Tag Archives: dads

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!
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Who’s Feeding Momma? 10 Ways to Support a Breastfeeding Mom

16 Apr

1. Share your successful breastfeeding stories and experiences and leave the negative experience or breastfeeding “horror stories” for another person……a new mom is already emotionally full as she processes her birth experience and contemplates motherhood…she is full of desire to be successful at breastfeeding and bonding with her new baby.  Offering stories of challenges may not fill her with the inspiration she needs, especially if she is struggling…..certainly let her know she is not alone even if there are struggles but adding to the list of “what if” and “could that happen to me” worries is probably going to have a negative effect.

2. Bring her food!! And NO it does not have to be bland and boring just because she is breastfeeding. Most nursing babies have no problem with any foods a mother eats even spicy or bold flavors. You could ask a mother about her preferences but don’t hold back on foods she enjoys. Or make her easy-to-grab, healthy snacks that she can store in her nursing nest and can eat while she feeds the baby!

3. Pamper mom!! Bring her some flowers to brighten the room, offer a foot rub or shoulder massage or bring her some chamomile tea to relax. Fill Momma’s love tank so she can fill baby’s!!!

4. During a feeding help her relax.….if you are present for a feeding, and you see mom getting tense, some gentle relaxation reminders can be helpful! Sometimes her shoulders creep up to her ears. Reminding her to relax and encouraging a few deep breaths can even help with the milk letting down!

5. Ask her what tasks around the house would help reduce her stress.….often times offering to hold the baby or take the baby so she can rest will only stress the mom more or make her feel inadequate as a mother. What may enable her to relax and focus on the baby is clearing the kitchen sink or doing some laundry. Straightening a room or walking the dog? Ask her!!

6. Be the gate keeper…..the early days of learning to breastfeed are usually filled with fumbling and adjusting as mom and baby learn the dance of latching. Mothers may find it hard to manage and focus if there are many visitors stopping in. Help decrease visitors, and you may also want to hold off on long visits until she requests it or feels up to them!

7. Send encouraging texts and emails….let her know how proud you are of her efforts to breastfeed, her dedication to breastfeeding, her amazing mothering abilities…….a simple text like ” You are an awesome mom and every drop of breastmilk you give your baby is a precious gift!” can carry her to through a long feeding at 2 am or a round of evening cluster feedings!

8. If she needs help…help her find good help…..IBCLC’s are the gold standard for  lactation care, bring her a list of local IBCLC’s to call on if she is having any issues!

9. Look up her local chapter of La Leche League and help her get to a meeting! Mother to mother breastfeeding support is invaluable…..she needs to feel like she is not alone…..even if everything is going well, it is good to meet other like-minded moms doing all the same things she is!

10. Help educate others around the new mother about ways to help support her! If you are reading this blog, there is a strong likelihood that you have a new mom in your life…..pass this blog on to others in her life as well.  Create a “village” around this new mom to inspire and support her on the journey of breastfeeding her baby.  Each child we see breastfed in this generation will contribute to a healthier and happier world in the next!!