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?

______

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?

_____

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.

Combining Lactation and Maternal Nutrition

Today, I'm thrilled to introduce a new guest blogger, Lindsey Hurd, MS, RD, LDN, IBCLC.  Lindsey is the owner of Angel Food Lactation & Nutrition, LLC, a business in Wilmington, NC that specializes in perinatal nutrition and lactation services.   Over the next several months, Lindsey will be sharing her brilliant knowledge about breastfeeding and nutrition, including multiple articles about breastfeeding children who have food intolerances.  

Before Lindsey starts writing her monthly articles, we wanted our readers to have the opportunity to get to know her first.  Welcome to our blog, Lindsey!  We are so excited to have you share your passion and expertise!

Tell us a little about yourself.

My name is Lindsey Hurd and I am a registered dietitian (RD) and board certified lactation consultant (IBCLC) working in private practice in Wilmington, NC. My business, Angel Food Lactation & Nutrition, LLC, specializes in providing perinatal nutrition and lactation services. Consultations are offered in a home or office setting. Skype consults are available for families who are not local or are in need of flexible scheduling. Locally, I offer grocery store tours to instruct families on how to navigate their food selection and how to prepare foods that taste good and fall within their nutritional goals. Overall, I am here to support moms and babies, uniquely catering my advice and suggestions to fit their needs. Families trust Angel Food Lactation & Nutrition to provide specialized counseling for food sensitivities in baby, gestational diabetes, lactogenic (foods that enhance milk supply) meal planning, and nutrition support from infancy through preschool.

My journey began with an undergraduate degree in Exercise Science. In learning about the powers of exercise, I found a passion for instructing individuals on the role of nutrition, the biggest contributor to one’s overall wellbeing. Upon completion of my undergraduate degree, I continued to expand my knowledge in health and wellness by completing a Master of Science in Nutrition and a program in dietetics to become a Registered Dietitian. To provide comprehensive care from preconception through preschool, I chose to become an IBCLC, the expert in lactation support. I completed the Mary Rose Tully Training Initiative through the Carolina Global Breastfeeding Institute at UNC- Chapel Hill and successfully passed the boards, fulfilling my goal for the future. With my career path set, I continued to work in nutrition and lactation for more than 4 years.

Why did you decide to focus on perinatal, postpartum, and pediatric nutrition?

I quickly became fascinated with perinatal and pediatric nutrition as I progressed through my studies. The most noteworthy experience was completing my master’s practicum with an International Board Certified Lactation Consultant (IBCLC) in private practice. I fell in love with her job and was amazed at the impact she had on infant nutrition. I immediately realized that I would never find another profession to fulfill my aspiration of providing families with the tools necessary to find their perfect balance of health and happiness. I truly believe this stage of life ‘chose’ me!

From establishing childhood eating habits to the physical demand of sustaining a pregnancy, family planning naturally becomes one of the most important seasons in our lives. Offering education, counseling, and individualized support to those who wish to make the most of this opportunity fills my heart with joy. I am motivated to improve my practice daily to better serve families needs, large or small. Currently, I am very active on Facebook, posting educational resources, up to date research, and a little something fun every now and then. I enjoy connecting with my followers who simply wish to further educate themselves or find a little motivation to continue achieving their goals. Clients teach me how their passion and determination can improve personal habits, overcome speed bumps, and create a ‘new normal’ with the ideal support in place. I am honored to receive an invitation into the lives of each family as a trusted resource in helping them meet their feeding goals. 

What role does nutrition play in breastfeeding and making milk?

From flavor learning and brain development to boosting milk supply, each bite directly affects baby from conception to weaning, and some even argue beyond. Enhancing maternal nutrition to balance foods mom needs with foods she loves will directly change the outcome for mom and baby alike. Nutrition plays a huge role in our lives beginning with the first feeding at the breast to the last bite of your favorite meal - mine would be ground honey almond butter on fresh bread from our local bakery! On a physiological level, pregnancy and lactation are two of the largest periods of nutrient demand for a woman’s body. Naturally, it makes great sense to say nutrition plays a strong role in maintaining the health and wellbeing of a mother and her baby. The two are largely connected throughout the perinatal period with mom’s diet providing the foundation for baby to grow in pregnancy. 

