Breastfeeding After Breast Reduction - It IS Possible!

Written by Ashley Treadwell, IBCLC

Many women wonder if they will have a full supply after having a breast reduction.  While the basic answer to this question is “we don’t know yet” - there are many factors, as well as things she can actively do, that can affect her ability to breastfeed successfully.  In this article, we will discuss what those activities are and how a mom can maximize her supply when breastfeeding after a breast reduction. We will also look at what long-term supplementation can look like, if it is necessary.

It is important to remind you that breastfeeding does not have to be an “all or nothing” endeavor!  We need to re-define what “success” means when it comes to breastfeeding after a breast reduction. Anytime a woman has a physiological factor that can affect milk supply, we always want her to understand that ANY amount of breastmilk is amazing. Whether she is able to provide 10% or 100% of what her baby needs, she is doing a fantastic job.

What Factors Will Affect My Ability to Breastfeed Exclusively?

An initial factor is how the surgery was performed.  Fortunately, surgeons are currently performing breast reduction procedures in a manner that protects as much of the lactation function as possible - increasing a woman’s chance for breastfeeding later in life.  If a large amount of breast tissue has been removed, or the ducts that deliver the milk to the nipple openings are severed, breastfeeding may be negatively affected. There are many different types of procedures and it isn’t always possible to tell which type was performed by simply noting the shape and placement of a woman’s scars.  If you have had a breast reduction surgery and don’t know the specific type that was performed, the best way to gather this information is to contact the surgeon who performed the procedure.  The most popular surgery performed in the United States is one that is also known to have the best implications for breastfeeding later in life. In this procedure, the areola isn’t completely removed and, therefore, connection between the nipple and breast tissue/ducts is partially protected.  If the procedure involves removing the nipple completely and then surgically reattaching it, your chances of exclusively breastfeeding can be decreased.

Another factor that will affect your milk production is when the procedure was performed.  The longer the time between the birth of your baby and the procedure, the better your chances will be to develop a full milk supply.  Also, your milk supply is likely to increase with each subsequent birth - so if you are not able to exclusively breastfeed a first baby, there is still a good possibility you will be able to with a second or third child!  These factors are each important because with both time and breast stimulation, breast tissue can actually re-grow and re-connect.  This can be very encouraging for first-time moms to hear - that even if they are not able to provide their first baby with 100% of their breastmilk needs, all the hard work they are putting in is likely to pave the way for a larger milk supply with later children.

What Can I do to Maximize my Milk Supply - Before and After my Baby Arrives?

Something ALL moms can do to best prepare to breastfeed a baby (those who have had reduction procedures and those who haven’t!) is to educate themselves prior to the baby’s arrival.  Take a breastfeeding class taught by an International Board Certified Lactation Consultant (IBCLC) and find out which resources are available in your area.  Free support groups are a wonderful place to get help and support, as well as connect with other moms who are currently breastfeeding.  We encourage women to attend our breastfeeding support groups while still pregnant - it’s a great way to familiarize yourself with breastfeeding women. A breastfeeding class will teach you what normal breastfeeding looks like in the first few weeks - this knowledge can help to reduce a lot of stress and anxiety.

Find an IBCLC who is knowledgeable about helping women breastfeeding after a breast reduction.  Most offer prenatal consults that will specifically address what you can do to maximize your milk production, including different herbs available to help with supply.  And even if you don’t meet with one prior to birthing your baby, she can be there as soon as baby arrives to help, if needed.

Once your baby arrives, the very best thing you can do is to breastfeed that baby constantly!  The more stimulation your breasts receive in the early days, the better your milk supply will be.  Babies feed frequently in the early days - knowing the signs that baby is getting enough are important.  We have great information in a blog post about how to know baby is getting enough in the first week - I’ve Had My Baby, Now What? Breastfeeding During the First Week.

Some signs that baby isn’t getting enough are: baby not gaining weight after the 5th day of life, baby not having the recommended number of pee and poop diapers per day, or baby is well under birth-weight by 2 weeks of age.  If you are experiencing any of these issues, it is important to seek out the help of an IBCLC.

If Long-Term Supplementation is Necessary - What are My Options?

