What is Skin to Skin Care?

by Kim Walls, mom and creator/owner of BabyTime by Episencial.  This post made possible by the generous support of BabyTime Episencials.

Kangaroo Care
The most classic definition of ‘Skin-to-Skin Care’ (which is the same as ‘Kangaroo Care’) refers specifically to sessions of 60 minutes of continuous touch between baby and mom in the first moments, hours and days after baby is born. First, baby is placed on mother’s chest immediately after birth, where the cascade of normal hormonal physiological benefits will occur. Baby will show nine distinct stages of bonding including relaxation, crawling (Yes! A newborn will actually wiggle towards the breast!) and rooting to suckle.
The latest research shows that while the 60 minute time frame recommended for classic Kangaroo Care is important, it touches on just a fraction of the benefits available to baby and mom from a more comprehensive understanding of skin to skin care. Even six seconds of skin to skin touch is often enough to raise the ‘love’ and ‘bonding’ hormone oxytocin, which could make breastfeeding easier and reduce the symptoms of postpartum depression. Additionally, it is within the first 48 hours after birth that baby’s skin is first colonized with the beneficial bacteria that will help keep her dermal microflora (skin surface bacteria) in protective balance.
The immediate separation that’s typical in most U.S. hospitals may not be as ideal as time spent snuggling together – skin to skin – for at least 60 minutes immediately after birth, and as much as possible for the first 48 hours. Studies have shown that even brain development is enhanced in babies who had ample skin to skin contact in those early hours and weeks after being born. Your baby instinctively knows that nestling into your chest is the best place she could be.
The natural colonization of baby’s skin with the same bacteria as found on mom’s skin, plus breastfeeding, are thought to help prevent allergic reactions in baby as she ages. Skin to skin closeness with Mom, immediately after birth and beyond, are critical to support breastfeeding and the proper microflora colonization. It also helps bring baby’s heart rate, temperature, blood pressure and breathing rates back to normal after the stimulation of being born. Babies experience stress as they go through the birthing process. After birth and for a long time after, the healthiest place to be is on mom’s chest.

As baby gets older, there are plenty of opportunities for parents to share increased skin to skin contact time, through baby massage, giving baby a bath, taking a nap together, or just playing simple games together (Peek a boo with baby in your lap and a board book!)

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Did you use Kangaroo Care with your little ones?

How do you enjoy skin-to-skin time with your little ones still?

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References:

Lozoff B, Brittenham GM, Trause MA, Kennell JH, Klaus MH. The mother-newborn relationship: limits of adaptability. J Pediatr 1977 July;91(1):1-12.

Lozoff B, Brittenham G. Infant care: cache or carry. J Pediatr 1979 September;95(3):478-83.

Morton D, Thierry B, Peretta G, Lankeit M, Ljungberg T, van Hooff J A R A M, and Scott L. The welfare of non-human primates used in research. Report of the Scientific Committee on Animal health and Animal Welfare.  European Commission Health and Consumer Prtoection Directorate-general; 2002 Dec 17.

McKenna JJ, Mosko S. Evolution and infant sleep: an experimental study of infant-parent co-sleeping and its implications for SIDS. Acta Paediatr Suppl 1993 June;82 Suppl 389:31-6.

McKenna JJ, Thoman EB, Anders TF, Sadeh A, Schechtman VL, Glotzbach SF. Infant-parent co-sleeping in an evolutionary perspective: implications for understanding infant sleep development and the sudden infant death syndrome. Sleep 1993 April;16(3):263-82.

Laughlin CD. Pre- and Perinatal brain Development and enculturation: a biogenetic structural approach.  1991.

Schore AN. Effects of a secure attachment relationship on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal 2001;22(1-2):7-66.

Bates E, Thal D, Finlay B, Clancy B. Early language development and its neural correlates. In: Rapin I, Segalowitz S, editors. Handbook of Neuropsychology. 2nd edition ed. Amsterdam: Elsevier; 2005.

Doussard-Rossevelt J, Porges SW, McClenny BD. Behavioral sleep states in very low birth weight preterm neonates: relation to neonatal health and vagal maturation. J Pediatr Psychol 1996 December;21(6):785-802.