Lactation quickly follows this period, requiring enough nourishment to triple the baby’s growth within the first year and establishing his or her immunity throughout the first two years of life! Beyond providing nutrients for baby, mom must also support the needs of her own body. Fortunately, a woman’s body is built to increase the absorption of nutrients, the efficiency of energy metabolism, and to put the baby’s needs first, ensuring optimal development.  What does this mean for the mom’s body you might say? It means that she must increase her awareness of proper nutrition to keep this well-established process functioning at full capacity! This is often easier said than done, especially as a family multiplies. This is where I feel the most effective in my practice, bringing clarity and assurance to women as they progress through the childbearing years. 

What type of guidance do you offer to breastfeeding moms whose babies are dealing with food intolerances?

Food sensitivities in our littlest ones can often be a challenging and stressful event for families. The sudden onset, the varying symptoms, and the persistent nature make this speed bump hard to navigate for families in today’s society.  I found a need for diving deeper into food intolerance within the breastfed baby and toddler as I saw more and more families struggle with elimination diets, unnecessarily removing critical foods, and navigating the world of food selection with restrictions. In hopes of enhancing my understanding, I completed a certificate of training in food allergy management and many days of self-study to learn how milk transfers food components from mom’s diet and how maternal and infant immunity play a role in the progression of sensitivities. My goal with each family is to educate moms on how to restore balance, to find replacement meals for foods they love, to honor breastfeeding, and to get baby symptom free. Overall, I am here to support moms and babies - uniquely catering my advice and suggestions to fit their needs.

What type of services do you offer?

Angel Food Lactation & Nutrition, LLC offers nutrition and lactation assessments for the whole family. Skype/web based consultations are available for those who are unable to schedule a direct face-to-face visit, or wish to have flexible scheduling.  Have more availability after bedtime? Wish to schedule on a weekend or when both parents are home? Want to schedule, but live in another state? This offering is best for you! Consults are held in the comfort of your own home, using your preference of video chat or voice only.

Classes, small group consultations, and professional seminar presentations are additional ways Angel Food Lactation and Nutrition, LLC, aims to serve those interested in nutrition and lactation for families local to the Wilmington NC area.

Want to know more about these topics? The how, what, and when? Stay tuned for more posts to come and visit my webpage www.angelfoodlactationandnutrition.com for individualized counseling to meet your unique goals.

The Lip Tie/Tongue Tie Challenge

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?

_____

Written by Julie Sanders

My issues with breastfeeding my daughter started pretty much as soon as we left the hospital. I started experiencing a lot of pain in my nipples. Not just while she was nursing, but all the time. I was told it was normal for her to nurse 8-10 times a day, but my daughter was nursing 20+ times a day. Essentially, she was constantly nursing, with maybe a 10-20 minute break between sessions. I found that since any side-lying, cradled position was extremely painful, only the football hold position worked for me. I went to a breastfeeding support group her second week, and I learned that my daughter was chomping my nipples while she nursed, and that’s why they were in constant pain. Nipples are supposed to come out of a baby’s mouth just as round as when they went in, but mine were shaped like a football after a nursing session. No wonder! Someone suggested I try nursing her lying down because she was perhaps trying to stem a strong flow of milk into her mouth, but that didn’t help. On top of it all, I also got a clogged duct, which was painful and scary. I was in such excruciating pain I would cry when my daughter wanted to nurse because I just wanted a break for my poor nipples to heal. I didn’t know why it was so hard or what was wrong. The only thing that got me through this period were gel pads. The moist, cold combination was wonderfully soothing.

When my doula came over for our postpartum visit, she checked my daughter’s latch and suggested that we have her evaluated for a tongue tie. She said it didn’t look like her tongue reached far enough forward in her mouth (past the gums). We had never heard of a tongue tie before. She explained it is a very common, simple procedure our pediatrician could perform to snip the underside of her tongue to allow for greater mobility. I rejected the idea at first. The idea that my daughter wasn’t born with her mouth properly equipped to handle breastfeeding seemed ridiculous to me. My daughter was perfect in every way! But later that week when she had a wellness checkup, we asked about the tongue tie. Our pediatrician said it looked like there was indeed a tongue tie, and he would revise it if we wanted him to.  So he clipped the frenulum under her tongue. It was done with scissors while the nurse and my husband held her down. He gave her just a topical gel to numb the area, then had to do about 3-4 snips to cut what he deemed enough. She wailed like I had never heard before and cried real tears. I cried real tears too. It was scarring. I nursed her immediately afterwards to help stop the bleeding and she slowly calmed down. The bleeding stopped very soon and she seemed on the road to recovery. She had a little discomfort for the next day or two. I thought the nightmare was finally over. But it wasn’t. At first I noticed a relief in how she nursed, but it was very short lived. I found out at the breastfeeding support group the next week that there were exercises we were supposed to be doing to help my daughter learn to use the full range of motion of her tongue. The lactation consultant who runs the group emailed me a video with instructions. I did them several times a day, as suggested, but nothing changed.

