Tag Archives: Breastfeeding

Watch the Baby

How long to feed baby picture.

How long to feed baby picture.

Something I see new Moms and Dads struggle with is how long a baby needs to feed at the breast to be full, satisfied and thrive.  I have heard all different numbers from my clients: 10 minutes each side, 20 minutes each side, 30 minutes one side.  None of these times are correct for all babies; no one time fits all.  Just like adults, each baby needs a different amount of time to eat.  When I sit down to eat with friends and family, we all finish at different times; babies are the same.  Timing feeds is misleading: it rarely provides an accurate measure of how much baby is taking in.  If we were to take two three-day old babies and measure how much they had eaten during a 15-minute breast feed, one could take in 5ml and the other could take in 35ml; if we cut off the first baby at 15 minutes, he could be underfed.  Timing also takes the focus of your baby and learning to watch/listen to them and places it on numbers which can lead to more stress.

One of the most common reasons I am called in for in-home consultations is high weight loss in the first few weeks and/or a baby having trouble gaining weight by breastfeeding.  I have seen Moms use the knowledge they were able to retain from their whirlwind visit to their Hospital for delivery, and stop a baby mid-feed at the 10- or 15-minute mark to burp the baby and switch sides.  I have even seen a Mother set a 10-minute timer so she would remember to switch sides.  Following the clock can lead you to cut your baby’s feed short.  You may be stopping them when they were just getting in to a good suck-and-swallow pattern, or you may even be limiting their ability to take in the fatty rich milk.

Watching your baby for signs of satisfaction is a much more accurate way to gauge your baby’s satiety.  Watch that baby has had a good, sustained suck-and-swallow pattern, and is not sleeping on the breast.  Watch baby for a relaxed arm; a newborn’s arm will start a feed flexed tightly with a clenched fist, a “chicken wing”.  Over the course of a good feed, your baby will slow down their sucking/swallowing pattern, relax their arm and fist, and may even fall off the breast with a relaxed open mouth; this tells you Baby is full and happy.  Once your baby gets in to this more relaxed state on the breast you can help them by performing breast compressions- ‘squeeze your breast-hold your hand their- then release the squeeze’ repeat a couple of these in a row.  Watch to see if your baby increases the sucking and swallowing.  If not you can sit your baby up and burp baby, mostly to wake so you can offer the other breast.  Offering both breasts in the beginning allows baby to take in more milk, practice breastfeeding more, and give your milk supply extra stimulation.  Your baby may not want the second breast at each feed, just like we don’t always want dessert with each meal.  Once your milk transitions, you also should feel relief in your breast from the start of a feed to the end.

Sometimes in the early days babies can be sleepy at the breast you can help them to stay actively feeding by using breast compressions and switching breasts- even going to each breast twice in a feeding to help them stay more awake and take in more milk.  If they are sucking and swallowing no need to switch breasts until they slow down/stop.

Watch that sweet baby; they can tell you a lot!

Katie Wickham RN BScN, IBCLC

info@babiesfirstlactation.com

www.babiesfirstlactation.com

www.facebook.com/BabiesFirstLactationAndEducation

Don’t Bite the Boob that Feeds You!

baby teeth

Don’t Bite the Boob that Feeds You!

“My son bit me last night; I guess it’s time to wean.”

“I see teeth coming; you can’t keep breastfeeding can you?”

In most cases, Moms will see Baby’s new teeth but won’t feel them; somehow Baby knows Mom is not food to be chewed.  But then sometimes baby gets distracted, or is struggling with teething pain, or trying to be playful, or thought your reaction from the first bite was hilarious; so Baby tries again.  There is nothing funny about teeth marks on your breast!

Here are 5 steps to help prevent or stop Baby bites.

Step 1: Before a feed offer your little one your knuckle; see Baby wants to chew for teething comfort, or suck for nourishment/soothing.  If chewing, offer a cold cloth, teething toy, etc., or give pain relief of your choice if you think they need it.  Then try to Breastfeed in a little while after Baby is soothed.

Step 2: If baby is distracted or uninterested in nursing, this can lead to biting.  If distracted, try to find an environment where baby will stay focused on feeding.  If baby is uninterested in nursing, do not force baby to nurse; allow Baby some time to play and then try to offer again.

Step 3: As babies age their latch can get relaxed.  Ensure you are helping Baby to latch deeply during this biting phase: when a baby is latched deeply to the breast and actively feeding, they physically cannot bite because of the position of their jaw and tongue.  Go back to your newborn latching technique to help baby get on deeply.

Step 4: Most biting happens at the end of a feed when Baby is full and playful.  When you start seeing signs of playfulness, end the feed, early if necessary, and distract with a song or toy so Baby isn’t upset.