It may be the case that some amount of supplementation is necessary for a woman breastfeeding after a reduction, especially for her first baby.  If this is true - there are many options available.  Whether mom has little to no supply, or close to a full supply, the best way to supplement a baby to establish a wonderful breastfeeding relationship is to feed the baby the additional milk at the breast.  There are supplemental nursing systems (SNS) available that are made for this specific situation - an IBCLC can help a mom learn how to use this.  If mom doesn’t want to supplement baby this way, but does want baby to have time at the breast, she can still feed the baby at the breast and then follow up with another feeding method - like a slow-flow bottle.  If having baby at breast is important to mom, we do recommend that a bottle isn’t introduced until baby is latching well at the breast - some time after week 3.  Prior to then, mom can supplement using a SNS, and then move to some combination of that and a bottle after the baby is 3-4 weeks of age.  Supplementation can either be with mom's pumped milk, donor milk from another breastfeeding mother, or commercial formula. Here is our YouTube video showing one way a mom can supplement her baby at the breast: Supplementation: SNS at Breast

What Resources are Out There to Help Women Who Want to Breastfeed After a Breast Reduction?

Having support and help both before and after the birth of your baby is crucial and can have a lasting effect on your breastfeeding experience.  We encourage all moms, whether they’ve had breast surgery or not, to look for breastfeeding support in their communities.  Women who are breastfeeding after a breast surgery may need additional support and information specific to their unique situation.  One of our favorite places for support is the website Breastfeeding After Breast and Nipple Procedures.  Here you can find links to health care providers in your area who specialize in helping women post breast surgery, as well as a community of women who are in your same situation.  Robin also interviewed Diana West for The Boob Group podcast episode: Breastfeeding After Breast Reduction Surgery.  

Additional Resources:

Defining Your Own Success. Breastfeeding after Breast Reduction Surgery by Diana West.

Using YouTube to Help Achieve Comfortable Breastfeeding Positions

Written by Ashley Treadwell, IBCLC

In the beginning, breastfeeding can feel somewhat awkward and uncomfortable as new moms learn how to get their baby properly latched on.  As an IBCLC, I see a lot of new moms breastfeeding their babies sitting straight up or hunched over, looking very uncomfortable.  Heck, I did this as a new mom myself!  I remember the constant aches in my neck and shoulders from sitting in contorted positions for long periods of time.  Breastfeeding is something moms do very frequently in the early weeks and months - it should be comfortable.

Out of all of the breastfeeding positions, there are two that happen to be our favorite - the side-lying and laid-back breastfeeding positions.  We like these positions for so many reasons - the laid-back position often helps a baby achieve a deeper latch, and both positions are extremely comfortable for both mom and baby and promote lots of rest and relaxation.  This is great for moms as their bodies need good rest to recover from delivery and is great for babies as the best milk transfer often happens during sleepy, calm times.  Sometimes a mom may find that she is having a difficult time replicating these positions on her own - so we decided to provide a video demonstration!  Here are two videos showing the laid back breastfeeding position and the side lying position.  For mom breastfeeding videos, check out our YouTube channel: DIY Breastfeeding!

Breastfeeding Positions: Laid Back Breastfeeding

 

Breastfeeding Positions: Side Lying Breastfeeding

 

What is YOUR favorite breastfeeding position?

It's Here! Our DIY Breastfeeding YouTube Channel

Ever wish you could actually watch a mama breastfeed her baby in a laid-back position because you couldn't picture it in your mind from the blog article you just read?  Wonder how you can tell if your pump flanges are fitting correctly? Well, look no further!

Today, we are beyond excited to annouce our newest baby, DIY Breastfeeding!  

 

What is DIY Breastfeeding?

On our DIY Breastfeeding YouTube channel, you will find 2-3 minute instructional videos about different breastfeeding topics, ranging from positions to latching to pumping and more!  Each video was recorded with one of our lactation consultants and some super cute local moms and babies.  

Which topics will be included on DIY Breastfeeding?

A few months ago we started collecting video topics from all of you and your ideas were AWESOME!  We are proud to say that today we are launching our channel with 10 stellar videos fitting into 5 different categories. Here are our current categories:

• Breastfeeding While Babywearing
• Latching
• Breastfeeding Position
• Pumping Strategies
• Breastfeeding Twins

Lastly, we would like to share a HUGE amount of gratitude to our DIY Breastfeeding partner, New Mommy Media!  Without Sunny's awesome video shooting and editing expertise, these videos would look completely amateur and out of focus!  Sunny, we adore you to pieces and we cannot wait to create more videos with you!

So head on over to DIY Breastfeeding!  Let us know what you think about the videos and share your ideas for additional topics/categories you would like for us to include.

Which other topics/categories would you like to see included? 

Podcast and Personal Stories about Tongue Ties and Lip Ties

Written by Robin Kaplan, M.Ed, IBCLC

Last week on The Boob Group, I had the esteemed pleasure of interviewing one of the most prominent experts on tongue ties and lip ties, Catherine Watson Genna.  Catherine has written multiple articles and books about the mechanics of the tongue while breastfeeding, as well as the breastfeeding challenges that can occur when a baby has a tongue or lip tie.  One of her earliest articles was written for the American Academy of Pediatrics, helping to bring awareness to this subject for the practitioners who babies see the most.