J Investig Dermatol Symp Proc. 2001 Dec;6(3):170-4.

Skin microflora and bacterial infections of the skin.

Chiller K, Selkin BA, Murakawa GJ.

J Appl Microbiol. 2013 May;114(5):1241-53. doi: 10.1111/jam.12137. Epub 2013 Feb 1.

Bioactives from probiotics for dermal health: functions and benefits.

Lew LC, Liong MT.

PLoS One. 2013;8(1):e53867. doi: 10.1371/journal.pone.0053867. Epub 2013 Jan 16.

Probiotic bacteria induce a ‘glow of health’.

Levkovich T, Poutahidis T, Smillie C, Varian BJ, Ibrahim YM, Lakritz JR, Alm EJ, Erdman SE.

Clin Microbiol Rev. 2003 October; 16(4): 658–672.

Potential Uses of Probiotics in Clinical Practice

Gregor Reid,1,2,3,* Jana Jass,1,2 M. Tom Sebulsky,2 and John K. McCormick1,2

Clin Microbiol Infect. 2005 Dec;11(12):958-66.

Probiotics: facts and myths.

Senok AC, Ismaeel AY, Botta GA.

Garcia Bartels N, Mleczko A, Schink T, Proquitte H, Wauer RR, Blume-Peytavi U. Influence of bathing or washing on skin barrier function in newborns during the first four weeks of life. Skin Pharmacology. 2009;22:248–257.

In Search of the perfect latch

Sugarbaby 1 week old. Photo by Kelli Elizabeth Photography

“I’m really scared of breastfeeding.”  Pregnant with her first my friend subconsciously rubbed her 34 week belly as I made dinner and we chatted.  Puzzled, I asked her why.  She said she googled and learned that it can be so painful, particularly if they don’t have a good latch.

“How do you get a good latch?” she asked me.  She went on to explain that she had read different blogs and forums about how hard it was to get a good latch, women with bleeding nipples, and babies not gaining weight.  She wondered what was the secret to a good latch and what if it didn’t happen for her.  It’s true that these issues do happen and probably far too often but here she was, weeks away from having her little baby, scheduled to take a breastfeeding class in the next couple of weeks, and worried that she was facing a world of pain if she couldn’t get this elusive latch and not find the secret for it ever to happen.

Earlier that same day I had coffee with a good friend, an IBCLC at a local hospital.  The topic of the elusive perfect latch came up and she surprised me by telling me that she thinks we make too big deal about the latch.

“If mom isn’t in pain and baby has plenty of soiled and wet diapers, why do we need to mess with anything?  Sure, if there’s a problem such as pain or a dehydrated baby then we need to fix what we can but so what if that bottom lip is curled in if it’s not bothering anything.”

In other words, if it’s comfortable and it’s working, it’s a good latch.  There is a wide range of normal.

I love this woman, she often says exactly what I’m thinking.

In general, if everything is working right, babies are ready to breastfeed and mom’s breasts are ready to feed.  It just works and we really don’t need to mess with it, it doesn’t have to be this complicated endeavor.  Maybe it will be difficult but we don’t have to expect trouble.  More often than not moms need support simply because breastfeeding isn’t so common in our society and women don’t see breastfeeding as a part of normal life making the learning curve steeper than it would be if seeing breastfeeding was commonplace.  There would be less stressing about the perfect latch if more women saw what it looks like when a baby is at the breast as they go about daily life.  Their moms, sisters, aunts, friends, coworkers, or even strangers breastfeeding would have already demonstrated a baby feeding well.  The wide range of normal would be seen and experienced.  Today a woman may never see another woman breastfeeding until she’s feeding her own baby for the first time.  Seeking out support she may look online or join a breastfeeding support group, seeing breastfeeding dyads in a very specific setting that she had to find.  If she is experiencing difficulty with pain or ineffective milk transfer for her baby, because she hasn’t been exposed to breastfeeding pairs, she may not even realize that the way her baby is latched could be what’s causing the problem or that it may even be a fairly simple fix.  When there are issues such as poor weight gain for baby or bleeding nipples the first thing to consider is a poor latch.  After I shared a few pictures of Sugarbaby’s latch on Facebook, there were several comments and I received several emails from moms stating that they never knew saw what a latch looked like and had endured pain in breastfeeding because they didn’t realize something was wrong.  Side note: if you are ever experiencing pain with breastfeeding that is more than a brief moment of discomfort or lasts beyond initial latch please seek out help, pain is usually an indication of a problem than can be corrected.  This doesn’t mean you’re doing something wrong, it just means you probably need help.

