Breastfeeding Gospel According to Courtney

I've been asked a few times for advice on being successful with breastfeeding. Everytime I retype the tips I have from my experiences.  I finally decided to blog them to have them in one places forever. I'll add to it from time to time as I feel knowledge is always expanding.  You never stop learning! 

Determination You have to have your mind made up that come hell or high water, you are going to do this.  If you say "I'm going to try it and see" you'll probably never make it.  It's hard, in the beginning mainly. But once you get your feet under you it is the most rewarding experience. You'll never regret the decision to nurse.  

Information Inform yourself. Read everything you can get your hands on about breastfeeding while you are pregnant. Go to a breastfeeding class, most hospitals have them.  In the first hours and days after you give birth hormones are high and advice is abundant.  It is imperative to have a good base knowledge of breastfeeding before the baby comes.  Set yourself up for success! 

Support Let the people close to you (or everyone) know you will be breastfeeding. Your husband, mom, sister, grandma, best friend, your doctor, your nurses.  Even if the women in your family didn't nurse, let them know early on that you plan to and you would like their support.  Reach out to other breastfeeding moms.  I highly recommend joining a few breastfeeding groups on Facebook and liking some breastfeeding pages.  It's a wealth of information, a network of support, and in the case your close friends and family aren't familiar with breastfeeding, seeing breastfeeding support and advice as you scroll through social media makes you feel the norm.  I know personally sometimes I felt like my family thought of my nursing relationship as atypical and mysterious, the social media exposure was great for my confidence! 

Now for the mechanics of nursing:

*Put the baby to the breast as soon as possible after birth. This is an alert phase of life, prolonging nursing for pictures and first holds can result in a sleepy difficult to latch baby for the first feed, avoid that if at all possible.  A good goal is to get the baby nurse within 1-2 hours after birth, the sooner the better!  Again, let your fan club know ahead of time you will be feeding the baby as first priority so they are expecting a small "delay" of coming into the room, taking pictures, and passing the baby around, etc etc.   it most likely won't take that long and is a best start on your breastfeeding journey. Baby comes first.  

*Nurse every 3-4 hours and on demand.   Now allow me to break that down as this simple instruction can get crazily misinterpreted.  Your goal is to nurse the baby every 3 to 4 hours. The "on demand" part means to also nurse at any other cues of hunger.  3-4 hours is your goal, the on demand is any extra your baby desires.   In the beginning this means you will have to wake the baby to eat if the allotted 3-4 is upon you. This is crucial for weight gain, preventing jaundice, and establishing your milk supply.   This does NOT mean you have to wake the baby up every 3 hours to eat for the rest of your life!!! Once your milk has come in, supply is stable, baby is gaining weight, and you have dodged or gotten through jaundice, you can let the baby (and yourself) sleep for longer intervals.   This intense phase doesn't last forever.  

*Get a good latch.  There is only so much I can do to describe a good latch through typing. But here goes! Get comfortable sitting up and support you and the baby with pillows as needed. Get skin to skin.  Undress the baby and do a diaper change, this will help wake them up.  Undress yourself. Put the baby's belly against your belly for the skin to skin contact. Keep the baby's ear, shoulder, and hip in line.  Make sure you are supporting the baby with you hand at the base of their neck NOT the back of their head, the head should be slightly tilted back.   Tickle the baby's upper lip with your nipple and wait for the baby to open WIDE. Be sure to bring the baby to the breast, not the breast to the baby.  If the baby closes their mouth, don't force your nipple in. Bring the baby back and tickle their lip to get them to open wide again. Aim your nipple toward the top of their mouth when inserting, not the middle of their mouth. The baby should take a good portion of the areola into their mouth, not just the nipple.  You can stroke the top of the baby's head the and the side of their jaw to stimulate sucking. 