Click here to listen to The Boob Group's podcast episode: Tongue Ties and Lip Ties: Symptoms, Treatment, and Aftercare.

Here is a list of SDBFC's articles about tongue ties and lip ties, including serveral personal memoirs from breastfeeding mothers who experienced this with their children.

Does Your Baby Have a Tongue or Lip Tie? 

Advocating When Your Baby has a Tongue or Lip Tie

The Tongue Tie/Lip Tie Challenge

What a Difference a Tongue Tie Revision Can Make

Breastfeeding After a Tongue Tie Revision

If you have a story to share about breastfeeding a child with a tongue or lip tie, whether you have the revision procedure or not, please send it to Robin Kaplan (robinkaplan@sdbfc.com)

You Know You Are a Breastfeeding Mother of a Toddler When....

Jenn: You can have a conversation with him WHILE he has a mouth full of boob!

Julie: Your boob is visibly lopsided because it’s full and you’re at the park so your kids is too distracted to nurse.

Tiffany: Your nipples start reminding you of Stretch Armstrong. 

Stacy: Your lap is full of toys and your toddler is dangling off the furniture while he eats.  You have to tell your utensil-obsessed kiddo that spoons are for the table, not mommy’s milk.  You laugh when people say that nursing a toddler is for YOUR benefits and not for the toddler.  They have obviously never tried to get a toddler to nurse who didn’t want to, or stop one who does.

Lindsay: Your toddler offers her mommy milk to her teddy bear, dolls, toy animals, and daddy.  It’s so nice she is willing to share!

Cat: They ask you to hold their cracker.

April: When he/she is hurt, the first words are, “Boob! Mommy! Boob!”

Julia: They announce, “That kid needs boo-boo” every time they hear a kid crying.

Laura: He’s dancing all over your chest, tummy, chair, the floor, the walls, the dog, WHILE nursing!

Colina: Nursing begins to feel more like a Cirque du Soleil performance.

Sarah: You see nothing wrong with sittin on the couch with your boobs hanging out for the quick ‘run by milking!’

Paula: After nursing you find gum on your nipple!

Laura: You are simultaneously a food source and a raceway for Matchbox cars.

Ariel: You get bras that are specifically padded to hide your nipples from twiddling hands.

Elisa: Your aren’t phased by nursing with a baby standing up!

Shannon: When you actually pray that he will sit and nurse longer than 4 minutes at a time so that you can rest for just a minute!

Cindy: You have to remind your kid to unlatch BEFORE walking away from you.... or jumping on the bed!

Ariel: When they know you’re touched out, so they ask for ‘just a little bit’ oh, so sweetly.

Kristin: They are constantly upside down.

Jamelle: Sometimes they just want to hug their boobies.  They play ‘Tune in Tokyo” on whichever one is not being used.

Lisa: When you can’t make it from the dining room table to the shower without a nursing break.

Maryjane: When they put your boobs away after nursing! (I actually really appreciate this one!)  When they tell YOU having milk (just a tiny little bit) will make them feel better.

Check out some of our fantastic articles about breastfeeding a toddler:

Toddler Nursing Part 1: How it Helped Me Manage My Circus

Toddler Nursing Part 2: Toddler vs. Breastfeeding

Toddler Nursing: Part 3: Super Breastfed Baby!

Check out some of our awesome podcasts about breastfeeding a toddler:

Breastfeeding Beyond Two Years

Breastfeeding Toddlers: Frequency, Biting, and Staying Motivated

Breastfeeding Toddlers: Night Nursing and Weaning

How would you finish the following sentence: You know you are a breastfeeding mom of a toddler when....

Advocating When Your Baby has a Tongue or Lip Tie

To help parents understand a bit more about how tongue and lip ties can affect breastfeeding, over the next few weeks we will be featuring stories from moms whose babies experienced these challenges.  We would like to extend a HUGE thank you to the brave mamas who submitted their stories for our blog!  We know you went through a ton of challenges and we are so appreciative that you were willing to share your stories!  If you have a story you would like to share on our blog, please send it to robinkaplan@sdbfc.com.

For more information about tongue and lip ties and how they can affect breastfeeding, please see our article: Does Your Baby Have a Tongue or Lip Tie?

