You, Your Baby, Breastfeeding, and COVID-19

by Jessica Martin-Weber

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Breastfeeding Coronavirus Hand Washing

 

Friends, your baby has the right to breastfeed if that is what you were planning to do, want to do, and are able to do.

Not even COVID-19 should stop that from happening.

Even if you test positive for coronavirus.

Even if a health care provider insists that you should be separated from your baby for your baby’s health.

Overwhelmingly, evidence supports that if you are well enough to hold your baby, you are well enough to breastfeed even when you test positive for COVID-19.

(If you are not well enough to hold your baby, you still deserve to be supported in breastfeeding- see here as to how that can be possible).

 

** See this collection of resources of research on breastfeeding and COVID-19, what you need to know, what health care providers need to know, how you can advocate for you and your baby and more. We will be adding to it as materials become available.**

 

We’ve heard from a number of families who are being told they have to separate from their baby at the time of birth if they test positive. Even if they are not symptomatic. Even if they are able to mask and care for their baby following the recommendations of the World Health Organization, the CDC (in the USA), and other major health organizations.

After giving birth is an incredibly vulnerable time and it can be difficult to advocate for yourself and your baby in the immediate hours and days following your baby’s birth. Having a plan and communicating that with your health care team and support person can go a long way in making that easier. Being aware of current recommendations and evidence-based practices as well as being informed on your birth facility’s protocols will allow you to better advocate for you and your baby.

The following is for those in the USA who are COVID-19 positive and physically able to provide care and breastfeed their baby. 

Communicate your wishes to breastfeed even if you are CV19+ with your health care provider BEFORE giving birth if possible and request that it be included in your chart even if you do not test positive. It may be helpful to reference the WHO and CDC recommendations (included in the document linked here) and request that they be included in your chart as well. For example ask that something like this be charted:

“Patient has communicated that breastfeeding is a priority according to the recommendations of the CDC and WHO and requests lactation support regardless of patient’s COVID-19 status at time of birth.”

Current recommendations from the World Health Organization encourage breastfeeding and skin-to-skin when the lactating parent is COVID-19 as the best available protection for the infant with the parent wearing a mask and practicing good hand hygiene (and doing so for the chest area as well).

 

Breastfeeding when COVID-19 positive

 

Current recommendations from the CDC are vague at best, conflicting and confusing at worst. Hospitals are given quite a bit of autonomy in determining their protocols and there’s a wide range of interpretations of the CDC recommendations. Key in their recommendations (updated as of May 20, 2020) is this: “…the risks and benefits of temporary separation of the mother from her baby should be discussed with the mother by the healthcare team, and decisions about temporary separation should be made in accordance with the mother’s wishes.”

So what do you do if you give birth, are COVID-19 positive, and are told that separation from your infant is mandatory?

First, remember that nobody can take your baby from you without your permission without reasonable cause. You have the right to refuse to comply with protocols and practices with which you do not agree or understand. You have the right and responsibility to understand what is being recommended for the health of your child and the evidence for those recommendations. You have the right and responsibility to ask questions until you are satisfied and have the understanding you need. You have the right and responsibility to make fully informed consent in the health care decisions of you and your child. You have the right to make decisions about your child’s health care without bullying, coercion, or threats.

If you are told that your health care facility’s protocols require separation and no direct breastfeeding (pumping only), ask to speak to your child’s doctor directly, tell them you want to work together with them for the health and well-being of your new baby, that you want to understand exactly what is being recommended and why, and inquire why the WHO recommendations are not being followed. 

Listen respectfully as they explain.

Then communicate clearly that you wish to follow current evidence-based recommendations to breastfeed directly and will practice good hand and chest hygiene and wear a mask but that it is your intent to breastfeed your baby according to the WHO recommendations on breastfeeding and COVID-19 positive status. 

If you are told that the institution does not follow the WHO recommendations, you may want to point out that the CDC clearly states “…decisions about temporary separation should be made in accordance with the mother’s wishes.”

If you are again told separation is mandatory, you may find it helpful to say that you appreciate their concern for you and your child’s well-being but that you do not consent to separation based on current evidence-based recommendations to breastfeed.

If you are told that they will call CPS, you may want to state: “I would like it charted that you, Doctor/Nurse _____________ have said that CPS would be called on me if I followed the recommendations from the WHO and CDC regarding separation of the breastfeeding pair in the case of CV19+ status and that this institution would not support me in following current evidence-based recommendations regarding breastfeeding during the coronavirus pandemic.” Asking for this to be in our chart is protective for both you and the health care team. Documentation is very important. Maintaining your own documentation is also important should things escalate. Hopefully that won’t be the case but it is wise to be prepared.

If things continue to escalate, it may be time to reach out to seek legal counsel.

As much as this is a vulnerable time and there’s a lot happening in the body postpartum, as much as possible, remaining calm and non-combative is helpful. Keep in mind that information is changing rapidly and protocols are often decided by hospital administration rather than the actual care providers. The majority of healthcare professionals are just trying to help others as best they know how and may have been given no say in the hospital policies. Attacking them rarely is beneficial and could cost you an influential ally.

 

 

You and your baby should be together and evidence supports that. Should you find yourself dealing with a situation of mandatory separation at birth due to COVID-19 status, please know that all evidence supports that you and your baby should be together, have skin-to-skin, and breastfeed. You are the best person to advocate for your baby and your baby needs to be with you.

For an ever growing list of resources and information on breastfeeding and COVID-19 including studies, health organization recommendations, and more, please see this list. We will be adding resources as they become available so check back frequently.

 

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Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of wereallhumanhere.com, freelance writer, and co-founder of Milk: An Infant Feeding Conference. Jessica lives with her family in the Pacific Northwest and co-parents her 7 daughters with her husband of 23 years.

Breastfeeding and COVID-19 Research and Resources

Updated June 19, 2020
Compiled by The Leaky Boob, theleakyboob.com, Facebook.com/TheLeakyBoob

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The Leaky Boob is committed to providing free information, support, and community. You can be a part of making that possible by joining our circle of support. Any and all support amount makes a difference.

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This resource list is an evolving work in progress. If you are aware of some resources or materials that should be included, please comment with the link.

 

Health Organizations Recommended Practices and Protocols:

Considerations for Inpatient Obstetric Healthcare Settings

  • CDC (Centers for Disease Control and Prevention)

 

Evaluation and Management Considerations for Neonates At Risk for COVID-19 – Caring for Newborns

  • CDC (Centers for Disease Control and Prevention)

“…the risks and benefits of temporary separation of the mother from her baby should be discussed with the mother by the healthcare team, and decisions about temporary separation should be made in accordance with the mother’s wishes.”

 

Breastfeeding advice during the COVID-19 outbreak

  • WHO (World Health Organization)

 

ABM STATEMENT ON CORONAVIRUS 2019 (COVID-19)

  • ABM (Academy of Breastfeeding Medicine)

 

Pregnancy, childbirth and caring for newborns: Advice for mothers during COVID-19

  • Public Health Agency of Canada

 

Clinical Management of COVID-19

  • WHO (World Health Organization)

 

Infant and Young Child Feeding in Emergencies, including COVID-19

  • United States Breastfeeding Committee 

 

 

Pregnancy, Birth, and Breastfeeding and COVID-19 Specific Resources:

 

SARS‐CoV‐2 and human milk: What is the evidence?

  • Wiley Online Library
    • Kimberly A. Lackey, Ryan M. Pace, Janet E. Williams, Lars Bode, Sharon M. Donovan, Kirsi M Järvinen, Antti E. Seppo, Daniel J. Raiten, Courtney L. Meehan, Mark A. McGuire, Michelle K. McGuire

 

New Studies Investigate How COVID-19 May Impact Breast Milk and Pregnancy 

  • University of California San Diego School of Medicine – Michelle Brubaker

 

Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records.

