Breastfeeding

Breastfeeding Tips for New Moms…

/ Katie P. Tolley, RN, MSN, CPNP-PC / Leave a comment

Breastfeeding…. and all its beauty, and all the sweet moments, and how wonderful it feels to do what you think is best for your child, and then the confusion of the feeding schedule, and which side did I leave off, and the fatigue, and a poopy diaper right in the middle of finally getting a good latch, and the leaking (UGH, the leaking), and the middle of the night feedings, and…. Ahhhh, breastfeeding, wonderful memories. 🙂 Really, I was lucky. I worked in a birthing center for 3 years before I had my first child, so I knew all about breastfeeding when it was my turn… HA, the naivety of my pre-maternal knowledge! I have since admitted that I right out lied to those poor new mom’s struggling to breastfeed, and I didn’t even know it. Of course you cannot latch a newborn when you are sitting completely upright, you have to lean in a little bit, it just works best that way; then you have to sit back so that you don’t have chronic back pain for the next 12 months. I know that now. Yes, I know you are having cramps when you breastfeed, but it’s just your uterus contracting back down, that’s a good thing. Umm, hello, those cramps HURT, have a little sympathy lady! Yes, you have to feed your baby every 3 hours, well, you kind of do, but there are exceptions to every rule, and until you breastfeed, you don’t have the opportunity to figure them out. Breastfeeding can be the most wonderful experience, but it can also be the most stressful, and difficult time for many new moms. I’ve been asked by multiple friends that are breastfeeding to write a blog about the basics, sorry it took so long, but here it is…

mother-baby-breast-feeding-32987944The Basics:

  • Newborn breastfed babies NEED to eat every 2-3 hours. This means they will have 8-12 feedings in 24 hrs. Babies need at least the minimum 8 feedings in 24 hours for adequate growth and development. My rule is wake them to feed every 3 hours when the sun is up, and they will reward you with more sleep at night. 😉 (This only pertains to babies that are gaining weight adequately. If your baby is having trouble gaining weight, please feed according to your health care provider’s advice.)
  • Babies should nurse from each breast for approximately 15-20 minutes. This should adequately empty the first breast before switching to the other side. Breastmilk supply builds on demand, the more the baby nurses, the better your milk will come in, and you have to empty completely to be able to refill adequately. Once your milk supply is established (~2-3 weeks), your baby may only eat on one side at a time until he grows a little. Joshua only at on one side each feeding from about 3 weeks until about 6-7 weeks when he went through a growth spurt. *Growth spurts (the first few) happen at about 10 – 20 days, and again at 4-6 weeks. Your baby will eat more often during a growth spurt. This helps increase your milk supply to meet his growing needs.
  • You know your baby is getting enough to eat by how content they are between feedings and if they can go the expected amount of time between feedings without showing signs of hunger. Adequate weight gain and between feeding contentment is the best indicator of optimal nutritional intake.
  • Utilizing different positions during breastfeeding is important: 1. It helps to stimulate milk production and 2. empties milk ducts more completely. Also, during the initial stages of feeding, it helps change the position of the baby’s mouth on mom’s nipple to decrease the discomfort that can initially be associated with breastfeeding. The different positions are cradle, cross-cradle, football, and side-lying. Side-lying is difficult until your baby gets a little bit older, then it’s the perfect 5am position. For more information on positions and some great latching advice, please check out this link on KidsHealth.org.
  • Speaking of discomfort, that initial “take your breath away” pain when your sweet little newborn first latches on is normal, and fortunately, a short-lived phenomenon. Keep in mind that nipple tissue is extremely sensitive. I don’t care what you’ve done in the past and with whom, no man can do the damage of a hungry newborn learning to breastfeed. This initial pain should last ~30-60 seconds, and then should subside. If the pain persists, the baby is not latched well, relatch (see above KidsHealth link for latching advice). This pain goes away after the first couple weeks, in the meantime, lanolin is helpful. Motrin can be helpful. A doc I worked liked a product called “Soothies” that were like a cool/second skin type pad to put over the nipple between feedings.
  • Do not pump in the first couple weeks to build your milk supply unless you have been instructed to do so by your health care provider. Overstimulation can lead to too much milk, engorgement, and even mastitis. If you need to pump to help relieve that engorgement pressure you feel when your milk supply first starts coming in (3-6 days), that is fine, but only pump a little. Do not empty the breast completely, just enough for relief.
  • SLEEP!!! Do yourself a big favor and get your rest. Sleep when your baby is sleeping. The chores can wait! You have other priorities now that you’re a mom. I beg you to do this, you will be so glad you did. If you don’t, you’ll understand why I begged you to try to slow down.

