Tuesday 23 July 2013

Milk sharing ~ a little joy for you, a lot of life for another.

“These babies must only have breast milk. They are not to be given formula” Says the big authoritative neonatologist to the wide eyed scared first time mum. This is me; babies only 6 hours old after a long difficult labour and birth of baby twin boys born 9 weeks early. I didn’t question the man and without any more words exchanged the importance of human milk for these little boys and babies everywhere was concreted in my brain forever.

Over the next days and weeks as my sick babies fought to grow ex utero, I struggled to express enough breastmilk to keep up with their needs. The words of the big stern doctor rung loud in my head as I looked at the measly 20ml id managed to painstakingly squeeze from my breast. Fortunately for me, I wouldn’t have to go against the doctors orders as each baby took turns being sicker and would both be nil by mouth and this would buy me some time to stock pile some milk. I would pump every spare moment I had.

These early mothering experiences laid foundation for my later experience of milk sharing. How much pressure this new mum would have been free from had the neonatologist been able to say to me “these babies must get breastmilk, don’t worry if you cant pump enough to start with, we have a plentiful store here in our milk bank”. If only. If only for all sick babies everywhere this was the norm. The very first option after his mothers own milk. Unfortunately this wasn’t the case and still isn’t. Milk banks just don’t exist in (all but one or two) towns and cities across Australia.

Busy with my baby twins, I breastfeed the months and years away. I learn more, I study, I become a lactation consultant. I learn of all the struggles some mums go through to make sure their babies receive the little breastmilk their mum can make. I am inspired by these mums and want to help.

I give birth to a healthy full term baby boy and breastfeeding is a breeze. I realize that for me to feed my little baby with out a second thought isn’t fair. Its not fair to the next mum who is pumping, comping, on medication, using supply lines and struggling with the thought that she still doesn’t have enough milk for her baby to be exclusively breastfed.

I came across the human milk 4 human babies Facebook page. I posted that I have some milk in the freezer that id be happy to part with if any mums and babies were in need. I was connected with a few passing mums and babies here and there. Then I was put in touch with a mum who wanted donors to contribute milk for her baby on a long-term basis. This was something I could do. It took just 10 minutes of my time to help a mum and baby in such a profound way. I got into a sweet groove of pumping one breast while baby Rhys had the other boob. One pump per day would yield about 120mls. Rhys was sharing his milk, about 1 litre a week with another human baby, my milk would only cover a little over a days worth of the other babies needs but between my self and the other donors and her mother she was at times receiving wholly human milk.

Rhys with his sharing milk 

I got nothing other than the sheer feeling of doing something good for others out of sharing my milk. It wasn’t at all a selfless act because when mum and baby would make the couple of hour round car trip to collect milk, handing the little stash over in the esky felt wonderful.

It was becoming difficult to keep up my pumping, Rhys was big and wouldn’t share me with the pump as easily. The recipient babe was also now over one and mum was managing her demand much better with less need of donor milk, so I decided to stop pumping for donation.

There were still many occasions where a local mum would get in touch with our local natural parenting group at a time of need and ask for one off donations and if there was milk at hand id happily part with it.

I urge you to look up human milk 4 humanbabies, if you’re struggling with supply and keeping up with your babies need for milk than there are other options than just formula top ups. Maybe you have a freezer full of milk that your baby will never make his way through. Don’t let it go to waste, there are babies out there that need it, and mums that would cry to see it go to waste.

Sunday 21 July 2013

Finding your breastfeeding groove ..... how to find it sooner.

Part 2 

Apart form sore nipples weeks down the track that are usually easily turned into normal nipples with a simple adjustment here and there, the other common reason holding mums back from finding peace within their breastfeeding experience is the doubt that their baby is getting enough because of how frequently baby feeds. Once it is clear to mum the reason baby feeds so often and mum embraces the frequent feedings mum can then embrace breastfeeding with peace.

Why do babies feed often?