  • The Lancet
    • Huijun Chen, PhD – Juanjuan Guo, MS – Chen Wang, PhD – Fan Luo, PhD – Xuechen Yu, MD – Prof Wei Zhang, PhD – Prof Jiafu Li, MS – Prof Dongchi Zhao, PhD – Dan Xu, MS – Qing Gong, MS – Jing Liao, PhD – Prof Huixia Yang, MD – Prof Wei Hou, PhD – Prof Yuanzhen Zhang, BS 

 

Antibodies in Infants Born to Mothers With COVID-19 Pneumonia

  • Jama Network
    • Hui Zeng, MD – Chen Xu, BS – Junli Fan, MD – Yueting Tang, PhD – Qiaoling Deng, MD – Wei Zhang, MD, PhD – Xinghua Long, MD, PhD

 

Guidelines for Healthcare Facility Management of Perinatal Care of Persons with COVID-19 of Suspected COVID-19

  • Bryna Sampey

 

Skin-to-Skin Care and COVID-19: downloadable file

 

Breastfeeding and coronavirus disease-2019: Ad interim indications of the Italian Society of Neonatology endorsed by the union of European Neonatal & Perinatal Societies

  • Wiley Online Library
    • Riccardo Davanzo – Guide Moro – Fabrizio Sandri – Massimo Agosti – Corrado Moretti – Fabio Mosca

 

COVID-19, Pregnancy and Breastfeeding: What We Know Is Reassuring

  • Helpful blog post with compilation of materials explained

 

Mother-Infant Contact and Breastfeeding Should Remain Top Priorities during COVID-19

  • John Hopkins Nursing, Dr. Cecília Tomori

Breastfeeding, Separation, and COVID-19 Specific Resources:

When Separation is not the Answer: Breastfeeding Mothers and Infants affected by COVID‐19

  • Wiley Online Library
    • Cecilia Tomori – Karleen Gribble – Aunchalee E.L. Palmquist – Mija-Tesse Ververs – Marelle S. Gross

 

COVID-19: Separating Infected Mothers from Newborns: Weighing the Risks and Benefits

  • Harvard Medical School – Melissa Bartick, MD, MS, FABM

 

Mother-Baby Separation for COVID-19 Not Evidence-Based, Experts Say

  • MedScape – Troy Brown, RN 

 

Should New Mothers With COVID-19 Be Separated From Their Newborns

  • The Hastings Center
    • Stowe Locke Teti – Christy Cummings – Louise P. King – Cynthia C. Coleman – Kayla Tabari – Christine Mitchell 

 

 

Maternal Mental Health, Separation, and COVID-19 Specific Resources:

COVID-19 and maternal mental health: Are we getting the balance right? 

  • MedRxiv (The Preprint Server for Health Sciences) – CHS (Cold Spring Harbor Laboratory – BMJ – Yale
    • Anastasia Toplidou – Gill Thomson – Soo Downe

 

Effects of COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study

  • Taylor & Francis Online
    • Ferit Durankuş – Erson Aksu

 

 

Breastfeeding and Separation Resources, General:

Rights of Children in Relation to Breastfeeding in Child Protection Cases: downloadable file

 

 

Helpful Breastfeeding Resources, General:

Exclusive breastfeeding for the first 3 months of life may reduce the risk of respiratory allergies and some asthma in children at the age of 6 years.

  • Wiley Online Library – Gayla Bigman

 

 

Working with Health Care Providers Resources:

Breastfeeding Empowering Language in Medical Settings

  • Mom2Mom Global- Amy Smolinski

 

The SHARE Approach—Essential Steps of Shared Decisionmaking: Quick Reference Guide

  • AHRQ(Agency for Healthcare Research and Quality

The SHARE Approach is a 1-day training program developed by the Agency for Healthcare Research and Quality (AHRQ) to help health care professionals work with patients to make the best possible health care decisions. It supports shared decisionmaking through the use of patient-centered outcomes research (PCOR).

 

 

Current and Ongoing Studies:

ISRHML Activities and Guidance related to COVID-19

  • ISRHML (The International Society for Research in Human Milk and Lactation)

 

 

Additional Resources:

Safe Handling of Containers of Expressed Human Milk in All Settings During the SARS-CoV-2(COVID-19) Pandemic

  • National Library of Medicine – National Center of Biotechnology Information
    • Kathleen A Marinelli – Robert M Lawrence

 

Publishers Provide Scholarly Content Free on Project MUSE During COVID-19 Crisis

  • Project Muse

 

Is there a resource or research you’d like to see included here? Please let us know.

 

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Breastfeeding While Sick and How To Recover Your Supply

by Jessica Martin-Weber with Rene Fisher, IBCLC

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The Leaky Boob is committed to providing free information, support, and community. You can be a part of making that possible by joining our circle of support. Any and all support amount makes a difference.

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This article made possible by the generous support of Ameda.

Ameda Finesse Double Electric Breast pump

*Please note, this is not intended to be health care advice or to replace or be a substitute for being seen by a qualified health care provider. 

Is it ok to breastfeed when you’re sick? Could baby get sick from your milk? From being so close to you if you’re contagious?

We often hear how great breastfeeding is for our babies’ immune systems, a highly motivating reason to  breastfeed. There’s plenty of evidence that shows this to be true and even though it’s no guarantee that our babies will never be sick (lowering risk is not eliminating risk), it can certainly be a motivating factor to breastfeed. In fact, we know that in infants, breastfeeding significantly reduces respiratory infections, gastrointestinal infections, SIDS and infant mortality, allergic disease (asthma, atopic dermatitis, and eczema), celiac disease, inflammatory bowel disease, diabetes, and childhood leukemia and lymphoma. (For more, see here and here.) There’s no doubt that breastfeeding can help reduce how often a baby is seek, the severity of their illness, and the duration of their illness. (More on that here.) Most of the time, breastfeeding is exactly what your baby needs when they are sick.

But what about when the breastfeeding parent is the one sick? Particularly with an infectious disease that baby could easily get being in close proximity to the one sick? Is breastmilk that magical it can protect our babies even then?

Not exactly but, well… kind of.

“…the immunologic components found in breast milk appear increasingly likely to play a specific immunologic role in the protection of the nursing infant.” (Mucosal immunity: the immunology of breast milk)

While it is possible your infant nursling could catch a sickness from you even with breastfeeding and since reduced risk doesn’t mean no risk, it certainly does happen, breastfeeding can reduce the duration of infectious disease in the breastfed infant and even beyond the first year of life.

The American Acadamy of Pediatrics recommendation on breastfeeding while sick:

If a mother has a cold or the flu, it is not necessary to discontinue or interrupt breastfeeding. Through breastfeeding, the infant will receive the antibodies that the mother is producing to fight the illness. Most infectious diseases are also not a cause for weaning or interruption. Generally, by the time a disease has been diagnosed, the infant has been exposed and will probably benefit more from the protection he gets from his mother’s breast milk than from weaning. However, each case must be evaluated individually.

There are times when it would be dangerous to breastfeed during an illness such as when the treatment for the illness carries a higher risk to the baby in the mother’s milk than not breastfeeding would. While this is rarely the case for infectious diseases, it is possible. It is important to speak with your health care provider and disclose that you are breastfeeding when considering treatment options. As not all health care providers are fully informed on human lactation, you may find the following resources helpful in determining treatment options that are safe for breastfeeding and to check a medication’s potential impact on breastmilk supply.

  • LactMed app to look up the compatibility of pharmaceutical treatments with breastfeeding.
  • Infant Risk the leading research for medication safety during pregnancy and breastfeeding.

