Can we talk breastfeeding?

mrs_massie · January 2018

Ok so the lactation consults in the hospital drove me absolutely crazy with my first born, which is probably one of the reasons I didn't beat myself up about not breastfeeding. My son wound up with a lactose intolerance, but I secretly was relieved that I didn't have to breastfeed anymore.

Anyway, I saw two lactation consults while in the hospital. The first one was on the schedule for the first 3 days I was in the hospital, so for three days I had her coming in to see me to make sure I was doing what I was supposed to be doing, which according to her was to breastfeed for an hour (whether I did one breast for an hour straight or both breasts for 30 minutes each didn't matter). Then she had me supplement feed my infant with formula and a syringe (because a bottle would really mess him up) and then I had to pump for 30 minutes to help my milk come in faster. By this time, it was time to nurse again. I was exhausted and confused because my mother always taught me 15 minutes each side was good enough. I tried just doing that several times, but the nurses who monitor everything you do scolded me for not nursing for an hour.

Well on my last day in the hospital I saw the second lactation consultant who thought I was crazy to be on the schedule I was on and couldn't understand why the first lactation consultant had me doing anything like that. While she did agree that I should nurse for an hour, she didn't think I needed to supplement feed my baby or pump, which now I agree with because in the first day out of the hospital I got so engorged and I developed fever, which made taking care of an infant dreadful.

This time around, I would really like to stick with breastfeeding, but still don't really know what the right way is. For the breastfeeding pro's, how did you do it, what worked for you, what methods, tips, and advise would you give?

mmmmkay · January 2018

here's the thing. EVERY NURSE/DOCTOR/LACTATION CONSULTANT/WELL MEANING FRIEND WILL TELL YOU SOMETHING DIFFERENT! so.. yay! the key is finding someone you gel with. and filtering out the advice that doesn't work for you. remember, if baby is growing and happy and having regular diapers than you are doing just fine.

anyway most of the different methodologies is because every woman and baby is different.

i am no expert, but here are some thoughts. At the beginning, you are not only teaching baby to breastfeed (and giving them nutrition) but teaching your body what to produce. an underproduction isn't great but an overproduction has problems too. at the beginning i wouldn't worry about overproduction too much though.

you want to stimulate each breast at each feeding session to keep milk production up.
you want to empty at least one breast at each feeding session to keep milk production up, at the beginning maybe both.
baby won't be an efficient breast feeder at first so it's gonna take a long time. they may fall asleep in the middle even if they are still hungry. as they learn and get stronger they will get more milk in a shorter amount of time. I remember doing 20 minutes a side to start. it was so stressful. literally waking the baby when she fells asleep in the middle several times. But I think at the end i was more like 8-12 minutes per side, with potentially a lot less on the second side.
i don't think you need to pump, but it can help stimulate milk production and give you a little bank of backup.
also if baby is feeding well you may not need to supplement.
not everyone agrees but there is worry about "nipple confusion" when introducing a bottle too early. it's easier to drink from a bottle than a boob so the theory is that baby might prefer the bottle and refuse the breast.

if you are worried take a breastfeeding class before hand. then at least you are armed with some information before all the nurses come in and tell you their opinion!

good luck. and remember, FED is best.

ngolimento · January 2018

I'm sorry you had such conflicting info from the consultants. That had to have been crazy frustrating. How often (or if you need to) pump in the beginning is totally dependent on your kiddo. I had a complete boob-monster right out of the gate who wanted to nurse every 15 minutes, so I never had to touch a pump to kick-start lactation.

If you have a kid that doesn't act like that, then pumping for 20 minutes at the top of every hour in the first few days makes sense. These first few days are the order window in the drive through. You are literally informing your body what you will need to produce via stimulation, then picking up your order at the window (the window being when you stop producing colostrum and settle into real milk production).

Pumping for an hour straight is overkill, imo. Newborns wouldn't nurse that long anyway. If you are told you have to suppliment again, ask the consultant to tape a feeding line to your boob, so you can have your kiddo nurse on you, and get formula at the same time. It was a game-changer for me.

rmmorris · January 2018

A lot of the breastfeeding rules/advice I got in the beginning was contradictory, unnecessary, or frankly just straight up bull shit. I needed nipple shields, we supplemented at first (with a bottle no less), etc and I was still able to nurse for a little over a year. I think for me it came down to persistence and problem solving (&luck). I agree with @mmmmkay and @ngolimento that it’s just not one size fits all, so you have to just keep adjusting things until you find what works for you and your baby.