At around three weeks we finally saw a lactation consultant. I wish I had seen her during week one! Within minutes of telling her our history and examining my daughter, she told us my daughter also had a lip tie, and explained that my daughter nursed constantly because she was only able to get enough milk to satiate her for a short time before she would get hungry again. I hated the idea that my daughter had another tie. My perfect baby was still perfect!  But we followed the advice of the lactation consultant and went to a pediatric dentist in the San Bernadino area who uses a laser instead of scissors, a tool that was supposedly less traumatic on both patient and parent. The thought of driving 80 miles with a baby so young almost deterred us, but we decided to go for it.

The dentist had my husband lie down in the chair and hold my daughter face up on his tummy. Being held by dad was far less traumatic than being pinned to a table by strangers. She also got to wear adorable little sunglasses to protect her eyes from the laser. The dentist checked her out and said she did indeed have a lip tie, and he wanted to do another revision on her tongue to cut more of the frenulum. It literally a minute per tie, if even. He lasered, she cried, and before I could even get upset he was done. I nursed her immediately, just like before, and she calmed very quickly. They gave me exercises to do with her several times a day to help the range of motion for her mouth. Once again I left with the feeling of “It’s over. It’s finally over.” But it wasn’t.

The discomfort again only lasted a day or two, and seemed a little worse for her lip than her tongue. I did the exercises but she just kept chomping. Though with the new mobility of her tongue, her bottom gums were padded a bit, and the pain, while still painful, was much more bearable by comparison. By this point I had gone through so much, I was determined to make this work. My lactation consultant had told us “body work” might be required. After all, my daughter had used her mouth to nurse a certain way her whole life thus far and she was used to it. So we went to a craniosacral therapist. The therapist observed my daughter while she nursed and felt all around her head to examine how her muscles were moving. She massaged around her head and jaw for a bit, and then she told us my daughter’s jaw was very tight, and that’s why she wasn’t latching correctly, but that there wasn’t anything she could do to loosen it.

Next we tried a chiropractor. Chiropractic was another kind of body work my lactation consultant had suggested we may need. She recommended a few people who worked with babies in my area. Over the next two weeks I saw the chiropractor three times. She adjusted areas in my daughter’s upper spine and around her jaw to try and loosen it. Between the three appointments and our periodic massaging of her jaw, gradually at around six to seven weeks old, my daughter’s jaw loosened, she stopped chomping my nipples, and started sucking the way Mother Nature intended. It felt like an eternity, but she is now three months old and our time breastfeeding is easy, a lovely bonding experience and no longer something I dread. It’s easy and wonderful, and it was worth every minute we spent at appointments and every dollar we spent on doctors and specialists and consultants.

I learned a great deal during this trial. A good lactation consultant is invaluable. Ours not only identified our issue right away, but she had all the references to specialists we needed. We were not in a place where we could have researched and found someone to go to on our own. We trusted our lactation consultant, we went where she sent us, and we were never disappointed. Surrounding myself with people who supported my determination to exclusively breastfeed was also pivotal. Being a new mom is an emotional time with many ups and downs even when breastfeeding is going well. My mental state really ran the gambit, and having people to tell me it would get better and that I could do it helped me through my lowest moments. The friend who introduced me to gel pads is an absolute saint! And I learned how strong a person I am.  Compared to this experience, labor was easy. I always referred to what we were going through as “a breastfeeding challenge” because a challenge is something you overcome, and usually leaves you stronger and better off than when you started. 

Nursing in Public - The Positive Spin

Recently, there have been a lot of stories in the national and local news about mothers being illegally harassed for nursing their babies in public (“NIP”).  The latest one involved a Twitter exchange between a breastfeeding mom and a Delta Airlines Public Relations employee. 

While we think it is so incredibly important that these types of incidences are highlighted and spoken about, we also believe it can paint an incorrect picture that if you nurse your baby in public, you’d better be ready for a fight.  So we thought we’d seek out some positive experiences mamas have had feeding their little ones while out and about - below are a few of the responses we received.  For every woman that may be made to feel uncomfortable for NIP, it is our greatest hope that there are 100 that receive smiles, nods, and even an occasional high five.

