Breastfeeding is NOT suppose to hurt - Part 2

During childbirth, the pains we feel from contractions do hurt and yet this is pain with a purpose. The work of labor is to cause the uterine muscle to go through changes that create the stretching of the uterine muscles... all to help bring your baby down and out into your arms. This labor period is a relatively short period of time and we can help ourselves tremendously to get through this period. Learning and practicing relaxation techniques, trusting birth and choosing the right careproviders are all part of the ingredients to help you have a safe birth as planned.

So, while pain during childbirth is expected and we can work through it, pain during breastfeeding signals us that something is wrong and we should not have to use techniques to help us get through the pain each and every time you breastfeed. So, what do we do as new mothers when there are people around us who say that newborn breastfeeding pain is normal? My first thought is: Normal for who? And why? And for how long? And just because that was there experience, does not mean it has to be your experience also.

So, here's the thing. My peer lactation consultants and I are pretty intense about teaching mothers that this should not be hurting. Why? Because frequently this means breastfeeding failure. You just discontinue offering your milk altogether, whether it be from the direct breast or from a bottle. Or you decide to exclusively pump and bottlefeed.

What is wrong with this picture? Well, it does not matter so much what I or someone else wants. What is wrong with this picture is that this is not what you had wanted.
You looked forward to the experience of holding your baby against your body, having them latch on and seeing them drink your milk,, directly from you. I strongly encourage mothers who are in this position to seek help from an experienced IBCLC. At least until you can get help, be sure to keep up your milk production with regular pumping and be sure to feed your baby as frequently as he/she desires, which is usually 8 - 10 feedings a day.

If the pump you are using is anything less than a hospital grade pump and you are finding that you are not making enough to keep up with your baby, I would encourage you to switch pumps, at least just temporarily, until you can get breastfeeding going well.

As lactation specialists, our mantra is:

1. Feed the baby ( even if it means temporarily with a bottle)
2. Protect the milk production ( regular and frequent milk removal)

As long as you are doing numbers 1 & 2, there is always lots of opportunity to work on your breastfeeding challenges, solve your issues and begin breastfeeding in comfort.

Stephanie and Sadie - Part 3 - conclusion

Each and every time I work with a mom, it confirms to me the importance of taking the time to hear her story and asking and receiving answers to some very specific questions. Mothers have different medical backgrounds and babies can also come with different problems that they bring to the breastfeeding situation.

NOTE: If you are new to this blog, you will want to first read my December 28th post as that is the beginning of this story, which has 3 parts.

The facts surrounding what happened after Stephanie's pediatric visit is what is most interesting to note.

Stephanie had not been pumping to increase her supply and was relying solely on her baby to remove the milk and increase her supply. Sadie had a very shallow latch which tends to reduce the amount of milk transfer. She also was a baby that seemed okay to be pacifying at breast without getting a good feeding. Sadies output decreased gradually which made the changes less noticeable. As the days went on, Sadie became labeled as a "good sleeper." Stephanie and her family were grateful for this. While her energy level was gradually picking up after the birth, she was still quite tired.

Once I ruled out any anatomical issue in Sadie's mouth that might be causing a problem with her achieving an excellent latch, I worked closely with Stephanie in teaching her proper position and latch. I wanted to be sure that by the time this consult was over, Stephanie could latch her baby on well and was comfortable doing so. I also discussed the importance of helping her increase her milk production as quickly as possible, however, until then, it would be necessary for Stephanie to begin supplementing baby again. While Stephanie was not happy about this, she understood that a poorly fed baby has a lack of energy and will make it more difficult to become a good breastfeeder. She understood this as she could relate with regards to her own fatigue issues.

Stephanies care plan was very specific to her and her babies situation.

1. She was to breastfeed with an excellent latch every feeding and be careful to keep baby at breast during nutritive suckling activity. This is the period when baby is actually transferring milk from the breast into the baby's mouth.

2. Once baby tired and was no longer suckling effectively, she was given a bottle of milk, while Stephanie could then put her efforts into pumping.

3. She agreed to rent the hospital grade pump from me and was fitted with the correct size flanges, given detailed pumping instructions as well as offered herbs to help increase her supply.

4. Since her baby was 4 weeks old, I was realistic with Stephanie and stated that this could easily take several weeks or more until she has a full supply. There was also a chance that she might not gain a full supply and always need to be supplemented. The best she could do was stay on this care plan and check in with me every few days. Based on her feedback, I would help her moniter her progress and make changes as needed.

I am happy to report that it took about 3 weeks for Stephanie to have a full supply and no longer need to supplement baby with any milk in a bottle. She slowly weaned from her regular pumping, however, will continue to take a small amount of herbs on a regular basis at least for the next month or so as we continue to moniter her progress.

I wanted to share this story so my readers could see how a breastfeeding challenge that to some might seem hopeless, can be turned around into a successful breastfeeding experience.

I also wanted to share a few other important aspects of this story as I have found that sometimes mothers who are searching for answers can read a story and if it sounds like their problem, they begin to follow the care plan stated.

It is important to note that there are frequently variables in each mother/baby couple. There could be variations in mothers medical history, her breast and nipple tissue as well as something different with babies oral cavity that needs to be addressed. For all these reasons, I continue to fully support and encourage mothers who are suffering with breastfeeding challenges to seek the help and expert guidance of their local IBCLC. This is how we can assure that there are no missing pieces to the puzzle and all avenues have been pursued, before giving advise and suggesting a care plan.

I wish all my website and blog visitors and clients a very Happy and Healthy New Year.

Lori

Getting breastfeeding off to a good start

The First Day - Getting Breastfeeding Established - Part Two

The foundation to comfortable breastfeeding is to ensure that your baby has achieved a good latch. This is a skill that is easier acquired if you have someone assist you. When your baby is latched on well, you may feel a strong, but painless tugging sensation on your nipple. Some mothers describe it as a sliding back and forth of their nipple or a pulling sensation. All these would be normal descriptions as the baby opens mouth wide, lowers tongue over his gum line to provide a nice padding between their gums and your nipple. If baby latches on deeply and with just the right angle, your nipple is placed far back in baby's mouth and you avoid nipple compression. If at any time, you feel soreness or pain, please request help from an experienced breastfeeding consultant.

It is normal for your baby to be quite sleepy the first 24 hours and you may need to put some effort into waking your baby up. If the first several feedings are effective with no pain and a normal amount of milk transfer, your baby begins waking up on his own by the second day of life and should be interested to feed at least 8 or 9 times a day.

Once your baby latches on and it feels comfortable, and you feel your baby's sucking behavior is vigorous and yet painless, it is best to let your baby stay on the breast until he changes to a more pacifying/light suck with minutes in between suckles or until he falls asleep. A diaper change and an effort to wake baby up is helpful before you offer the other side. The first 24 hours some babies are only interested in 1 side per feeding, however, they usually are hungry enough and cue for the "second side", from the second day on.

There is a lot more to say on this subject and I will continue this discussion in my next post. From this point on, you will notice that I will repeat one of my favorite sayings several times in the hopes that you understand the truth.

The truth is - Breastfeeding should not hurt - Not on Day 1 or Day 2 or Day 3.

So, if it is hurting, and the people who have been helping you have not been able to show you how to fix this, you will want to seek the help of an IBCLC. As an experienced IBCLC, I have learned that the sooner you seek help, the quicker your problems are fixed and the less pain you have.

You can follow this link to learn more about what a private breastfeeding consultation with an IBCLC includes. If you are not in the local Phoenix, Arizona area, you will want to perform a google search for an IBCLC in the area in which you live.