mother is having a complex breastfeeding problem, I recommend a consultation with an IBCLC. She can make an appointment with me if desired.

A mom shares that she isn’t getting enough sleep and she doesn’t know what to do. Three other moms nod their heads with empathy and give her suggestions. I merely listen, because it seems the mom is getting exactly what she needs.

A conversation about pumping ensues. One mom says.. “I have a love/hate relationship with my pump!”  There is laughter and more pumping discussion.

A baby poops loudly which results in more laughter.

A mother asks me to help with latching her baby so that it’s not painful. I help her make a few adjustments and she looks up at me and says, “That feels better! Thank you!”

A mother confesses she doesn’t know how to determine if her baby is swallowing. So I sit with her and interpret what’s happening as her baby nurses. Another mom listens in, then asks me to watch her with her baby as well.

Every few minutes a baby is weighed. When it’s good news all of the mothers rejoice.One mom cries after learning her baby didn’t gain enough weight—other moms cry with her or grow silent.  One reaches out and gently pats her back. They always seem to know the right thing to do.

A mom asks me to check if her baby has thrush. I don’t do oral exams in drop in groups, but this baby took one look at me and stuck out her tongue and showed me the thick white patch!

When one baby cries loudly, the other babies look worried and begin to whimper. I hear things like, “Yes, that baby is sad, but his mother is helping him.” and “That is a loud sound and it’s scaring you.” and “I’m right here, you are ok.” I marvel at the intuition and skill of these first-time moms.

Babies fuss and cry with diaper changes. A mom goes to use the restroom and hands me her baby to tend. He smiles and coos at me.

It’s 11:30… time to end the meeting. But the moms linger… asking one more question, enjoying the company of other moms and babies. There are hugs and word of encouragement.

When they leave they look a little happier, a little lighter and more confident. They have a plan. They know who to call if they need more help. They entered the space as strangers and as they leave, I hear 2 of the moms exchange phone numbers.

I hope they are all doing well. I hope I see them next week.

Breastfeeding Twins: Getting off to a Good Start.

Tandem nursing.

Tandem nursing twin boys.

You’re expecting twins!  How exciting! After the shock wears off, you may start wondering about how you will breastfeed 2 babies!  No need to worry. With some preparation and lots of support, most mothers of twins have plenty of milk for their babies. Here are a few general tips for ensuring ample milk supply when breastfeeding twins:

  • First of all, don’t listen to anyone who says you won’t be able to do this! If you can make enough milk for one baby you can make enough for two! In fact, the research shows that mothers with twins make MORE than double the amount of milk for one baby and moms of triplets make more than triple. Yes, our bodies over-compensate. Another cool thing. Your breasts know you are carrying twins before they are born and prepare accordingly!
  • Find other moms who are breastfeeding twins and enlist their support. La Leche League may be a good resource to connect with moms of multiples. Many communities have support groups for families with multiples. In Seattle, it’s Seattle Families of Multiples. Get connected while you are pregnant!
  • It would be a good idea to meet with a Board Certified Lactation Consultant (IBCLC) while you’re still pregnant. Especially true if this will be your first experience breastfeeding. She will help you find resources, locate the best breast pump and help you develop a plan for success.
  • Read books about breastfeeding—general books as well as books about twins. One of my favorite twin resources is “Mothering Multiples” by Karen Gromada.
  • Plan on renting a hospital grade pump to use until your milk supply is established. If the babies are born early, or one or both have trouble breastfeeding at first, you will have a machine that can act as a substitute for your babies. Pump as often as your babies eat! Of course, if your babies are both nursing well from birth, you will have no need for a pump. Remember if only one twin is nursing well, you will still need to pump to simulate 2 babies at the breast!
  • Research shows (as well as the experience of my clients) pumping 8x a day will yield the same amount of milk as pumping every 3 hours. So if babies can’t breastfeed yet, give yourself a break and sleep for 4 hours in a row at night. You can pump more often during the day to get in those 8 pumpings!
  • Hire an experienced, trusted lactation consultant (IBCLC) as soon as possible after the babies are born. It’s very important to get things off to a good start. Expect the LC to be supportive of your efforts and positive about your desire to exclusively breastfeed. I recommend asking her about her experience/philosophy before you meet with her. Your local twins group may have some recommendations.
  • Plan on doing nothing but feeding babies, feeding yourself and sleeping for the first 3-6 weeks. (Longer if the babies are premature) You will need help for meals, laundry, cleaning and errands. Let your wonderful helpers do everything non-baby. Your babies need you! Everything will feel much easier and you’ll be able to cope well if you take good care of yourself. Hiring a postpartum doula who is experienced with twins is a great investment!
  • If you’re having trouble with supply or babies aren’t breastfeeding effectively, try pumping for 5-10 minutes immediately after breastfeeding them. This will help you remove any milk they left behind and tell your body to make more milk.
  • Breastfeed simultaneously as much as you can. This tells your body definitively that you have twins and you need to make a lot of milk NOW.
  • Familiarize yourself with lactogenic foods. Milkmakers are one delicious way to help your supply. Foods that are rich in calcium and iron are also supportive. There are a variety of herbs and medications that can help increase your milk production, but please check with your IBCLC for advice!
  • Yes, it’s true that some mothers are not able to make enough milk for their babies. If that is your situation, you can still breastfeed. You can use donor milk or formula for supplementation when necessary.

Note: Many sets twins or triplets were conceived with the help of IVF or some other technology. If you have fertility issues, please be extra cautious the first week or so after the birth of your babies and seek help from an IBCLC immediately after birth.  Some causes of infertility are correlated with low milk supply. If you are prepared, you can avoid unnecessary newborn weight loss.

See also, “Breastfeeding Twins? Yes!”

IGT: Four Stories from Moms Who Have Been There

Nursing with homemade SNS

Nursing with homemade SNS

This post is dedicated to the incredible moms I have met over the years who have IGT.

The stories below are as uniquely individual as the mothers who wrote them. Even so, they do have many elements in common. All of these moms were very committed to breastfeeding. None of these moms were screened for possible IGT prenatally or early enough postpartum to avoid severe infant weight loss. All of these babies lost a significant amount of weight—a weight loss that was completely avoidable. All of the mothers put an extreme amount of effort into producing enough milk for their babies. All of these mothers have felt guilt and remorse—even though none of this was their fault. All of the mothers received inappropriate advice from the professionals they trusted to help them with a very basic function—feeding their babies. These mothers have no reason to feel shame. It is our system that has let them down. Continue reading

Low Milk Supply: Could it be IGT?

Baby and mom breastfeeding with IGT

Baby and mom breastfeeding with IGT

Your breast anatomy was determined even before you were born. During the early months of fetal development, breast buds are formed. If the breast buds do not develop properly in utero, development in puberty may not occur normally. Breasts may develop minimally or not at all. And future milk making ability may be compromised. Continue reading

Thankful for Breastfeeding

Thankful for baby bliss.

Thankful for baby bliss.

Recently a client sent me a nice note with a generous check. She had been feeling gratitude for the help she received to breastfeed her son. There were multiple lactation consultations in her home, a frenotomy (the procedure to release a tongue tie) and body work for baby. There were many up-front costs–some of which were not covered by insurance. Here’s what she wrote: Continue reading