Breastfeeding prep?

mummaeff · March 2018

Hi All! First time poster and first time mummy here! I'm 18w6d and wondering if there's anything I can start doing now to improve my chances of successful breastfeeding/mill supply?
I'd really love my baby boy to breastfeed and willing to do anything to help that happen.

pghctwife · March 2018

Try to go to a bf support meeting while pregnant to meet people and have irl support in place, if you have a local fb group join that too, and read everything. research ibclc in your area, so if you need help you can reach out.

I found it helpful to read the womanly art of breastfeeding before I had my first just to know somebstulff to watch for. And read posts and conversations about nursing when you come across them and try and soak it up.

Maje sure your partner is on board and will support you, if you decide to stop or not pushing you to stop. It can be hard on the partner in the early days bc they really can’t help with nursing and really can be hard to comfort. If your family might not get it, talk to them about it and make sure they won’t make you feel uncomfortable nursing in front of them.

chevk with your insurance about a pump. Some women like nursingpillows too. And lots of snacks ready to go - it will make you hungry!

But really its putting baby to breast often, drink water, and watch the baby not the clock.

Finally, welcome and you should change your name to a unique handle so we can recognize you!

hfooter · March 2018

Take a breast feeding class with your partner or whoever will be your main support.

F47 · March 2018

Agree with the ladies above. My hospital offers a breastfeeding class. It’s just a couple of hours one evening.

redheadbride15 · March 2018

Good advice above! Some more ideas:

- Find lactation support in your area. If you have not yet chosen a pediatrician for your son then ask if any of your local practices have an on-site lactation consultant who will be available at your newborn visits. Also ask about lactation support at the hospital where you are delivering. Finally, La Leche League is often a good place to find local resources for you (just Google them!). Prenatal breastfeeding classes are great preparation but personally, I found that I mostly needed help when the baby was actually there in front of me trying to latch and suck.

- Believe in yourself and your baby! But also know that while breastfeeding comes easily to some, it doesn't always. You need a good milk supply and the support of your partner, community, and employer (if you will be going back to work). Some of these things can be outside of your control, so if you find that you are struggling then don't blame yourself! Formula fed babies do just fine

pghctwife · March 2018

^yes!! I never bothered with a bf class. I just went to a lll mtg or two beforehand, which I did find useful. Breastfeeding USA is another similar organization.

lalala2004 · March 2018

I never took a breastfeeding class, but I did a Bradley Method class, and it was covered in there. I bought The Womanly Art of Breastfeeding, but I didn't read the whole thing before he was born. Joining local LLL and breastfeeding support Facebook groups was the most helpful thing. You see people troubleshooting actual problems and see what you're up against before it happens. It really helped me feel prepared, and I got great advice, too.

hannahh18 · March 2018

Hi!! That's so exciting!! Educating yourself as much as possible is the BEST thing to do!! Find a local Facebook breastfeeding group, go to a local breastfeeding class and meet the lactation consultant at your hospital or see if there is any local breastfeeding support.
Keep in mind it will hurt for about the first week because your breasts are not used to getting chomped on all day BUT I PROMISE it gets better and is so worth it!!

calimom2524 · March 2018

But also keep in mind no matter how educated you are, no matter how much support you have, no matter how prepared you feel, it may not matter. I simply just had trouble with my first no matter what I did and I took it SO personally and felt like such a failure. There is such a huge pressure on us as moms to do everything perfectly and do all of our research and take all of the classes and read all of the books but sometimes things aren't perfect and it doesn't matter what you've done in preparation. I don't say this to discourage you, I just hope maybe you'll remember in the back of your mind that no matter how prepared you are now, it may all completely change with baby and THAT IS OK.

livinthesunnylife · March 2018

^^^^^^^ WSS!

hfooter · March 2018

Also, I feel like a lot of tongue and lip ties cause nursing problems and they are overlooked.