_____ 

From Lara Snyder:

Our son is three months old and so far I have had nothing, but positive and amazing breastfeeding experiences! The first time we ever tried NIP-ing was when my family was flying home to Colorado, for Christmas. It was my husband's and my first time flying with an infant so we got to the airport early. Our son was only one month old and like any one month old he got hungry often! Since it was my first time flying with a baby and NIP-ing I was really nervous that someone would give me a hard time and make the flight difficult. Luckily nothing like that happened! After getting through security our son started to get fussy because he was hungry, so my husband found a comfy bench to put all our stuff down and so I could nurse. Oddly enough the bench was right outside some bathrooms and quite a few people saw what I was doing!! Once we got all our stuff situated and I got comfortable, my husband simply said, "Ok I'm going to the bathroom, you feed the baby," without even second thinking my boob was going to be out in public. Sitting right there in the middle of the San Diego Airport, I fed our baby boy while airport employees and multiple travelers walked by. No one said a thing about my nursing! I'm sure a few people felt uncomfortable, but they just looked away. One man even came out of the bathroom and began talking to my family. It was a little strange to me and my husband because we didn't know this person, but he was rather nice and wished us safe travels! Once we got on the plane the positive experience continued and our wonderful little man slept the entire flight! The pressure changes bugged him a little, and even then I started nursing him and everything went smoothly! My husband offered to sit in the middle seat (even though he hates it) just in case an unappreciative person sat next to us, they would have nothing to complain about because they would see my husband and not me! After our flight landed in Colorado we waited to be the last couple off the plane, and a lot of the other passengers were surprised there was a baby on board!  Both my husband and I were so grateful I could nurse my son during the rough patches during the flight, and we felt so proud of our little man surprising everyone by not being that crying baby on the plane!

_____

From Marion Luebberman:

I had to take my little guy to two life celebrations for friends who had passed away before he was four months old. I was terrified both times because I was sure people would give me the stink-eye for bringing a baby to something so somber, but the truth is, people love to see babies during times of sorrow. At the first event, I had to nurse during the eulogy and my son was only a couple months old so he was very floppy and not cooperative at all. The mother and aunt (neither of whom I'd met before) of our deceased friend came over and offered to help me. I was struggling with my cover and they both said "we've all been there, do what you gotta do!" I felt so comfortable there and my boy was fed and happy. At the next service, which was attended by 200+ bikers, my husband and I were talking to the widow of the friend we had just lost. She lit up at the sight of a little baby and told me that if I had to feed him at any time, I was welcome to "whip it out and do what you gotta do!" I did just that and nobody blinked an eye. If I could pass on any message to moms who are wary of nursing in public, I would tell them what these awesome moms told me - do what you gotta do!

_____

From Tiffany Kyle: 

In my 15mo of breast feeding I can honestly say I have never had a negative experience nursing in public. One day stands out especially for me as being an incredibly positive moment. I was at Starbucks with my son and I think he was probably 7 or 8 months at the time. It was one of the Starbucks that has comfy furniture and it was quite crowded. I had been chatting with the people around me a little bit and they were commenting on how cute my baby was. When my son needed to nurse, we did our thing. I'll admit I wondered for a split second if any of these strangers who were sitting very near to us would have a problem with it, but everyone was more than supportive. The lady across from me gave me a high five and said what a great job I was doing and no wonder my son was such a happy guy. Seriously made my day. :)

_____

Thank you so much to all of the ladies who contributed their positive stories - let’s keep it going by not only sharing our own experiences, but creating a happy memory for the next woman you see feeding her baby at the zoo, or the park, on the airplane, or in the grocery store - give her a high-five and tell her what a fantastic mama she is, and “to do what you gotta do!”

Do you have a positive NIP experience you would like to share with our readers?  Send your story to ashleytreadwell@sdbfc.com and we will include it in an upcoming article!   

Does Your Baby Have a Tongue or Lip Tie?

Painful, cracked, compressed-after-breastfeeding nipples.  Baby not gaining weight well.  Constant breastfeeding sessions that seem to take over an hour.  Excessive baby fussiness and gas.  These are some of the many signs that your child may have a tongue and/or lip tie.  So, what is a tongue and lip tie and how do they affect breastfeeding? What are ways to fix them and improve breastfeeding?

With several fantastic articles already written on this subject, we are going to give brief answers to these questions and link to our favorite comprehensive resources.  Also, over the next month, we will be sharing stories from breastfeeding mothers whose babies had tongue and/or lip ties.

 

What is a tongue tie and lip tie?

