Common Concerns While Breastfeeding - Sore Nipple Therapy for the Breastfeeding Mom

Help!  I Think My Nipple Just Fell Off!

Welcome to our newest blog series…. Common Concerns While Breastfeeding. These aren’t the complicated, ‘come-to-my-house-immediately’ phone calls I receive. Rather, these are the questions that come from clients and friends in the middle of the night, by text or by email, that don’t necessarily warrant a lactation consultation. They can often be easily resolved with a few simple tricks. So, I would like to share those tricks with you! 

12 hours before sore nipples! Painful, sore nipples are the worst thing EVER when you are a breastfeeding mom! My youngest son is almost 5 years old and I can still remember crying every time he woke up to breastfeed that first week of his life.  There are so many horror stories about painful nipples out there that some women are petrified of breastfeeding. 

Well, my friend, let me give you the low down about sore nipples and how to prevent and overcome them!  With a few simple tips, and the support of your ‘circle of breastfeeding support’, you should be able to avoid painful nipples, or at least know how to get your nipples back on track.

Symptoms:

• One side of the spectrum is nipple tenderness. This is normal. When’s the last time you had hours of nipple stimulation in a 24 hour period? My guess is NEVER or NOT SINCE THE LAST BABY WAS BORN.

• Middle of the spectrum is painful feedings with maybe some cracking. This shouldn’t happen, but it could have been the result of a poor latch here and there. Have a lactation consultant or a support group leader take a look, just to make sure.

• The opposite side of the spectrum is bleeding and cracked nipples. RED FLAG!!! This is not supposed to happen. This is your body’s way of telling you that you could use some assistance from a lactation consultant to see what is causing this pain. Don’t wait!

Prevention:

Look at this gorgeous latch!

• Nice wide latch – you don’t need your whole areola in your baby’s mouth, but the latch should be more than just on your nipple.

• Your baby’s lips are flanged like a fish’s mouth

• Don’t push on the back of your baby’s head to bring him/her to the breast. Instead, try a laid-back feeding position. Bring your baby’s torso into yours. His/her head will follow.

Treatment:

• Express breast milk on your nipples after your baby has fed and then let the ‘girls’ hang out for a few minutes.

• Some sort of nipple chapstick: Organic coconut oil, organic nipple cream, etc.

For those breastfeeding parents with cracked and bleeding nipples, you might need to try a few other options

• Hydrogels – wet wound management to place on your nipples in between breastfeeding

• All-purpose Nipple Ointment – can be prescribed by your physician to be made at a compounding pharmacy. This link, from breastfeeding expert, Jack Newman, includes the ingredients to give to your care giver.

• Don’t hesitate to call a lactation consultant! When a baby is latching correctly and his/her tongue is doing what it should, a mom’s nipples should not become cracked and bleeding. A lactation consultant should be able to figure out the cause of your pain and offer suggestions of how to fix the situation, ASAP!

5 Ways to Get Rid of Postpartum Visitors without Offending Anyone: Advice for the mom-to-be

Birthing classes, breastfeeding classes, baby showers, etc.  Everyone wants to be prepared for the arrival of a new baby, especially when it is your first.  But, there is one IMPORTANT point, one DETRIMENTAL point, which most of your class instructors and friends with kids will neglect to tell you. 

Limit the number of visitors you are willing to see each day!

“Why would I do that?” you may ask.  “Don’t I want to have everyone share in the joy of having a new baby?”  “Won’t my family members get upset if they can’t spend every minute with the new baby?”

Let me describe my postpartum scenario for you.  If it not unlike most of my friends’ experiences after the births of their babies as well….that is, until I shared this advice with them.

This is what surviving a 20-hr labor looks like!When my son, Benjamin, was born, he was the first grandchild born on both sides of the family.  He was literally like Simba up on the mountain top being revered in all of his glory.  Family and friends from around the country flocked to our little home in San Diego to meet the first child of the new generation.  I, too, was mesmerized by this little being that I had just birthed a few days before.  

Everyone who came to visit in the hospital and then at our home wanted to hold Ben…. To smell his sweet scent and listen to his sighs as he slept.  As my visitors sat on my couch and relaxed with my sleeping son, what do you think I was doing?  Resting after my 20-hour labor? Napping after breastfeeding all night, with painful bleeding nipples? 