Sometimes, illness can have an impact on breastfeeding. Some changes to breastfeeding that can happen during an illness of the breastfeeding parent:

  • Low milk supply
  • Milk color changes
  • Increased feedings
  • Decreased feedings
  • Sensitivity
  • Fussy baby at breast
  • Sore nipples

Decreased feeding or pumping, fever, and dehydration can lead to a lower supply of milk. Severe dehydration (such as can happen with gastrointestinal illness) can cause a sudden and drastic drop whereas a slow decrease in milk volume is more typical of illnesses such as the flu. Low supply as a result of dehydration will typically come back quickly with hydration, electrolytes, and rest. Low supply as a result of not fully emptying breasts due to fatigue and other symptoms will take time to rebuild. Low supply as a result of medication side effects usually will begin to recover when the medication is stopped and frequent emptying of the breast increases.

American Academy of Pediatrics breastfeeding through sickness

Recovering Milk Supply Following Illness

If you experience low supply as a result of illness, the best way to increase your supply to meet your baby’s needs is simply to let them breastfeed as often as they are interested in doing so. Complete and frequent draining of the breasts will signal the body to produce more milk. Keeping your baby close and doing skin-to-skin will also help encourage milk production. For lactating parents who pump, adding a 10-20 minute pumping session after several feedings or in between feedings can have the same effect. Don’t be surprise if you pump for 10 minutes immediately following a feeding or even an hour later and get nothing or just a few drops. The stimulation will tell your body to make more milk. It may take several days to see results.

Always be sure to be seen by a qualified health care provider for high fevers, prolonged illness, or severe symptoms.

For further discussion and Q&A on breastfeeding through illness and recovering breastmilk supply following illness, see this video chat with Rene Fisher, IBCLC and Jessica Martin-Weber, The Leaky Boob.

 

This is general information and does not replace the advice of your healthcare provider. If you have a problem you cannot solve quickly, seek help right away. Every baby is different. If in doubt, contact your physician or healthcare provider.

 

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If this resource was helpful for you, consider helping The Leaky Boob by giving back. Help us keep our information, support, and resources free by becoming a patron and get access to exclusive content just for our supporters. Join here today.

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Mother of 4, Rene Fisher has been an IBCLC since 1998. Rene has worked in private practice before going on to be a hospital Lactation consultant for 10 years where she was responsible for nurses and patient education and hands on assistance with breastfeeding mothers. Rene got started in lactation support as a La Leche League Leader 1993 and became a member of La Leche League Area Professional Liaison Department from 2000 -2010. Today, Rene supports families in reaching their baby feeding goals working with Ameda breastfeeding products.

 

 

 

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of wereallhumanhere.com, freelance writer, and co-founder of Milk: An Infant Feeding Conference. Jessica lives with her family in the Pacific Northwest and co-parents her 7 daughters with her husband of 23 years.
 

 

*My Body* On Demand

by Jessica Martin-Weber

Content Note

This piece focuses on sexual assault and includes discussion and detailed description of birth including birth trauma, anxiety, and mention of sexual assault.


The sweet smell of a new baby was more intoxicating than I had imagined. My heart swelled every time I held her, I thought I had known love, this was even more. Joy, relief, peace, total contentment.

It had been a difficult pregnancy and an even more difficult birth. So often, most of the time, I felt completely out of control as though I had no say over my body or what happened to me. Spending hours and hours reading text books, reading personal accounts, absorbing all the literature I could on pregnancy and birth, I had taken advantage of every resources I could to be prepared. Long ago I had found that learning as much as I could about an experience I was facing helped me feel less out of control and more calm. It helped me to think rationally, ask informed questions, and make decisions that didn’t seem desperate. So I managed better than I expected with the sense of lack of control and autonomy. Reading and listening to the stories of others that had traversed the path of parenthood through pregnancy and birth before me, I understood that modesty might fly out the window, that decisions may need to be made quickly, that plans may need to be altered for life saving measures.

As a sexual assault survivor who was still processing and recovering, I saw a therapist regularly, journaled, and read materials on sexual assault survivors giving birth. It was important to me that my birth partner- my husband and my birth team be aware that I was a survivor and that consent was particularly important to me for any touching. We were all prepared.

But in the end it wasn’t the pregnancy and birth that brought anxiety flooding back for me as I became a mother for the first time. It wasn’t the incessant vomiting, multiple hospitalizations for hydration, the numerous failed IV placement attempts, the premature rupture of membranes at 32 weeks and the rushed amniocentesis without anything to numb the insertion of the largest needle ever to enter my body, the diagnosis of asymmetrical IUGR, the weeks of steroids, or the diagnosis of pre-e that made me feel that I had no say over what happened to my body. Even when we had to fight in the hospital for certain accommodations to help me relax in labor I didn’t feel out of control. And when an episiotomy was performed without my consent I was angry but at the time accepted it was necessary (it wasn’t but I made peace with it). Not even when my doctor shoved her arm up inside me to her elbow to manually scrape out my uterus and perform an extraction of my partially retained placenta when I was hemorrhaging, not even then did I feel that my autonomy was threatened.

It wasn’t until a few days later, at home, as my milk flooded my breasts making them hot and swollen and my baby suddenly was desperately and constantly in demand of my breasts that I experienced my first panic attack.

Feed on demand.

sexual assault survivor breastfeeding

I wanted to run away. I wanted to say no. I felt trapped and stuck and completely at the mercy of another human being.

Every time she rooted or fussed, her little mouth searching, I felt it wash over me.

Feed on demand.

Those 3 words were the sentence that thrust me back to when someone else had the control, the say, and all the power over my body. Their hands, their mouth, their fingers, their body probing mine and demanding what they wanted from me. I had no say, I was overpowered. And later, in another context, there was a charade of my own power but if I truly loved them, truly trusted them, I would give my body over to their demands, because that was what love did, even if it hurt. Love meant obligation.

Feed on demand.

But this was my baby. The greatest love I had ever known. And this wasn’t sexual, this was nurturing and caring, this was mothering.

What was wrong with me? Why did I feel like this?

Feed on demand.

This other person outside of myself had all the say over my body. She had the right to demand my body and I had to give it to her or I was failing in loving her fully and in giving her what she deserved. Her right to my milk was so much more important than my right to my body, what kind of mother would I be to deny her demands?

Feed on demand.

I loved her. I was obligated to her. I would do anything for her.

So I would expose my breast to her demanding mouth. I would draw her close through her demanding cries. I would try to control my reaction as her suck demanded my milk. I offered myself to her demands because she mattered more than me.

Feed on demand.

Utilizing breathing exercises I had practiced for labor and staring up at the ceiling as I ran through songs in my head trying to distract myself from the anxiety that clawed at my throat as she suckled at my breast. I got through weeks and weeks of feeds. Months. I was loving her, I told myself. Love required sacrifice, motherhood is full of sacrifices. I would meet her demands for my body because I loved her.

Feed on demand.

Mommy and Arden bfing hand kiss

Eventually it got easier for me. I didn’t stay stuck there and I even found feeding my baby to be a healing experience. As she grew our relationship developed and I could look into her eyes as I fed her, her contented sighs and complete trust helping my anxiety to subside. I’m sure oxytocin helped too. But personally, it was having the option to always say no by instead offering a bottle of breastmilk that helped me find the autonomy I had in saying yes too. It took time but slowly I was able to reframe what was happening.

I wasn’t losing control of my body to a demanding, controlling, abusive person in an imbalanced relationship that was causing me pain. No, my baby was dependent on me and powerless herself as an infant. I was choosing to respond to her and care for her needs.

