Tuesday, February 5, 2013

doula site post 2 : breastfeeding


Breastfeeding Q & A

Why breastfeed?
Breastfeeding is the natural, biological way our species was designed to survive, yet much of the American population uses artificial milk from another animal to support the growth and development of infants. Mother’s milk is far superior because it provides nutrients, comfort and a whole host of other substances that can’t be replicated in a lab.

I’d like to begin by linking to a really fantastic list featuring the benefits of mother’s milk. http://milkmatters.org.uk/over-101-reasons-to-breastfeed/

And here’s my version.  Mother’s milk contains:

Nutrition-Mother’s milk actually changes with the age of your baby to give him or her exactly what he or she needs at every stage of development, for as long as you choose to breastfeed.  It is a complete nutritional food that provides everything your child needs to survive in the first year of life.

Antibodies-Breastmilk contains all sorts of antibodies that prevent childhood illnesses like colds, diarrhea, ear infections and more. If you breastfeed into toddlerhood, your milk will continue to provide these benefits, which will help keep the daycare bugs to a minimum!

Development-Breastmilk contains a complex mixture of items that help your child’s brain to grow and thrive.  These components, plus the security and comfort of being at mom’s breast, typically help breastfed babies have a greater IQ and more independence than non-breastfed babies.

Digestive enzymes/probiotics-Babies’ stomachs are not designed for anything except breastmilk in the first six months.  During that time, the breastmilk actually helps create a protective lining in your baby’s stomach to help him or her when you finally start introducing solids.

Stem cells/DNA-That’s right; stem cells.  If you breastfeed, those cells help ensure that your child is developing properly and can reduce the risk of come cancers, like leukemia, down the road.

Long chain fatty acids (DHA)— Your child needs the unique long chain fatty acids like DHA to support brain development, and in fact some studies have indicated that the brain needs these until around age 5.  The long chain fatty acids produced in breastmilk are unique and so far have not been replicated in a lab

Comfort-Okay, so it’s not the breastmilk per se that provides comfort.  However, the mother’s breast operates as a sort of home base for infants and children in the early years.  You may find that as your baby gets older, he will come to you when he is hurt, scared or just needs a little comforting. This kind of healthy attachment in the early months will let your child know that the world is safe, and eventually help your child to become much more independent later on.

Here is a neat little infographic about breastfeeding in America.  And remember, scientists are finding exciting new compounds in breastmilk every day; it’s a relatively new science, with exciting possibilities!

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How do I get started?

1.     Attend a breastfeeding class before the birth, or better yet, attend a birth class that includes breastfeeding education as part of the course.
2.     Connect with other breastfeeding moms before your birth.  Trust me, it really does take a village and you will need the support at some time during your nursing relationship.  This can be as simple as picking a friend’s brain, or it can mean going to a breastfeeding support group meeting. Organizations like La Leche League and Breastfeeding USA are a great place to connect with local resources.
3.     Read, and if possible own, the books “Breastfeeding Made Simple” and/or “The Womanly Art of Breastfeeding.” These are great resources that you can turn to any time you have questions.
4.     Find a board certified lactation consultant and put her number on your fridge.  In fact, just set aside money equivalent to a month’s worth of formula for any necessary lactation consultant visits (if your insurance doesn’t cover it, that is). 
5.     Choose a pediatrician who is breastfeeding friendly. If you can find a doctor who is also a lactation consultant, that is awesome.  But if you can’t, then find a doctor who knows a good lactation consultant, so you can get assistance instead of samples when you run into trouble.
6.     Hire a doula for your birth.  Yes, doulas are primarily labor support, but it is also in their job description to help you establish breastfeeding in the first few hours after birth.  I would not be breastfeeding today if it weren’t for my doula.  Doulas are: Worth. Every. Penny.
7.     Bookmark kellymom.com.  This is a fantastic resource for breastfeeding mothers, and their Facebook page is full of people who are experienced with and support breastfeeding.  This website has so much good information and so many resources that you will be glad you have it at your fingertips.
8.     Here is a good video about initiating breastfeeding in the first moments after birth (there are naked people, gooey babies and breasts in this video): http://www.youtube.com/watch?v=qXAjp96nGS8
9.     Here is a great list of resources about how to get a good latch: http://kellymom.com/ages/newborn/bf-basics/latch-resources/

Does it hurt?