I don’t think so! 

I was sitting on my doughnut (so that my episiotomy stitches wouldn’t rip out), chatting it up with the crowd.  I was making sure everyone had something to eat or drink.  Now, to be clear, this wasn’t expected of me by my guests.  This was self-imposed hostess torture.  I felt it was something I had to do.  Everyone held my sleeping, gorgeous child, until he woke up and started to cry.  Then, it was my turn to hold him, soothe him, and breastfeed him. 

Pure postpartum exhaustionAfter everyone finally went home (a week later), I had an infection from my stiches, a nipple shield I was trying to wean from, and an exhaustion like I had never felt before.  I made a promise to myself then and there that this was NOT going to happen the next time around. 

As I learn from my mistakes (oh, and there are so many since I became a mom), I try to share a few gems so that others won’t succumb to the same mistakes I made.  So, here you go…

5 Ways to Get Rid of Postpartum Visitors without Offending Anyone

1. Decide how many visitors you are comfortable with per day:  Have this discussion with your partner prenatally.  That way you won’t be persuaded after the baby is born (when hormones are topsy-turvy).  You might have to make an exception for family members, but that is up to you.

2. Assign your partner or husband to be the bouncer:  After the baby is born, it is the bouncer’s job to answer the phone, not you!  His/her phone response should be, “We have already had a few visitors today.  Would you like to come tomorrow instead?”

3. Ask visitors to bring dinner: You may laugh at this….my husband did.  But, whenever he asked someone to come another day, the visitor always replied, “Sure. What can I bring?”  Have the bouncer always reply, “Dinner would be great!”  My fridge/freezer was filled for 2 weeks!  It rocked!Time to unwind with my babe

4. Have an exit strategy: Sometimes visitors stay a little bit too long and you may feel weird asking them to leave.  Remember, you need to take care of yourself!  Your body and your baby are depending on it.  As soon as I felt like I wanted my visitor to leave, I said I was feeling a little dizzy and needed to go lay down.  They usually got the hint and headed for the door.

5. Don’t play hostess: Don’t feel the need to cook or clean your house before someone comes over.  Would they expect this if you had back surgery?  No.  So, sit down, snuggle that sweet little baby, and chat for as long as you want to.  Then, use your exit strategy and rest.

Did you limit your visitors after your baby was born? 

How did you limit your visitors without offending anyone?

The Breastfeeding Basket: a little advice for the mom-to-be

A few months ago I came across this ridiculous article written by a very self-righteous mom.  In all of her judgmental glory, the author scorned moms who watched TV and read books while breastfeeding their babies.  She claimed that the act of breastfeeding was a mom’s time to bond with her child and should never be used to catch up on things like Facebook or Oprah.  GIVE ME A BREAK, LADY!!!!  I don’t often comment negatively on other people’s blogs, but this one made my blood BOIL!

As many of my friends know, I spent countless hours watching episodes of Sex and the City in the middle of the night while I breastfed my son.  30 minutes of pure, mindless entertainment saved my sanity during those long middle-of-the-night feedings.  By the time the show was over, I had breastfed my son, changed his diaper, and burped the little puker.  Sure, I could have fed side lying in bed, but Sex in the City was my guilty pleasure and I am not ashamed to admit it. 

Clearly, the author of this infuriating article was a self-imposed martyr (too bad for her kids!) or completely lying.  Either way, her article did nothing to support breastfeeding moms.   Instead its purpose was to initiate ‘mother guilt’, which I definitely don’t need a complete stranger to do for me or for the women that I love. 

Hence the breastfeeding basket….

Since you will be breastfeeding for 30-40 minutes at a time, 8 or more times in a 24 period, don’t you want items near you that will help you pass the time and make you self-sufficient?  I hated yelling down the hallway to my hubby to bring me a snack while I was nursing.   I wanted everything I would need during those breastfeeding sessions to be within arm’s length. 

Stuck on creative ideas?  Here is a list to get you started.

