Breastfeeding when it didn’t work out the first time

I breastfed my daughter for 2 weeks. I had great support in hospital to breastfeed but it didn’t continue once I left. I saw a GP who I thought was going to be supportive and it ended my breastfeeding relationship.

I should have fought harder, I should have sought a second opinion. But I didn’t. The buck stops with me, it is my fault my daughter was denied her right to breastmilk.

But this post isn’t about that.

Many first time mums struggle with breastfeeding. Before we give birth it seems we’re either of the impression that it’s natural so it will work OR that it’s really hard and super painful.

We aren’t told the truth. The reality is this;
Breastfeeding is a learnt skill.

It’s not hard it’s just different from how the media portrays babies being fed, which is via the bottle, and takes a little extra effort in the beginning.

We no longer have a breastfeeding culture, girls aren’t seeing babies being breastfed by their mothers, aunts, sisters, and cousins. Breastfeeding is barely shown on television if at all and you are bound to see a billion bottles at any mainstream baby shower.

Yet we know breast is the best choice. We say that breastfeeding reduces the risk of cancer for both mother and baby but the reality is by not breastfeeding, by not doing what our bodies are designed to do we increase our risk and our babies risk of cancer. And obesity. And a whole range of conditions and illnesses.

If you don’t have the support of someone who has successfully fed her children then I highly recommend seeing a lactation consultant as soon as possible, even before your baby is born. $200 may seem like a lot of money, but you’ll shell out a lot more in formula if breastfeeding doesn’t work out.

How can I make it work if it didn’t work the first time?
First, find out what the issue was the first time and see of there were any ways you come have remedied it. This isn’t about laying blame for not succeeding, it’s safeguarding your next breastfeeding relationship.

Then, read read read and research. Kellymom has a great list of resources, especially regarding common breastfeeding concerns.

When preparing to breastfeed my second child I read books by Pinky McKay and Breastfeeding Real Mums Tell You How. Now that book did have stuff about Bottlefeeding however it have me great strategies for managing problems if they came up.

I made a breastfeeing plan and formula just was not an option. When I was feeding my first I always said I would formula feed if I had to. It was always in the back of my mind. If I had to then I would formula feed. I even bought bottles just in case. I shouldn’t have. So I didn’t the second time around. I was going to breastfeed and that was that. I forced myself to work through any issues instead of just giving up. And I did, and we’ve been breastfeeding 1 year on Tuesday.

Finally, I found support. My birth attendant and I made a breastfeeding plan, in NICU I stuck to my guns and said no bottles allowed, even after we moved interstate I asked my breastfeeding questions via Joyous Birth or looked for information at the Australian Breastfeeding Association or called their hotline on 1800 mum2mum.

Breastfeeding is what our bodies are designed to do, and just like a VBAC is totally possible after a csection when the body is left to do what it is suppose to do and given the support has no hidden agenda, you can breastfeed a second child it you didn’t breastfeed your first.

Of course not everyone can breastfeed, in those cases the WHO recommend expressed milk from the mother, nursing from another woman, donated breastmilk with formula as a last option. If you are looking for donor milk Human Milk 4 Human Babies is a global network linking pumping mums with mums in need of breastmilk.

Good luck, I know you can do it, I did.

Is he getting enough?

Often mothers worry about their milk supply.  Occassionally I hear about a mother with too much but more often then not it’s mum’s with too little.

First things first, always keep the following in mind.

Call your doctor, midwife and/or lactation consultant if:

• Baby is having no wet or dirty diapers
• Baby has dark colored urine after day 3
  (should be pale yellow to clear)
• Baby has dark colored stools after day 4
  (should be mustard yellow, with no meconium)
• Baby has fewer wet/soiled diapers or nurses less
  frequently than the goals listed here
• Mom has symptoms of mastitis
  (sore breast with fever, chills, flu-like aching)

Right, now milk supply.  Truth is an overwhelming percentage of mothers DO have enough milk, but outside influences are hindering this.  Schedule feeding, for example, is the enemy of supply.  Unhindered access to the breast is key to keeping up a good supply.  Now some days babies feed more then others, this is NOT an indicator of low milk supply.  Babies feed for a hosr of different reasons, comfort, pain relief, nutrition, thirst.  When wondering why baby is feeding so much today ask yourself the following question, do you limit your own access to food or water?  Of course not!  Some babies just cannot wait until lunch time for lunch.

Are you eating enough?  Your body will not starve itself to make milk.  So feed yourself.  You need fuel to keep your car going, you need nutrition to keep that milk flowing!

Drink plenty of water, dehydration will hinder milk supply.

Remember it can take up to a week OR LONGER for your milk to fully come in.  Colostrum will sustain your baby, so put your baby to the breast often to stimulate milk supply.  Weight loss is normal in newborns.  It’s not a reason to switch to formula feeding.

Forget the scales, unless you’re weighing at the same time every day on the same scales then the measurement will not be accurate.  Instead look at babies overall health.  Colour, muscle tone, does the skin bounce back, wet nappies, dirty nappies.  Weight is an indicator of baby health, but doesn’t always give the whole picture.

Babies are often fussy in the early evenings and often cluster feed at this time, doesn’t mean you have no milk, it just means your baby is normal.  I like to think of this period as tanking up for the longer periods of sleep at night.