You might have heard that you will need to “prepare” your nipples for breastfeeding, by doing things like rubbing sandpaper on them, or coating them with lanolin in our third trimester.  Well guess what?  Breastfeeding should not hurt at all!  If it does hurt, then you should see a lactation consultant to resolve any issues.  A good latch should feel like nothing more than a tug and if it does, the sooner you get help the more likely you can avoid sore, cracked or bleeding nipples.

When do I stop breastfeeding?

The short answer is: breastfeed as long as you can.  Any time you spend breastfeeding gives your baby so many benefits, so whether it is six weeks or six years, you are giving your child one of the most wonderful gifts she will ever receive.  This will be different for each mom, but know that the longer your child breastfeeds, the more she will benefit.

The AAP, WHO and UNICEF all strongly suggest (and probably wish they could require) you exclusively breastfeed for the first 6 months (no cereal, formula, solids, etc).  A baby’s stomach is not designed to handle any substance other than breastmilk until around 6 months or a little thereafter.  WHO recommends continuing to feed solids alongside breastmilk until the age of two or as long mother and child wish to continue breastfeeding.

The longer you breastfeed, the more benefits it has for your child.  Breastfeeding until your child self-weans helps him to become more secure, reduces the likelihood that he will get sick, and promotes better dental development.  However, it is hard in today’s busy world to breastfeed this long.  Do keep in mind that nursing after the age of two is usually just limited to just a couple of short nursing sessions a day.

If you are a little squeamish about extended nursing, that is okay.  Nurse as long as you can.  Here is a great article debunking some myths about extended breastfeeding: http://www.iamnotthebabysitter.com/toddler-nursing-myths-debunked/

Won’t my breasts get misshapen?

No.  There have actually been a couple studies on this topic, and they have found that after you are done breastfeeding your breasts pretty much go back to normal. Add in a reduced risk of breast cancer, and I’d say your breasts will be better off than before you breastfed!

Can I still give my baby a pacifier or bottle if I am breastfeeding?

You may hear that giving your baby an artificial nipple will cause “nipple confusion.”  Some recent studies have brought this theory into question.  Certainly, giving your baby a bottle of breastmilk is far better than giving him nothing at all, so in the case where your baby won’t get a latch, pumping into a bottle is a good alternative until you can get some help from a lactation consultant.  (And remember, babies keep the rooting reflex for about 6 months, so you have plenty of time to get nursing down.)

Pacifiers are a little bit of a different story.  In the early weeks of breastfeeding, your baby’s suckling helps to establish your own milk supply.  If your baby is suckling on a pacifier and not your breast, then your breast is not getting the right level of stimulation to produce the amount of milk your baby may need.  Some babies have very strong sucking needs and a pacifier may be necessary to help mom get a break, but try to avoid a pacifier for as long as you can, preferably until at least 6 weeks.

What if I have to go back to work?

You can still breastfeed when you go back to work.  If you have a lactation consultant in your area, I strongly suggest you meet with her to discuss your going back to work plan and learn how to use a pump.  Some hospitals and WIC offices also offer classes for moms going back to work.  If you can take one of these, you will have a lot more success keeping your supply up while you are away from your baby.

You may find that your baby wants to nurse more when you do get home from work.  This will help keep your supply up, but it might be helpful to room-in with your baby so you can get an easier night’s sleep.

How will dad be involved if he can’t feed the baby?

A lot of dads think they can’t bond with the baby if they can’t give the baby a bottle, and this couldn’t be farther from the truth! Dads can burp the baby and snuggle after mom nurses, giggle and coo with the baby during diaper changes, read her bedtime stories, cuddle skin to skin during naptime or throw him in the baby carrier for a nice long hike!

Once my baby gets teeth, then what do I do?