 I talked with my friend Star Rodriguez, IBCLC of Lactastic Services and WIC peer counselor for the following lists.

When do you need to consider latch issues and improving your nursling’s latch?

  •  When breastfeeding is painful beyond the initial latching.
  • When there is tissue damage to your nipples.
  • When there are weight gain issues for the baby.

What latch pointers can moms try?

  • 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 and baby’s arms are not pushing away at you.
  • It is best to let the breast fall naturally if possible.
  • If large breasted or when milk first comes in, it may be helpful to hold your breast with your hand.
  • Aim baby’s nose toward the nipple; if necessary to encourage a wider mouth, tickle the very top of the baby’s upper lip with your nipple.
  • Latch should be asymmetrical. Chin will touch the breast, nose will be unobstructed. You do not need to push your breast away from your baby’s nose in a good latch.
  • You will hear or see baby swallowing – short sucks/swallows at first, longer ones as milk starts to let down.
  • If using a nipple shield, ensure that the nipple and surrounding tissue is being pulled into the shield.

What can a mom do to try to improve a painful or ineffective latch?

  • If baby isn’t opening mouth wide enough, attempt to show baby by opening your own mouth wide.  Many babies will subconsciously mimic this.
  • Make a “breastwich” with your hand in the shape of a C behind the areola to help baby get a bigger mouthful.
  • Get baby as naked as possible for skin-to-skin or lightly dressed.
  • Hold baby securely, a snug, close hold will help.
  • Pull baby in quickly when mouth is open wide.
  • It is common to experience some discomfort at latch in the first few weeks of breastfeeding.  It should go away as the feeding continues.  If it does not end after around 30 seconds, you may need to remove the baby from the breast and reposition the baby.  Break the suction by placing your little finger into the corner of the baby’s mouth and trying to latch again.  Some lactation consultants can show you ways to fix a latch without taking the baby off the breast, but those are easier to learn from being shown rather than told.  You may need to put the baby in a different nursing hold or position.

When should a lactation consultant be called?

  • Repositioning doesn’t work
  • If there is sudden soreness after there has been painless nursing
  • If you feel stabbing or burning pain in breasts or at latch
  • If you have cracked or bleeding nipples
  • If your latch is not painful but your baby is not having a good amount of wet and dirty diapers

Check out these other resources on latch:

11 Common Pitfalls When Latching a Newborn

 

Latching and positioning resources

Latching: Thoughts on Pressing Baby’s chin down

 The Mother-Baby Dance

 

Coming soon a photo gallery of latched on babies and their mother’s commentaries on their latch experience illustrating the wide range of normal and potentially problematic latches. 

 