I breastfed both of my kids for the first year, Josh 13 months, and I had to cut him off. He was using me to go to sleep. The first night we didn’t feed, I put him to bed with a cup of water, and he was fine. So, again, got lucky with him. He was such a good baby! If you’ve read anything about Josh in my blog, you know he is anything but an easy child to raise now. I love him with all my heart, but he is the biggest challenge God has ever given me! I breastfed Drew Elizabeth for 11 months, and then she wasn’t interested anymore. She’s always been that easy, love my girl! 🙂

How long do you have to breastfeed? As long as you want to! It’s not a question for anyone but you. I wasn’t sure how long I would breastfeed until it happened. I didn’t really think I would breastfed for a year, but it was easier for me to keep breastfeeding. I enjoyed it. The recommendation is a year. The majority of mom’s stop between 4-8 months.

Breastfeeding provides so many health benefits for mom and baby, please visit the American Academy of Pediatrics statement on breastfeeding to read more. For a great link to all kinds of different breastfeeding knowledge, check out Lactation Education Resources.

So, that is my 2 cents on the basics of breastfeeding. I hope it is helpful. I was actually a Certified Lactation Consultant for a good part of my career. I’ve let the certification go, but the knowledge is golden. Please share with all the new moms that you know. If you have any questions or comments, as always, please let me know. I will compile a Breastfeeding Basics V.2 for followup. 😉

Breastfeeding is such an amazing part of the journey. I hope your experience is as good as mine. Enjoy! 😉

Do you ever serve chocolate milk?

Happy Birthday Baby Boy…A whole new world!!

/ Katie P. Tolley, RN, MSN, CPNP-PC / 5 Comments
image baby

Babies make the world a happier place

At 5:46am, I will have been riding this train called Parenthood for 10 years! Oh My, What a ride it has been so far… 😉 If anyone thinks it’s easy, I beg to differ!!  I remember 10 years ago I started having contractions at the beginning of NYPD Blue. For those of you that remember, NYPD Blue was on Tuesday nights at 10, well, I contracted about every 8 -15 minutes throughout the show.  I called my best friend, who was so excited. She was going to forget about her fear of blood (I’m talking pass out kind of fear 😉 ) to be there when this new little bundle was going to enter this world. My husband didn’t quite get this was the real deal, and thought he was going to take a Benadryl and go off to sleep. I had to explain that I thought it was going to be a long night, and Benadryl was not a good idea! Well, it wasn’t too long, I was having contractions every 2 minutes as we were on our way to the hospital at midnight.  And, wouldn’t you know it, we pulled right up on a cop half way there. Morgan was so excited, he wanted to throw on the flashers, and speed past him.  I dared him to pass.  That was the last thing I wanted to deal with… This baby wasn’t coming quite that fast.

I wasn’t at the hospital for more than 4 hours, before my Joshua made his entrance, Thank GOD it was quick!! There are a few things that needed consideration during this birthing process….DRUGS!?!? I needed to decided if I wanted an epidural, or no epidural, this $#!+ hurt!!!  I’m not going to bore you with all the details of my birth story, we each have our own….and, each is definitely a Rite of Passage!

