Tag Archives: breastfeeding challenges

Round Two: 10 Tips for Nursing Your Newborn While Chasing a Toddler

7 Jun

Tears streamed down my face

as I sat in the recliner nursing my one week old son, holding my 18 month old daughter and watching my mom drive away.   Though breastfeeding was much easier the second time around, I was unsure how I was going to manage with a toddler and a newborn.  I had visions of my busy toddler coloring on the walls or playing in the toilet while I was sitting every 2-3 hours (or more often) nursing my son.  How I wish I knew then what I know now!

“Breastfeeding the second time around was SO much easier. Probably because I had the confidence. I breastfed my first for 2 years, so I ‘knew’ I could do it again. I just felt way more comfortable, and I knew the early pain was normal and would get better in a few days. It’s been tough because my toddler still needs attention, but the baby needs to eat! So we’re working on it and figuring it out together. But overall, it has been way easier and more comfortable the second time around.”   Beth, pictured above

  1. Prepare them.  Depending on your toddler’s age, consider taking her to a sibling preparation class.  Classes vary but usually include watching a video about becoming a big brother or big sister, diaper changing and swaddling practice on dolls, a craft project and sometimes a visit from a real newborn.  Read more about preparing your child for baby’s arrival here.  This is a great list of books geared toward sibling prep, and click here for children’s books about breastfeeding.
  2. Feed them.   Have healthy finger foods available for your toddler to snack on during some of your nursing sessions.  Put together little baggies of their favorites that are easy to grab and go.
  3. Surprise them.  How many times have you remarked your toddler has too many toys?  Pack some of them away in plastic tubs for awhile then pull them back out during the times you are caring for the baby.  Designate those as the breastfeeding toys.
  4. Contain them.  As I remarked above, I was concerned what my toddler would get into while I was nursing.  Create a nursing nest in a safe space where you can keep an eye on your toddler.  Installing a gate is an easy way to create a boundary.
  5. Include them.  Encourage visitors ahead of time to make sure and pay special attention to your toddler as the baby is a magnet!  I even suggest in my sibling class that visitors bring a treat to big brother or sister.
  6. Involve them.  Making the baby off-limits to big brother or sister will only cause them to resent the newborn.  Show them how to be gentle while staying close to prevent any accidental head bops or eye pokes.  Let them “help” with diaper changes, baths, retrieving clothes or your nursing pillow.
  7. Spend quality time with them.  Your time will be divided but your love is not.  Steal lots of moments to hug and kiss on your toddler.  When your partner gets home, hand over the baby and take big brother or sister aside to read a book with them, play a game, take a walk around the block or start their bedtime routine.   Plan toddler “dates,” such as a trips to the park or library, where the whole family can get out and brother or sister understands that the baby can be fun, too.
  8. Pack for them.  Take a trip to the dollar store, and pick up a few items like stickers, notepads, colors, pens, etc, and a little bag or basket to pack them in.  Make it the special bag that only comes out at nursing times.
  9. Expect regression from them.  For reasons they don’t even really understand, your toddler may regress to more baby-like behavior after the new baby comes.  If they are potty-trained, they may even regress in that area.  Refrain from disciplining this behavior and understand it is temporary and perhaps the toddler’s way of expressing “I need an extra, extra hug so I can feel like I am still important.”
  10. Embrace flexibility.  Learning to be flexible is a requirement for motherhood as our kids don’t always fit into the neat little boxes our culture creates for them.  Anticipate the diaper blow-outs right before you walk out the door.  Be ready for the toddler melt-down in the store.  Carry an extra shirt to change into after the unexpected spit up.  And most of all, look forward to the intangible rewards being a mom brings, whether you have one, two, or five!

What other tips can you share for moms going from one to two?