I no longer saw it as feeding on demand but rather responsive feeding. Responding to her cues and cries for me, the safest person she knew. She was safe for me too.

Love is responsive.

Responsive feeding. Feeding with love.

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Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.

Nipple Pain in Breastfeeding

by Jessica Martin-Weber

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The Leaky Boob is committed to providing free information, support, and community. You can be a part of making that possible by joining our circle of support. Any and all support amount makes a difference.

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This post is generously made possible by Bamboobies

bamboobies banner - 2016

 

All kinds of advice and myths abound when it comes to breastfeeding and preparing nipples for the experience or what to do when there is pain. Dire warnings and emphasis on getting a “good latch” can make it seem as though it is tricky, inevitably painful, and consuming. (Do you need to worry about your baby’s latch? See here for more on what to look for in a good latch and what to do if it is causing problems.)

But there’s good news! While some do experience nipple pain, many do not and for those that have pain, there is usually an answer and steps that can help resolve the underlying cause. Breastfeeding shouldn’t hurt but that doesn’t mean it won’t and it doesn’t mean that if it does it is your fault or that you did something wrong. Seeing a professional breastfeeding helper such as an IBCLC (International Board Certified Lactation Consultant) may help identify the cause of the pain and find a resolution that will help you reach your breastfeeding goals.

Here are a few points on nipple pain in breastfeeding and tips for how to handle such pain. It is our hope that nobody goes through pain in feeding their babies but if you do, most of the time it doesn’t have to stay that way.

bamboobies nipple pain

Is it serious? Figure out if this is the type of pain that indicates an issue or is within the range of normal sensitivity with initial latch. If it lasts for 30 seconds or so and doesn’t bother you when you’re not breastfeeding or pumping then it is possible it isn’t serious and just an adjustment period while your nipples are a little sensitive. If it is toe-curling, swear-worthy pain that makes you hold your breath and try not to scream obscenities or toss your baby far, far away from you, then it is serious and you need to be seen by an expert professional breastfeeding helper. Any tissue damage, cracking, bleeding, scabbing, inflammation, bloody expressed milk, etc., will require proactive treatment and you need to see a health care provider. Keep in mind that if your pain tolerance is high, you may push through pain that is a warning sign that something is wrong, don’t wait too long to get help from a breastfeeding helper such as an IBCLC.

What is the cause? It could be a number of causes from baby’s physiology such as a high palate or tongue-tie (frenulum restriction) to your anatomy such as flat or inverted nipples, bifurcated nipples, or Raynaud’s syndrome (vasospasms), or from a pathology such as a bacterial infection or yeast overgrowth, to a damaging latch. Unfortunately sometimes the case is baby just needs to grow more and it will take time but there may be ways to improve things until that time comes and a breastfeeding helper should be able to help you with that.

What’s the treatment? Working with an experienced breastfeeding helper, once the cause is determined, the first step is to address the underlying cause. This may mean changing positioning and learning latch techniques (such as this “Flipple” technique for latching), a prescription to treat thrush or a bacterial infection, using a device to pull flat or inverted nipples out, a procedure to correct frenulum restriction, therapeutic suck training, and a number of other possibilities. We should start with the easiest to implement first, such as positioning and latch but an early diagnosis can mean resolving the underlying cause for the nipple pain quickly and getting back to reaching those breastfeeding goals.

How to heal? Pain, particularly pain that was ongoing for a while, usually means some tissue damage that’s going to need to heal and until it does, the pain will continue. Treating the underlying cause of the pain is essential for complete healing but there are ways to encourage healing even as the cause is addressed.

bamboobies nipple pain 2

Air drying is important for healing, as much as possible, allow your nipples to air dry before closing up your bra. Air is healing and having the area dry prevents bacteria and yeast from growing in a dark, damp environment. Additionally, rinsing them several times a day (not after each feeding but frequently) can also reduce possible irritation from baby’s saliva.

A good nipple cream, one that is plant based, breathable, and safe enough to leave on during breastfeeding can not only help with healing but can prevent chapping in the early days of breastfeeding as a preventative measure. Wiping off an ointment from sensitive and damaged tissue is painful and can cause further injury so picking one that is safe for baby to ingest in tiny amounts is ideal. Apply after every feeding after allowing the area to dry and pick nursing pads that won’t stick to damaged tissue and your nipple cream.

Your own breastmilk may help your nipples heal. Breastmilk is full of good things that can expedite healing, including stem cells! Be careful though, the sugars in breastmilk will feed a yeast overgrowth, making thrush worse.

Air and sunlight may help nipples healing from thrush as yeast thrives best in dark, damp areas. Make the environment hostile for yeast by exposing your nipples to sunlight and taking a probiotic and cutting out refined sugar.

Heat or cold packs can provide comforting relief, it’s personal, some will love these and others will find them uncomfortable for addressing nipple pain. For those with Raynaud’s Syndrome there is no cure or way to permanently resolve the problem but a heat pack like this one may help minimize the symptoms, apply immediately after feeding.

Cold shredded carrots in the bra (will stain!) promotes healing and is soothing. After breastfeeding or pumping, put shredded carrots stored in the refrigerator in your bra (if you don’t mind your nursing pad turning orange, they can help hold the carrots in place).

Protect the nipples with a nipple shield may be necessary. Nipple shields should be used with caution and hopefully with the guidance of an experienced breastfeeding helper such as an IBCLC because there is a risk of lowering milk supply with using a breast shield (not everyone experiences this, just a factor to be aware is a possibility), but they can be a good option for some to help with tissue healing for a short time.

Take a break if you need to. Sometimes damaged tissue just can’t heal until it has the chance to rest. Regularly empty your breast to protect your supply and have breastmilk for your baby, be sure that you’re using the proper flange size so as not to potentially cause more damage.

 

What are your tips for preventing and healing nipple pain and tissue damage?

Share with us in the comments, together we can support each other in reaching our baby feeding goals.

 

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If this resource was helpful for you, consider helping The Leaky Boob by giving back. Help us keep our information, support, and resources free by becoming a patron and get access to exclusive content just for our supporters. Join here today.

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Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.

Breastfeeding Confession: I don’t love breastfeeding

by Jessica Martin-Weber

This post made possible by the support of EvenFlo Feeding

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As I was nearing the end of my pregnancy with Sugarbaby, now 4, I had noticed a few women commenting online that they hated breastfeeding or at least didn’t love it. Not that they were stopping or refused to do it but that they didn’t have any of the warm fuzzy feelings they’d heard others talk about and they were looking forward to experiencing themselves. Often with their confession came the question: “does this make me a bad mom?”

My heart ached with them. I had felt the same.

I watched as some people responded making suggestions as to how they could maybe enjoy the experience more, or how it may take some time to get to that place, some sharing how much they love breastfeeding and are sorry the poster didn’t, and sometimes a few responding that they could relate. These women would respond that they were really struggling or felt broken, or questioned that maybe they didn’t love their child enough and that there was something wrong with them.

And again my heart ached with them.

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I was 35 weeks pregnant that week, preparing for a new nursling. Expecting baby #6, I was fairly confident that everything would be fine with breastfeeding. Not overly so, as I know each breastfeeding experience is different but there was no doubt in my mind that I’d be breastfeeding and that if there were any challenges we’d be able to work through them with our incredible support system. Still, there was this tiny part of me that wasn’t really looking forward to it. Maybe even dreading it a little. Which is almost heresy coming from the person that started The Leaky Boob.

