Lactation Consultant

[AppleCrisp]

Visited the lactation consultant at the regional medical center last week. I wasn't sure if it would be worthwhile or not. She was great - had so many good things to say that I hadn't thought of or read about. I highly recommend going for a pre-natal visit with one if you don't have a LLLI connection already! :thumb I would say one of the best prep things I've done so far.

[Metasequoia]

Ditto that, I wish I had done so with my first child, bfing was a nightmare :( . With Dd2, I wasted no time in seeing an LC & she completely saved our nursing relationship - Dd2 just turned 3 & is still happily nursing :love .

[Kam]

Good for you both! So, what did you learn, A? I went in a few weeks ago, and was just told that if there's a problem, the LCs are on call every day of the week. :shrug

warmly,
Kam, mamamama! to Meg and one more

[AppleCrisp]

Most of what we talked about applies more to hospital births (she's a labor & delivery nurse as well).

I had some concerns about using shells, and she was able to at least take a look and tell me that I had nothing to worry about. For some reason our OBs don't look, and it was helpful to know ahead of time if I might anticipate latch issues or need to use shells.

She also said, make sure your DH brings a button down shirt so that while you're rooming in, he can tuck the baby in his shirt skin to skin to give a little comfort so you can sleep for an hour or two if the baby has nursed, but still hasn't settled.

Also - never occurred to me - she said if you haven't successfully nursed at least a little, don't shower, because the baby will be stimulated to nurse at first partly by smell - lots of hospitals whisk the baby off to check it so you can shower and clean up, but then you temporarily remove all your natural scents I guess. I think most people here would be trying to nurse immediately anyway.

She also had personal/first hand experience with just about every pump that exists and was able to give good recommendations as to what's good, what's not. Talked a lot about what to look for in a good latch - dimples bad, ears moving good, talked about which bottles to avoid. She had a lot to say too about oxygen levels being more appropriate in breastfeeders right after birth because the way babies suck when BFing facilitates better breathing patterns in comparison to bottle feeding. She was very anti-pacifier. And she said, once they give that good lusty cry, they're perfused - put them to tbe breast and calm them down (I guess some medical people rank Apgars lower if the baby is calm which is silly). And, BFers obviously get just a little colostrum at a time before the milk comes in, but FF babies get waaay too much the first few days because they're being fed much larger quantities than they would naturally be getting.

I'm sure this is mostly repeat to those of you who have nursed before...feel free to comment if you think her advice is good or irrelevant?

[Metasequoia]

I think her advice sounds right on. My main issue has always been engorgement & then my nipples are stretched almost flat, so it's hard for the baby to get a good latch, which leads to sore nipples (or cracked, bleeding nipples - ouch!)

I'm always on the lookout for plugged ducts, I tend to get them a lot in the beginning (I make a ton of milk:thumb .) So as soon as I feel too engorged, I either get baby to nurse, which, at that young age, doesn't seem to get enough of the milk out for me. I either get in the shower & let the warm water hit my breasts & massage the milk out, concentrating on any lumps (plugged ducts.) I also have a few pumps, I like my Ameda Purely Yours, so I'll pump & massage at the same time & that really gets a lot of milk out. Another thing, & this is REALLY comforting, is cold cabbage leaves tucked into your bra. Something about the cabbage helps with the engorgement & the cold feels REALLY soothing.

I had mastitis twice with Dd1 & it was awful. With Dd2, I came close, but stayed on top of those plugged ducts & never actually develpoed mastitis, phew!

I forgot to add....this is how I have & still do nurse my children, rather than doing 15 minutes on one side & then switching to the other side during the same feeding, I just feed on one side per feeding, *completely* emptying that one breast at every other feeding.

[honeybee]

I agree that all sounds like good advice. The most important thing is to get help with the latch pronto, BEFORE problems develop. Find out if your hospital (if you're in a hospital) has LCs on staff, and ask for one whether you think you need it or not. I would also make sure to keep the baby with you at all times, to make sure she doesn't get sugar water, formula, or a pacifier.

Here are some other things most new moms need to know (based on common questions at the bf group and LLL meetings I've attended).