Get a nurse experienced with breastfeeding to assist you and make sure you have a correct latch more than once throughout your hospital stay.  There are some great YouTube videos out there as well for different positions and tips.    I would also like to say that you won't have to get yourself and the baby undressed forever :) 

*Not so hasty with the bottles. So many reasons I've heard for moms wanting to rush to bottles: 1)So dad, grandmas, siblings can feed the baby and bond. There are plenty of other ways to do that! Baths, burping, diapers, rocking, dressing, the list could go on and on.  Let grandma pick out the baby's hair bow today, let dad get that poopy diaper.  Feeding is far from the only bonding tool. 2) So mom can rest.  I beg your pardon, I never promised you a rose garden.  In the beginning beginning is pretty crucial if you haven't noticed you must nurse to establish your milk supply.  Even if you give the baby a bottle, you will need to pump to replace that feeding. No one is helping you out but giving the baby a bottle. (I'll get to the supply and demand rationale in my next point) 3)I don't feel comfortable nursing.  Well there are a few things that will help you with that. One is nursing anyway.  I was uncomfortable at first too, the more you do it the stronger you get. Tits...not a big deal.  Excuse yourself to another room, like the baby's nursery to nurse.  Use a nursing cover. Kick everyone out of the room you are in.  You have several options. Your baby will make you strong, just remember why you are doing this.  And like I said, the more you nurse the more comfortable you will be.  Breastfeeding is natural!   4) I'm just going to pump. Whoa. Back that thang up no one and I mean no one just pumps. Pumping is a big deal and all women who exclusively pump deserve a free Cadillac and a tiara.   The vast majority of exclusive pampers did not choose pumping from the get go, but got there due to complications.  Pumping is by no means an easier alternative to nursing.  I understand pumping is nessecary when you go to work, or must be away from the baby for other reasons.  But don't say "I'm just going to pump" insult to exclusive pumpers everywhere.  Also, statistical data, hard cold facts, tell us that planning to just pump right out of the gate decreases your success rate drastically.  It can be done if it needs to be, but if you have the choice...choose nursing over exclusive pumping.  Pump for occasions like work etc. Nurse when you can.  I venture to say you won't be sorry! 

*Supply and demand.  Alrighty, let me try to break it down and make it simple.   The more your baby nurses, the more milk you make.  By removing milk from the breast, your baby is putting in the order for your body to make more.  Skipping feedings result in less milk production.   

Also, a pump isn't as effective at removing milk as the baby is.  So pumping to "see how much the baby is getting" doesn't add up.  It isn't a true measure of the baby's milk intake.  If there is reason for concern, contact a lactation consultant for a weight check. They can weigh the baby before and after a feeding using a very sensitive scale to see how much milk the baby has ingested.  

Babies have growth spurts. When they do they want to nurse. A LOT. Let them! This does NOT mean you aren't making enough milk.  By letting the baby nurse on demand through a growth spurt, you are increasing your milk production.  Don't be in a hurry to supplement with formula.  The growth spurt won't last forever and you won't permanently have a baby latched to your boob. Swear!  

Judge how much the baby is getting by adequate number of wet and dirty diapers. Not the just the baby is crying,  must be hungry.  Babies cry for lots of different reason as it is their only form of communication.  Crying does not equal insufficient milk supply. 

Also you should know how big your babies stomach is. 

See! A new born has a tiny stomach, they don't need 7 oz to fill them up.  Breastmilk is jam packed with the good stuff, nutrient dense, so breastfeeding is different than formula feeding.  

I always followed the cave woman rule, having doubts or trouble, get naked and nurse.  Skin to skin and nursing on demand can help in many many situations.  Back to basics so to speak. 

*Wet and dirty diapers.  This is the easiest way to tell that your baby is getting enough milk.   You need to know what is considered normal.  

In the first days of life, breastfed babies are getting colostrum, more dense in the good stuff, so the baby doesn't require as much of it.  At least 2 wet diapers a day until your milk comes in is okay.  You may see some dark, concentrated urine, called brick dust, and it can be scary. The color may vary from dark yellow, orange, red, or pink.  Just keep nursing!  After your milk comes in, by the 5th postpartum day on average, the urine will no longer be concentrated.  

Once your milk is in, your baby should have at least 6 to 8 wet diapers a day (24 hrs).  

You should contact your pediatrician if: you see less than 6 wet diapers a day at 5 days old, brick dust diapers persist or the baby is only producing small amounts of concentrated urine past 4 days old.  