Speaking of Epidurals… a topic for any of you still in the baby making phase of parenthood.  I think women should decide if they want an epidural with no persuasion from husbands, mothers, in-laws, etc.  This is a personal decision!! There is nothing wrong with having an epidural, each person tolerates pain differently, and has different philosophies about pain. If labor is long and difficult, an epidural can be quite beneficial for mom and baby.  If mom is too stressed during labor, baby can be stressed during labor.  One thing to remember is that it takes time for the epidural to wear off after the baby is born. If a woman is induced, she should consider that the contractions induced by Pitocen (the hormone used to stimulate uterine contractions) can cause some really powerful and painful contractions.  Now, don’t get me wrong, contractions are a 15 on a pain scale of 1-10 with or without Pitocen, but with your body being forced into something it isn’t quite ready to do naturally, it just seems to make the contractions more forceful.  I’ve had friends that have had babies and needed Pitocen, and had no epidural. My hats off… it is an amazing feat, just plain amazing! I had no Pit, and my contractions hurt like He!!, No ifs, ands, or buts about it…Any woman that gives birth and doesn’t have an epidural can tell you, CHILDBIRTH HURTS!

When to go without an epidural?? I went without an epidural because I was blessed with quick labors.  Joshua was born 4 hours after I got to the hospital. This baby wasn’t waiting for the sun to come up or an epidural, he was in a hurry to get out and see what this world was all about.  Believe me, I thought about it, I have some back problems that made things a little iffy, and helped make my decision. If labor is quick, then, my personal opinion is suck it up, and get it over with.  The movie Fast and Furious was in theaters, that was what Joshua’s birth reminded me of…  He was 3.5 weeks early, 6#4oz, and 21.75″long, born in less than 8 hours from my first contraction. 1.5 hours of that was pushing…ughhh!!  All I could say, that was the hardest thing I have ever had to do in my life! At least that’s what I thought at the time, but the actual parenting thing is much harder!  All that pushing causes the baby to spend longer in the birth canal, causing a nice little cone head… it usually returns to normal within 24-48 hrs.  The little hats they have in the hospital are necessary to keep their body heat in because babies are learning to regulate their body temp, but the hats are perfect to cover up that little cone head until it is a little cuter. One of the best things in the world is the downy softness of a babies head! Enjoy it when you can, it only lasts a few months.

Aunt Shell made it and thought it was an amazing experience; and there actually wasn’t all that  much blood…We love Aunt Shell, she’s tops! 🙂 Aunt Kathy also made it in time, and was the first to say It’s a Boy!! (yes, we impatiently waited to find out). She was also the first to notice that Joshua looked just like his Daddy! Well, I do love the daddy, so that’s ok, I guess!

Another question that comes with babies – Breastfeeding or Bottlefeeding. This too is a personal decision for parents, but I am going to have to say the decision does have to weigh Mom’s feelings the most.  Breastfeeding takes dedication! It can be one of the most rewarding things you ever do (it was for me!), but for some women, it can be very difficult.  Breastfeeding can provide so many benefits to a baby, such as: increased immunities through breastmilk, help with allergies, management of cholesterol later in life, help with lifelong management of a healthy weight, help decrease ear infections, more easily digested by immature GI system, and the bonding experience is priceless, and there are so many more….  Yes, I am  an advocate for breastfeeding, I am also a lactation consultant.  As a practitioner, I support whatever decision Mom makes, no questions asked! I have helped so many moms and babies through their breastfeeding difficulties.  For the mom that is dedicated, breastfeeding can work out.  There are some women that are not capable of producing an adequate milk supply for their child.  This happens when women have insufficient glandular tissue for adequate lactation. This is real, I have friends that have had this grueling experience.  I enjoy a blog by a female pediatrician that expresses the distress from a mother that was unable to produce an adequate supply for her child.  Check out her struggles, at Confession of a Dr. Mom.  The information I have read so far on her blog has been awesome!

My Joshua, in Gryffindor tie with wand in hand! LOVE HIM!!

My Boy has changed my world, he has taught me that there are rules to parenting that don’t always fit every kid. Just when you think you know what you’re doing, the kids forget to read the book and respond appropriately….ugh! So, Fast and Furious has been going on for about 10 years….and hopefully will continue for many, many, many more!

All I really wanted to say was Happy Birthday to my Joshua! The catalyst that started this unbelievable journey called parenthood!

I LOVE YOU JOSHIE!! 🙂