Nurse whenever the baby wants to nurse. Some babies need to nurse more often than every 2-3 hours and will nurse longer than 20 minutes. There were times when my ds would nurse for 45 minutes and then take about a 20 minute break before wanting to nurse again! This is normal, and it helps establish your supply. Some babies have more of a need to suck than others. You can't overfeed a bf baby (don't make them "wait" until it's "time"), and frequent/long feedings do not necessarily mean they're not getting enough. As long as there are plenty of dirty and wet diapers, your baby is getting enough. Sometimes, however, you do need to wake a sleepy baby up every 3 hours that first week or so in order to get them to eat.

Also, don't let hospital staff or your ped freak you out about weight/getting enough, etc. This seems to be the most common "problem" for a newborn, and it is quite often a matter of the ped not being well informed about bf. Supplementing can seriously affect your supply and getting bf established.

I would make sure to get second (or even third) opinions from a certified IBCLC and talk to a LLL leader before beginning to supplement. My milk came in a little on the late side (day 5, which is still in the normal range), and ds lost a pound of weight. He acted starving (more than usual for a newborn), and his wet and dirty diapers had even stopped, so there was some cause for concern. Luckily, my doc was very low key and knowledgable. She said I could just keep bf very frequently to stimulate my milk supply and then come back in two days. My milk came in the next day, and ds regained 6 oz. in those two days. He was back above his birth weight at 2 weeks. If my milk hadn't come in, we would've started supplementing with pumped bm and a syringe feeder (to avoid nipple confusion), only adding formula as a last resort. But, often docs just tell moms they need to supplement and don't offer help with how to do so without jeopardizing bf.

Here are some great sites to bookmark where you can get help and information online.

http://www.lalecheleague.org/vbulletin/index.php
http://www.kellymom.com/
http://www.breastfeeding.com/

[RedOakMomma]

This is a great thread! It's good to be reminded of all the newborn nursing stuff.

Here's a question that I never got a good answer to when I was nursing the twins...

During the first week or so of nursing, I seemed to get little white sores on my nipples...like blistered, unhealed skin. Hurt like crazy. It wasn't an infection or thrush, I know that for sure. Were they blisters? Does that happen? Using Lansinoh really helped, but still....I'm hoping it doesn't happen again.

My top advice for breastfeeding:

ditto what someone said about pressure that "baby isn't getting enough." Don't let the drs. or nurses freak you out. Once your milk comes in, baby will be just fine. Along with the ridiculous "write down every wet diaper or bm" routine drs. give you, the "your baby isn't getting enough milk" ranks as the most annoying b*llsh*t people use to panic new parents. :irked:

The "lower lip flip"....Make sure when baby is latched on that his/her lower lip is turned down. Makes breastfeeding feel ssoooooooooo much better! :thumb If his/her lip is sucked in, just pull down on his or her chin so that the lower lip pops out and is between his/her chin and your breast. That little move can save a person so many breastfeeding troubles!!

Breast infections....they start out as a hard or really hot area on the breast, then gradually you start feeling like you've been hit by a truck (aches, fever, headache, low energy), and then it moves to a full-on infection. If you find you have a hard lump in your breast, use heat, massage, and most of all NURSING to get that lump taken care of. Make it your #1 priority. It hurts to nurse an infected breast, but it won't hurt baby and (as always, huh?) nursing is the best cure. It's a lot better than avoiding the breast, developing an full infection, and then having to go on antibiotics. (Breast infections don't happen a lot, though...in over two years of nursing, I only had two.)

[Kam]

This is a great thread! So many things I had forgotten about those early days. Yes, cabbage leaves are good for engorgement if not overused. Make sure you have comfy bras ready and have thought about what you'd use for breast pads if you end up needing them. Our bed was drenched until I found some. The lower lip flip was really important for us in getting a good latch.

Here's a new one that really helped me, too. Instead of holding baby on your lap and leaning down into him/her to nurse, bring baby UP to your breast. That way your back won't start to ache halfway through a feeding. Nursing pillows are great.

And something I wish I had known earlier: nursing while lying in bed will save your back and help you get more sleep. It isn't as easy, in my opinion, as learning to nurse sitting up, but once you've got it down, you'll get lots more sleep (if you're cosleeping)! My hospital even supports cosleeping in those narrow little beds. Don't know how they manage to make it safe, but it's worth asking about.

A nurse insisted I take a picture of us nursing in the hospital, and I'm so glad she did. It is one of my favorite pictures now. We call it "milky mouth." :love

warmly,
Kam, mamamama! to Meg and one more