Success with Support
Breastfeeding Success with IBCLC Support
Recently I had the opportunity to welcome my sweet grandson, Aaron, into the world. Anyone who knows how passionate I am about breastfeeding and helping mamas would think my daughter would be in the perfect position to have a flawless breastfeeding journey.
However, despite our best preparation, often things don’t go quite as we plan, and even experienced mothers can find themselves facing unexpected difficulties.
Today I’m sharing Breanna’s story, with her permission. I’m hoping to give hope to new mothers who may be struggling, and help you understand that not every breastfeeding journey is a linear progression. Sometimes, even with the 24-hour support of a lactation consultant, breastfeeding can be difficult, but there is hope with determination, the right support, and the proper interventions when needed.
Breanna’s Story
My daughter Breanna went into labor at 4 a.m. on Thanksgiving morning. Her contractions were timed at about a minute apart, so she hurried to the hospital. As this was her third baby, we expected the labor to progress quickly.
Spoiler alert—it did not.
Breanna had decided on a natural labor and birth, and she did amazingly well, but the labor dragged on. After twelve tiring hours, Aaron finally came into the world. Breanna was exhausted. Although the physical delivery had gone smoothly, her midwife quickly recognized that Breanna was experiencing a postpartum hemorrhage. Pitocin was administered to help control the bleeding, and once Breanna was stabilized, both mother and babe were reunited.
As we initiated breastfeeding and began working on the latch, baby Aaron started to grow more and more frustrated at the breast. Eventually we decided to implement the use of a nipple shield to help Aaron with his latch, and to protect Breanna from sustaining any nipple damage as mom and babe learned to work together.
I brought all of my tools to bear in an attempt to help Breanna optimize her likelihood of success. Breanna put an enormous amount of effort and time into expressing colostrum during those early hours, trying to encourage her milk to come in. We worked on making her as comfortable as possible, with time to rest and recover. We examined diet and water intake. However, after half a day of poor diaper output, we realized we needed some backup.
A friend of Breanna’s who was also breastfeeding, in a lovely and generous gesture, was willing to donate some of her breastmilk to Aaron, to help keep his weight from dropping too precipitously as we waited for Breanna’s milk to come in.
After each breastfeeding session, we supplemented baby Aaron’s intake with donated milk, along with any extra drops of colostrum Breanna was able to pump.
It was an enormous amount of work, especially for a mother and babe still exhausted and recovering from childbirth. As many years of experience as I have in helping moms in very similar situations, my own grandson was challenging me.
As a result of his symptoms—insufficient diaper output, poor latch, pain during breastfeeding on the part of the mother, frustration at the breast—and a thorough physical assessment, it became clear that he likely had a tongue tie.
On day five, our suspicions were confirmed, and a tongue tie release was performed. Aaron began to feed better, no longer struggling to latch properly, and as a result Breanna’s milk came in more abundantly. Their breastfeeding journey improved daily, and baby Aaron continues to gain weight and thrive.
While I’ve always had a passion and a commitment to helping mothers successfully breastfeed, this hands-on experience with my daughter gave me even greater empathy for the mothers I have the pleasure of working with.
So what made this experience more difficult for Breanna than her previous two breastfeeding journeys? I’d like to break down some of the issues she faced, and the choices we made.
The Perfect Storm
In a convergence of complications, Breanna’s longer labor and postpartum hemorrhage placed an enormous amount of stress on her body. Both of these things have shown to delay the initial production of breastmilk, which kept her milk from coming in as quickly as it had with her previous two children. C-section surgeries can have similar effects.
Baby Aaron also experienced some bruising from the delivery, which resulted in significant jaundice. Jaundice can cause babies to be especially sleepy, which can contribute to poor feeding. Ultimately, the fact that Aaron was also tongue tied was the greatest contributing factor to why breastfeeding was so difficult. In addition to making nursing painful for the mother, a tongue tie can tire babe out, making babe even sleepier when feeding, and the insufficient removal of breastmilk in turn negatively impacts supply.
That accumulation of stress and poor feeding can snowball, creating a negative feedback loop that—without the right support and intervention—can end a breastfeeding journey prematurely.
How to be Successful Despite Struggles
Here are some key practices to implement not only when issues arise, but in anticipation of any unforeseen difficulties.
Antenatal Expression
Starting at 37 weeks, you can begin expressing colostrum in anticipation of babe’s arrival. Antenatal expression can increase colostrum and help bring your milk in more quickly after birth. You can read more about antenatal expression here.
Get your little one’s tongue checked.
Have babe assessed for a tongue tie by a tongue tie savvy IBCLC (International Board Certified Lactation Consultant) as soon as possible, especially if you’re having issues. Not all IBCLC’s or other pediatric healthcare providers are well versed in tongue ties, so it's important to find one who can make an accurate assessment.
Ensure babe is getting a good latch, and feed frequently.
You’ll want to feed on demand—as often as babe wants—but as a general rule, don’t go any longer than 2-3 hours between feeds during the day, or 3-4 hours at night.
Spend time skin-on-skin.
Skin-on-skin contact with babe increases mom’s production of oxytocin, which helps reduce stress, enhances bonding, and encourages babe to nurse more frequently, which leads to increased milk production.
Examine diet and fluid intake.
What you eat and drink can have a significant impact on your milk production. Shoot for healthy foods over processed foods and simple sugars to keep your blood sugar and hormones stable. Read more about that here. Breastfeeding also requires approximately 500 additional calories over your base metabolic needs, so make sure you’re eating enough.
You also need to drink to thirst, consuming roughly 100 ounces of water a day to keep up with the natural fluid loss of breastfeeding. A dehydrated mom will not produce as much milk as a hydrated one. With such a large volume of water consumption, you’ll want to be careful to replace any lost electrolytes.
Use breast compressions.
While waiting for milk to come in, or when dealing with a sleepy or frustrated eater, incorporate breast compressions throughout the duration of every feed, to help babe transfer as successfully as possible.
Express and supplement colostrum.
While waiting for milk to come in, hand express or pump colostrum after each breastfeeding session. You can then spoon, cup, or syringe feed this to the baby. Aim for 10ml on the first day, and add 5ml per day until milk comes in and babe is transferring enough on their own.
Consider pediatric bodywork and chiropractic care.
Birth can be stressful not only on mom, but on babe as well. Chiropractic care and bodywork performed by professionals trained to treat infants can address muscle tightness, misalignments, and other issues that may be making babe uncomfortable, and unable to feed well, and help retrain babe after a tongue tie release. Stress and pain can inhibit babe’s ability to feed, and mom’s ability to produce, so be sure to receive the care you need as well.
Address any tongue tie issues as soon as possible.
A tongue tie impairs the function of babe’s tongue, and makes it difficult—if not impossible—for them to remove a sufficient amount of milk from the breast. Adequate milk removal is crucial for the adequate production of milk, as any milk left in the breast after a feed will signal the body to make less. You can read more about tongue ties, how to spot the signs, and why it’s so important to revise them here.
Not everyone’s breastfeeding journey is the same—and as Breanna’s story showed, it can vary not only from mother to mother, but from child to child. This is why hiring an International Board Certified Lactation Consultant can increase your chances of success. We are able to assess the mom and babe for issues and write an individual care plan to ensure success. Contact me to make your appointment. I offer in clinic, home, and virtual consults.