Babymooning- 12 signs you are the mother of a breastfeeding newborn

I’m babymooning.  Sugarbaby and I are doing very well, now 12 days postpartum.  I’ve been trying very hard to take it easy and respect this postpartum time for myself and it has been paying off.  Over the last almost 2 weeks I’ve been simply enjoying my baby, my family, and resting.  Cherishing this newborn time that goes too fast has been my priority.
I wanted to share some observations I’ve made during my babymoon, maybe you can relate and I’m sure you can add some of your own.
You know you’re the mom of a breastfeeding newborn when…
  1. You finally get to take a shower and within 10 minute of getting out you already have leaked milk all over your clean shirt.
  2. As much as you like the longer, thicker hair you grew during pregnancy, hacking it off with a dull pair of scissors is starting to sound like a good plan between the frequency of showers you get, the death-like grip of a tiny handful of hair your baby is capable of, cleaning spit up out of it several times a day, and the nagging fear of a hair tourniquet.
  3. You wonder why you didn’t invest in more yoga pants and are certain you will never wear blue jeans again.
  4. Your favorite food is: “anything someone else made.”
  5. Any time someone hugs you any way but with a side hug you wince.
  6. The old adage “never wake a sleeping baby” doesn’t apply when your boobs are rock hard boulders crushing your chest.  Yes, you will wake your baby for some relief.
  7. You wish you had jedi powers for every time you forget to grab a drink of water before you sit down to breastfeed… again.
  8. “Sleep when baby sleeps” seems like a good plan but you wonder when you’d get to pee or brush your teeth or eat.  Then you realize that sleep trumps everything else and decide you’ll pee, brush your teeth, and eat while holding your baby.
  9. Something seems really funny and you laugh hysterically only to forget what was so funny 5 minutes later.
  10. Shirts are “clean” unless the smell is too bad or there is obvious spit-up or poop on them, dried milk leaks don’t count as “dirty.”
  11. The stash of reusable breastpads that seemed so impressive before giving birth is used up in one day after your milk comes in.
  12. You’d rather sniff your baby’s head snuggled on your chest than even your favorite flower any day.

The Leakies on The Leaky Boob Facebook page had plenty more here and I hope you’ll add your own in the comments below.  Now back to my baby head sniffing!

 

Sugarbaby Introduces Herself

by The Piano Man

Hello world, Sugarbaby here.  My name is Arden, or so I’m told.  Most of the time Sisters call me baby, but Mommy and Daddy are trying their hardest to get them to use my name.  I have 5 sisters!  And there’s never a lack of hands to hold me close, but my favorite place to be in the whole world, as I know it, is in Mommy’s arms.  Daddy’s ok, but there’s nothing like the smell, the touch, the feel of Mommy.  I’m pretty sure she feels the same way, because I can feel her face touching my head and I can hear her breathing me in as well.  I can’t imagine a happier place.

Mommy and Daddy noticed that I already dream when I sleep, but I’m not telling them if I dream of the last couple of days where everything is so bright, or of the day I left my first home, or of when I was still in that warm and comfy place before that.  It was getting really crowded in there, so it’s nice to be able to stretch out my arms and feel the emptiness around me in between my fingers.  But sometimes that makes me scared, and so Mommy or Daddy hold me close with my arms tight against my tummy, and I feel much better.  I really like being close, really, really close.  When I’m awake, and when I’m asleep.  All the time.

I really didn’t want to come out of Mommy’s tummy at first.  It was crowded in there, but I didn’t want to leave.  I would wiggle my head and refused to go through the right way.  But in the end, I decided to come out anyway, but it had to be my way.  And my way was without my head being squished.  Plus I waited until absolutely everything was just right, which took a while, and then I came out in one push.  Everyone was so surprised!  And then they said things like how big I was.  I guess I’m just a bit ahead of the curve, full of surprises.  They measured me and weighed me and determined that I was actually a week and a half older than they estimated.  But that was after I got some serious cuddle time with Mommy.  It was a little strange feeling her from the outside, but I really love the way she smells, and the way it feels to be against her chest with her arms around me.  Oh yeah!  I can smell!  And breathe!  I practiced all that before but it’s really different when you breathe liquid.  But all that practice really paid off.  The world is lot bigger than I imagined, but it’s ok because I have Mommy to hold me, and feed me.  Oh, and I eat!  That’s new too, but I really like it.  I could do it all day.  And don’t worry, this is all totally normal and your own baby can tell you all about that right here.

Anyway, when everybody saw me, they said things like how big I am, and how my head is perfect – which, of course it is, I worked hard to keep it that way! – and then later they said how I looked like a 3-month old Cosette!  That’s so funny.  She must have been teeny!