Feeling for those women struggling I posted this status update on The Leaky B@@b Facebook page: 

“I don’t *love* breastfeeding. Nope, I don’t. It doesn’t give me warm, fuzzy feelings. I don’t look forward to sitting down with my nursling. I don’t particularly care for the sensation. But I breastfeed and I actively advocate and educate about breastfeeding. Why? Because I believe it’s the biologically normal way to feed a human infant. I don’t see myself as a martyr, just doing what I need to do to care for my children. I also don’t think this makes my a bad mom any more than the fact that sometimes I really hate making dinner. Or breakfast. Or lunch. Or changing diapers and doing laundry. What about you? Anyone else not “love” breastfeeding? What’s your breastfeeding confession?”

Responses started pouring in and in less than an hour there were close to 200 comments. The first 20 or so comments (I didn’t count, it could be a dozen or 50) are either people sharing they can relate, thanking me for such an honest confession because they felt less alone or freakish, sharing that it’s a love/hate relationship for them, the random “don’t like seeing people breastfeeding in public” (what’s that doing there?), the super excited ones that LOVE it and can’t relate, and the true confession of wanting to go out drinking (one brave soul shared that). Most of the 200 responses were from women grateful to hear my confession, thanking me for letting them know they weren’t alone and weren’t a bad mom for having these feelings. Then came the handful of comments saying that status was terrible and would discourage moms from breastfeeding. A few said that if they had seen that post when they were first breastfeeding and things were rough it would have made them want to quit. They asserted that we shouldn’t lie but we have to be selective with our words so as not to scare someone off. A few came down hard saying they were disappointed to see a post like that on TLB and called into question if I really support breastfeeding with posts like that.

I told my #4 nursling at the time that I didn’t like breastfeeding. Apologizing that I was gritting my teeth through her nursing sessions, I stroked her cheek and told her that even though I didn’t love breastfeeding I did very much love her and so she was worth it. Too young to understand, I felt my little girl sleeping in my arms and my chest tightened as the truth of my love for her surged through me making it hard to breathe. In that moment I vowed that even if I never loved breastfeeding I would focus on how much I love my daughter while she’s at my breast and I could take pleasure in how much she enjoyed breastfeeding even if I didn’t personally enjoy it.

Going into breastfeeding my 6th baby, my feelings about breastfeeding had changed, the skin-crawling, teeth gritting feeling was gone and while I still couldn’t say that I personally loved it I truly and deeply loved how much my baby loves to breastfeed. As her mother, there is an expansive satisfaction in making her happy that overwhelms even my own discomfort. She went on to breastfeed for 4 years and no, I don’t regret doing so. I don’t see myself as a martyr, just as a mother who, like most parents, has to give up some of my own personal comfort for a time for the benefit of my child. Though I’m not breastfeeding now, when I was, when my baby would grin up at me briefly letting go of my nipple, a little dribble of milk coursing down her cheek, I feel privileged to share and be the source of this moment she enjoyed so much. I will continue to support and advocate for breastfeeding and I will continue being honest about my own breastfeeding journey and feelings because in the long run we all need the kind of support to be who we really are if we’re going to grow.

I followed up with this that day on Facebook: (edited here)

“So sometimes breastfeeding isn’t an amazing experience, sometimes it is. We can be honest about our feelings with ourselves and with others and need to have safe places to do so. If that’s announcing loving the experience or sharing that it’s a struggle not enjoyed, it’s important to have that place. Even for me. Being brave enough to be honest enough to admit the hard stuff is where true support is found. When I first started breastfeeding and hated it deeply it wasn’t helpful to only hear how wonderful it was for everyone else. I needed to hear a balance of the good, the bad, and the ugly. I didn’t believe anyone actually enjoyed it, they just said they did it because it was expected. Today, 6 nurslings later, I’ve learned that it’s complicated and that’s ok. Everyone’s experience is different and nobody should have to hide it because what we need is to be honest, supportive, and real. Some things are going to encourage you, some are going to discourage you, either way, own YOUR experience.”

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What about you? Have you had times where even if everything was working fine, you just didn’t enjoy breastfeeding? Why do you continue?

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Jessica Martin-Weber

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.

A Heartfelt Latch – What You Need To Know

by Jessica Martin-Weber

This post is generously made possible by Bamboobies

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That moment when they’re finally in your arms and you can count fingers and toes and sniff their head and stroke the softest cheek you’ve ever felt in your life, that moment is, whether you can feel it right then or not, when you heart is captured forever. Suddenly everything this little person needs from you, you are ready to do with all your heart. Comfort them, change them, bathe them, sing to them, and feed them, simple yet profound tasks of care are heartfelt acts of love.

No matter how your feeding journey unfolds, there is no doubt that every moment is fueled by love. Even if it is stressful at times. But it does help to know some of what you can expect, how things may unfold, and what you should know going into it. Love may be all you need but love with information and support is just so much more… well, lovely.

There’s a lot of information so we’re just latching onto one little tidbit for now here: the latch.

If you’re breastfeeding or planning to, you’ve probably heard a lot about the importance of a “good latch.” For some, that can create some anxiety about getting that good latch and a sense that doing so can be elusive so we wanted to help break it down a bit with 3 need-to-know tips about a breastfeeding baby’s latch.

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  1. If it ain’t broke, don’t fix it.

Many of us want manuals for everything, how-to guides so we avoid making mistakes and pursue the elusive perfection. You’ll find all kinds of diagrams, pictures, and descriptions of what constitutes a “good” latch. Step 1, step 2, step 3 and if you follow them exactly, voila! The thing is, that’s very rarely how it works with human beings, not even textbook babies.

It is really very simple: if it’s comfortable and it’s working, it’s a good latch.

If it isn’t comfortable and it isn’t working well, then it may not be a good latch.

Baby has plenty of wet diapers? Gaining weight? Good signs!

Baby has low wet diaper count? Difficulty gaining weight? Hmmm, not so good signs.

Mommy can feel her breasts soften a little with baby at the breast? Nipples doing well? Good signs!

Mommy has pain beyond initial latch through the feed? Nipple damage? Not so good signs.

There is a real possibility that your baby’s latch won’t look like the textbook “good latch”, there may even be clicking (though I’d get that checked out just in case anyway), but if it is working for you both then it’s not a good latch, it’s a great one!

A good latch is one that works for mom and baby!

  1. It’s a team effort.

Mom and baby make a dyad, a new team, and they have to work together. Which can be tricky since you barely know each other. But you also know each other better than anyone else. Working together can seem really complicated but don’t borrow trouble and remember that you’re both equipped to do this.

Given that one of the team hasn’t been around too long, that can get tricky sometimes, especially if there are other obstacles in the way such as jaundice.

What team work looks like in achieving that latch of your dreams:

Mom is in a comfortable position and has brought the baby to her level to her instead of leaning down to the baby.

Baby has wide open mouth.

Baby’s body is facing yours.

Chin will touch the breast, nose will be unobstructed, lips will be flared like a flange around the nipple taking in as much of the areola as possible.

Hold baby securely, a snug, close hold will help.

Pull baby in quickly when mouth is open wide.

If you can relax, try leaning back on some pillow, work together, and remember that first rule, it may all just surprise you.

If your baby is not able to do their part of the teamwork, it is time to seek out the support of a health care professional. Speaking with an IBCLC and your child’s pediatrician to identify the cause and options early can go a long way in getting on track to reach your breastfeeding goals.

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  1. If you’re hurting or even just worried, ask for help.

Once upon a time women feeding their babies was visible in our communities and while we’re shifting that way now thanks to the global village of the internet, we still don’t really see it regularly and not all that up close and personal. This has led to us entering our baby care days without much of an idea of what’s normal and even when to ask for help. In fact, it can be easy to start thinking we shouldn’t ever ask for help.

Can you imagine telling your child some day that their nipples may be in agony but they shouldn’t ask for help? Of course not! That would be cruel.