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Written by Kimberly Berry

I am often referred to as a "boob nerd" by many friends. Articles, research, blogs....anything breastfeeding related always interested me. I absorb the information like a sponge. Sharing and helping moms with nursing just came naturally. I never heard of tongue or lip tie though until I was pregnant with my second. A few things I read made me wonder if some of the struggles I had with my daughter were due to a possible tongue/lip tie in her. She had self weaned recently though, so I never gave it much more thought. That reading on tongue ties proved to be invaluable to me in just a few short months however.

My handsome baby boy came flying into this world at 5:01pm on a Friday afternoon. The moment he was handed to me after his birth, I saw it glaring right back at me as he cried and took his first breaths. A tongue tie. His frenulum stretched all the way to the tip of his tongue. I kissed and nuzzled him close to calm him, warm him. Once calm, I looked at my husband and said, "He has tongue tie." My husband, confused said, "..ok?" not knowing what I knew. Not knowing how that can affect breastfeeding. Not knowing the possibility for pain and injury for me while nursing our second child. The nurse nearby heard me and chimed in to say "Oh, it's just a small one, no worries!" I told her I wanted to see a lactation consultant. She nodded her head and continued on with her work. 

I then began the process of trying to get him to latch for his first feed, although I knew that it could quite possibly be as bad, or even worse than the pain I just endured to bring him into this world. He was disinterested. So we snuggled and I tried every five minutes or so. Finally, 45 minutes after his birth, he latched. I unlatched and relatched him over two dozen times before it felt even remotely close to ok. I asked again to see the lactation consultant on staff. I did breast compressions and massage to help encourage colostrum into his little mouth that he was trying so hard to get to work correctly. Becoming annoyed, I would then ask every person that came into my room to bring me a IBCLC. I was met with "Yes, sure thing!", "You are on the waiting list", "Your nipples are just too big for his mouth"... I could go on and on with the excuses I heard the rest of that day and overnight. We struggled through each feeding. He was frustrated, and so was I. When he cried, his tongue looked like a heart. My heart broke that this was going on and help was seemingly out of reach. 

Finally, at 9am the next day, a IBCLC stopped in to "see how breastfeeding was going." I told her that I had been asking to see a lactation consultant since his birth the evening before. Shocked, she said she was not made aware we needed her. We discussed for several minutes how crucial nursing support is to new mothers and who she was going to speak with about the situation. I made my notes on who to contact as well  as who to advise of the lack of proper treatment. Then we got down to the business at hand. She agreed immediately that my son had a tongue tie, and not "just a small one" as the nurse had called it. She called right then for the ENT to work us into the schedule immediately to have it clipped. Unfortunately, we were knocked back on the list several times due to other emergency surgeries that day. While I am a patient person, I was becoming angered that the fact that my child was having trouble eating was not a concern to most of the staff. 

The next day, the day of our discharge, arrived and we were still muddling through feeds. I was starting to become very sore. Again, we were told time after time that we were next in line for his procedure, only to be knocked back again by an emergency surgery. How many emergency surgeries were there?! How many other new mothers were waiting for the same help I was??? The IBCLC I had spoken with the day before was not working. The other IBCLC couldn't get to us until that afternoon. Our nurse was sympathetic, but said this seemed to be typical of the weekend. Finally, I said enough is enough and took matters into my own hands. I looked up the ENT my daughter sees. Being a Sunday, the after hours line was activated. I left a message to see if anyone could call me back to let me know if they preformed frenulectomies on newborns. Thankfully, a sweet nurse called me back after about 5 minutes. She said that they did do the procedures, but I would have to call back in the morning for a appointment. 

We left the hospital and never looked back. I bared through the pain of the feedings until that appointment with the ENT the next afternoon. The frenulectomy was not easy to watch, but it helped so much. When he nursed when it was over, I could tell a difference, not a huge one immediately, but enough that I didn't wince up and have tears in my eyes the whole time. We only had to relatch six times instead of more than a dozen times. Each day thereafter, nursing was getting better and better. We practiced the exercises and I continued trying to heal my nipples. After several days, he started gaining weight and I was settling into being a mommy of two. Nursing became a joy again. Something I once again looked forward to. It was now my time to look in awe at my newborn and be proud of my body’s amazing ability to grow this perfect being and now continue to nourish it. 

Without a doubt, if I didn't know anything about breastfeeding or tongue ties, I would have thrown the towel in and given up. It was clear for me to see why so many new mothers do. In a mom’s group I help with, I constantly tell new mothers to check for tongue/lip ties. Even if someone says there isn't one, or if its minor and won't affect breastfeeding, know how to look yourself and find someone who will help you. You have to be your own advocate. Your babies advocate. We look to these medical professionals to guide and help us. Unfortunately, sometimes that's not always the case. It's crucial for them to receive the proper training, listen to their patients, and have resources available to help mothers and babies. It's crucial for mothers to be determined, educated, and supported. All of these things go hand in hand for successful breastfeeding. My son went on to nurse until he self weaned at 13 months.

