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Articles from Hope breastfeeding support

Strategies for moms anticipating breastfeeding difficulties.

This page is designed for moms who have previously experienced breastfeeding difficulties or have been informed by a skilled provider that they MIGHT have difficulty breastfeeding. These strategies do NOT guarantee that mom will avoid these problems, but serve as a sample of actions that moms have taken that have proven successful in their breastfeeding journey.

Flat or Inverted Nipples

A flat nipple is one that, when the areola is compressed about an inch behind the nipple, flattens out and appears level with the surround areola or becomes thick and barely protrudes past the surface.  An inverted nipple pulls behind the surface of the areola and may pull inward into the breast.

Prenatally:  Try Supple cups starting at least 8 weeks before delivery. Check out supplecups.com for product information. Begin using these as per instructions. Consider purchasing softshells for inverted nipples http://www.medelabreastfeedingus.com/products/103/softshells-for-inverted-nipples to wear over the supple cups to allow longer periods of wearing to help correct the condition prior to delivery.

After Delivery: Try Latch Assistant by Lansinoh. This can be used on the nipple itself or placed over a nipple shield (if needed) to draw the nipple out or to pull inside the shield before latching.

Supple cups can also to be used in the same way.

History of Latch difficulties with delayed or slow onset of Stage 2 of lactogenesis.

Research has shown that optimal breast stimulation and expression of colostrum during the first 72 hours after delivery can double milk output at 10 days.

  1. Initiate breastfeeding within the first hour after delivery with mom in laid-back position, using biological nurturing approach. See: http://hopebreastfeedingsupport.com/the-first-100-hours-getting-breastfeeding-off-the-ground/ for more basic tips.  If areola is tight (feels like your chin or the end of your nose), use reverse pressure softening and areolar expression to increase nipple availability before baby latches.  See:  http://hopebreastfeedingsupport.com/video-resources/.   Once baby has latched, remain reclined throughout the feeding. Switch breasts when baby starts to pause a lot (usually every 5 minutes or so). At 24 hours, begin softening and expression before every feed, even if you don’t think your areola is firm.
  2. Ask for a hospital breast pump to be brought to you right away, along with syringes for milk collection. If your baby is not latching well by 12 hours, begin using breast pump in addition to hand-expressing. 
  3. Offer the breast every 2 hours until 10:00 at night, and then every 3 hours during the night. If baby is too sleepy to latch, hand express about 10 minutes and then pump for 15 minutes. Give any colostrum to the baby by finger-feeding. This is for first 3 days of life. Pump early/pump often!
  4. If your baby cannot latch to the breast or stops latching, ask for a small and a large nipple shield. Try both to see if baby can latch to either. Ask for demonstration from your care provider.  If you have not started pumping yet, begin doing so. Pumping in the first 3 days should be about 15 minutes using the Symphony initiation program. Once your milk starts coming in, use the maintenance program and move the vacuum up to about 10 bars on the screen.  Ask for written instructions for pump use. Plan on taking a rental pump home from hospital if needed. Remember milk does not start squirting until Day 7 after delivery.
  5. Check baby’s suck using your thumb to see if baby is drawing your thumb back to the back of her tongue or is only “peanut butter sucking” on the tip of your thumb. Sometimes a little suck training before latch can correct what is just a habit baby has at birth.
  6. If no comfortable latch, strong latch is obtained, plan to see a lactation consultant around 4th-5th day (optimal time when milk surge normally begins and baby is more alert).
  7. Monitor baby’s weight loss. If mom’s milk is not coming in quickly, have donor milk or ready to feed formula available for early supplementation as needed. Many organizations recommend hydrolyzed formula if human milk is not available.  If supplementation is needed in the hospital after the first day, ask for oral syringes and a feeding tube for easier finger feeding or at breast supplementation. If long-term supplementation is required, a Dr. Brown’s bottle and side-lying baby-led bottlefeeding technique can be used.  See information and videos http://hopebreastfeedingsupport.com/video-resources/.  

Breastfeeding Assistive Devices 

(available from walmart.comamazon.com and target.com)

  • Latchassist by Lansinoh
  • Hydrogels by Medela (2 pkgs)
  • Nipple shields 20 and 24 (if not obtained from hospital)
  • Bacitracin
  • Medela Harmony manual pump
  • Haaka milk collector
  • Tube top – makes a comfortable holder for nursing pads, can be used as a pumping bra
  • Dr. Brown’s 4 oz regular newborn bottle (not glass, not wide mouth)
  • Microwave sterilizer bag (if you have a microwave)

From Hospital

  • Oral syringes – 12 ml at least 3
  • Pump kit
  • Rental pump
  • Feeding tube (used for finger-feeding or at breast supplementation

A word of Encouragement

Did you know?