 

Top 10 Things I Put in my Breastfeeding Basket

1. Diapers – babies poop while breastfeeding, so it is good to be prepared.
2. Wipes – self explanatory
3. Burp cloth – my kids spit up all of the time, so this somewhat guarded my clothes from being covered in it all day.
4. Klean Kanteen – so thirsty while nursing!
5. Snacks – you burn 500 calories a day while breastfeeding….you will be starving!
6. TV remote – DVR all of your favorite shows and enjoy.  This is your time to relax as well.
7. I Pad, cell phone, etc. – catch up on phone calls, texts, and anything else to keep you connected to your pre-baby life. 
8. Camera – sleeping babies are so adorable!
9. Magazines – I never had time to read People, Lucky, and In Style before I had kids.  Now I knew what all of the celebrities were doing and the fabulous outfits I would buy when I lost some of my pregnancy weight.
10. Receiving blanket – many babies will fall asleep after breastfeeding.  When this happened, I would just cover my babe up and let him sleep on my chest for a while, soaking in the sweet scent of his little body and enjoy our ‘bonding’ moment.

Ladies, you don’t have to lose yourself once you become a mom!  Bonding with your baby happens continuously throughout the day.  So, take a little time to yourself when you have the chance and NEVER feel guilty if you take a little personal time while breastfeeding your little one!

Also, check out one of my breastfeeding student’s blogs, Hank and Lucy, for wonderful ideas and photos of her breastfeeding basket.  She has much more style than I do!

Our readers would love to know what items will you put (or have you put) in your breastfeeding basket? Please share in the comments!

Hi Ho, Hi Ho, It’s Off to Work We Go…

The time has come. Your maternity leave is slowly coming to an end. Whether you are sad to be leaving your little one for a portion of the day, excited to have some adult interaction, or a combination of the two, it is now time to consider how and what you will feed your baby during this time of separation. I remember feeling somewhat overwhelmed about this whole process. What was my son going to eat when he was away from me? How was I going to stockpile enough breastmilk before my first day back to work? Where was I going to pump while at work? The list went on and on in my mind and made me a little crazy. Yet, once I sat down and made a plan for myself, everything seemed less daunting and more feasible.

Well, ladies, my plan for the next few blog postings is to help make your 'back to work transition' easy and manageable. Are you ready? Here we go:

Starting the Pumping Process

As soon as your baby has gone through his/her growth spurt (around 2-3 weeks old) and if breastfeeding is going well, you can start pumping to get breast milk for bottles and your stock pile. Now you may ask, if I am exclusively breastfeeding, how I am going to have extra breast milk to pump? Well, usually your baby will remove about 75%-80% of your breast milk during a feeding, so there should still be some milk in there to pump out. Also, you may find that there are certain times of the day where you feel fuller, even after your baby has had a full feeding. I found that this time for me was in the morning. Even though I wasn't sleeping THAT much at night, my body was resting and replenishing while I was sleeping.

After our first mid-morning breastfeeding session, I would pump afterwards and save the little I got (usually .5-1oz) in the fridge in a milk storage bag. After pumping at this time for a few days in a row, I had about 3oz in the fridge….a perfect amount of breast milk for my 3 week-old son.

Introducing the Bottle

So, mamas, how do we introduce this first bottle of liquid gold???? Have someone else do it! Yes, you read correctly. Your baby can smell you from practically a mile away (well, maybe not that much!) and will probably have no interest in a bottle if he can have the real boob. Instead, hand your bundle of joy to dad, grandma, etc and immediately leave the room. And wait. And wait. Caution: Do not pump in place of this feeding session until you receive the 'All Clear' that your baby happily drank the bottle of milk and is as happy as a clam. I made the HUGE mistake of pumping as I THOUGHT my hubby was giving our son the bottle. Long story short, my son didn't take the bottle the first day. I had pumped because I thought he was drinking from the bottle. We ended up with a screaming little boy, empty breasts, and a frustrated mama. Moral of the Story: Wait until your baby takes the bottle and then pump in place of the breast feeding session. Now baby is full, mom has empty breasts, and now you have breast milk for your next bottle.

How Often Should I Give a Bottle?

If you are going back to work, I would recommend giving your baby a bottle a few times a week. That way, she/he gets used to going back and forth between bottle and breast and will continue to take a bottle once you return to work.

