Breastfeeding Q & A

Breastfeeding Q & A from Isis Parenting

August is World Breastfeeding Month and while I nursed my children, I did so because it worked for my family not because it is the only way to be a good mother. I am really uncomfortable with all of the judgement going on around breast feeding/bottle feeding. Really, do what works for you and your child. Nothing else. Dr. Claire McCarthy says it better than I can here in Breastfeeding and the Mommy Wars.

Go read it now. I’ll wait.

Back? Glad you read it? Me. too.
Here is an excerpt from Dr. McCarthy’s post:
I think we need to be ground rules when it comes to talking about breastfeeding, something along the lines of:
1. Nobody may berate any mother for her breastfeeding choices.
2. All mothers deserve not just information about and support for breastfeeding but the benefit of the doubt when it comes to the choices they make.
3. We all need to acknowledge that there is more to parenting than breastfeeding.
 
I think that if we could agree to ground rules like these it would help all mothers, whether or not they breastfeed. As a pediatrician and a mom, that’s what I want most of all.

I’m sharing this because I find it helpful, kind and the way it should be. That said, I am also sharing the following information in honor of World Breastfeeding Month, and because I love the tagline from the Isis Parenting (a great resource), Because babies don’t come with instructions. (they sure don’t).

Nancy Holtzman, Vice President, Clinical Content & Learning at Isis Parenting, answers two of the more common questions she gets from new nursing mothers.

Q.     Latching on – how does a mother ensure the latch is good?
A “good latch” is one that is comfortable for the mom, and provides good milk transfer for the baby. There are all kinds of beliefs about what a “good” latch should look like, but the reality is that a latch can look great, but that’s going on in the baby’s mouth isn’t great at all.
So back to the basics: If the latch feels okay to mom (not pinching, burning, clamping or causing pain), and if baby is swallowing milk, softening the breast, and gaining weight, it’s a good latch.
In general, the baby’s jaw should be dropped, mouth open wide before latching, with lips flanged out, not tucked into the mouth. It helps for baby’s head to slightly recline back (lead in with the chin, over and on) when approaching the breast. Having the chin tucked down toward the chest restricts the baby’s ability to open wide. (Try it yourself: curl your chin down toward your chest and try to open your mouth wide. Restrictive).
Another way moms inadvertently restrict baby’s ability to get a “good” latch is by holding the breast too close to the areola and nipple. If your fingers are in the way, baby can’t get a deep mouthful of breast tissue. Try supporting the breast with a big “C” of your hand closer to your ribs, and make sure your index finger doesn’t creep too close to the areola.

Note: If there is initial nipple damage, latching will probably hurt until the crack or abrasion heals. Just like a skinned knee – the initial damage can cause ongoing discomfort during “use”, even if the latch is corrected. The good news is that when correcting the latch, damage should heal and not reoccur.

Note: Tender latch from “newness”. Sometimes even when the latch is good, there can be temporary latch discomfort during the first week or so of breastfeeding – even without damage. Both the external skin, and the internal tissue of the nipple, will adjust quickly, but sometimes a new mom will have latch discomfort for the first few sucks – After counting to ten and/or taking a few deep breaths, the pain should be gone and the feeding should feel like a gentle tugging sensation and not painful. If a mom continues to have pain throughout most feeding sessions, or nipple damage that isn’t healing, then it’s time to call a Board Certified Lactation Consultant (IBCLC) for help.

Q: What are best positions for nursing?

·         There are as many different breastfeeding positions, as there are, mothers and babies. In general, some key things to pay attention to are:

Baby’s comfort for eating:
-Baby should always have nose and belly button in a straight line. Why? Well, if baby is laying on his back, with his head turned to the side, it’s very difficult to swallow. Try it yourself: look over your shoulder and try to swallow.

-Baby should feel securely supported. If baby’s hips or legs are “dangling”, he may compensate for this tenuous position by clamping hard with his gums. Ouch!

-Foot reflex: make sure your baby’s feet are not pressing up against the sides of the chair when nursing in a cross-cradle position, or against the back of the couch or chair when nursing in a football/clutch hold. A young infant will reflexively press against the chair (stepping reflex) which results in arching away from the breast. Baby becomes frustrated because he wants to eat, and mom becomes frustrated because she doesn’t understand why baby is arching away from the breast.

Mom’s Comfort:

 -Mom may be comfortable sitting upright in a supportive chair with a footstool and firm cushion or pillow to support either the baby, or her arms holding the baby.

 -Mom may be comfortable reclining back on a couch or propped up on her bed, with the baby draped tummy-down over her chest.

 -Make several rolled “sausages” (tightly rolled flannel blanket secured with a piece of tape) which are left in usual nursing spots. These are very helpful to support mom’s wrist, baby’s head or neck, or even tucked under a heavy breast.

-Mom should be able to “relax” her neck, shoulders, arms and wrists once baby is comfortably latched on. Keeping a tense, tight “chicken wing” position can lead to muscle soreness and tension headaches. Having supportive materials to assist finding a good feeding position will help this.

There are so many nuances when it comes to positions. Special positions can help special situations, like a very heavy milk let down (commonly causing baby to cough/choke/splutter at the beginning of a feeding), or a baby with a tongue-tie, preemie, or lower muscle tone.

For more tips on positioning, here’s the webinar on that topic:
http://www.isisparenting.com/page/webinarsbreastfeeding#bfpositions

There is a live Breastfeeding Webinar and Chat each Thursday at 12:00 PM ET and all are welcome to attend. Discussed are specific nursing or pumping related topics, or specific weeks are dedicated to “All Questions and Answers”.

There are 40 recorded breastfeeding webinars available on topics including blocked ducts and mastitis, nursing the first week, pumping and storing milk, helpful products for nursing/pumping moms, breastmilk and childcare, introducing solid foods, and “help, my baby won’t take a bottle!”.

Great resources for if you are nursing – no pressure if you are not.

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