If your baby has a shallow latch and it hurts, ask for the pediatrician to look for tongue and lip ties. When they are brand new babies it’s so much easier to take care of.

lalala2004 · March 2018

hfooter said:

Also, I feel like a lot of tongue and lip ties cause nursing problems and they are overlooked.

If your baby has a shallow latch and it hurts, ask for the pediatrician to look for tongue and lip ties. When they are brand new babies it’s so much easier to take care of.

Important to note that not all pediatricians can diagnose ties, though.

pghctwife · March 2018

Agreed on ties and on skipping your pedi for that. That’s where your local support be in irl groupsbor fb comes in handy - real referrals and recommendations for drs in your area.

homequiltingmama · March 2018

Both my girls had the tongue/lip tie issue (apparently it's genetic, so I'm assuming our third will have it and I'm already planning to have her checked out shortly after birth, just to be sure). Anyway, our pedi thought my first had a shallow tongue tie so we limped through the first year. After several rounds of thrush (from milk getting trapped in her upper lip), I finally took her to a dentist who specialized in diagnosing/lasering ties. He was so surprised we had made it a year of breastfeeding bc everything was so tight! Once cut, her nursing went from 45 minutes to 10-15 minutes. I had my second checked at 1 week old - the process was so much easier with a baby (no sedation), less bleeding, quicker healing time. Nursing my second was so much more pleasant (for me) bc we didn't have those long long nursing sessions.

Anyway, we found local recommendations from a FB support group (search for tongue tie support group). Of course, not every baby will have a tie, but if you suspect it a specialized dentist would be the one to diagnose - they'll give you a level of tie which corresponds with how it may affect them. Not all ties need to be removed either and they can give you pros/cons.

pghctwife · March 2018

@homequiltingmama totally agree!

fyi the mthfr gene mutation can be associated with ties - bc you aren’t absorbing the folate (in part I think). I’m taking methylfolate and b complex this time and my mw said it’s possible it could help with this baby being so badly tied

lalala2004 · March 2018

pghctwife said:

@homequiltingmama totally agree!

fyi the mthfr gene mutation can be associated with ties - bc you aren’t absorbing the folate (in part I think). I’m taking methylfolate and b complex this time and my mw said it’s possible it could help with this baby being so badly tied

That’s interesting, but I thought the mutation made it harder to process folic acid, and that folate itself is better?

pghctwife · March 2018

That was a typo / misspoke! I meant folic acid.

calimom2524 · March 2018

DS2 has a pretty big lip tie but it never interfered with our nursing relationship, he always had a great latch and never seemed like he was left hungry. I'll probably have to look into getting it corrected when he starts losing teeth as it does cause a gap but for nursing it was never an issue.

homequiltingmama · March 2018

calimom2524 said:

DS2 has a pretty big lip tie but it never interfered with our nursing relationship, he always had a great latch and never seemed like he was left hungry. I'll probably have to look into getting it corrected when he starts losing teeth as it does cause a gap but for nursing it was never an issue.

My second only had a lip tie, though it was pretty tight. The dentist told us it may not interfere with nursing, but would likely cause a gap later on. He said that lots of kids naturally rip this one on their own (like a big fall that busts their lip) so there's a chance it could go away on its own...not that you hope for the injury of course

calimom2524 · March 2018

Oh yeah, he ripped it partially once, talk about blood!! I was hoping he'd rip it completely on his own but alas, of all the falls he's taken, his lip tie has remained mostly safe haha

pghctwife · March 2018

they reattach really easily

my oldest has a lip tie that was never an issue and he’s busted it but it akways grew back

kburg15 · March 2018

To @pghctwife’s point, they can grow back. I think that’s part of the reason they have you do the stretches after they’re lasered/clipped.

pghctwife · March 2018

kburg15 said:

To @pghctwife’s point, they can grow back. I think that’s part of the reason they have you do the stretches after they’re lasered/clipped.