In the early days (days 0-3) they are getting hungry. Baby is waiting for mums milk to come in.  Baby isn’t trying to bring mums milk in, baby doesn’t know its not there yet, all baby knows is that the breast is the source of food and after 48hours or so some babies are getting quite the appetite and the small volumes of colostrum aren’t quite cutting it any more. This is normal, baby does not need any formula to top her up, she simply needs access to the breast, the milk will come in and baby will soon be sated. It really is patience on mums behalf and an understanding that baby isn’t starving; the colostrum she’s getting is nourishing her plenty even if she’s adamant she wants more.

Breastmilk is a complete food, baby uses up every last bit of milk, and there is very little waste product. Breastmilk is largely water and is digested very readily. 

Babies regulate their own intake. Unlike bottle feeding where for example 150ml is taken in on time, every time. A baby feeding at the breast will take in a different amount every time. What she takes in is dependent on her appetite, when she last fed, how sleepy, how warm or cold she is, among many other factors. How much she takes will then directly affect when she feeds next. Little feed, little sleep. Big feed, big sleep. In theory J

Breastfeeding is so much more than just food. Do you only eat breakfast, lunch and dinner? All your baby needs is access to the breast and she will tell you how much and how often she wants it. It might feel like a lot. Its not a lot though, when you consider that’s what your baby needs to grow and thrive and be content because she’s not just hungry, she’s thirsty, she’s cold, she's tired, she’s lonely.... she’s smart.

Baby Louie at the boob.

Louie is slung in mums arms, he is grizzly after a car ride to the park.
He boobs.
He breaths, he drinks, he sleeps.
He lets go the boob, he's warm and full.
Brother comes bounding.
He wakes with a start,
Hes ok.
He looks all around, he's cold.
He cries.
He boobs.
He coughs and splutters, he goes back in for for more.
He's done.
He gets passed around.
He doesn't like that much.
Back to mum.
He boobs.
He's not happy, he fusses, he farts.
 He doesn't want to be put down so brother can be tended to.
He gets mum back.
 He gets the other boob.
He breathes, he drinks, he sleeps.

baby louie 6 weeks

Tuesday 9 July 2013

Finding your breastfeeding groove....... and how to find it sooner! (The myth of the magic 6 week mark)

Part 1 ~

I remember as a midwife, before I had children, I used to teach mums that there was nothing to worry about if they were having breastfeeding difficulties in the early weeks, not to worry because it will all magically get better as soon as the baby turned 6 weeks old.

Then I had my twins, they were 9 weeks premature so by the 6-week mark they were only just beginning to really feed from the breast. Ok so 6 weeks corrected age must mean it will all be sorted… Still no. The nurses that visit my home tell me “oh it’s because there’s two of them, it will all be good by 12 weeks”. 12 weeks?!?! That’s 3 months of sore nipples, annoying nipple shields, managing with low supply and medications and herbs to boost such supply. And two babies feeding on and off around the clock. I was struggling.

The question to continue and persevere or wave my arms in surrender tormented me, mostly during the long lonely days when everyone else was at work. The family and friends that were a steady flow of traffic in the early days had pretty much disappeared, after the exciting arrival of the twins their lives all returned to normal, mine didn’t, I was trying to come to terms with what my life now was. By now I had postnatal depression, somehow I knew that for me to give up breastfeeding would have made me spiral down worse. I pushed through, the following months were a struggle and a bit of a blur but I do remember a very gradual feeling of things slowly looking up.

I remember when the boys started eating foods at around 6 months I felt the pressure ease a lot. With the load lifted off me a little I was able to come off the herbs. At 8mths old someone said to me “Geez, they’re nearly 1 are you going to stop breastfeeding soon?” STOP? I only just got the hang of it!

My twins at 8 months, breastfeeding was finally a breeze. 

So for my first babies, all be them twins I hit my breastfeeding groove at 8mths of age. My third baby, 5 years later, I was shocked to find that at 10 days of age I found my self with really sore cracked and grazed nipples. I reminded myself how diligent I had to be with attachment, soon enough I hit my groove. I was on day 12.

