7 minute read
Breastfeeding: Answers and Support for Common Struggles
Jennifer Yoon, RDN, LDN, IBCLC
Breastfeeding provides the best nutrition and protection for your baby. The benefits of breastfeeding
for mother and baby include protection from infection and long-term health concerns including allergies, diabetes, and certain types of cancer. Breastfeeding is low cost and environmentally friendly. Breastfeeding is natural! But breastfeeding does not always come naturally, and many moms experience challenges on their breastfeeding journey, especially in the early days. Here are some common breastfeeding challenges and how to handle them:
Sleepy feeder: Newborns are often sleepy and will choose sleep over feeding. Your newborn may need to be woken every 2-3 hours to feed. Baby may also require rousing during the feed. Baby should be unclothed and uncovered for feeds – mom’s body provides adequate warmth. Baby may also require stimulation of cheek, chin, hands, feet, or ribs to stay awake for feeds. Some parents will resort to applying a cool wash cloth. Getting baby away from mom’s warm body and possibly exposing the diaper area to air are also helpful for keeping baby awake and on task for a productive feeding.
Difficult or painful latch: The early days of feeding are a learning curve for mom and baby. Latching baby to the breast within the hour after delivery provides a great start for successful latching, but even babies who latch well initially can have trouble in the days that follow. To help baby latch successfully, watch for early hunger cues such as lip smacking, rooting, or chewing on fists. Begin feeds by placing baby on your chest skin to skin and return to this position intermittently if baby has difficulty latching. Baby should be supported on a firm base, in close, belly to belly with mom. Baby should be positioned where his nose is lined up with mom’s nipple so the chin comes in first to achieve a deep comfortable latch. Enlist the help of your partner or other caregivers to help you achieve a good position- a bird’s eye view can be helpful. Finally, the breast should be supported to help newborns achieve and maintain a deep latch.
Is my baby getting enough?:
Uncertainty about how much milk baby is drinking at the breast, whether baby is getting enough, or fear baby isn’t getting any milk at all is a common concern and often leads moms to reconsider breastfeeding. For reassurance, watch for long sucks and listen for swallows. In a typical feed, baby will swallow once for every long suck for the first few minutes, and then slow down to swallow once every 2-3 sucks for the duration of the feed- typically around 20-30 minutes total but this can vary. Look for signs your baby is satisfied after the feed- baby will be relaxed and restful, hands will be relaxed. Look for an increasing number of wet and poopy diapers, and poop that is changing from black and tarry to green or brown, then to yellow.
Cluster Feeding: Common in newborns, Cluster feeding is a block of time when baby is fussy and demanding to be fed very frequently, is consoled while feeding, and can not otherwise be calmed. The reason babies cluster feed is not fully understood, but thought to be a combination of normal feeding and developmental needs. Cluster feeding is emotionally and physically exhausting and leaves many moms questioning whether their breast milk is enough for baby. For reassurance your baby is getting enough nutrition, listen for swallows during the feeding, monitor for adequate wet and poopy diapers, and consider whether baby is feeding at least 8 times a day in a 24 hour period. To manage during cluster feeding sessions, enlist the help of other caregivers to comfort baby – swaddling, shushing, rocking, swaying – and rest as you have opportunities. Change positions often and use a breastfeeding pillow to reduce fatigue. Keep food and water close by. Use calming music, diffuse essential oils, and dim lights to create a calm atmosphere.
Deep Latch Technique
From The Pump Station & NurturyTM
Images used with permission of Fit Pregnanacy magazine 2001
My Milk Isn’t In Yet!: Colostrum is present in small amounts for baby’s first few days of life and provides the perfect nutrition for your baby. Colostrum provides important antibodies, coats baby’s stomach and intestines to help release meconium, and prepare for the milk that is to come. Mother’s milk generally starts to come in on baby’s third or forth day of life. Sometimes, the transition from colostrum to milk can happen more gradually over 10-14 days. The best way to hasten the milk supply is feed baby often and on demand. Time spent skin to skin with baby also helps increase of oxytocin which triggers the milk supply. Rest and self care is important to reduce stress hormones that can work against milk supply and let down. Hydrate well and eat nutritious foods that can contribute to a healthy milk supply such as oats, flax, nuts, and seeds, carrots, spinach, and fennel.
Engorgement The milk is in!:
And suddenly the breasts are full, firm, and perhaps painful. Very full breasts can also make latching a challenge for the baby. This fullness and discomfort is partially from the sudden supply of milk, but also from the collection of blood vessels and tissue springing to action. Warm compresses or warm shower prior to feed can help soften tissue and relieve pressure before a feed. Reverse pressure softening is a massage Education and support: We offer a variety of support services for breast-feeding moms, including: > Breast-feeding classes: Moms-to-be and new moms can participate in classes led by lactation consultants. Learn more about our pregnancy and childbirth classes.
> Phone consultations: Lactation consultants from West Penn Hospital are available to answer your questions. Please call (412) 578-7030.
If we miss you, please leave a message and we will return the call as soon as possible.
> Support groups: West Penn Hospital lactation consultants host free weekly support groups for breastfeeding moms. For more information or to register call (412) 578-7030.
technique that can reduce pressure and alleviate discomfort (see video here https://youtu.be/3ULnIUeHAIM). Supporting, or sandwiching, the breast in a U Hold can help baby latch to a full breast- like taking a bite of a big hamburger. Cool compresses after the feed can calm the tissue and relieve discomfort. Hand expression, the use of a haaka, or very brief use of a manual or electric pump can be helpful in alleviating pressure but should be used with caution as your body may respond by making more milk than your baby needs, resulting in prolonging engorgement and causing an over supply.
Nipple Pain: Frequent feedings in the first days of life, especially before the milk comes in, inevitably leads to sore nipples. Normal nipple pain generally peaks in the first few days of breastfeeding, healing completely in the first couple of weeks, and is most prominent during the first minute of the feed until the milk starts to flow. Help for sore nipple includes applying warm compresses, breast milk, or nipple cream or oil after each feed. Allowing the breast to be exposed to air a few times a day or using nipple shells in the bra to reduce friction can be helpful. Nipple soothing gel pads can also be worn to protect the nipple and promote healing. Ensure positioning and support of baby to achieve and maintain a deep latch. Use a finger to relieve the suction before unlatching baby. If nipple pain persists for longer than a week, lasts throughout or after feed, or is not bearable, it should be evaluated.
There are many more questions and concerns that can arise in the early days of breastfeeding and beyond. At AHN Pediatrics, your baby’s healthcare team is here to help. Board Certified Lactation Consultants place phone calls to families of babies born and AHN facilities and choosing AHN doctors within 48 hours of discharge, when many of these feeding questions and concerns arise. The Breastfeeding Support Line is available to all of our families throughout their breastfeeding journey. For families who may need more help, video or in person visit are available at many of our AHN Pediatric Sites.
AHN Pediatrics Breastfeeding Support Line
(412) 325-5616
Board Certified Lactation Consultants are just a phone call away
Breastfeeding check-ins within 48 hours of going home with your baby
Phone consults for questions or concerns
Virtual or in person lactation support
Breastfeeding offers the best nutrition and protection for your baby, but there are many challenges that can arise in the early days of feeding your newborn and beyond.
At AHN Pediatrics, we are dedicated to supporting families throughout their feeding journey to navigate the challenges and find the feeding methods that fit the needs of the baby and family.