Yesssss because the last thing you want is to have to get it redone!!!

hfooter · March 2018

@lalala2004 yes very true. But then I’d say get a new pediatrician lol. But if you have troubles breast feeding see a LC.

both my boys have lip ties. Never interfered with their feeding, but I hope they bust them, @homequiltingmama lol. Otherwise we will get them fixed because they can mess with teeth.

lalala2004 · March 2018

hfooter said:

@lalala2004 yes very true. But then I’d say get a new pediatrician lol. But if you have troubles breast feeding see a LC.

both my boys have lip ties. Never interfered with their feeding, but I hope they bust them, @homequiltingmama lol. Otherwise we will get them fixed because they can mess with teeth.

Ehh.... if you expect your pediatrician to be an expert in everything, you’ll have a hard time finding one. They may have some knowledge of it, but just like they aren’t lactation consultants, nutritionists, dentists, etc.... They aren’t the expert on everything child related. Just childhood illness.

pghctwife · March 2018

lalala2004 said:

hfooter said:

@lalala2004 yes very true. But then I’d say get a new pediatrician lol. But if you have troubles breast feeding see a LC.

both my boys have lip ties. Never interfered with their feeding, but I hope they bust them, @homequiltingmama lol. Otherwise we will get them fixed because they can mess with teeth.

Ehh.... if you expect your pediatrician to be an expert in everything, you’ll have a hard time finding one. They may have some knowledge of it, but just like they aren’t lactation consultants, nutritionists, dentists, etc.... They aren’t the expert on everything child related. Just childhood illness.

Yeah I’m here too. I am obsessed with our pedi. I ADORE him. So nice. Bedside manner. Gets the breastfed baby thing. Excellent diagnostician - I have a few friends who see him, one switched to him for a second opinion and boom he figured it out. I know from friends he’s amazing with allergy issues. This guys kid go to the same school as mine and one day he saw us at pickup, he not only knows my kids names even though he has so many patients but he stopped and comforted my son who had just bumped his head. Im obsessed. I’m glad he’s not old so he won’t be retiring any time soon lol.

but he doesn’t ‘buy into’ all the ties stuff. So I go to other specialists for that, I inform him ‘hey FYI I had the babies ties lasered.’ I’m definitely not switching over this. Frankly I doubt many/any other pedis around are well trained in them and if I found one who was I’d maybe lose the other qualities that are important to me.

Justknow not to necessarily take a pedis word as final on ties, they just aren’t trained on them. Seek out experts in your area to consult. And focus on the other stuff in picking your pedi.

hfooter · March 2018

@lalala2004 Lol yah I expect my pediatrician to be an expert in everything...

hfooter · March 2018

And the stupid app ate the rest of my comment.

But I said it’s easily diagnosed and when they are so focused on your baby gaining weight they should be able to look for something that could potentially be hendering BF like a lip or tongue tie.

By no means do I expect DS1 and DS2 doc to know all. He’s human.

delujm0 · March 2018

I specifically selected my pediatrician office because they have 2 LCs on staff. One of them is also a nurse practitioner and if you're breastfeeding you have your 4 day old appointment with her and she does a weighted feed and watches you nurse to give advice on latch etc. With DD1 she also showed me how to use my pump. We want to change to another office closer to the house but I won't do it until I'm done breastfeeding because of the LC.

pghctwife · March 2018

See, I wouldn’t get it revised to the pediatricians office anyhow… I would want to go to a pediatric dentist or ENT or similar because I want it done with lasers and be done by someone is an expert and does them more often. Which luckily we have a lot of nearby. So, it’s not that big of a priority to me since I’ll be seeing somebody else anyhow. We do have some other pediatricians locally that have LCs on staff, but there’s other aspects of those offices that are less appealing to me unrelated. So... I mean sure, ideally a pedi would be well versed in everything but this is only one small thing among many important considerations, and it’s mpre easily overcome (by seeing a specialist) than say, a pedi with whom you disagree on how often they prescribe or they are hard to get into for emergency sickness visits etc

pghctwife · March 2018

Plus, even some LCs are not as good at understanding tongue ties. The one that was at the hospital when I delivered my third was great with positioning and latch and everything, but, and I’m not joking here, my midwife knew that I had gone through tongue tie revision so she and the lc had me come talk to another mom who also just delivered about what to look for in tongue ties and who to see to get one revised. Unfortunately it just isn’t widespread knowledge right now… Which is why groups like this one or specific local groups are great for sharing that information about what to look for Etc