*Hunger cues.  You need to know how to tell if your baby is hungry.  Yes, a screaming baby could be signaling hunger.  But chances are they showed early signs and we missed it.  A infant raging mad with hunger can be difficult to calm down and latch. So try to stay ahead of the game and catch those early cues.  This picture shows it perfectly! 

 

*when the milk comes (to be continued)

*infant weight loss (to be continued) 

Let me finish by saying. Go you!!! You want to breastfeed, and it is a wonderful choice for you and your baby. The benefits are endless.  It is the most whole and perfect form of infant nutrition. You can do this! It is the best paying job you could ever find. Breastfeeding has truly been the most fulfilling experience of my life.  You will be giving your baby a beautiful gift. 

You can do this!

Peace.Love.Boobie Milk. 

Pure adoration. Thank you momma. 

Breast exclusive

I'm Courtney Hollowell, a registered nurse, a certified Breastfeeding specialist, and a mom.   

When I had my daughter Georgia, I made the decision to breastfeed.  It has been one of the hardest, yet the single most rewarding experience of my life.  When we were first starting off on our journey, I prayed she would take to the breast. I have spent my entire 7 year nursing career in women's health and have many times heard mothers say "I couldn't breastfeed" I didn't want that to be me, for whatever reason. So I gave breast feeding my best shot and we were successful.    In preparation for my maternity leave coming to an end, we introduced pumped milk in a bottle to Georgia.  She did fine with the bottles, and her dad was able to feed her.  Then when she was 11 weeks old, with no rhyme or reason, Georgia stopped taking a bottle.   

What? This was never on my radar.  I hoped we would have a strong nursing relationship, but I never dreamed she wouldn't take a bottle while I went to work.   We tried every bottle manufactured, every technique, every trick in the book.   It made Georgia hysterical.  I went to my first shift post motherhood at work and cried the whole way there because I knew my baby wouldn't eat while I was gone.  Georgia and her dad had a horrible night.  She would suck on his arm, his shirt, her hand, but not drink from a bottle.  She cried and screamed, devastated and hungry.   It left my husband heartbroken and in tears.  She went hours and hours  without eating until I got home and was able to nurse her 

That's my story. In the end I quit my job, stayed home and nursed Georgia.  

What if quitting your job wasn't an option, then what would you have done? Got a different job, nursed Georgia on my breaks and lunch. Anything to keep my baby fed. Work from home, get a job that I'm overqualified for, whatever it took. Quitting my job was a sacrifice.  I'm thankful I was in the position to stay home, but it isn't a fairy tale. It drained our savings account, dreams of a different home have been pushed back years on our family's calendar, just to touch the tip of the iceberg. 

If she gets hungry enough, she will take a bottle. Not true.  You should never make mealtime a battle anyway.  Starving a baby into submission is not a healthy behavior modification tool. It's torture actually. Babies do not have logic.  When you say a baby can reason to think "if I don't take this bottle, I'll go hungry" you are assigning far more mature skills than an infant possesses. My Aunt Judy has been raising babies for 50 years, I left Georgia with her to see if she would take a bottle from her. She called me "you get back here and feed this baby, I've never seen anything like this." Sadly, because bottle feeding is the norm and breastfeeding is foreign to most of her generation. 

I would also like to say, I was made to feel like I was nuts when I told some people Georgia wouldn't drink from a bottle.   If a mother says "I couldn't breastfeed" it is widely accepted. If a mother says "I can't bottle feed" she is questioned.    Breastfeeding is the most natural, perfect form of nutrition for babies. Primal instinct.  If Georgia preferred breast over bottle, it's not a problem to be solved or an error to be corrected.   Just because you've never had this situation, or never heard of such before doesn't mean it isn't a legitimate issue. 

Put yourself in the baby's shoes. We have to be a voice when they don't have one.  No one is saying a father shouldn't have rights or visits, but that a baby should be able to be nursed during those visits. 

Because if Landry's father's family truly loves, cares for, and wants what is best for Landry they will want her nursed at their visits. If not, the visits are going to be less than enjoyable for everyone, especially Landry, who is the one who will suffer the greatest when she is the most innocent.