There are pieces of connective membranes under the tongue and behind the upper lip called frenula.  Everyone has a lingual (tongue) frenulum and a labial (lip) frenulum, which means that if your baby has one, it doesn’t automatically mean that you are going to have breastfeeding challenges.  It’s how the tongue and upper lip function that determine if the frenula are causing a problem.

Tongue tie

Upper lip tie

How do tongue and lip ties cause breastfeeding challenges?

When the frenula are tight, they act like rubber bands, tethering down the tongue to the base of the mouth or the upper lip close to the upper gumline.  This makes it difficult to move the tongue in an effective manner or flange the upper lip out.  When the tongue doesn’t have full range of motion, it can cause all sorts of issues.  Some moms’ nipples will be compressed, causing pain and ineffective milk extraction.  Some babies will become very tired and fatigued while breastfeeding, having to work extra hard to compensate for the lack of range of motion in their tongues.  This can turn into ineffective, long feedings and slow weight gain for babies.  Other babies gain weight perfectly fine, but have tons of gas and excessive fussy periods because they are taking in so much air while breastfeeding due to the inability to push the milk back in a wavelike motion.  Babies with tongue ties or significant lip ties often continually fall off the breast, as they are unable to form a good seal and suction.  Other babies have such difficulty latching on to the breast that they refuse to breastfeed altogether.

Here are two articles that describe how tongue and lip ties can affect breastfeeding:

A Breastfeeding Mom’s Symptoms are as Important as Baby’s

Baby’s Weight Gain is Not the Only Marker of Successful Breastfeeding

Why didn’t my healthcare provider mention this to me? 

Most health care providers have not been trained to assess and diagnose tongue or lip ties.  Again, it is how the tongue and lip function (or not function) that cause the breastfeeding challenges.  Most health care providers have not been trained to complete suck assessments on infants, therefore they cannot accurately assess what the tongue is doing while feeding.  The best person to assess for a tongue or lip tie is a trained IBCLC (International Board Certified Lactation Consultant).

Who can treat my child’s tongue and/or lip tie and what are my options?

The best person to diagnose and treat a tongue or lip tie is a trained dentist, ENT (Ear, Nose, and Throat surgeon), oral surgeon, naturopath, pediatrician, or other medical professional trained to do minor surgery.  Make sure to do your research, as not all professionals that revise tongue and lip ties know how to release them effectively.  If the professional doesn’t do the revision procedure effectively and completely, then it will not fix the breastfeeding challenges completely and your baby may have to have the procedure again.  

In most cases, the tongue or lip tie revision is done at an office visit.  Some practitioners will numb the area before the procedure, although it isn’t necessary.  Some practitioners, such as ENTs and pediatricians, may use blunt-edged scissors to snip the tight frenulum.  Others, such as dentists, may use laser for the revision procedure.  

Are there any negatives to having the tongue or lip tie revised?

There is very little risk for having your baby’s tongue or lip tie revised.  Most parents comment after the procedure that their only regret is that they didn’t do it sooner, as it improved their breastfeeding challenges tremendously.  Some babies may be a little fussy after the procedure, but most will settle with some extra cuddles.  Some parents find that a little infant tylenol or homeopathy can help relieve pain (but always check with your healthcare provider for appropriate dosing.)  

How can I keep the frenulum from scarring down after the procedure?

It is very important that parents do suck and stretching exercises after the procedure to prevent scarring down.  My colleague, Melissa Cole, IBCLC, created this quick and easy video for suck exercises after tongue tie revisions: http://vimeo.com/55658345.  She recommends doing these a few times a day, during baby’s quiet alert time, to retrain baby’s tongue to suck effectively and to prevent scarring down.  A local dentist recommends bending baby’s upper lip up to his/her nose after an upper lip tie release to prevent scarring down.

Will my breastfeeding challenges resolve immediately after the procedure?

Most moms report some immediate improvement after the procedure, but it can sometimes take up to a few weeks or months to resolve all of your breastfeeding challenges, depending on other confounding issues, such as mom’s milk supply or baby’s progress.  Remember, your baby has been using his/her tongue and upper lip in this way since he/she was in utero, so it may take some time to ‘relearn’ how to use his/her tongue and upper lip effectively.  Body work, such as craniosacral therapy and chiropractic, can help speed up this process as it can reset your baby’s nervous system, as well as relax the muscle tension that your baby may have developed while using compensating mechanisms.