Granted, I would totally expect an LC to be better informed than the one I saw at the hospital on this

hfooter · March 2018

@pghctwife yes I would not have the pediatrician correct the lip/tongue tie...I’d go to an ent/pediatric dentist that specializes in correcting them...all I said is I’d expect the pedi to be able to know what it is especially if they are concerned about the baby’s weight gain or lack there of and are exploring reasons why. Doing a simple google search even I could diagnose it and I don’t have a medical degree...

But whatever, all I’m saying is find someone to Check for a lip/tongue tie for you if you are having latch/bf issues. It may not be the reason but at least you can rule it out.

lalala2004 · March 2018

@hfooter but you aren’t qualified to diagnose a tie just because you know how to google, and neither are most pediatricians. Knowing what they are and being able to diagnose their severity and whether or not they need to be revised are two different things, and the latter should be left to professionals. That was my point.

pghctwife · March 2018

Lots of pedis can dx orveven snip the obvious ties but not the posterior ones. There are lots of ties babies that are harder to dx. In my other groups I’ve known plenty who ignored a tongue toe bc their pedis didn’t see it. Just sayin, see an expert if you have reason to suspect one. It’s a widespread knowledge gap so while it would be great if all pedis were trained in it, many aren’t who are otherwise excellent pedis.

hfooter · March 2018

@lalala2004 sure I get that, but wouldn’t it be better if they knew what to look for and then refer you rather than putting your baby on formula when you’d do anything to breastfeed? If I were to ever be in that position (and thank god I didn’t have to be with either kid) I’d want a pediatrician that is knowledagable enough to be able to see what could be the issue. That’s my point.

lalala2004 · March 2018

hfooter said:

@lalala2004 sure I get that, but wouldn’t it be better if they knew what to look for and then refer you rather than putting your baby on formula when you’d do anything to breastfeed? If I were to ever be in that position (and thank god I didn’t have to be with either kid) I’d want a pediatrician that is knowledagable enough to be able to see what could be the issue. That’s my point.

Well sure, I’d love for them to know it all. I’m all for having a pedi that’s pro-breastfeeding, and I do, but even some that are don’t know it all. I love my pedi, but they gave me some questionable advice about how to use essential oils. I’m not going to ditch them for that, because they aren’t certified aroma therapists. People tend to ask their pediatricians about child nutrition, sleep, behavior/discipline and all they really have to offer is their personal opinion, but because they are pediatricians, people put a lot of stock in it. As important as I think it is to have a qualified pediatrician who stays up to date on research, it’s equally as important to recognize their limitations.

pghctwife · March 2018

MDs have a ton they need to stay current on, and I just don’t see a gap on knowledge here something to switch over, personally. Obvs everyone will have their own priorities in a dr which is totally fine and understandable. But my guess is that in most cases switching won’t guarantee better knowledge on this.

i think it’s still seen as more a midwifery thing, or a little ‘woo’ and that may be why the literature and training on it isn’t pushed on them too.

he’s referred me out for other things before too - derm, dentist, optometrist. This is more a dds thing than a pedi thing so it makes sense that a pedi may not be well trained in it.