I’ve Had My Baby - Now What? Breastfeeding During Weeks 3-6

Welcome back to our new series, I’ve Had My Baby - Now What?  This is a guide with basic information to help you navigate the first days, weeks, and months of breastfeeding your new baby.  

Today we’d like to talk about weeks 3 through 6 of your baby’s life, and what breastfeeding looks like.  What can you expect for normal behavior from your new baby, and when do you know there’s a problem that you should seek professional help for?

What does normal breastfeeding look like in weeks 3-6?  How often should my baby be eating, and how long should feedings take?

It’s extremely common for babies at this age to still want to feed frequently, every 2-3 hours.  Some *may* become more efficient and take in more at feedings and start to space them out a bit more, but don’t fear if your baby hasn’t done this yet!  Feedings may start to speed up as mom’s milk volume is higher and baby has had good practice breastfeeding, but again, don’t worry if your baby still feeds at the breast for as long as he/she did in the early weeks.  It can take some time for mom and baby to really get their groove and you may still be working out some kinks during weeks 3 through 6.

How much weight should my baby be gaining at this age?  How will I know if he/she is getting enough when I’m not seeing my pediatrician as frequently for weight checks?

Up to 4 months of age, we expect babies to gain .5-1 oz/day, or 4-7 ounces a week.  There are many ways other than weight to be sure that your baby is getting enough milk.  If your baby is having plenty of wet and soiled diapers each day, and generally seems content after feedings for two hours or more (outside of growth spurts and cluster feeding periods), you can feel good that he/she is probably getting enough.  If you want a little more concrete evidence, a great way to track your baby’s weight is by attending a free weekly breastfeeding support group.  There will often be a scale there to weigh your baby, you can do test weights to see how much baby is taking during that feeding, get help from a lactation consultant or educator, and, the BEST part, meet and connect with other moms.

Can I give my baby a bottle now?  If so, who should give it and how often should they do so?

 Once breastfeeding has been established, weeks 3-5 are the perfect time to introduce a bottle to your baby if you’d like them to take one.  It’s normally best that someone other than mom gives the baby the bottle, as babies often associate mom with breastfeeding and may refuse a bottle from her.  Plus, often times, partners and grandparents have been waiting for their moment to participate in the feeding of the baby.  We recommend that mom start pumping after week 3, once a day or so, to start to save up milk for that first bottle.  2-3oz is an appropriate amount to start with.  Be sure that the bottle is fed to the baby in a breastfeeding friendly manner.  If mom is going back to work, we recommend that baby receives a bottle on a somewhat regular basis, a few times a week, so that he/she remains familiar with it.  Plus, mom should pump every time baby receives a bottle to maintain her milk supply.

My baby is inconsolable for a few hours in the evenings.  Why is this happening and what can I do?

Many babies have a “witching hour”, or as I like to call it, “an unhappy hour”.  The term is a bit misleading as the behavior normally lasts for more than an hour!  It occurs most frequently in the late afternoon/evening hours.  Babies are often fussier than normal during this time, and want to eat often.  And while they want to feed often, they may pull off more frequently as well.  There are a number of theories as to what causes this fussiness at this time.  They may be feeding often to “tank up” on calories before taking a long sleep (sounds wonderful!).  They may be overstimulated from their day and having a hard time winding themselves down.  This is often a busy time for the entire household, as partners are home from work and older siblings may be home from school.  Best thing that you can do during this time is to offer the breast often.  Learning to nurse in a baby carrier can be a lifesaver as it will allow you to be hands-free while the baby is snuggled, fed, and comforted.

How will I know if my baby is colicky?  Is this the same as the ‘witching hour?’

Many parents confuse normal fussy behavior for colic.  Colic is defined as 3 hours or more of crying, 3 or more times a week, for 3 or more weeks in a row.  It normally resolves itself around month 4.  If your baby’s crying looks like this, he/she may have colic.  There are no definitive cause for colic, but it could be related to gut issues due to food sensitivities.  The “witching hour” is the period of time of day when your baby may seem unusually fussy, normally lasting for a couple of hours. This behavior peaks around 6 weeks and then often starts to fade.

If I am still having a challenging time building up my milk supply at this time, have I missed the window for increasing my milk supply?

Not at all!  Depending on the reason for mom’s low supply, there are plenty of things that can help boost  supply at this stage.  The most important thing is to learn why mom is struggling with her milk supply.  As always, lots of good breast stimulation is best - either from a baby or a hospital grade pump. There are also herbs and medications that are available that can help boost supply as well.