Here are some additional online resources that have excellent information about tongue and lip ties.  Stay tuned for our featured stories from moms whose breastfeeding challenges improved after having their babies’ tongue and lip ties revised.  Better yet, sign up for our newsletter and have these articles delivered directly to your email inbox!

Websites that offer ways to see if your baby might be tongue tied:

Catherine Watson Genna: Is My Baby Tongue Tied?

Dr. James Ochi: Tongue Tie Survey

More researched-based articles about tongue and lip ties:

American Academy of Pediatrics Tongue Tie article

Dr. Kotlow: Tongue Tie Fact Sheet

The Leaky Boob: The Basics of Tongue and Lip Tie: Related Issues, Assessment, and Treatment

Boob Group episode: Tougue Ties and Lip Ties: Symptoms, Treatment, and Aftercare

If you would like to submit your personal story about breastfeeding a baby with a tongue or lip tie, please email it to robinkaplan@sdbfc.com

Did your baby have a tongue or lip tie?

How did this affect breastfeeding?

Help a Mama Out: Tips for Talking with your Boss about Pumping

'Help a Mama Out' Topic of the Week:

Tips for Talking with Your Boss about Pumping

What's your best tip for discussing your pumping rights/schedule with your boss? 

Shelly Hovies Rogers: Be assertive with your rights, but be flexible and willing to work with your boss and coworkers.  I found my workplace to be quite accommodating to me when I nicely, but matter of fact, told them what I needed.  Also, although I didn’t have to quote the state law, I familiarized myself with it, just in case I needed to use it. 

Kelly Reyes: Before I left for maternity leave, I discussed my need to pump with my boss and then HR, just to make sure we were all on the same page.  When I had issues with the way the ‘wellness room’ schedule was being managed, my boss went to bat for me and fixed the problem that day! 

Marie Bishop: My best advice is to know the law and stand up for yourself and your baby.  In states, such as California, it is required by law that your employer provides a non-restroom space that is private for you to pump.

Meggin Dueckman: We just talked about it!  We’re all pretty close at work, so it was no problem.  I was the first of our staff to want/need to pump at work.  Mind you, here in Canada we get a year of maternity leave, so it’s not as common for people to want to pump as frequently when they return to work.  I only pumped 1 times a day at work, more for my own comfort!

Jamie Howell Swope: As a teacher at a school, it wasn’t an easy process, but I went in knowing the law and advised my principal ahead of time why I wanted to meet with her.  That way she had time to think about how to make it work, too.

Kat Picson Berling: I was really lucky in that 2 of my coworkers were pumping moms, so they had paved the way.  I told my boss that I was going to take 2 pumping breaks at x and y time and I will be in this office and it will take 15 minutes.  He was fine with it.  I’m not going to lie…. Because I had a cubicle at work, it was sometimes difficult to find a place to pump.  Even our HR coordinator wasn’t sympathetic for me.  Just make sure to know the law. 

Chantel McComber: My advice would be to put your fears aside.  Sometimes it’s hard as a working mom to ask for things because not everyone has them.  Remember that you are doing this for your health and your baby’s health and those are two things that should always come first.

Jennifer Haak: When I discussed my date of return, I told my boss that I needed a lock installed on my office door and I explained why.

Andrea Blanco: First, know your right.  Be sure that your company falls under those rights.  Then file that information away and try *not* to use it as it can be perceived as a threat (and no one likes to be threatened.)  Second, have a plan in place.  I find that if you’re willing to have the conversation in advance, go into it as sweet as possible, and have it all planned out as to how it will work for you (with consideration given to work environment/demands/pumping law.)  Then, it is much harder for your employer to say no. 

For the United States Lactation Accommodation laws, check out Break Time for Nursing Mothers

Baby Jaws - Breastfeeding a Teething (or Toothy!) Baby

Duh Nuh Duh Nuh………….Duh Nuh Duh Nuh. (come on, you know you just read that out loud).  

You know they’re coming.  You’ve heard all the severe warnings from well-intentioned friends and family.  You’re scared of what’s to come, but know you’ve gone too far to turn back.  Shark-infested waters, you ask?  Noooooo - a breastfeeding baby who has grown TEETH!  