ecwk · March 2018

My pedi did not diagnose a lip/tongue tie despite weight loss in the beginning. Neither did the LC. Eventually I brought it up with the pedi again and she agreed that there was a lip tie and referred me to an oral surgeon. The oral surgeon diagnosed both a lip and tongue tie but advised against any surgery/lasering etc. and told me to monitor it for the next couple of years. Just an anecdotal story to say that yes my Pedi eventually recognised one of the ties but did not have the expertise to recommend any further action. If it happens this time around and we struggle in the beginning I’m definitely going to be far more proactive about it!

carrotsandpeas3 · March 2018

This is slightly off topic but just wanted to quickly interject... @lalala2004 @pghctwife love your descriptions of being a good pediatrician but also still having limitations and being okay with that. There is so much pressure on physicians to have all the answers, and there is simply not time to know it all. Balancing when to refer to a specialist is tricky for everybody, so I'm glad to hear patients defending their physicians a bit. Makes my heart happy.

pghctwife · March 2018

doctormom33 said:

This is slightly off topic but just wanted to quickly interject... @lalala2004 @pghctwife love your descriptions of being a good pediatrician but also still having limitations and being okay with that. There is so much pressure on physicians to have all the answers, and there is simply not time to know it all. Balancing when to refer to a specialist is tricky for everybody, so I'm glad to hear patients defending their physicians a bit. Makes my heart happy.

Of course! My husband is in the medical field (pharmacist) so I have some bias from him.

No no one is perfect and if not ‘getting’ ties is my only beef with our pedi we are in pretty good shape.

Secretstapler · March 2018

DS really struggled with latching from the very, so we gave him formula a couple of times in the hospital while we tried to figure it out. They tried a nipple shield, which didn't help and I hated it. The day after he was born they suggested it could be a tongue tie. I think the pediatrician in the hospital is the one who officially diagnosed it, but she wasn't at all certain. They (the pediatrician and the LCs) said there were almost no risks to cutting the tie, so it wouldn't hurt if it wasn't the problem, but it could really help if it was the problem. We said go for it, so they took him away immediately and snipped his frenulum. They said the frenulum wasn't especially short, but it was extra thick. It seemed to help, enough that we were nursing well enough to bring his bilirubin numbers down enough to let us go home.

A week or two later, we still struggled a bit with nursing, so I saw the lactation consultant at the hospital. It turned out that we had lots of weird little issues:

1. DS didn't have the rooting reflex in his cheeks, so he wouldn't search for the nipple when it was right next to him. However, he did have the rooting reflex at the back of his head (I had no idea that was a thing, but it apparently is). So I'd put my hand behind his head to guide him in, and he'd twist around looking for a nipple behind him. It was pretty hilarious to watch, but super frustrating to deal with a dozen times a day.

2. He kept falling asleep while nursing. I think that can be a sign that the baby is working hard and not getting anything, but it didn't seem to be the case with DS. We just had to strip him down so he'd be cold, tickle him and rub his head to try to keep him awake. We'd also do a diaper change mid nursing when we got up in the middle of the night, so he could wake up and finish eating.

3. He also kept trying to nurse with his tongue at the roof of his mouth, which obviously didn't work very well. The LC suggested that we introduce a pacifier so he could practice sucking properly. We did, and I think it helped a lot. Although I still occasionally see him putting his spoon under his tongue. Two plus years later, he still uses the pacifier, but we've set limits on when he's allowed to have it, so I feel a lot better about it.

All of those things pretty much resolved after the first few months (I wish I could remember better how long it took). We nursed for 15 months. Actually, I think today might be the one year anniversary of the last time we nursed!

I don't know how much any of this helps for breastfeeding prep, except that I did almost nothing to prepare for it ahead of time, and I don't know if there's much I could have done to prepare. I am super grateful that I had so much support before I even left the hospital, and I think they even scheduled my appointment with the LC before we were discharged. I honestly don't know if I would have sought it out if it wasn't mostly done for me. I would definitely recommend seeing someone if you are at all struggling or even uncertain about it. I felt so much better after having someone confirm that my kid did have some pretty weird habits, but was still getting enough milk. And she did have some good tips that made things easier for us.

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