Posted by: webbhouston | December 18, 2008

what do yo do when breastfeeding isnt working?

My last post was all about how great breastfeeding is. I fully understand that wanting to breastfeed is not enough. For many women and families it is a challenge and it is hard work.  There are so many breastfeeding challenges that can arise and sometimes there just is not enough support out there for women who really want to nurse.

Both of my chidren have had jaundice and there is a great deal of pressure to supplement when you are told that it might help your child get better faster. This brings me to my very first tip for breastfeeding.

  1. Do not go to a doctor for breastfeeding advice, even a pediatrician. They actually know very little about breastfeeding and might give you erroneous information without wanting to. If you need help then try contacting La Leche League.  Many hospitals have Lactation Consultants and IBCLC certified women availble for help as well. Those people have been trained in how to help others be sucessful at breastfeeding. Don’t be afraid to seek help.
  2. Go to a Le Leche meeting at your local location even before you give birth. The best way to prepare yourself is with knowledge. Since you cant really practice yet, make sure that you are armed with the information that you will need in case problems arise.
  3. If you are on any type of medication do not just trust someone that is telling you that you cannot nurse while on this medication. Dr. Hales’s book about medications in mother’s milk is necessary if you are going to be on any type of medication. Also if you do find that your medication is not ok to take while breastfeeding, dont be afraid to ask if there is an alternative that you can take that might be safer. Many times there is.
  4. Skin to sking contact is crucial. Babywearing is a great way to get the baby to be with you at all times while you get other things done, but especially in those first few days… just relax and lay in bed with your baby. Let your body heal and let your baby nurse all day long.
  5. Flat or inverted nipples: The use of nipple shields can be quite useful. While care does have to be exercised when using them it can help many mothers with this problem nurse successfully. This tends to also be less of a problem with the 2nd, 3rd, etc. kids.  Also different positions can help with finding a latch that will draw out the nipple better.
  6. Low milk supply: This is a haunting problem for many mothers… someties it isnt even a problem but our own insecurities about nursing lead us to think that it is. Other times a pediatrician might suggest it, when the problem might be something else.  First of all do not just assume that you have low milk if you dont feel engorged. Some women never feel engorged. Second, drink alot of water. Staying hydrated is key to making milk.  Thrird, make sure that you are not sleeping on your stomach or on your breasts. Also make sure that you are not wearing clothes that compresses your breasts. This inhibits milk productionNurse more often. Milk is a supply and demand thing in our bodies. If our bodies feel like we need more supply, it will make more. Make sure that you empty out the breasts when nursing. Pump. Let your child nurse all day long.  Take things that are made to stimulate milk production, these are called galactagogues. What can you take? Eat oat meal, take fenugreek until you smell like maple syrup, drink Mother’s Milk tea, take Domperidone, there are many things that you can do to increase your production.  Do not rely on a pump, a pump is not as effective at emptying the breast as a child is so you will not pump as much as the baby gets when he/she eats.  Some women cant pump at all. If you want to see how much a baby is getting during each feeding then it is a better idea to weigh a child before and after feeding using a sensitive scale.  If the baby is having enough wet diapers then you really dont have to worry about your supply.   There are cases in which a mother has thyroid problems, hormone issues, breast tissue problems, etc. and cannot make enough milk for their baby. This is extremely rare and it should not be assumed that you have one of these issues if your feel like you have a problem with supply.  If you just gave birth and your milk isnt coming in or you have a low supply then make sure that you dont have a piece of your placenta retained.