In a study conducted with moms with history of breastfeeding difficulties, that 95% of them had success with following births – even if the previous breastfeeding experience was not what was expected or planned? This just validates that every breastfeeding experience is unique with a unique baby and a mom with a different (and growing) skill set! It’s just like childbirth – each birth, each mother-child relationship is different, but all are valuable!

WHEN I FIND MY WAY HOME

You can take a picture, you can write it down

When I find my way home, I’m gonna come right back to town.

Stompin’ through the streets and kickin’ up the dirt

When I find my way home, you’re gonna have to change your shirt

Runnin’ through the alleys, climbin’ up the trees

When I find my way home, I’ll be fallin’ on my knees

Listen for the foot steps, put your records on

When I find my way home, We’re gonna dance until the dawn.

When I find my way back home, I know just what to do

I’ll be lookin’ for a party and a couch to crash onto

And when I find my way back home, I’ll never have to doubt

That being part of something is what life is all about.

Speakin’ with a stranger, everywhere you go,

When I find my way home, I’m gonna bug someone I know.

Lookin’ for the street signs, make another lap,

When I find my way home, I won’t need to read a map.

Tossin’ and turning, no matter where you lay your head

When I find my way home, I’m gonna sleep in my own bed.

Retracin’ all my steps now, lookin’ for a clue,

When I find my way back home, I can spend the night with you.

When I find my way back home, I’ll know just what to say

I’ll tell you how much I love and I’ll never go away

And when I find my way back home, I know I’ll never doubt

That being part of something is what life is all about. 

Tim Cooper  Circa 2006

Categorization

It seems to me that folks in every field attempt to categorize everything. Perhaps it’s a method of being able to understand how things work by extrapolating from known to the unknown. Perhaps it’s a way of making predictions for the future. Perhaps it’s a way of manipulating facts and controlling behaviors.

Some examples? Astrology, Myers-Briggs personality typing (and all that ilk), IQ tests, Spiritual gift tests, etc. In the material world we categorize vehicles as sedans, SUV’s, trucks, passenger vans, cargo vans, etc.  In the animal world, we categorize by species. When we categorize, we develop a mental picture and expectations for that category. We would not accept a cat that looked like an elephant. In the material world, preparing our expectations through identifying the category of the object we are encountering helps to modify our reactions. Improper categorization can lead to unrealistic expectations and either disappointment or surprise.

When it comes to human beings however, I am beginning to wonder if the need and the effort we put into categorizing each other has some negative consequences. If I judge someone by their behavior, am I writing them off in the future, am I having expectations for them that are unrealistic or not in keeping with truth? It is definitely a challenge to note what God has to say about making judgements.

Here are some verses on judgement:

John 7:24 Judge not according to the appearance but judge righteous judgement.

James 2:13 for he shall have judgment without mercy, that has shewed no mercy; and mercy rejoiceth against judgment.

Psalms 37:30 The mouth of the righteous speaketh widom, and his tongue talketh of judgment.

Psalms 119:66 Teach me good judgment and knowledge: for I have believed thy commandments

Matthew 7:2 For with what judgment ye judge, ye shall also be judged: and with what measure ye mete, it shall be measured to you again.

Romans 2:3 And thinkest thou this, O man, that judgest them which do such things, and doest the same, that thou shalt escape the judgment of God?

1Corinthians 6:4 If then ye have judgements of things pertaining to this life, set them to judge who are least esteemed in the church.

1 Samuel 16:7b For the Lord seeth not as man seeth; for man looketh on the outward appearance, but the Lord looketh on the heart.

In these contexts, I see judgment being exercised individually against individuals and corporately against both individuals and groups. There are lots of verses about judgment in the Old Testament, but much fewer in the New Testament. It seems that once God became incarnate in Jesus, He began to convey to mankind how far we had missed the mark of righteousness.

What I wonder about is why we feel the need to compartmentalize people? Is it self-protection? Is it our own insecurities about our weaknesses and fallibility? The older I get, the more I am aware of my own failures and limitations – and realize that those will only grow as my body and mind begin to grow weaker. I know that when this mortal shall put on immortality, all that I have known on this earth will be dust compared to what I will experience when I am with Jesus. My prayer and hope is that I will become more like Him, walk in the Spirit more with better spiritual discernment, and that I will point others to Him more clearly. The only treasures we can lay up in heaven are those that have eternal value – souls who turn to Jesus and can join us in praise and worship someday.