There may be times when things aren’t going the way they should.  If you find this, please contact an International Board Certified Lactation Consultant to help you.  Some signs that you might need some additional help:

• Sore, cracked, bruised, or bleeding nipples.

• Baby is gaining less than 4oz per week.

• You suspect your baby may be tongue-tied.

• Painful, recurrent engorgement.

• Oversupply.

• Baby is having problems stooling.

• Overly gassy, fussy, or colicky baby.

• Breast infection - mastitis, abscess, or thrush.

For  more information about what normal breastfeeding looks like in the first few weeks, check out our article,What Every Mom Should Know About Breastfeeding During the Early Weeks, which highlights our brand new brochure!  Also, check out Ashley as she discusses more tips and tricks for breastfeeding during weeks 3-6 on the Boob Group episode, New Mom Breastfeeding Manual: Weeks 3-6.

I’ve Had My Baby - Now What? Breastfeeding During the Second Week

Welcome to our new series, I’ve Had My Baby - Now What?  This is a guide with basic information to help you navigate the first days, weeks, and months of breastfeeding your new baby.  

Today we’d like to talk about the second week of your baby’s life, and what breastfeeding looks like.  What can you expect for normal behavior from your new baby, and when do you know there’s a problem that you should seek professional help for?

Now that my milk has increased in volume, what should feedings look like?  How much does a baby need at each feeding and how long should it take?

Most moms will see their milk change from the first low-volume colostrum to the fuller-volume mature milk somewhere between day 3 and day 5.  So by week 2, there is often more milk for baby to take per each feeding.  However, in the early days of the second week, a baby only needs about 1.5 ounces per feeding.  By the end of the second week, the baby will need 2-2.5 ounces per feeding.  Feeding length should still be determined by baby and when baby seems satisfied, but most little ones at this age should be able to get a full feeding in 30 - 60 minutes.

How much weight should my baby gain in week 2 of life? When should they regain their birth weight?

It’s normal for all babies to lose some of their birth weight in the first few days of life.  Once mom’s milk transitions to the fuller volume milk between day 3 and day 5, baby should gain ½ - 1 oz per day.  Most babies who are breastfeeding well will reach their birth weight by 10-14 days.  If your baby doesn’t regain their birth weight by 14 days, it might be a good idea to seek the help of a lactation consultant.

My baby seems to prefer one of my breasts over the other, and even has a difficult time latching onto the other one - is this normal and what can I do?

It is common for babies to prefer one side over the other.  They have often been lying in one position in utero, which can cause tightness in their necks and jaws.  Sometimes a long and difficult labor can affect the baby’s ability to latch onto one side - if the pushing section was long and baby was in birth canal for many hours - the compressions to his head may affect him in this way.  Often babies will work it out in the first few weeks, but if your baby continues to struggle, we often recommend body work for the baby, in the form of Craniosacral Therapy or Chiropractic care.

My baby starts choking shortly after starting to breastfeed.  What is causing this and what can I do?

Some moms find that their milk “lets down” very quickly.  When a baby begins to feed, the stimulation of the nipple releases hormones for mom to signal her body to “eject” the milk from the milk ducts.  When this happens quickly and forcefully, sometimes the sudden flow can take the baby by surprise and they may come off the breast coughing and sputtering.  If all is going well, the baby should learn to manage this within the first couple of weeks.  Feeding in a laid-back position can also be very helpful to slow down your let down. If your baby continues to struggle with a forceful letdown, it could indicate that there is something happening anatomically that is preventing him from being able to adapt.  This would be a good time to visit with a lactation consultant.

My 2 week-old baby is suddenly famished!  He went from eating every 2-3 hours to wanting to eat *constantly*!  He never seems satisifed and is fussy at the breast. Does this mean my milk supply is decreasing?

All babies go through a growth spurt around 2 weeks of age. The behavior above describes what a baby will act like during these growth spurts. It’s a natural occurrence to help build your milk supply to help keep up with the baby’s increasing needs.  Growth spurts usually last 48-72 hours.  As long as your baby is continuing to have plenty of wet and dirty diapers, there is no reason to think that your milk supply is faltering.

There may be times when things aren’t going the way they should.  If you find this, please contact an International Board Certified Lactation Consultant to help you.  Some signs that you might need some additional help:

• Sore, cracked, bruised, or bleeding nipples.

• Baby is still well under birth weight near 14 days of life.

• You suspect your baby may be tongue-tied.

• Painful, recurrent engorgement.

• Oversupply.

• Baby is having problems stooling.

