Saturday, July 25, 2009

Breastfeeding 101

My son Julian recently had his first birthday...and as he reaches that milestone I realize so have I. I have been breastfeeding my son for 1 year. The last year has been a rollercoaster of emotion, from fear that he wouldn't find that perfect latch (got over that pretty quick) to elation as he thrived and grew on his mommy's own. I look back with a sense of pride and accomplishment. This did not come easily. There was pain, there was swelling, there was even blood! and there were many sleepless nights. I have run into many of the problems and challenges that women face when breastfeeding and I can see how many women give it up. It is hard. My first son Gabriel never got the latch right. I had PIH when I delivered him and became too sick after delivery to put a good effort into getting him on the breast. The nursing staff too was too busy trying to get me to rest to worry about my desire to breastfeed. In the end I pumped for about 3 months (which ended shortly after I returned to work) and my first born went to formula. When I look back I still have feelings of failure that I didn't get to breastfeed my firstborn, and when I see the bond that I have with my second son I feel even worse, because Gabriel and I don't have that same connection. Julian has been attached to me from day one and I think sometimes that he will take me to kindergarten with him! But I try not to dwell too much on the negative and I look to the positive. Gabriel is a fiercely independent child with a bit of a wild streak...I love how he takes the initiative and wants to do as much as possible for himself, BY sense of adventure is as strong as only a 3 year old boys can be...fearless and headstrong he plows through his life taking on any challenge. Now, my Julian is as bold and fearless as Gabriel (more sometimes I think)...and he frightens me with some of his antics in trying to keep up with his older brother...but when he's done and ready, he wants his spot in my lap, puts his head on my shoulder and is content to cuddle for long periods of time.

So I begin this look back at the beginning, I will try to go in order so as to keep this as streamlined as possible. There is nothing you need to do to get your nipples "ready" to breastfeed....put that washcloth DOWN and don't rub your nipples to "toughen" them will just irritate them. The most you can do while waiting to have your baby is to avoid washing your nipples with soap (this dries them out) and use a protective coating of lanolin. I use Lanisoh and am very happy with it. I used it for everything from cracked nipples, bleeding nipples, sore nipples and dry even helped when my son recently bit me hard enough to break the skin on both sides of my nipple.

When you have your baby, get him/her to the breast as soon as possible. Many times after you have your baby the nursing staff will want to take the baby to the nursery as soon as possible...try to stall them if you can. They won't physically take your baby from you and don't feel like you have to do things on their time table. With my first I had him for 2 hours after he was born, because the nursery was overfull with babies and they had nowhere to put him. I learned then that they don't HAVE to take them to the nursery straight away (unless of course your baby had a complication).....with Julian, I had to push to keep my son for 30 min after he was born..they wanted to take him right away...I know the issue here was more that it was shift change and they wanted to go home. I had Julian at 730am, and shift change is around that time in that hospital. I didn't care. In my opinion if you want to go home GO...another nurse can take him later. So I held my son and got him to my breast as soon as his cord was cut (he had a short cord and it had to be cut before he could be placed on me) I let him nuzzle and smell and get familiar with me. He even did the little crawling motions trying to get to my breast! The nurses kept saying "oh he wont nurse right away, you can give him to us"...I know he wasn't going to nurse right away...that wasn't my point....What you want to do is immediately have your child smell you and get familiar with your scent and your skin. This helps with bonding and later with that first latch. To the nurses great surprise, I got him to latch on before they took him. He suckled for a moment, nothing too long, just long enough for him to get the feeling of it. Then I was satisfied with his attempt I let them take him to the nursery. I also insisted they didn't bathe him, just rinse him off a bit....Its good for them to still smell the amniotic fluid on themselves comforts them...remember they have been in it for 9 months, they are familiar with that smell and the taste, so in my opinion, why wash it away and replace it with the smell of Johnson and Johnsons so soon? There's nothing wrong with Johnson and Johnson, don't get me wrong, we use all of their products,...but in those first few hours, let them be comfortable, they have been through enough with delivery and the shock of that change.

Here are some links to help with the beginning:

I cannot stress how important that proper latch is. You will probably not get it the first few times. Breastfeeding is a learn as you go process. As natural as it is, it is not entirely instinctual. The trouble I had with my latch showed up in the diagonal red lines that went across both my nipples after the first day...they were like hickies on the tips of my nipples. With some lanisoh and adjusting the latch we got that do go away in a few days.

Doctors and nurses will tell you that you should only nurse the baby for about 10 min on either side...that there is no benefit to letting them nurse longer...I cannot tell you how untrue this statement is. I horrified nurses and doctors alike while I was in the hospital. I nursed my son every 2 hours like they said....but for 45 min on each side. Sounds like a lot of work...and it is! I let him nurse for as long as he wanted to, I never took him off the breast, I let him come off on his own. When all was said and done, I had a fabulous milk supply. Letting you baby nurse for as long as they like stimulates milk production. Sure, they may not be getting a whole lot in the beginning. But the activity stimulates your body to produce more milk. The better the supply! It is easier to decrease an overabundant supply than it is to increase an insufficient one. The only side effect I had of my overabundant supply was heavy letdown sometimes (which can cause choking and/or gasping at the breast)...and my freezer was SO full of milk, I started to donate my extra milk. Isn't that terrible? lol.....also, because I nursed him so frequently and for so long at each time...I never experienced the engorgement of my milk coming in. The one thing that DID come with the first few days of breastfeeding that was painful were the after pains. Every time I put my son to the breast I had cramps that seriously felt like I was in labor again. They let me take 600mg of Motrin every 4-6 hours for this. Yes, it helped...but there were times I wished for a Motrin drip in my IV! After a few days the pains subsides and you feel better. Here is a link on issues that can arise with a poor latch:

My biggest problem with latch issues was milk blisters and plugged ducts. At 3 months I got my first plugged duct. I thought my boob would burst! The whole underside of my right breast engorged until it was rock hard and the nipple was painful to the touch. I tried nursing him on that side every 45 min or so trying to relieve the pressure...finally after nursing him in 3 different positions I got the breast to drain. I nurse him side lying on my right side, side lying on my left side (letting my breast fall over me to him) and on my hands and knees while leaning over him. The next morning I went to the bathroom and saw the big white bleb on my nipple and realized that was where all the nipple pain was coming from. I popped the blister myself (not really recommended) and in a week it healed completely. Some months later it came back and refused to go away totally. I never got the stringy piece like some moms get when they clear a plugged duct. I got more like pieces of cottage cheese (gross I know)...and I never got Mastitis. What I found finally worked and it has never come back since, was getting bigger flanges for my breast pump. This allowed my breast to completely drain and got all the hard stuff out. Since I got bigger flanges I have not had any issues with the duct.

I hope that helps with any questions or concerns with the first few months of breastfeeding. Please keep an eye out for follow up posts on Pumping, Biting, Introducing Solids and more! Please feel free to comment, ask questions, make suggestions for future posts...etc

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