At http://www.kellymom.com they list some potential causes of low milk supply -

• Supplementing. Nursing is a supply & demand process. Milk is produced as your baby nurses, and the amount that she nurses lets your body know how much milk is required. Every bottle (of formula, juice or water) that your baby gets means that your body gets the signal to produce that much less milk.
• Nipple confusion. A bottle requires a different type of sucking than nursing, and it is easier for your baby to extract milk from a bottle. As a result, giving a bottle can either cause your baby to have problems sucking properly at the breast, or can result in baby preferring the constant faster flow of the bottle.
• Pacifiers. Pacifiers can cause nipple confusion. They can also significantly reduce the amount of time your baby spends at the breast, which may cause your milk supply to drop.
• Nipple shields can lead to nipple confusion. They can also reduce the stimulation to your nipple or interfere with milk transfer, which can interfere with the supply-demand cycle.
• Scheduled feedings interfere with the supply & demand cycle of milk production and can lead to a reduced supply, sometimes several months later rather than immediately. Nurse your baby whenever she is hungry.
• Sleepy baby. For the first few weeks, some babies are very sleepy and only demand to nurse infrequently and for short periods. Until baby wakes up and begins to demand regular nursing, nurse baby at least every two hours during the day and at least every 4 hours at night to establish your milk supply.
• Cutting short the length of nursings. Stopping a feeding before your baby ends the feeding herself can interfere with the supply-demand cycle. Also, your milkincreases in fat content later into a feeding, which helps baby gain weight and last longer between feedings.
• Offering only one breast per feeding. This is fine if your milk supply is well-established and your baby is gaining weight well. If you’re trying to increase your milk supply, let baby finish the first side, then offer the second side.
• Health or anatomical problems with baby can prevent baby from removing milk adequately from the breast, thus decreasing milk supply.

If you do have a low supply, then what can you do?

1. Stop using bottles, pacifiers and formula.  Offer the breast often and make sure you’re feeding AT LEAST every 2 hours during the day and 4 hours at night.
2. Make sure you’re eating and drinking well.
3. See a lactation consultant.
4. Forget the housework and concentrate on feeding.  Take a nursing vacation for 2-3 days, take your baby to bed with you all day, all night, watch a DVD and just feed, feed, feed.
5. Switch sides while nursing every time it changes to comfort suck many times during the feed to keep stimulating the let down reflex and stimulate supply.
6. Eats oats, fenugreek, linseed, flaxseed, and brewer’s yeast.  Try these lactation cookies.
7. Consider pumping. Adding pumping sessions after or between nursing sessions can be very helpful – pumping is very important when baby is not nursing efficiently or frequently enough, and can speed things up in all situations. Your aim in pumping is to remove more milk from the breasts and/or to increase frequency of breast emptying. When pumping to increase milk supply, to ensure that the pump removes an optimum amount of milk from the breast, keep pumping for 2-5 minutes after the last drops of milk. However, adding even a short pumping session (increasing frequency but perhaps not removing milk thoroughly) is helpful.
8. Consider a galactagogue. A substance (herb, prescription medication, etc.) that increases milk supply is called a galactagogue.
9. Ask for motillium, a medication that can increase milk supply.
10. Ask your health care provider to test for hyperthyroidism, this can effect milk supply and cause depression.
11. Wear your baby and have lots of skin to skin.

If it doesn’t work and I truly don’t have enough milk for my baby…

Supplement with a supply line or supplemental nursing system.

Even some breastmilk is better then none at all.

Donor breastmilk is favourable over formula.

If you are struggling to find a donor try - www.hm4hb.net/

Breastfeeding with ‘different’ breasts

Every poster I’ve ever seen showing a woman breastfeeding her baby shows women with breasts that are the right size, shape, and with perfect perky, sticky-out nipples.  That woman would have no trouble with too big, too small, flat or inverted nipples.  Today, I’m blogging about flat and inverted nipples.

The first thing to remember is that a significant number of women have some degree of inversion.  Have a look at your nipples while you’re still pregnant and if you think they might be flat or inverted, see a lactation consultant BEFORE you give birth.  You can determine whether or not you have flat or inverted nipples by compressing your areola about 3 centimetres behind your nipple.  A normal nipple will evert or protrude, an inverted nipple will retract.

If you do have flat or inverted nipples this does not mean you cannot breastfeed your baby.

You can use a niplette during the first and second trimesters of pregnancy to bring out the nipple.

You can use a breastpump before a feed to bring out the nipple.

You can use these nipple formers.

Try the Hoffman technique to prepare your nipples - Pressing down and pulling away from the nipple with your thumbs a few times. Do this up and down and sideways. The hoffman process will help your nipple move outwards and can be done about five times a day.

Nipple stimulation – You can roll your nipple in your hands or place something cold on it for a few minutes to get it to stand out.

With an inverted or flat nipple you will need to nurse as soon as possible after birth, and every 2-3 hours after that. This is to avoid engorgement because breast engorgement can push flat nipples out, making them even harder to grip.

Make sure that your baby is latching on correctly.

Try calming baby.  A calm baby is easier to attach and feed then one screaming and crying.

If you are breastfeeding with inverted nipples you should always remember that baby should get as much of your breast into his mouth as possible.

You could try using a supplemental nursing system with expressed milk.

As a last resort mom might feel that she would rather pump exclusively.  Now exclusive pumping would be the last option after trying everything else, however any breastmilk is better then no breastmilk.

If you have on going nipple pain you should consult a lactation consultant or ring the ABA helpline (1800 mum 2 mum).  A natural birth is the best set up for your breastfeeding relationship so avoid induction.  The more frequently you nurse the more your baby will draw out the nipple so don’t schedule feed, demand feed, or better yet cue feed.  Watch for hunger signs BEFORE crying to avoid having to calm baby to attach them to the nipple.

Don’t let anyone tell you that you can’t breastfeed, only around 2% of women can’t physically breastfeed which means around 98% of women CAN!

Remember it’s called breastfeeding not nipple feeding, you can feed your baby.