Thankfully, between the internet, hopefully some in-real-life friends, and health care providers, more and more we have resources to help us find our way. Ask in forums, watch videos (this “flipple technique” is helpful for correcting some common latch problems), and read resources (like this one and this other one).

If you’re experiencing anything more than an initial twinge of pain with breastfeeding your baby it may be a sign that something is wrong. Not that you’re doing something wrong or have somehow failed, but rather pain can be a common sign of a problem that with support may be able to be corrected. (There are some conditions that will lead to regular pain in breastfeeding such as Raynaud’s phenomenon.)  It is possible that a painful latch, a baby with too few wet or soiled diapers, low weight gain for baby, stabbing or burning feeling in the breast, or a fussy baby at the breast in combination with any of these issues could be an indicator that there is some problem to address. From tongue and/or lip tie to high palate to jaundice to any number of reasons that a mom and baby dyad would be experiencing difficulty, seeing an IBCLC (International Board Certified Lactation Consultant) can help bring things together and set you and your team mate well on your way to reaching your breastfeeding goals.

And then you can get back to doing what you do best, holding them close to your heart and loving them completely.

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What helped you get a good latch?

Leave a comment below! We’d love to hear how you figured out what was best for you and your baby.

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Jessica Martin-Weber

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.

Not Having Enough But Still Being Enough

by LaTia Wilson Barrett 

Note from the editor: This guest post from a Leaky is sharing one person’s journey through breastfeeding. Her story isn’t a prediction for yours but like your story, her story matters. For those that can relate to LaTia’s story, we hope you find encouragement and support to know you are not alone, for those who can’t relate, may empathy and understanding be your guide.

LaTia Wilson Battett article- June 2016 pt.1

When I first found out I was pregnant, I was ecstatic. My mind was instantly flooded with all the hopes and dreams I had for myself as a parent. I was excited for the chance to experience that first flutter, first kick, first… everything. One of my first thoughts about giving birth, well, following wincing at some of the stories I’d heard about the process, was about the experience of breastfeeding. So many of the parents in the various online groups I was a part of talked about how much of a bonding time breastfeeding was, and how much their sweet newborn took to it right away, and how much pride they had in being able to exclusively breastfeed their baby. I read these kinds of stories with a kind of wonder and glee that one feels when thinking about the magic of Christmas. I mean, it all sounded so idyllic and perfect. I never had any reason to think that things wouldn’t be just as magical for me. As it turns out, it was not at all magical for me. I had always assumed that everyone could breastfeed their child if they chose, and it never occurred to me that I would have an issue. But I did. And it hurt. A lot. It shattered me, until I was able to redefine for myself what it meant to be a mother.

My daughter was born at 36 weeks and 3 days via emergency cesarean after 32 hours of labor and 1 hour of pushing. I had been induced due to severe pre-eclampsia, and by the time my daughter was actually born, I was too exhausted to fully enjoy the moment. But here she was, all 6 pounds 14 ounces of her, looking just as harried as I felt. But she was here and not too much worse for wear. While I was in the recovery area, one of the first things I asked for was a breast pump. I knew that if my daughter and I were going to be separated even for a just a few hours that I would need to try to get things started on my own.

However, a few hours turned into 5 days. Over the course of the days that we were separated I pumped, even during the 2 days that I spent in the ICU due to respiratory distress. I never got the “rock hard”/full feeling, I never woke up leaking, but I continued to pump, assuming that I was one of those women who took a little longer than a couple days for her “milk to come in”. I was so happy the first day I saw a few drops, and cried happy tears (and took pictures!) the first day I was able to pump a measurable amount (about 10mls)! I very clearly recall the day that I finally was able to put my daughter to breast. I cried because it was one of the moments I had been looking forward to the most since finding out I was pregnant. We were both tired and more than a little worn due to our experience, but we were finally together and all was right with the world.

LaTia Wilson Battett article- June 2016 pt.2

After 10 days in the hospital, we were finally released to go home. My milk still hadn’t “come in”, but maybe I was just one of those who was a little later than everyone else. I mean, I did have an emergency cesarean, an ICU stay, and was really sick following her birth. But, it was going to happen any day now, right? Right?? As it turns out, I did have milk, but it just wasn’t enough to feed my baby. It never dawned on me that I could actually have supply issues and that I wouldn’t be able to feed my daughter.

We are never really told what to do when breastfeeding doesn’t work out, aside from, “take fenugreek… pump more… drink more water…” But what about those of us who have serious supply issues that a simple cup of tea or oatmeal cookie just won’t fix? Why aren’t more women educated about what CAN happen, and how to address it? Why are so many of us made to feel like failures and told if we just “put baby to breast more often” or “pump more often” things will work out just fine? I spent many months and lots of money chasing my dream of breastfeeding my baby, when I really should have been more focused on just enjoying her.

LaTia Wilson Battett article- June 2016 pt.3

At the height of my breastfeeding journey, I produced roughly 2 ounces of milk PER DAY. My self-worth for quite some time was measured in ounces. It wasn’t until I developed tendonitis which required I stop pumping altogether around 5 months that I realized that my daughter loved me whether I gave her breastmilk or formula. She would smile just as bright and laugh just as long. She loved ME, not what my breasts could or couldn’t give her. And while I cried on the last day that I gave her my breast milk, I know that she has gotten not only what’s best for her, which is a full tummy, but I’ve also gotten what’s best for me, which is less stress. I still think about “what ifs”, and all the things I maybe could have done differently to produce more milk, and I still feel a slight pang whenever I see a parent nursing their child, but I know that our journey turned out “right” for us, and that’s just fine with me.
 

Concerned you may have low supply? Go here to learn more about what’s normal, what’s not, signs of low supply, what you can do, and when to seek help.

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LaTia's headshot- June 2016

 

LaTia lives in Maryland with her wife and daughter. She loves all things food and Disney, and tries to combine the two as often as possible. When not at Disney (or planning a Disney trip), she is a WAHM, babywearing educator, postpartum doula, and singer.

When Food Makes Your Child Sick- Allergies and Parenting

By Heather Mackles, RN, BSN

When the food you’re feeding your child is making them sick, what do you do? One mother, a member of The Leaky Boob Community group admin team, shares her family’s journey with food allergies and how it has changed them. A registered nurse, the author shares some points for families on potential signs for allergies and how to proceed.

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It started with a crying baby, a “sensitivity” to my breastmilk, and a transition to soy formula under the direction of our pediatrician. Then it became vomiting, weight loss, and a hospitalization. Eight years later, we’re dealing with food anxiety, rebelling, and a struggle with autonomy. Somewhere in there was a major food overhaul.

Food allergies.

I am a parent of a child with multiple food allergies. We wield EpiPens, Benadryl and a rescue inhaler. We see a pediatrician, dermatologist and allergist every few months. We are one piece of candy away from a trip to the ER.

Food can kill my son.

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I was told while pregnant from a lactation consultant that babies rarely have an issue with actual breastmilk. Only babies with true milk protein allergies were unable to breastfeed due to the whey protein in breastmilk. My pediatrician agreed after we had several visits with complaints of horrible crying with no relief and constant diarrhea. He told me that my baby may have a sensitivity to my breastmilk and that it would be in my best interest to wean him immediately to soy formula. There was no mention of removing dairy from my diet first. Now knowing more than I did then, I probably could’ve tried removing all dairy from my diet and chances are strong that would have been a better option for my son. For more on breastfeeding a child with food sensitivities or food allergies, see this post here.

But I didn’t know then what I know now. I didn’t know how to fight and advocate for my son.