Also, I never felt like I had “mastered” the art of breastfeeding. There were always new problems that made me feel like I was on the verge of failure. Google was my savior. And reminding myself that baby doesn’t care as long she gets fed.

beach_mama · January 2018

Goodness what a mess of advice from the lactation consultants. I totally would have quit w all that pressure.

Every person's experience is different and you already have some great tips above. The only other thing i would add is to make sure baby latches wide enough. I'm pretty sure baby needs to go as wide or wider than your nipple (someone correct me if I'm wrong...it's been awhile since I've nursed). And for the the love of god break baby's latch if it's not good! Your nips will thank you.

ekendall09 · January 2018

@beach_mama the lactation consultants and nurses came in and helped me basically learn to shove alot more nipple surface in DDs mouth, I wish they had been there from the start. I had an awful crack from whatever I was doing prior and it took FOREVER to heal. That nipple will never look the same even 5 years later.

fancybelmont · January 2018

If you aren't meshing with an LC you can also politely decline their services. One thing I've learned from having two kids is that you have to be an advocate for yourself. If something doesn't feel right with the LC just ask them to leave. It's not like you're refusing treatment. They aren't a doctor. They are just supposed to be there to help and support you. If you aren't feeling supported then they aren't helping you.

I feel like LC's are either AMAZING or they are on some high horse about breastfeeding. I've dealt with both types. Just tell them to hit the road if they are pressuring you to do anything you aren't comfortable with.

fancybelmont · January 2018

Can I also add, if you wanna use a pacifier....use it. I feel like I remember getting sh!t from an LC about it at the hospital and it made me stress for no reason. Both my kids used pacifiers from the start and both were successful breastfeeders. I'm not saying that's true for everyone, but it's your child, you get to make those decisions.

mmmmkay · January 2018

I don't know if this will make you feel better or worse, but the first nurse that came in to help me breastfeed (literally within 30 minutes of giving birth) grabbed my arm and pulled it across my body, catching my hospital bracelet on my nipple and putting a deep cut in it.
Made breastfeeding SUPER fun for the next 4 months on that side. it took forever to heal because it basically reopened every time i nursed. YAY! so at least that didnt happen.

riversdoctor · January 2018

Ugh that sounds like that lc needs a new gig! And absent from any growth concerns no normal baby needs to be forced to eat for an hour!

My first I had AMAZING lcs and an awful pediatrician. Pediatrician set me up for failure from day 1, but the lcs steered me right.
(Ironically with my second I had an awesome doc but horrible lc)
My my best advice, in the hospital nurse often. Your nipples smell like amniotic fluid so to them it’s the most familiar thing there! Lean back to latch on, get comfy, get support and shove as much in their mouth as you can. If there is pain more than a mild discomfort get a tongue tie Eval! And you may need to get more than one.

Biggest misconceptions I ran into: 1.) they are usually sleepy the first day then the second seem like they nurse the. Fall asleep then want to nurse again. This is OK!!! This article brought me peace: the lcs shared itsfter dd was born and I reread it a million times. https://kellymom.com/ages/newborn/bf-basics/second-night/

2.) losing weight the first week is expected! Up to 10-12% or more if mom had an Iv during labor! After week one, expect about 4oz per week/1 pound per month AVERAGE. growth will happen in spurts. Weigh-feed-weigh is only valid if done over a 24 hour period! The best indicator of your supply is diaper output. (If it’s coming out it’s going in).
6-8 diapers per day. Poopy counts as too. Should have 1-2 quarter size or larger poops a day. For my son the no pooping was our big indicator of a problem. (It was tongue tie not supply related, but still took 5 weeks, doc lc and pediatric dentist before we got it fixed).

3.) pacifiers are a mom replacement. I’m not a purist but I tried to only rely on them for when I needed a break or I wasn’t around. I always nursed first, if I was home. There were times I just couldn’t handle any longer and I used that nuk. But most of the time they just wanted to place a bigger order from the tap. If I was gone dh and daycare used the nuk to help space feedings. 1-1.5 ounce per hour of separation is the golden rule if you’re trying to pump while away and nurse while together , and that goes up to age 1. We did 2oz bottles every 2 hours until about 4 months then 3 oz bottles every 3 hours. This keeps mom an “all you can eat buffet” and the bottle “a sad brown bag lunch” and helps keep moms pump supply up. Yes you can do more or larger bottles but you will run the risk of a supply drop. This happened with dd, but when we stopped with the big bottles my supply came back.