The breastfeeding groove is simply defined as when breastfeeding becomes easy. When breastfeeding goes from taking a lot of time and effort, to just happening with out even thinking about it. When it goes from a lot of painstaking agonizing about whether it’s the right thing to do, to keep going. To it becoming a quiet peace in your mind, you realize you haven’t thought about it for a while now, it feels right.

As you can see, from my story alone, reaching that peace, the breastfeeding groove, takes time. The amount of time is different for everyone. And different for each baby. When I think about what slowed me from reaching my groove sooner I identified two main things, these were also common in all the women I see in my practice. The two things that I believe will impact how soon you reach your breastfeeding grove are understanding what normal breastfeeding should feel like and what breastfeeding babies behave like. (The latter will be discussed in part 2)

“Your nipples might be sore, but breastfeeding shouldn’t HURT you.” After sifting through and tossing out a lot of “what breastfeeding should feel like” quotes I decided on this one of my own. Words like Breastfeeding should be 100% pleasant and comfortable and pain free can be wrong on so many levels.

Nipples that have never been sucked on before, or not sucked on in a while (be it years, months or weeks) will become quite tender from all the sucking. They might be extra sensitive if you brush past them, you may need to protect them in the shower as the water streams can feel like needles.

Nipples can be sore when the baby first latches but as the breastfeed continues breastfeeding shouldn’t hurt. When the baby first latches, you have newly sucked on sensitive nipples adjusting from being warm and soft and safe inside a bra to firm and erect and stretched down to the soft palate of the baby’s mouth. Tender, yes, toe curling even, but it’s normal, its not causing damage so its not HURTING you. This whole process might take 10 or 20 even 30 seconds. After the nipple reaches the soft palate and baby sucks rhythmically any pain should disappear. If the pain continues then the latch is not right, it is no longer normal; the feed will HURT you because the pain is signifying there is damage occurring.

What do I do if pain is continuing throughout a feed? Seek help. Someone well trained in breastfeeding support should be able to identify the source of pain and work with you and baby to find strategies to help resolve the pain so that breastfeeding no longer hurts and damage is no longer occurring. The source of pain may be easy to identify, simply a positioning issue perhaps. It could much more difficult to pick up, something like a posterior tongue-tie or an oddly shaped palate could be the culprit.

Don’t let anyone tell you that your baby’s latch at the breast looks good so it must be ok. It might be textbook picture perfect as far as your midwife/nurse is concerned. Big wide mouth, flanged out lips etc. if you are experiencing pain throughout the duration of the feed you need a thorough feed assessment to ascertain the source of pain. (And visa versa, you could be told the latch looks terrible but if you are pain free and comfortable and you observe baby taking in milk it can look as crap as you like.) 

Rhys' latch here on around day 7 was really uncomfortable. Initial latch was 
very painful and a dull pinching pain continued through out the feed. To look 
at it nearly "ticks all the boxes" of a good latch. When i put my LC hat on and
adjusted a few things, the comfort levels were much improved, and from there 
my nipples were able to heal and got better from here on in.

Adjustments made here to improve this attachment: Rhys had to be lifted higher 
across my other breast and turned in more tummy on tummy. Bringing him in
 closer so his chin is compressing the breast and allowing him to latch deeper
 into the breast. His top lip often had difficulty turning out. I was able to flip it out
 with my finger, allowing him then to draw the nipple back a little further.
  By releasing this latch and retrying for a better one, a better, more asymmetrical
(more of the breast on the chin side in than the nose side) was achieved, making 
it much more comfortable on the nipple.

Basically the point i am trying to get across is if you can be knowledgeable as to what correct attachment should feel like and what a damaging latch would feel like you have all the tools you need to have breastfeeding bliss from the very start of your journey. To wait until 6 weeks ticks by, waiting for something to magically change is silly and unnecessary. As soon as you assume something is not right, seek help. With the correct help you can have all the difficulty turned around and you'll be cruising in your groove before you know it.

Good luck on your breastfeeding journey.


Part 2 will cover - normal newborn behaviour and how understanding it can help you reach your breastfeeding peace sooner.