For a great resource about the different types of pumps and which ones are best for moms going back to work, check out one of my favorite web site: Breastfeeding for Working Mothers. As for bottles, always choose a slow flow nipple that looks most like your own anatomy.

If breastfeeding is still a challenge by 2-3 weeks, please see a lactation consultant before starting this process, as it could cause more difficulties if breastfeeding is not going well.

Making Plans with your Employer

So, now you should have mastered the pump, built a small supply of milk in your freezer, and introduced a bottle to your little one. No problem, right? Next step, get your employer on board for giving you your well-earned break to pump while at work. Sometimes, this is a no-brainer. If you live in a state like California, businesses with more than 50 employees are mandated to give breastfeeding moms pumping breaks and supply a clean, private space to pump (which cannot be a bathroom stall.) Other states do not have such laws in place, so you might be paving the way in your business for you and future breastfeeding moms. Either way, it is helpful to know your rights and how to be proactive to get what you deserve: time to pump so that you have something to feed your breastfeeding baby. Let’s get all of your ducks in a row so that this is an easy process for you.

Reasons Why Pumping at Work is Good for Your Employer

Sometimes it is helpful to have a list of reasons why allowing a mom time to pump at work is beneficial for her employer. Bosses like to look at the bottom line. Here’s a handy-dandy list of reasons to share with your boss:

• A study of multiple companies with lactation support programs found an average retention rate of 94.2%

• One-day absences to care for sick children occur more than twice as often for mothers of formula feeding infants.

• Businesses with lactation support have lower turnover rates, higher employee satisfaction, and additional health care savings.

All of this information, and more, can be found in the Business Case for Breastfeeding: For Business Managers

What You Would Like for Your Employer to Provide

A pumping mom needs very few things from her employer to continue making milk for her baby. Really, all you are looking for is a private, clean space (that is not in a bathroom) with outlets, a comfy chair, and a lock. An optimal break time is about 20 minutes: 15 minutes to pump, 5 minutes for set-up/clean-up. You should be able to take a break every few hours, since you will need to pump as many times as you are missing that breastfeeding session with your baby. It is amazing how efficient you will become in your pumping space. The supplies you will probably have to provide will be a pump/pump pieces and freezer bags (in which to keep your pumped milk.) Some savvy employers may provide a small fridge to keep your milk in and a super comfy space. Others may provide the bare minimum. Regardless, it is your right and you can make it happen!

What Should You Do if Your Employer Does Not Provide Pumping Breaks for You?

Check out your federal rights at the Workplace Support in Federal Law web site. All of your rights are there in front of you. You can make it happen!

Gentle Weaning: What is the Process?

In this second article in our Weaning series, we will start the conversation about how to gently wean your baby and why pacing is so important in this process.  If you are wondering when you will know when to begin weaning your child, check out our last article, What is Weaning and When Should I Wean my Baby?

At what pace should you wean your child?

Very slowly.  The weaning process can take several months, as you want to make sure that both you and your child are adapting well to this new pattern of breastfeeding.  Drop one feeding at a time (for example, from 6 times a day to 5 times a day) and try this out for a week or two. This will give your breasts time to acclimate and hopefully not become too engorged.  This will also allow your child to get used to doing something else, or get his/her nutrition from another source at this time.

This process will most likely take a month to several months; depending on how many times your child is breastfeeding in a 24 hour period.  Remember, weaning can affect you and your child physically and emotionally, so it is best to take your time and wean very slowly.

What are the risks for abruptly weaning?

It is very rare that a mother would have to abruptly wean her child from breastfeeding.  The risks associated with abrupt weaning for the mother could be:

• Breast pain

• Engorgement

• Mastitis

• Breast abscess

There are also risks associated with abrupt weaning for the child.  Remember, breastfeeding is not only a source of nutrition for your child, but also a sense of comfort and bonding.  To suddenly remove this could be very confusing and scary for your child, especially if he/she is still developing his/her sense of attachment and trust.  As with all methods of parenting, it is most respectful and effective to initiate change at a slow pace.

What physical and emotional changes should a mother expect when weaning?