When we first got the diagnosis from the gastroenterologist, I made that first trip to Whole Foods. I was beside myself. I didn’t know what I was looking for. Then this saint of an employee came up to me, and asked if he could help me find something. I poured my heart out to him while he helped me navigate the store.

My child, who loved homemade fettuccine Alfredo (which starts with a stick of butter and a pint of heavy cream), now could not have anything that had the milk protein, casein, in it. It’s not a lactose-intolerance. He can’t just drink lactose-free milk and be fine. He can’t have any animal milks, butter, cheeses or whey protein. His reactions continued going up until his diagnosis had only been gut and skin related, but that doesn’t mean that the next exposure couldn’t affect his respiratory system.

The threat is very real.

My son can’t eat or have contact with:

  • Dairy
  • Gluten
  • Tree Nuts
  • Peanuts
  • Tomato anything
  • Nitrates
  • Fluoride
  • MSG
  • Artificial Colors
  • Preservatives

We now have to read every ingredient list for EVERYTHING. When he’s prescribed a medicine, or even if I go to give him over-the-counter medicine, I have to call the manufacturer and get the all clear that it does not contain dairy or gluten. Sometimes the manufacturer is closed, or won’t return my calls for days, but he needs the medication at that moment. So I have to take a deep breath, weigh the risks and benefits, pray, and give him the medicine. His allergy medicine prescribed by his allergist? I gave it to him for a month and couldn’t figure out why he was breaking out in hives and having diarrhea. It contained gluten as a main ingredient. Because his vitamins were cultured in milk, but they didn’t list it because they don’t contain milk, he had a reaction. Now he’s taking vegan vitamins to be sure they are dairy free. His allergies have evolved over the years, though he has yet to grow out of any, as many kids with one food allergy usually become allergic to other foods over time.

Every single thing that goes into my child’s mouth requires me to check the ingredient lists. Unfortunately, if something in it is milk-derived, it doesn’t have to list that according to the FDA. There’s a lot of ambiguity when it comes to artificial and natural flavors, colors and preservatives, and transparency is not required. So do I give him the food that should be okay and risk a reaction, or do I disappoint him and tell him it’s not safe? We play that game. Every. Single. Day.

Sometimes I hear him coughing in his room at night, one of his common early symptoms of a reaction, and the panic starts rising. “What did he eat today? Was it anything that we ate differently? Have I looked at our safe foods’ ingredient lists recently? Did they change their ingredients?” And then I mentally go back through everything he ate in the past 24 hours, because reactions can be delayed. His are usually around 8 hours after ingestion. Sometimes it could be anything, sometimes I may not even know for sure what he has eaten.

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I cringe when other kids offer him food because he SO BADLY wants to take it, but he does good most days on refusing. Sometimes he slips, but I have to give him some autonomy. I cannot keep him in a bubble forever. He has had to learn how to resist temptation in the most evil of ways. Food is more than eating. It’s a social and cultural enjoyment. Good food brings people together and celebrations often center around food. Many people take offense even, including family members, when we say that he can’t have whatever they’re offering, because we aren’t sure of the ingredients.

My son experiences discrimination every time he’s on some sort of a team or in a group activity. I’ve heard such things as “We don’t accommodate for people with food allergies.” and “Can’t you just bring him his own snack to every game?” told to me by other parents, teachers, and team leaders. But there’s always that one parent on the team that texts me to ask me for suggestions on my son’s safe foods because they want to make sure he feels included. One parent who shows they care. They are the shining beacon of light, and by being able to share in team snack with everyone else, just like every other kid, you made his day. It warms my heart to see him so happy. And it makes me so angry when people blow off his food allergies like they’re nothing.

My child’s food allergies aren’t a preference, they are a life and death risk. I know it is inconvenient, my family lives with and accommodates those inconvenient risks every day.

Our safe restaurants include Mellow Mushroom and Disney restaurants. That’s about it. Going out to eat is another adventure. It takes a lot of time and energy, because we have to call ahead and make sure they can make something for my son that he can actually eat. He’s not picky by any means, but he does have his preferences, and most places either have 1-2 things on the menu he can have, or none at all. Like most of us, he wants to enjoy eating beyond considering whether or not it will make him sick. Most times, the restaurant’s employee we talk to on the phone can’t guarantee that they’ll have a meal free of his allergens. By the time we call around to 3-4 places we’ve selectively picked, we usually throw in the towel and make something at home. We make 95% of our food at home from the most basic ingredients. It takes too much time, planning and effort to go to a new restaurant, where most of the time, the employees are very poorly educated on food allergies and cross contamination. Fast food is mostly out of the question. We don’t even try there. If we need fast food, we make him a safe option at home.

Do I want to be this controlling? HELL NO. I want to let him eat whatever he wants, and I would cut off my left arm if he could just have one slice of birthday cake at another kid’s birthday party. But his diagnosis requires vigilance and I must provide that.

Still, I refuse to allow food to define my child. He is a smart, funny, easy-going kid. He’s never met a stranger and will hold a conversation with anyone he meets. He is good at acrobatics, circus aerial arts, and baseball. He just signed a modeling contract through a worldwide agency. His smile is infectious and that lights up the room. Food allergies are NOT who he is. He may have them, but they are not him. He is Ian, a boy who has food allergies.

And I stand in the background, ensuring he stays safe as he blossoms into his own person.

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Right now, we take it one day at a time and we learn and grow with him. There will be more rebellion. There will most likely be more ER visits in the future. There will be times where he chooses to not bring his EpiPens with him because it’s not cool to have special needs. Hopefully that day, he won’t need it, as most days he won’t. Hopefully he won’t learn this lesson the hard way. But there will also be good friends that we meet along the way, and we will cherish them forever.

I went on to successfully breastfeed two more children. My middle child was breastfed until 18 months old, and my youngest is 19 months old and still breastfeeding with no end in sight. We introduced the top eight most allergenic foods at 6 months old under the direction of our (new) pediatrician and both of my youngest kids have no food allergies.

There’s a lot I wish I knew back in the day with my son that I know now. For new parents it can be overwhelming and scary. Most of the time I’m not scared any more, just vigilent. And I’m able to share what I’ve learned. There are boundaries to learn, together we can figure them out. In this post, another parent shares a few methods about food boundaries with her food sensitive child. 

Want to know what to look for and what could be a warning sign of an allergy in your child? Here are some of the most common things to look for when evaluating for food allergies in children:

  •      Rash around the mouth
  •      Flushed face
  •      Hives
  •      Vomiting and/or diarrhea
  •      Behavioral changes, mostly severe anxiety or restlessness after eating
  •      Fast heartbeat*
  •      Face, tongue or lip swelling*
  •      Constant coughing or wheezing*
  •      Difficulty breathing*
  •      Loss of consciousness*
*If your child exhibits any of these symptoms, call 911 immediately as these are signs of a life threatening medical emergency.

They could encounter the allergen once and react to it, or they could’ve been exposed to the allergen 100 times before and all of a sudden start reacting to it. There is no telling when or how bad they’re going to react to the allergen, if their body chooses to react to that particular food protein.

Many life-threatening food allergy reactions (called anaphylaxis) happen to kids who did not know they had a food allergy. If you suspect that your child has a food allergy, please consult your physician for further allergy testing. 

If you’d like to learn more about food allergies, please visit: www.foodallergy.org.

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Living with the reality that the very nourishment that should sustain us, bring us joy, and lead to health could make our child sick, endangering their lives, isn’t easy. If you get to enjoy life without these scary obstacles, please be patient with those of us who must learn how to navigate them. If you are just discovering that allergies may be a part of your child’s life, you’ve got this. It may require a lifestyle change but you’ve got this. With community and information sharing you can be your child’s strongest advocate and learn how to navigate this terrain without it stealing your joy. 