4.) normal pump output is .5-2oz combined for a missed feeding! Anything more is overachiever territory so don’t think because you don’t spray like a dairy cow you have a supply problem! Baby is much more effective than even the best pump.

5.) you don’t have to love it, you don’t have to get the warm fuzzies and it’s ok to downright despise it! I’ve nursed for a combined 63 months and it was just another task like laundry or dishes. Never the warm fuzzies!

6.) set your own goals based on what works for yo. You can exclusively breast feed, exclusively switch to formula or any combination of the two, but never quit on a bad day! I think that second bit of advice saved my sanity with dd. She was a great nurser but I was having gallbladder flares and wanted to quit in the middle of the night one night. Dh took over that night, Gave her a bottle of pumped milk and hung out in the living room while I took a pain pill and crashed. That rest put my mind at ease and I swear dd became a more mellow babe after that! Self care is important!!!

luna8433 · January 2018

I would check out the discussion on apps and find one that keeps track of how often and which side. That helped me at the beginning to keep track of which boob I started with. You'll want to switch during nursing and like pp your second boob may not empty all the way so start with that one on the next feeding.

When I had my first I don't remember a consultant coming in at all. I had a few nurses help me work on the latch but that was it. I was given no rules to follow, so I did what felt right. I took cues from baby about when to feed and how long and when boob 1 was empty and ready to switch. However I was one of the lucky ones that didn't struggle with production.

petethecat · January 2018

Man, I'm sorry that you had such a terrible LC experience @MrsMassimilla. That sounds horrible.

Without writing a terribly long reply, I'll just say that I agree with most of the advice already given.

I'll also add a suggestion to find a good book on breastfeeding to read, if you've never done anything like that. I read this one before having DD and found it to be a super helpful and nearly complete breastfeeding handbook--

Image: https://us.v-cdn.net/5020794/uploads/editor/zq/mxt533pvbuzg.jpg

(I just noticed that this book has a rec on the cover from the author of What to Expect-- a book that I actually hated. I don't feel like this book compares in any way as far as information presented or format though, FWIW.)

Another great resource is kellymom.com. Read read read everything there. I loved it for so many challenges that I came across relating to breastfeeding.

riversdoctor · January 2018

Ooh yes I second kellymom.com. Also great books are “so that’s what they’re for” by Janet tamaro and “the womanly art of breastfeeding “.

ladythrice · January 2018

I just wanted to drop this in here: https://forums.thebump.com/discussion/12717098/breastfeeding-survival-guide

Previous thread that went into some good detail. People might find some helpful tidbits there too!

ladythrice · January 2018

Also, @riversdoctor, I have a breastfeeding lady crush on you. GREAT advice!

riversdoctor · January 2018

@ladythrice! Hahah thank you! I am a huge advocate for mom meeting her goals, but doctors who sabotage or set you up for failure drive me nuts!!!

mrs_massie · January 2018

Thanks so much for all the advice!

mrs_massie · January 2018

I came across this article and though it is short, I think it is useful.

https://pregnantchicken.com/breastfeeding-in-the-first-week-4-things-you-will-be-glad-you-knew/

AlphabetFish · February 2018

My midwife told me to let the baby decide--basically, that I would breastfeed on demand. There was no time limit at which I took him off or tried to keep him on until. Basically, from the day he was born 'til he was 6 months old, every time he showed the slightest sign of interest or hunger, I nursed him.

When he woke up, I nursed him. When he cried, I nursed him. When he rooted on my shoulder or shirt, I nursed him. When he nommed on his hands, I nursed him. And once he was on, I let him take as much time as he wanted (which could be a long time when he was very little). When he pulled off, I would offer the other side. In the beginning he rarely took it; he was full off of one. As he got bigger, he'd usually drink about half the milk in the second breast. When he pulled off twice in a row or refused to latch, then I knew he was done. When he fell asleep nursing, I would give him like 5-10 minutes or so then delatch.

After a few days, he quickly settled into his own schedule where he wanted milk about every 1.5 to 2.5 hours, 'round the clock. If he wanted more, he got more, even if it had only been 10 minutes. If he wasn't interested, I didn't push him. He gained weight marvelously and dirtied lots of diapers, so I knew he was getting what he needed, and that made everything very worth it to me. I definitely plan to breastfeed my next child when she comes.

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