All rights reserved, Susanne Klein photographeAs you begin to drop a breastfeeding session during the weaning process, you may feel fullness in your breasts, which can become uncomfortable.  Here are a few tricks to relieve that fullness:

• Pump or hand express, just to relieve the fullness.  Don’t pump to drain or you just defeated the whole purpose of skipping that breastfeeding session.

• Take a hot shower, which will help you leak a little and may reduce the pressure in your breast.

• Cabbage leaf compresses – good old green cabbage wrapped around your breasts can help to reduce fullness.

• Sage tea – drink sparingly while gently weaning, as it can really tank a milk supply when consumed in large quantities.

Emotionally, your body is going to go through some hormonal changes as you begin to wean.  During the weaning process, prolactin levels begin to drop.  Prolactin not only helps to stimulate your milk supply, but it also provides a sense of relaxation and calmness.  Some mothers may even feel depression after weaning. 

I remember feeling a sense of loss, that I had a difficult time describing, as I was weaning my son.  It was somewhat temporary, but it definitely was there.  I just felt sad that this aspect of mothering and comforting my child was coming to an end.  Something that helped me adapt to this change was creating a different bedtime routine for the two of us.  Instead of nursing my son to sleep, we now read a story together in his rocking chair.  Then, I turned off the light and sang him a song as I rocked him into a state of sleepiness.  My son is now five years old.  At bedtime, we still read a story in his bed and then listen to a song on his IPod as I lie down next to him and snuggle.  It is my favorite time of the day!

Now it’s your turn to share how you paced your weaning process with your child. 

How long did it take you to wean? 

What physical and/or emotional changes did you encounter?

Does traveling cause a dip in milk supply?

A close friend of mine was at a breastfeeding support group recently and was told that many moms see a dip in their milk supplies when traveling with their babies. My friend speculated that this may be a reaction to the stress of traveling with an infant. I told her I would look into this, since I couldn't fathom why traveling would make a mom's milk supply decrease. A mom's milk supply could surely decrease when traveling WITHOUT her infant, but why WITH her infant? After some internet and article searching, I couldn't find any scientific reasons that would cause this phenomenon. But, since a few moms have seen this happen, I thought I would offer some advice on how to make sure that this doesn't happen to you.

5 WAYS TO MAINTAIN YOUR MILK SUPPLY WHEN TRAVELING WITH AN INFANT

1. If traveling by plane, nurse your baby during take-off, landing, and turbulents. This will relieve the pressure in your baby's ears, thereby relieving your stress level.

2. Keep to your baby's regular feeding schedule. If this means you will have to nurse in public, practice before you go on your trip so that you are confident and comfortable. A baby wrap is a great way to nurse discreetly in public.

3. If you plan to go out and have someone else watch your baby, pump before you leave so that you are not full and uncomfortable while away from your baby. A hand pump should suffice for this moderate use.

4. Some babies have a difficult time sleeping away from home, so plan to take a few naps during your trip, so that you can make up for some lost sleep during those restless times.

5. Don't plan too many activities during your trip. Try to keep your stress level down, which will preserve your milk supply, making for a happier, more content baby....maybe even a rested and relaxed mommy!

Happy travels!

Secrets of Baby Behavior

One of the best trainings I have ever attended was taught by Jane Heinig from UCDavis. She teaches a workshop about understanding infant behavior. Check out her department's blog at http://www.secretsofbabybehavior.com/. Great advice for all moms about reading your baby's cues and understanding infant sleep patterns.

Welcome to The Sanity Spot

Sleep deprivation, diapers, feeding, crying.....sound a little familiar? And not just describing your baby??? All within a matter of minutes, your life has completely changed and sometimes all you want is for it to go back to the way it was.... pre-baby! But then, that sweet little baby of yours (or your three and four year olds, in my case) just look at you with those adoring eyes and you are brought to tears as your heart fills with so much emotion that it is impossible to describe. Welcome to motherhood... the most rewarding and, definitely, the most difficult job you will ever have in your life!

So sit back, put your feet up, lay your baby (infant, toddler) on your chest, and smell his/her sweet scent while he/she sleeps for a few moments. It is all about being present, in the moment (if you will), and taking a deep breath. For it is those moments you will remember the most. Hey, if we remembered all of the difficult times, we would never have any more kids.