  7. If a baby cries at the breast or seems to be having stomach problems please do not believe that your child is allergic to your milk. That is almost impossible. Please do not believe that your baby hates you… I know I thought it for a while. I was SURE of it. Look into these alternatives:  Overactive letdown, this basically means your milk is coming out too hard and too fast. I have this problem and it makes my babies have tons of gas and get frustrated. Milk squirts in their faces… it is funny but not fun.  Help this out by maybe pumping a bit before nursing or letting the baby suck until your get the let down and then letting the “spray” go into a cup or somewhere else so the baby doesnt freak out.  Food sensitivities: my children have this. It took me months to figure it out.  My daughter cried and was constipated.  It was awful and stressful for all of us… until we realized that she was sensitive to dairy products. When I drank milk, she suffered. I cut milk or any dairy out of my diet and she was better. Was this easy? Um no. Not at all. I love ice cream. I love cheese. But it was worth it. Some children have issues with soy, nuts, seafoods, etc. There is an elimination diet that you can do to see what works. It isnt instant, so have patience.. it takes like 2 weeks to get everything out of your system to you might not notice a change for a few days. Dont give up.
  8. If you have pain while nursing it could be a few things but it is most likely one of these.
  • A bad latch:  you can try correcting this by trying a different position. Some children nurse better while laying down other prefer sitting up. For Kate we used the football hold because she did not like laying down to nurse. It caused her to get too gassy. Calvin loves laying down to nurse, he doest like the cradle or cross cradle at all. Invent your own nursing position!! Kate liked me laying on my back and her being held up by me on my side and nursing while “standing up”.
  • Chapped or bruised nipples:  Use lanolin to try and help that. It works wonders.
  • If it is more than just bruised nipples and there is burning inside of the breast then you might have thrush.  Thrush is basically a yeast infection. It is a common ailment that you might need a midwife/OB/GP to diagnose. There are a few treatments available.  If it is not bad than just keeping the breast clean and “airing” your breasts out can be a huge help. It is possible that things like diflucan might be necessary to help clear it up. There are also some scripts that are useful in helping cure thrush that can be given to both mama and baby. We had thrush with Kate and it cleared up on its own with some care on my part.  I wiped my breasts with a vinegar solution and cleaned them with castille soap in between feedings.  It is also possible to use gential violet to help with thrush. It is messy but it works.  Other signs that it might be thrush are diaper rashes and white blotches inside of the baby’s mouth.
  • Mastitis:  This is an infection of the breast. It is important to get this treated as soon as you think this might me what you have. The symptoms include fever and chills, almost like you have a cold or flu.  You might get antibiotics perscribed if this is found to be the cause of your pain, which can lead to thrush… so be careful when you are on ABX and nursing.
  • Plugged duct:  Warm compresses and massages really help fix this common problem. Another thing that helps many mom is  a nice powerful electric breast pump.  Bras and clothes can cause a duct to get plugged so keep on the lookout for that.  This feels like a lump in the breast, not a hard one… a soft one. If you feel a hard lump that doesnt seem to go away then you might need to go see a doctor.

To prevent issues from happening make sure that you put the baby at the breast immediately, or as soon as you can.  Try to have a natural birth if possible.  Women who have had csections or vaginal trauma due to vaccum extractions or foeceps use tend to have trouble breastfeeding because they are in pain and healing from their ordeal. Epidural use can make babies lethargic and not want to latch on during the first few critical moments and also can delay milk coming in.

Do not worry if your breastfed baby isnt having a bowel movement everyday. It doesnt mean that the baby is starving, some breastfed babies only poop once a week. This is normal and nothing to worry about.

Sure it might seem that breastfeeding is a huge ordeal but it really isnt.  Most of our bodies work just fine with nursing and not much else needs to be done.

These of course are not all of the things that can happen with a nursing relationship… but they are some of the most common. Please dont be afraid to ask for help and do have patience. The first few weeks are the hardest, once you have made it a few weeks it is easier from there.

and since no blog post is complete without a picture… he is a picture of my son nursing within the first few hours of birth. Please excuse the hair… i had just given birth. 🙂

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Responses

  1. I bookmarked your blog, thanks for sharing this very interesting post

  2. […] enough milk for their babies. They are rare and many times they can be helped by doing things like making sure the latch is good, taking supplements to enhance production (like teas and herbs) and a few other […]


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