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Heather Mackles is a 32-year-old retired PICU RN, who is happily married to her husband, and stays at home with her three children, two dogs and an antisocial cat. In her minuscule amounts of free time, between changing diapers and homeschooling/unschooling her kids, she enjoys traveling, taking frequent trips to Disney, sewing, and critiquing medical TV shows. She believes in advocating for all women from all walks of life, and loves helping women achieve their breastfeeding goals.

Understanding, Treatment, Prevention, and the Emotional Toll of Mastitis: The Red-Eyed Steaming Pooh Pile Jerk-Monster of Breastfeeding

by Jessica Martin-Weber
This post made possible by the generous sponsorship of Ergobaby and their Natural Curve Nursing Pillow.

Ergobaby

 

Not going to sugarcoat it: Mastitis is a jerk. A real jerk. It hurts.

Other than being a jerk though, what is mastitis?

mastitis definition

Inflammation of a boob. A boob infection. A boob infection that may turn into a boob abscess. And it can spread from there.

This jerk is no joke.

Mastitis can present as a range of severity from engorgement when milk comes in to a blocked duct, redness, swelling, pain, and a fever. Sometimes bacteria or infection isn’t always actually present.

The symptoms of mastitis can include:

  • Redness
  • Tenderness
  • Heat radiating from the area
  • Pain
  • Fever
  • Chills
  • Body aches
  • Hard area under skin indicating a blocked duct
  • Abscess
  • Feeling like someone electrified your joints when you already had the flue, punched you in the boob, and then handed you a baby and told you to feed it with the boob that was punched.
  • The desire to punch someone in retaliation.

Pretty much, you feel like a steaming hot pile of aching pooh with an infant to care for and dinner to make.

the emotional impact of mastitis

It is officially miserable. Women with mastitis have been known to compare the experience to torture and generally agree that it is worse than childbirth and dental work combined.

Oh yeah, this steaming pile of pooh just got real.

There are a range of treatment options including but not limited to:
(This is not intended to be health care advice, just information. Your health care provider can address your specific needs in care.)

  • Milk removal– get it all out! Repeatedly. (This milk is safe for baby to consume unless otherwise instructed by your health care provider)
  • Heat– this may provide relief and help with let down to empty the breast. Wet heat, such as a warm compress or soaking in a tub or shower (if you can stand it) or even a bowl of warm water is effective and provides a lubricant for massaging the effected area as well.
  • Massage– Nothing like massaging the area that hurts when you touch it but some breast massage can go a long way in relieving mastitis. This method is one to try very gently.
  • Rest– you’ll want to after that massage anyway but rest has a big role in helping the body heal itself.
  • Pain relief– such as Ibuprofen. Reducing inflammation won’t just help you tolerate the pain, it can help you heal.
  • Natural remedies– from cabbage to lecithin to arnica to garlic, there are tried and true natural options worth trying if you catch it early. If you experience recurring mastitis, lecithin supplements on a regular basis may help you avoid it again in the future if mechanical issues regarding milk removal do not appear to be the cause.
  • Pharmaceuticals– If caught early, you may be able to beat this monster on your own but it can rapidly progress to a much more serious condition if left untreated. The most effective known treatment is antibiotics.

Hopefully you’ll catch it soon enough to not have to pack up your children and monster boob to see the doctor but if you end up there most women respond quickly to antibiotics.

So how do you avoid this jerk in the first place?

There are some solid steps you can take to protect your boobs but as powerful and wonderful as they are, they’re not invincible. Still, here’s what we do know.

  • Treat damaged breast tissue ASAP. Nipple damage is pretty much an invitation for mastitis. Get that taken care of and address the underlying issue with a qualified health care professional (see an IBCLC) to prevent it from reoccurring. (Could it be tongue tie?)
  • Effective milk removal. This can be more difficult to tell but if your baby or pump isn’t removing milk well from your breast you could be set up to do the tango with Jerk-face here. Reoccurring mastitis could be a sign that your breasts aren’t getting emptied. This would be the time to see an IBCLC for some answers and hands-on support.
  • Frequent milk removal. Responding to baby’s cues for feeding rather than the clock not only helps ensure you have a consistent milk supply it also helps you frequently empty the breast (which tells your body to make more milk) which in turn helps you avoid mastitis. Feel like you’re feeding baby all the time? Yay! Hopefully baby’s helping you avoid mastitis! Listen not only to your baby but also to your boobs. When they feel full and particularly if they start to become painful when you’ve missed a feeding, be sure to empty them. This goes for pumping too!
  • Different positions for milk removal. It’s normal to have your favorite position or two but changing it up a couple of times a day will help ensure that the milk removal happening is more complete. If you’re pumping, try using breast compressions to full empty the breast. If you think you may have a plugged duct or the beginning of mastitis, try a dangle feeding position. It’s not cute or fun but it can be incredibly effective.
  • Free of restrictions. Make sure your bra, nursing tanks, and anything else that comes in contact with your breast isn’t constricting (check your seat belt placement). Red lines would be an indicator that there is pressure on your breasts that could block the flow of milk and increase your chances of infection.
  • Take care of you. Rest, eat well, hydrate even better. Giving your body the resources it needs to be healthy is the best preventative measure we can take.
  • Respond. If something is up with your breast and you notice tenderness, a hard area, a white bump (called a milk bleb) on the tip of your nipple, or anything that just seems off, take care of it by resting, massaging, and calling your health care provider.

ErgoBaby breastfeeding nursing pillow mastitis prevention tip

It is important to note that sometimes mastitis is resistant to treatment. If this happens to you, you can request your health care provider to do a culture to determine if a more targeted treatment protocol is in order and to detect possible other causes for mastitis-like symptoms that don’t respond to conventional treatment measures.

The emotional and psychological impact of mastitis can’t be ignored. It’s far more than a pathology, more than a clinical diagnosis. Anyone that has experienced mastitis can tell you that it is a soul crushing, mind altering invasive monster-jerk. Women have been known to question everything about their lives in the midst of battling mastitis.

I shared my emotional unraveling and how I ended up beating the Red-Eyed Monster of Breastfeeding here, including my detailed home treatments and a “flattering” photo demonstrating dangle feeding here. It’s not pretty. It’s war.

What is mastitis and how to care for it The Leaky Boob

If you find yourself entrenched in such a battle for your soul boobs, ask for help. Virtual help (head over to our FB pageFB group, and Instagram for a real dose of virtual help that’s chicken soup for your mom soul) and in person real life help. Trying to be super mom and super boob monster-jerk fighter isn’t going to position you well to win. Beg a friend to bring dinner, reach out to a family member to do a load of laundry, be cool with Netflix babysitting so you can get down to booty kicking the jerk and getting well.

Just turn on My Little Pony, give your kids the peanut butter jar and a spoon (as long as they aren’t allergic), and sit on the floor with a warm wet wash cloth massaging your boob and cry.

There’s no sugarcoating mastitis.

Mastitis is a jerk (I’m writing “jerk” but I’m thinking a different word) but with information, help, and some mom-moxie, most moms can kick it to the curb. Demand help from your health care provider when you need it, nobody will blame you for being a bit on edge with your breast invaded by the Red-Eyed Monster of Breastfeeding, Jerk Mastitis. Do what you need to do.

This a-hole jerk is no joke.

Sources: Academy of Breastfeeding Medicine mastitis protocol,  LLLI Mastitis Tear-off sheetThe Nursing Mother’s Companion,  The American Academy of Family Physicians Management of Mastitis in Breastfeeding Women, the CDC

 

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Have you survived mastitis? How did you get through?

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Jessica Martin-Weber Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and co-creator of OurStableTable.com, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book and a children’s book.