Somewhere around 6-8 months (sometimes earlier, sometimes later), your baby’s first tooth will erupt.  This is most likely an event you will celebrate, both because of the milestone that it is, but also because it may be a temporary break from the cranky, drooly, mouthy baby who replaced your own sweet one a couple of months back.  There are lots of symptoms that point to teething, but the most common ones are: red and swollen gums, increased irritability and drooling, sleep disturbances, and low grade fevers.  Your baby has most likely learned that chewing or gumming on items helps ease the pain and will try to cram everything within reach into his/her mouth.  As that tooth begins to emerge, there may be some small worries creeping in on your excitement about this next stage.  What will it be like to breastfeed a baby with teeth?  Will my baby bite me? Some moms will find that they do start to feel the baby’s teeth while nursing - baby may scrape teeth across nipple when latching or delatching.  And yes, sometimes the baby will bite.

Why did he bite me!?

Short answer is that it’s not because he doesn’t like you!  New teeth bring a whole new sensation for baby.  He may want to explore his world using his new teeth and will scrape and/or bite items that come into his mouth.  Another reason that your baby may clamp down onto your nipple during a feeding is because of teething pain. As mentioned above, babies learn that biting and chewing on items may offer them some relief.   If they are experiencing teething pain while breastfeeding, they may try to alleviate that pain by biting down.  Or, your baby is finished with the feeding and wants to play!

Note: Sometimes when persistent nipple pain starts when the top teeth come in, it can be caused by an unresolved upper lip tie that is causing the baby’s top teeth to scrape against the nipple.  Make sure your baby’s upper lip flanges out, like fish lips, to prevent this pain, or consider having his/her upper lip tie revised.

What should I do?!

Almost all moms will have the same reaction the first time their babies bite them while breastfeeding - some loud yelling and possibly a quick change of position!  This is a completely normal and expected reaction, but you may notice the sudden sound and movement startles your baby.  The best thing you can do is soothe your baby and resume the breastfeeding session.  If your baby should bite you again, calmly remove the baby, give them a quiet vocal command (‘no’, ‘that hurts mommy’, etc) and temporarily end that feeding session. If your baby is still hungry, then offer the breast again to finish the breastfeeding session.  

Also, some moms find it helpful to rub a cold, wet facecloth on baby's gums before latching to desensitize the teething pain before latching.

Because of the sucking mechanism babies use when breastfeeding, it is impossible for them to actually remove milk from the breast when they clamp down on the nipple, therefore biting may indicate baby isn’t hungry enough to feed.  This is clear when a baby will bite towards the end of the feeding.  One way to prevent this is to watch your baby while feeding, and when he/she starts to show signs that he/she is almost done (suck pattern will slow greatly, baby may come off often and smile and interact with you), calmly remove him/her from the breast and end the feeding session.  

For almost all breastfeeding babies, this biting is a temporary phase.  As they grow more accustomed to their new teeth and learn that biting means the breast is taken away, they will likely stop the behavior.  If your nipples become cracked or sore because of any biting, we recommend applying organic coconut oil - it is soothing along with having antibacterial and antifungal properties.  

Rest assured, the biting is normally a very fleeting behavior.  Before long, the waters will once again be safe to enter.  

If I Give My Newborn Baby a Bottle, Will She Refuse the Breast?

Originally published on February 11, 2014; Revised August 27, 2024

Author: Robin Kaplan, M.Ed, IBCLC, FNC

The short answer is “we don’t know”.  There is so much information out there about nipple confusion.  Some will tell you that if anything other than a breast *touches* your baby’s mouth, he’ll never want to breastfeed again. Others will regale you with stories about how their exclusively breastfed baby had bottles! cups! pacifiers! in the first few hours of life and had no problem switching back to breast.  Each baby and situation is different.  It’s never a given that your baby will, or will not, develop nipple confusion if he/she has a bottle before breastfeeding has been successfully established.

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges. 

SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

What is Nipple Confusion?

Bottle nipples and breast nipples have a very different feel to the baby, so sometimes when babies are used to one and they are introduced the other, it can seem confusing.  You can help to prevent this by choosing a bottle nipple with a sloped, wide base rather than a small, thin, long nipple.  This will help the baby to continue to open his/her mouth widely while feeding, which is what we want him/her to do while at the chest/breast.  However - it is often a “flow preference”, rather than nipple confusion, that can cause a baby to have a difficult time switching from bottle to chest/breast.  Even the “slow flow” bottles the nurses use in the hospital flow much faster than the breast, especially during those first few days when milk volume is low.  Plus, even with those “slow flow” bottles, the baby doesn’t have to work very hard to get the milk to flow into his/her mouth.  When the bottle is tipped, the milk often just pours into his/her mouth.  At the chest/breast, the baby has to suck for a while to elicit the “letdown” of milk, and then throughout the feeding is only rewarded when he/she sucks at the breast.  With a bottle, the milk pours into his/her mouth whether he/she’s sucking or not.  These babies are smart!  They learn very quickly that with one form of feeding, they don’t have to work as hard.