Well, I’m getting sleepy again.  I love to sleep.  I could do that all day too!  But before I go dream my secret dreams, I’ll give you some of the other information that those Other People seem to think is really important.

my full name: Arden Credence Martin-Weber – Arden is the name of a forest in England and the setting of a wonderful Shakespeare play they say is called As You Like It.  I’m going to read it later.  Arden means “ardent,” “passionate,” or “excited,” and I think I’m living up to that pretty well so far.  Credence means belief, faith, credibility.  Not sure where I stand on that one yet.

birth date: April 19, 2012 (I share a birthday with my godfather.  We were born 31 years and 30 minutes apart!)

birth weight: 8 lbs 10 oz – record breaking Martin-Weber baby! I may be the littlest but I’m the biggest too!  I rock.

birth length: 21 1/4 inches – not a record breaker, but still, I’m sure I’m long for my age.

I’m a girl – duh.  : )  And that’s just perfect for me.

I have a red birthmark on my forehead (wherever that is – I can’t see it), and it’ll probably fade with time, but it’s the same birthmark that my biggest sister, Ophélia, had, and also my wonderful uncle Preston.  It’ll probably fade with time, and pop up when I get angry, er, passionate about something, because that’s my name.  Arden.

Dear Nurse Julie- a letter to my labor and delivery nurse

Dear Nurse Julie,

You were in my life for about two and a half days 13 years ago, I’d never met you before nor have I seen you since.  It may have been brief but you made a huge difference in my life and I owe you a deep debt of gratitude.

I had prepared so much for the birth, read everything I could get my hands on including an OB text book, took a childbirth education class, and practiced Bradley method relaxation for weeks at home with The Piano Man.  We knew what we wanted for our birth and after a complicated pregnancy, we were prepared to fight for it.  When I went into labor at 41 weeks and 4 days we were ready.  The Piano Man was an amazing advocate for me, actively intercepting anyone that entered the room and questioning every procedure (no enema!) while helping me relax and focus on the work of birthing our daughter.  Together, he and I made a great labor and birthing team.  I’m pleased to say that 5 babies later and one on the way, we still do.

Our bags were packed, there was film in the camera (remember that?  Cameras that used film?), we were so ready to have a baby.  Except for one thing: we had done nothing to prepare for breastfeeding.  The thought hadn’t even occurred to us.  We knew that was how we were going to feed out baby once we had her in our arms but we read nothing, took no classes, and never even thought to see if there was anything we needed to know before breastfeeding.  Both of our mothers had breastfed, we knew a few friends that had so really, how hard could it be?

All our nurses were nice enough and the birth was mostly amazing with some traumatic experiences.  Earth Baby was born at 6.39am and we met you shortly after with the shift change.  Instantly I felt connected to you, your smile, your warmth, and your genuine congratulations on our baby as if you hadn’t seen hundreds of births and newborns every week.  After I was all stitched up, hydrated, and my blood loss dealt with you asked me an incredibly important question: “are you ready to breastfeed your baby?”

Nobody had mentioned it.  I knew it was in my chart because something I had read about birth plans suggested to ask for it to be put in my chart.  Still, you were the first to say anything about it.  Having just lost a lot of blood with a partially retained placenta and manual D&C, I was feeling weak and more tired than I had ever felt in my life.  Holding my baby, let alone breastfeeding her, completely wore me out.  Like a dear in headlights I told you yes, but only because I remembered that it was the plan.  Your response: “good, because she’s hungry and I think she’s ready to eat well for you” jarred me out of feeling my exhaustion and into the reality that my baby needed me to meet her needs.  I really was ready to feed my baby.

I don’t remember how long you stayed in my room but somehow, you made me feel like I was the only mom that needed your attention.  Perched on the side of my bed, you helped me get into a position I found comfortable, plumped plenty of pillows to support Earth Baby and I, encouraged me to drop the shoulder of the hospital gown, and talked me through latching Earth Baby for the first time.  Your encouragement for how well we were doing, what a healthy strong latch Earth Baby had, and suggestions for positions made me feel like not only could I breastfeed my baby, I already was and doing great!  You answered every one of my questions, no matter how basic or obvious the answer may have been, as though it was a pleasure to answer my important concerns with patience and care.  Even when Earth Baby was latched and I was comfortable, you stayed and chatted, telling me about your 2 boys, that you had breastfed your second one but not the first, and telling me about how you were drawn to OB nursing and how you loved helping moms.