Step 5: If Baby bites, remove Baby immediately from the breast and place Baby on the floor as calmly as possible and say something like “Ouch that hurts mommy, biting means no milkies”, or something along those lines.  Then you can try feeding again shortly. Baby learns very fast that biting means no milk. Try your best to stay calm; some babies find it hysterical when Mom’s yell, scream, or make faces, and try to get that reaction again, never realizing they are hurting Mommy; they just like the surprising reaction (some babies cry, some laugh).  When you are calm and repeat the same words each time (you hurt mommy, biting means no milkies), Baby probably won’t understand the words, but will make the association that biting means the boob is taken away and Baby goes on the floor.

Sometimes after new teeth emerge the latch feels uncomfortable.  Changing up your position can change the pressure those new teeth may put on the breast.  For the most part as your little one gets used to the new teeth the latch adjusts and becomes comfortable again.

Biting does not mean weaning.  Try following these tips to stop biting.

Consistency is the key.

Katie Wickham RN BScN, IBCLC

www.babiesfirstlactation.com

www.facebook.com/BabiesFirstLactationAndEducation

Image from dormenenem.com

The Newborn’s Stomach

I see many new families in the hospital, breastfeeding clinic, and in their homes with my private practice, and I hear many common questions.  One of the recurring themes comes across in statements like “my baby can’t be getting very much” or “my baby is feeding so frequently, I must not have milk. This cannot be normal!”  There are many charts on the Internet that show an illustration of the size of a newborn’s stomach, I felt putting these illustrations into real world sizes we can see would be helpful.

Below is an illustration I have created showing the approximate size and volume of a newborn’s stomach on day one, day three, at one week, and at one month.  Newborns’ tummies are tiny, and cannot/should not take in large volumes, so they need to feed frequently.  In the first day or two, their little tummy fills with 2-20 ml during a breastfeed, and then, snuggled in close to your warm chest and familiar heartbeat, they fall asleep.  Just as you may be drifting off to sleep or decide that you too should eat something, they start to wake up and show signs of hunger; their sweet little fists fly frantically to their mouth and their lips start smacking together.  Their little tummies have started to digest that perfect amount of colostrum, and they are starting to get hungry again.  A newborn baby feeds 8-12+ times in 24 hours, which means they will be feeding about every 1-3 hours.  After the first 24 hours and for the first week or two the baby should feed the minimum of 8 times in 24 hours to ensure they stay hydrated (shown by pees and poops), assist with things like jaundice and weight loss/gain, establish Mom’s milk supply properly and get lots of practice at the art of breastfeeding.

They often cluster feeds together; this means your precious little one may breastfeed for 45 minutes then fall asleep, then wake 30 minutes later and feed for another 30 minutes, and fall asleep.  The next feed may happen 2 hours later, then 3 hours after that, then an hour later… I’m sure you get the idea; there is no set schedule.  This is the best way to establish a healthy milk supply and to allow baby to control when they eat and how much.  You can not breastfeed your baby too much, but you can breastfeed them too little.

Many families feel the need to supplement their baby; maybe they are concerned with the frequent feedings, or feeling pressured from their doctor or family.  I often hear my clients comment that they hear their well-meaning family members say “The baby is crying again, she must be hungry” or “The baby is fussing, are you sure you have milk?” or “the baby just ate an hour ago, you must not have enough if he is hungry already.”  This can create, or further feed the insecurity a new mother may already be feeling, and often leads to unnecessary supplementation.  Some families feel they need to supplement due to pressure from the Doctor, and other families are supplementing for legitimate medical reasons (these reasons should be clearly communicated to you).  When you are supplementing it is crucial that you keep in mind how small those little tummies are.  If you supplement too much this will cause baby to sleep longer and feed less frequently and any time they are supplemented away from the breast you lose the stimulation  and removal of milk needed to signal your body to make more milk; this will directly impact your milk supply.  If you are supplementing always seek guidance from an expert in feeding- a board certified lactation consultant (IBCLC) will help guide you through how to supplement, how to protect your supply while supplementing and how to wean the supplements when the time is right.  Every baby is different and the size of your baby can impact how much they require/can take in by supplement.  Small term/preterm babies will often have trouble taking in the same volume as an 11lb newborn baby.  Seeking support will help customize supplementing based on your unique situation.

Understanding the size of your Baby’s stomach, the average volume taken in during a breastfeed and typical newborn feeding frequency can help alleviate some anxiety a mother feels when she is trusting her body to nourish her child.  Newborns are only this tiny for a short time, those stomachs grow quickly and they get more efficient at breastfeeding which means breastfeeding sessions become less frequent and shorter.  For now enjoy those snuggles, and feel encouraged that your baby is feeding frequently and doing a fantastic job of “demanding” a healthy supply of breast milk.  The great effort you and your baby put in during the first few days establishes a solid start for a happy and healthy breastfeeding relationship.