• Overly gassy, fussy, or colicky baby.

• Breast infection - mastitis, abscess, or thrush.

For  more information about what normal breastfeeding looks like in the first few weeks, check out our article, What Every Mom Should Know About Breastfeeding During the Early Weeks, which highlights our brand new brochure!

What a Difference a Tongue Tie Revision Can Make

To help parents understand a bit more about how tongue and lip ties can affect breastfeeding, over the next few weeks we will be featuring stories from moms whose babies experienced these challenges.  We would like to extend a HUGE thank you to the brave mamas who submitted their stories for our blog!  We know you went through a ton of challenges and we are so appreciative that you were willing to share your stories!  If you have a story you would like to share on our blog, please send it to robinkaplan@sdbfc.com.

For more information about tongue and lip ties and how they can affect breastfeeding, please see our article:Does Your Baby Have a Tongue or Lip Tie?

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Written by Nina Jacobs 

Aubrielle was born on August 3rd, 2013 at 36 weeks due to my preeclampsia. She was 5lbs 13 ounces of tiny beautiful joy. I knew from the moment I found out I was pregnant that I wanted to breastfeed (my goal being for a year). I had no idea then, that it would be such a wonderful, beautiful, bonding, humongous part of my life. We were in the hospital for 5 days because of Aubrielle being considered a "late premie" and all of the meds I had to come off of to make sure I didn't have a seizure. Aubrielle was immediately diagnosed with a severe tongue tie by the pediatrician and two lactation specialists. We made an appointment to have her tongue tie snipped at 4 days old with ENT. In the mean time, she was latching, and eating as best as her little mouth could while we supplemented with pumped milk and feeding her through a tube and syringe. 

When we arrived at her appointment, the ENT doctor asked us if she was latching. She was with a nipple shield. He said that she was so small and fragile and because she was able to latch, he would not perform the operation on his daughter if it was him. So, we went home. We spent the first month figuring everything out. We didn't keep to any schedule and just took cues from her. Aubrielle would eat for 40-70 minutes and ask to eat again 2-45 minutes later....all day and all night. I didn't know any difference and just was rolling with it. 

At her one month check up, she wasn't gaining THAT much weight. She was still under 5% (the same that she was born at). We chose not to supplement and to reschedule the tongue tie procedure because the pediatrician was outraged that she didn't get her tongue tie snipped and that she was feeding so frequently.   She would still fall asleep every time she ate and by the time she woke up she would be starving again. By the time we called to reschedule her procedure, they couldn't see us until she was 9 weeks old. Around her 6 week growth spurt, I came to the doctors office crying. It seemed like she was literally eating every second that she was awake. They still couldn't see us until 9 weeks. We pushed through and never supplemented.

At her two month check up she was still in the 5% for weight. We finally had the procedure done. It was awful... more blood and tears than I expected and I could tell that she was in pain every time she began to eat for 5 days after the procedure, even with the tylenol we were giving her. But, oh.my.gosh. The difference in her eating, her behavior, and my supply was NIGHT AND DAY. Instead of eating for 70 minutes she would eat for 20. She didn't fall asleep every time and was clearly satisfied after each feeding. It was the hardest, best thing we did. I wish we would have pushed for it at 4 days old. For three days after the surgery we had to "sweep" in between her tongue and bottom of her mouth, and for the first two days it would start to bleed a little, but nursing always stopped the bleeding. In fact, in the doctor's office, that is how they had us stop the bleeding. 

Before tongue tie revision

After tongue tie revision

We still used the nipple shield until she was 5 months old, which is when she took it off, threw it on the ground herself, and kept eating. Now at 6 months plus, she is a happy, healthy, thriving, nursing baby who went from the 4th percentile at her two month check up (a week before her surgery) to the 30th percentile at her 4 month check up. She has tripled her birthweight  at 6 months and only eats every 2-3 hours during the day, and only wakes up once at night to eat. 

Breastfeeding After a Tongue Tie Revision

To help parents understand a bit more about how tongue and lip ties can affect breastfeeding, over the next few weeks we will be featuring stories from moms whose babies experienced these challenges.  We would like to extend a HUGE thank you to the brave mamas who submitted their stories for our blog!  We know you went through a ton of challenges and we are so appreciative that you were willing to share your stories!  If you have a story you would like to share on our blog, please send it to robinkaplan@sdbfc.com.

For more information about tongue and lip ties and how they can affect breastfeeding, please see our article:Does Your Baby Have a Tongue or Lip Tie?