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Lactation Derailment Can Begin in the Hospital: 10 Tips for Avoiding a Trainwreck

29 May

I must preface this blog by explaining that

fourteen years ago I became a mother/baby nurse, and ten years ago I became the resident childbirth educator and “breastfeeding counselor” on staff at a local hospital.  We did not have an IBCLC on staff, so I was IT until we hired another educator.  My training as a nurse, some time as a member of La Leche League and my own personal breastfeeding experience was all I had in my arsenal.  Though I wasn’t “official,”  I worked the position of a lactation consultant.  And it wasn’t easy…so many moms…so little time…so many interventions.  That being said, please read the following with the understanding that I have been “on the other side,” doing my best as a nurse to help fresh babies latch…bending over beds as an educator positioning babies and sandwiching breasts for moms who were too sleepy on pain medication post-cesarean to do it themselves.

A week ago, I had the privilege of visiting a new family in the hospital to provide assistance with breastfeeding.  She has given me permission to share my observations.

When I arrived, I had dad undress baby down to diaper and in skin to skin with mom.  The baby was only 36 hours old and very sleepy after a long labor and difficult delivery.  Mom, Dad and I chatted for a moment then got to the business of latch.  The baby would not wake up.

A nurse came in to give mom pain medication.

Though I was not surprised at the baby’s behavior, he appeared jaundiced, and I knew it was important to get colostrum into him.  So, we proceeded to hand express and collect colostrum to spoon/syringe feed him.

Then the baby photographer came in to show the picture previews.

Mom asked her to come back later.  (Reminder:  Mom is sitting in hospital bed with her breasts exposed.) We continued hand expression and then fed the colostrum back to the baby.  He began to exhibit some hunger cues, so we put him back to the breast.

The OB came in to check on mom.

Once again, latch attempt without success.  More hand expression.

Knock, knock? Have you had a chance to look at your pictures? Baby photographer again. (Are you kidding me?)

More teaching, more skin to skin….fed baby more colostrum.

A different nurse came to check on mom.

Another latch attempt…

The first nurse came back to tell mom the baby’s procedure had been delayed.

We wrapped up latch attempts (and the baby) as we knew the nursery nurse would be coming to get the baby soon.  He was happily sleeping in Grandma’s arms as we discussed a care plan.

Persistent photographer, back again, insisting on showing the pictures.

I wrote out mom’s care plan.

Nursery nurse came to retrieve baby.

I ensured mom had my number for questions, planned to follow up with a home visit, and I made my exit.  Did you count the number of interruptions?  How long do you think I was there?

Eight interruptions in one hour and fifteen minutes. 

I left there concerned about derailment and feared I would encounter a trainwreck at her home visit.  Fortunately, when I arrived, breastfeeding was going well and she needed very little assistance from me at the follow up.

Now, I realize everyone that came in just saw me as a visitor.  They weren’t aware of who I was or why I was there.  However, my presence aside, feeding her newborn was mom’s priority, but what was the priority for the people that kept interrupting?  Definitely not feeding a 36 hour old, sleepy newborn who appeared jaundiced.

How can a mom even think about getting breastfeeding established when she is being bombarded by staff from all sides?  It’s sensory overload.  As a private practice lactation consultant, I see the outcome of this all the time….the trainwrecks…the result of the cascade of interventions.

What steps can you take to avoid the trainwreck?

  1. Take a prenatal breastfeeding class so that you know what’s normal for the early days of breastfeeding.
  2. Hire a Doula to minimize birth interventions which can lead to troubles breastfeeding.
  3. Find a breastfeeding friendly pediatrician who will support your breastfeeding goals.
  4. Research local resources for breastfeeding help that are available to you once you get home such as La Leche League or private practice lactation consultant that is an IBCLC (International Board Certified Lactation Consultant).
  5. Prepare your partner to be the gatekeeper after delivery to minimize interruptions in your breastfeeding. You may also want your partner to accompany your newborn to the nursery to keep watch and ensure your feeding preference is respected.
  6. Hand express your colostrum and feed back to the baby. Doing this up to 6 times a day can increase and speed copious milk production.
  7. Reinforce your desire to breastfeed without any supplementation to every nurse that you have contact with.
  8. Room-in with you baby to keep your baby close and to learn his hunger cues.
  9. Better yet, keep your baby “on” you to facilitate skin to skin contact which has been shown to stabilize temperature,
    heart rate and oxygenation. You are your baby’s best habitat!
  10. Ask to see the lactation consultant…and keep asking….getting help early is so important!