Keep nursing.  J  Suckling does not involve teeth, and in fact you will notice that your baby’s tongue actually covers her teeth while she is nursing.  You may find that your baby wants to use you as a teething ring when she is teething, but you can consult kellymom.com or your lactation consultant for some good suggestions on how to break that habit.  Nursing is the first form of gentle discipline.

I don’t know anyone who has breastfed; how will I get the support I need?

You will have to build your own support network, but don’t worry there is help out there!  There are many online communities like kellymom.com as well as local support groups like La Leche League that can help you connect with other nursing mothers.  I like to use the acronym YMCA to help other moms find some village people to help establish the support they need:

Y-Your family (your husband and mom can be very influential cheerleaders)
M-Medical professionals (find a lactation consultant and a good pediatrician)
C-Community groups for breastfeeding (La Leche League, Breastfeeding USA)
A-Any breastfeeding moms you know (new mom’s groups, church, high school friends, etc)

My breastfeeding story

To illustrate, I’d like to share my breastfeeding journey, and how the Village People and my YMCA saved my breastfeeding relationship. You might have a baby who is an expert nursling, but you might also need all the help you can get!

3rd Trimester
The Road Block: Lack of Knowledge
The Village People: Birth Class
The Support:  My husband and I signed up for a birth class that offered a FULL CLASS of breastfeeding education, and an introduction to the concept of a doula, who was essential to our birth and breastfeeding support.

The birth
The Road Block: A broken tailbone and a baby who wouldn’t latch
The Village People: A doula and my husband
The Support: Our doula went above and beyond, stayed for FOUR HOURS after our birth and called her mentor for instructions on how to teach my husband to hand express colostrum while I was out of commission. 

The first few days
The Road Block: A refusal to latch, jaundice, weight loss, painful engorgement
The Village People: my mom, 2 IBCLC’s, a lactation counselor, and our pediatrician
The Support:  The hospital lactation consultants worked tirelessly to help us out, and my mother supported me through tearful phone calls at all hours of the day. At our first Ped appointment, our pediatrician could have just handed us a can of formula, but instead she rushed us into see a lactation counselor, who taught me how to use a breast pump to relieve engorgement and how to feed my son a bottle until we could get a latch.

Six weeks
The Road Block: Pain, and lots of it
The Village People: My husband, our childbirth educator, an IBCLC, and a cranial-sacral therapist
The Support:  Thanks to the pump and bottle, our son was gaining weight, but the latch was still wrong.  I thought about giving up, but my husband encouraged me to speak to our childbirth educator, who referred me to an IBCLC.  She diagnosed an upper lip tie and taught me how to adjust my son’s latch.  It helped a little, and combined with a referral to a cranial-sacral therapist, our son was finally latching pain-free within a month.

2 months
The Road Block: Colic and later, projectile vomit after every feeding
The Village People: A lactation consultant, a pediatrician and a mommy friend
The Support: The lactation consultant was able to diagnose an oversupply issue and the pediatrician suggested my son might have a dairy allergy.  A mommy friend helped me adjust to the new diet, and within days the hours of endless screaming had stopped.

4 months
The Road Block: Teething and biting
The Village People: Nurse and Chat
The support: Within a few minutes at Nurse and Chat, a lactation consultant gave me several tips to help me nurse a teething baby who was using me as a teething ring. It was that easy, but imagine if I had never gone in! 

8 Months:
The road block: A lack of sleep from a babe who wanted to nurse all night
The Village People: La Leche League, New Mom’s Group, and our pediatrician
The support: Old friends from my New Mom’s Group suggested I read the No Cry Sleep Solution, and my local La Leche League had it to borrow from their lending library.  Our pediatrician gave us words of encouragement at our son’s nine-month appointment, and it really helped to lift our spirits.

And beyond:
I know that as my son approaches toddlerhood, our nursing relationship will change again.  Because I have my own personal YMCA, I will know whom to call to get my answers so that I can have true success feeding my child.  For all you expectant and nursing mothers out there, I hope that you can also build a network to support you through your breastfeeding years

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