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Written by Cinda Brown

Lily and I had a rough start with our breastfeeding relationship from the very beginning. She latched soon after she was born and in that instant I felt sharp pain and noticed there was blood. She had caused damage with her first latch. We stayed at the hospital for about 24 hours, and in that time she had pretty severely damaged both of my nipples. I consulted with friends and professionals who had breastfed before, but didn’t get the kind of guidance I probably should have. No one’s fault, but no one had seen or experienced what I was going through so they gave me what they thought was very well meaning advice. Unfortunately I really needed to see an IBCLC, but I didn’t know that such a person existed.

After 2 rounds of mastitis, one being 7 days postpartum with 104 degree temperature, completely exhausted with a baby who cried all night long, I finally called the breastfeeding warmline at Balboa Hospital. Lily was about 4 weeks old. I don’t know why I hadn’t called it before, but I suspect it was because I thought I had received help already. I had been told by a friend that I was getting mastitis because Lily wasn’t emptying all the milk from my breast and that I needed to pump. So I did, starting at about 5 days postpartum. I ended up with such an oversupply from this, but didn’t know that I shouldn’t have been doing that. I think that this is ultimately what caused my second bout of mastitis. All the while I was scabbed and cried every time Lily latched. My nipple looked like the pointed end of lipstick when she finished nursing. This was unsustainable and I had no idea how women were able to breastfeed their children.

So, back to the call to Balboa. The nurse had me come in right away. She said that she suspected that Lily had a tongue tie and tried to also help me with technique. The technique didn’t help a lot, but I had developed a ton of bad habits trying to deal with the pain....like cursing, hunching over, stiffening my body in pain while she nursed, and the list goes on. She tried to help me relax, but it was to no avail. I was in so much pain. She talked to me about seeing the doctor for a possible clipping and I was immediately against it when it was described to me. We were talking about cutting in Lily’s baby mouth! Really?!?! I just had to be tougher and with that thanked the nurse for her help, and I truly meant it. I just had to go home and practice more. My husband helped me with what we had learned and it was exhausting for both of us. Neither of us could get Lily’s latch correct no matter what we tried. This led to lots of tears and frustration between both of us as we struggled to get it right. I was adamant that I was going to breastfeed, and at some points I felt like it was going to kill me to achieve that goal.

Two days later I was back with the nurse at Balboa, in tears. I was ready to see the doctor to talk about this procedure. I knew that the breastfeeding relationship between Lily and me wasn’t going to last much longer. Lily was about 5 weeks old at this point, so I had been enduring for 5 long, excruciating weeks. We met with Dr. Jim Murphy and he explained the procedure. I was onboard, knowing that at this point I was willing to try anything. The procedure wasn’t entirely pleasant, but I suspect it was because Lily was being held still, which she didn’t like and that she wasn’t being held close to me, which she did like. The clipping was really quick and Dr. Murphy immediately gave her back to me to have her latch. It felt very different! No big pinching feeling. Relief!

We were told to do stretching exercises after each nursing session. I did them religiously. It wasn’t all rainbows and unicorns as Lily had developed her own technique to get milk, which involved biting or gumming my nipples. It worked for her, but not for me. We had to learn together how to make this work well for both of us. Because of my abundant oversupply, she was not the typical underweight baby at her checkups. In fact she was right around 100% for both height and weight at each one. No one had suspected that we were having a problem.

A few weeks later the lipstick nipples, pain, pinching, and scabbing were back. We went back to see Dr. Murphy and he said that her tongue had healed in a way that indicated that he had to re-release her tongue. Heart breaking. We had to do the clipping again. We did, it was quick, and Lily latched right on. Nursing became easier after this, although we did have to go through a relearning process again. 

By the time I had to go back to work (when Lily was about 11 weeks old) we were doing great. She was sleeping better at night and I was able to think about trying to go running. Prior to this the thought of running was horrifying because my breasts and nipples hurt so badly. I continued to pump ALL THE TIME to try to relieve the pressure, knowing now that I was just keeping the output at maximum level. I was so relieved to have identified the problem that had caused us so much pain and suffering, so I started trying to learn as much about it as I could.

I’m a huge breastfeeding advocate and am an active duty Navy mama. I understand the challenges and difficulties presented to mothers with young children, and trying to balance this with a demanding job. I have sought education and am now working toward completing the Certified Lactation Educator certification and hope to help many more mothers have a successful breastfeeding relationship with their children. My own command has responded with support for the new mothers by allowing me to establish breastfeeding rooms and a support group. Lily is now almost 2 and a half, and nurses now more than ever. I know that if it weren’t for that wonderful nurse and Dr. Murphy that we wouldn’t be here today, and I am forever grateful for their assistance and that we were able to get the tongue tie clipping procedure.