How Can I Avoid Flow Preference?

The easiest way to avoid flow preference is to only feed your baby at chest/breast until breastfeeding has been established, baby is back to his/her birth weight, and has gone through his/her first growth spurt that occurs around 2-3 weeks of life.  However, there are many different situations when it may be necessary or appropriate for a baby to fed in an alternative way during those first few weeks of life.  Some of these situations may include: premature babies who haven’t developed the suck, swallow, breath pattern yet; birth complications that force parent and baby to be separated for some period of time; anatomical challenges that prevent the baby from being able to latch on properly (tongue/lip ties); or sometimes parent’s preference - damaged nipples, etc.  If you do feed your baby another way, there are things you can do to avoid the possibility of your baby developing a flow preference, or preferring an alternative feeding method.  If your baby is able to latch comfortably, one option is to supplement at the chest/breast using a tube and syringe, and to either deliver the supplement very slowly and only when baby is actively sucking, or allow the baby to pull the supplement on his/her own.  This helps the baby to continue to associate the breast with food, as well as ensuring baby has to work for the flow.  If you do bottle feed, you can pace the bottle feeding so that it simulates a feeding at the breast - I’ll discuss this in greater detail in the next paragraph.

What if I Need/Want to Give my Brand New Baby a Bottle?

If a baby does receive a bottle, there are some things you can do to help prevent a flow preference from developing.  The most important thing to realize is that there really isn’t a truly “slow flow” nipple, and that most bottles are the same, even the ones that claim to be designed for a nursing baby.  It’s not so much the bottle you choose, but the method you use to feed the baby.  Baby should be fed in a paced manner, so that the length and pace of the feeding mimics a breastfeeding session.  The amazing online breastfeeding resource, KellyMom, has a great article on how to properly bottlefeed a breastfed baby - http://kellymom.com/bf/pumpingmoms/feeding-tools/bottle-feeding/.  Another great resource regarding bottle/breastfeeding is www.breastandbottlefeeding.com.  Both sites contain a great amount of information on “nipple confusion” and flow preference and how to avoid them.  

_____

Ashley’s Success Story

As an IBCLC, I work with a lot of moms trying to get their babies back to breast after being fed via bottle.  I’m always excited to share my own story to give them some hope and let them know that it is possible to transition a baby who is exclusively bottle fed to a baby who exclusively breastfeeds!  My first child was born in New York City, in the fall of 2007.  The hospital I delivered at had two lactation consultants on staff, but the one who was scheduled to work the day my daughter was born was in a car accident and not able to come in. So I fed my baby with an incorrect latch for a day and a half. By the time the lactation consultant arrived on the day we were being discharged, my nipples were cracked and bleeding.  I was in extreme pain and every feeding brought bouts of panic and anxiety with it.  Looking back, I realize that she had a lip tie and that may have been causing the painful latch.  I chose to pump for a few days to allow my nipples to heal, and found that pumping and bottle feeding caused much less stress.  So I exclusively pumped for my daughter for 4 months.  

Exclusive pumping is hard work!  You’re basically doing double feedings - by feeding the pump, then feeding your baby.  Plus with the constant washing of pump parts, I felt like I was chained to the house every three hours so that I could pump to maintain my supply. On the flip side, there were benefits to it as well.  My husband could feed the baby and I was able to get out of the house early on to do things like laundry.  :)  However, I always felt like I was missing out on a HUGE piece of those early months with my baby.  I’d always assumed I’d breastfeed exclusively, and felt like a failure that I wasn’t.  I kept trying periodically, but my baby would often cry at the breast and I would get frustrated easily and give up, assuming it would never happen.  But I kept trying, and finally, at 4.5 months, she was latching regularly and I was able to put away the pump!  She nursed until 14 months old, and I’d never felt such pride or accomplishment about anything before.  I use this story to encourage moms that just because their babies aren’t latching RIGHT NOW, that doesn’t mean that they won’t later.  

If your baby is struggling with bottle feeding or breastfeeding, we are just a consult away!

Don’t let bottle feeding or breastfeeding struggles cause stress for you or your baby!  Our consultants can help identify the root cause(s) of why your baby is struggling going between breast and bottle and can offer suggestions for ways to overcome these challenges!  Book a one-on-one postpartum consultation today

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.