A BABE Mom’s Story: 6 Tips For 6 Months

14 May

  Three weeks into her breastfeeding journey

we had the privilege of meeting this sweet momma and her precious little boy.  Our first contact was November 15, 2011.  She was our fifth client but our first real challenging case.  Over the phone, she described that she was having some pain and nipple damage with latch and decided it was time to get help as she suspected what she was experiencing was not normal.  This was her third baby to breastfeed yet the first time to experience this situation.

Baby was ready to eat soon after we arrived, so we had her proceed with breastfeeding in her normal fashion.  As she readied herself and the baby for latch, she was relaxed and calm.  We then got our first look and could hardly believe what we saw.  To date, we have yet to encounter nipple damage as severe as hers!  There were actual craters in the center of each nipple.  Leah and I could not believe she had made it this far.

Our assessment revealed that the baby had

a very shallow latch.  His mouth would stay open no longer than a millisecond to achieve latch, and once he did latch, his lips stayed pursed on the breast.  Our impression was that his jaw and mouth were hypertonic (increased muscle tone).  At rest, he kept his lips tight, and we could not even properly assess for tongue-tie (which we suspected right away because of the nature of mom’s damage) because his mouth was so tight!

Over the course of the next five or six weeks

we worked with Linda in person, via email and over the phone to assist her in getting to a comfortable and enjoyable place with breastfeeding.  Using a combination of breast rest, APNO, pumping, finger feeding, bottle feeding, chiropractic, time, and a lot of patience and determination, we were thrilled to hear from her late December that healing was complete and breastfeeding was finally pain-free!

Sweet, little Sam is now six months old.  He never had one drop of formula…how did she do it?  Keep reading for his mom’s advice:

1.  Let it go:  I had a hard time accepting that my house wasn’t always tidy, the laundry and dishes piled up, and gathering my hair into a ponytail was as close to “styling” as I could manage.  It took me a while to figure out that it is OK to not be able to accomplish everything I could pre-baby.  None of those tasks are as important as being able to meet the basic needs of my family and myself.

2.  Don’t be afraid to ask for help:  Asking for help doesn’t come easy for me but I learned to not be shy about telling others what needed to be done.  My husband was great at taking over the jobs he could do while I concentrated on my needs and the needs of the baby – but I needed to be sure to ask!  Something as simple as asking someone to look after the baby (and my 2yo and 4yo!) so I could take a shower or just have a few minutes to myself to eat a big bowl of ice cream in peace made all the difference in my outlook on life.

3.  Trust your instincts:  I think everyone who knew I just had a baby had an opinion on how I should be feeding the baby.  I had to believe in myself and my ability to know what will work for me versus what doesn’t feel right for my family.  My grandmother probably meant well when she told me that babies do just fine on evaporated milk, but after thanking her for her concern, I forgot she ever mentioned it.  I also had to trust my instincts enough to know that I needed outside help.  I figured that since this was my third, I should have known what to do on my own when he had problems – I didn’t.  My only regret was not getting outside help sooner.  I could have saved myself some addition pain.

4.  Find a cheerleader:  Having immediate family members and lactation consultants to tell me that I was doing a good job was priceless.  Affirmations are important – I needed to be reminded that I am strong and I could do it and that the sacrifices I was making were for the new little person I just brought into the world.

5. Set short term goals:  Even though it was baby number three for me, I was feeling overwhelmed about surviving the whole newborn period.  So I aimed to just make it through the week, the day, the next feeding session, or past whatever other hurdles were getting me down.  Once that was behind me, I would give myself a pat on the back, consider it an accomplishment and set a new goal.

6. Believe that does get easier:  It can be so hard to see past the present, but the first few weeks really are the most difficult.  I knew that if I could just make it past the hump, things would start to get better.  I had to cling to the knowledge that one day soon I would feel human again.  Six months down the road, I am grateful I stuck it out.

What most helped you get to where you are in your breastfeeding journey?