Copyright Babies First Lactation and Education

Copyright Babies First Lactation and Education

Katie Wickham RN BScN, IBCLC

www.babiesfirstlactation.com

https://www.facebook.com/BabiesFirstLactationAndEducation

*Original image has been updated 2 times to improve clarity and quality.  This image and any others on this topic by Babies First Lactation and Education may not be altered in any way or used without permission.  For information on using this image please contact Katie at info@babiesfirstlactation.com

Putting Your Best Breast Forward

ImageBreastfeeding is an amazing way to nourish your child; it is important for both of you for so many reasons.  This amazing gift you can give your child should be easy, the baby should come out and take to breastfeeding perfectly and stay that way for however long you choose to breastfeed, Right?  If only that were the case for everyone!  Breastfeeding is often a huge learning curve for both Mom and Baby.  The frustrations that are common in the early weeks can be exacerbated by the normal hormone fluctuations you experience, lack of sleep, self-doubt, naysayers and plain old exhaustion.

I wish I knew some of what I am going to share with you before starting on my breastfeeding journey 5 years ago with my preterm twins.

  1. Prepare mentally for breastfeeding.  It sounds silly, but a positive attitude can make all the difference in the world.  Firstly, if you have had a previous experience with breastfeeding, analyze what was good and bad about your experience.  Let go of any remaining emotions or guilt that may still be present.  It may help to discuss your previous experience with a Lactation Consultant and see if there was anything that could have been done differently that you may want to change this time around.  Similarly, if this is your first experience, think about any concerns you have and discuss them prenatally with a Lactation Consultant.  Many Moms have it in their head that they may not be able to breastfeed because of something like a flat nipple, or someone else in their family who couldn’t  but there are many things that can be done to remedy these concerns.  Setting yourself a reasonable breastfeeding goal may also be helpful.  I am going to try really hard with support to get to 3 months, or whatever makes sense for you.  This goal can be constantly moved further as things get easier with time.  If you enjoy reading books the book “The Motherly Art of Nursing” by La Leche League is a fantastic book to read prior to deliver or after for support.  Lastly, know who your supporters are and turn to them post-partum  whether they are friends, family or a Lactation Consultant.
  2. Try to minimize interventions in labour.  This includes things like, IV fluids, early epidural use, induction, and caesarean section.  Obviously some of these cannot be avoided sometimes, and if they do happen it doesn’t mean you won’t be able to breastfeed.  The fewer interventions, the easier the breastfeeding should be.
  3. Spend lots of time skin to skin and start breastfeeding as soon as possible after birth.  Your baby will be alert and ready to feed the first two hours after birth; thanks to a healthy release of hormones during labour.  Take advantage of this time and snuggle close.  Your partner can do skin to skin if you are unable to due to a caesarean section.  Initiating breastfeeding during these first 2 hours has been shown to increase breastfeeding success rates.  After these initial 2 hours your baby will get sleepy and so will you.   So hold off all those excited visitors during this time and enjoy the moment.
  4. Get help early.  If your baby and you are having trouble with latching, ask for help early!  Ask your nurse in the hospital for help, or ask to see the hospital Lactation Consultant.  Make sure you get a good latch each time to prevent damage; it can make future nursing sessions more painful even with a good latch.   Hand express a small amount of colostrum after each feed and rub it on your nipple and areola, allow it to air dry to help protect and heal nipples.  If you have damage on your nipples, you have been having a difficult time in the hospital breastfeeding, you are supplementing or you are using a nipple shield or tube at the breast; early access of community support from a lactation consultant is crucial to a successful breastfeeding journey.
  5. Start hand expressing as soon as possible after birth if any of the following is happening: your baby is very sleepy (and not feeding well), having trouble latching, or separated from you due to health concerns; this will help with your milk supply. Ask your nurse or hospital Lactation Consultant how to hand express.  If the difficulties continue or you are going to be separated for a while, start pumping with a hospital grade pump.  If you need to pump, ensure you speak with a lactation consultant for tips on how to establish your supply and properly remove milk from your breasts using a pump.  Spend as much time as possible skin to skin if your baby is having trouble latching or separated from you, this will help with your milk supply and help wake up a sleepy baby.
  6. Ask about what is normal.  If you are concerned about something, ask friends, family, or a lactation consultant what is normal.  There are many things that cause Moms worry but are totally normal.  Things like cluster feeding, fussy evenings, growth spurts, and changes in your breasts; to mention a few.  Hearing from other Moms, or an expert like a lactation consultant, can help you rest at ease or provide you with tips for how to get through these norms.
  7. Hang in there!  Get that support if you are feeling frustrated, and use those supporters you have surrounded yourself with to be your cheerleaders.  When everything is right (latch, supply, etc.) breastfeeding will just continue to get better!  Your baby becomes more efficient at feeding and you both get the hang of things… and each other.

I am always happy to answer questions or provide support!
http://www.babiesfirstlactation.com

Katie Wickham BScN RN, IBCLC

Babies First Lactation and Education