It showed.

Once I was moved to the postpartum wing, you continued to visit me.  You’re ongoing support regarding everything I was experiencing from peeing for the first time after giving birth to changing my baby’s diaper to breastfeeding helped grow my confidence that I could, in fact, take this baby home and not kill either of us.  When I told you my nipples were hurting you showed me how to position my baby’s chin lower on my breast so she took a big mouthful of nipple.  When I was still drained from the birth, you explained different positions and helped me practice using them.  Constantly considerate, you never touched me without asking and receiving my permission first and even then you rarely handled my breast choosing instead to carefully and patiently explain how I could do it myself.  I can’t even begin to tell you how far that went in helping me not be afraid or feel strange about my own body.  From the bottom of my heart I thank you for that gift, it has remained with me to today, growing stronger over the years.

When the grumpy nurse, who’s name I can’t recall because for the last 13 years I’ve referred to her as “grumpy nurse,” told me I was starving my baby because my breasts were empty and not meeting my baby’s needs, I cried.  A lot.  Earth Baby had lost over a pound in just a matter of 2 days and the grumpy nursery nurse that made me cry told me I’d never be sent home with my baby if I didn’t agree to give her formula.  Oh the things I know now!  All those fluids we had in labor… but back then I had now idea.  I caved.  Still weak from the blood loss, recovering from a 4th degree tear, and afraid my baby was hurting I agreed to a bottle of formula.  My heart ached, I never meant to starve my baby and my fears were confirmed, I was already failing as a mother.  She whisked my baby away, a satisfied smile on her face as she told me I was making a good choice for the good of my baby, and ran off with my daughter to feed her the bottle of formula.  I sobbed.  You came in shortly after and was surprised Earth Baby wasn’t with me.  When I told you why I saw the storm clouds gather in your normally incredibly friendly eyes and you told me you’d be back.  What I didn’t know is that you must have marched out to that nurses station, called our pediatrician, asked him about the situation, advocated for our breastfeeding relationship, asked him to call the nursery, and headed down there to get my baby back for me.  When you walked in about 15 minutes later with grumpy nursery nurse and my daughter, I had already spoken with our pediatrician who called me to assure me our baby was going to be fine breastfeeding and at this point did not need any formula.  He told me that he had spoken with you and trusted you that Earth Baby and I were doing great breastfeeding, that my milk was coming in, and that I was already a pro.  I cried again.  Someone believed in me.

Somewhere I still have the picture of you and I and Earth Baby just before we were discharged.  My face is red from crying having just gotten Earth Baby back.  You had told me that we were going to be fine, that I was a natural, that Earth Baby was lucky to have me as her mom, and that you enjoyed working with me.  That’s what you told me.  Some many had dismissed me as a young mom and at 20 I was, but you stuck with me respectfully teaching me as though my age was of no consequence.  What you taught me without directly saying so was that I could feed my baby, my body was amazing, I didn’t need to be afraid of my breasts, and I could advocate for myself and my baby.  My husband believed in me but I knew he was just as clueless as I was.  But you?  You were not only an experienced mother, you were a nurse that saw mother after mother with new babies and you believed in me.  If you said I could do it, I probably really could.

Today, 13 years later, I owe a lot to you.  For starters, my breastfeeding relationship with Earth Baby which lasted a year and then extending on to 4 (now almost 5!) babies.  Thanks to you, today I now help support other mothers with their birthing and breastfeeding journeys.  Thank you for supporting me even when I wasn’t sure how to support myself.  Thank you for giving me the courage to be the kind of mother I naturally was but was insecure about stepping into.  Thank you for being kind and encouraging when I was most vulnerable.  Thank you for making a difference in my life and the lives of my children.  You have touched more than you know.  I want to be like you and just love helping moms.

I hope it shows.

 

Sincerely,

 

Jessica Martin-Weber

The Leaky Boob

 

Unsupportive Support- Cultural breastfeeding ignorance: toddlers and introducing solids

breastfeeding beyond a year

I bet at least half of those reading this are uncomfortable with that picture.

I get that society isn’t comfortable with breastfeeding in many ways, despite all the lip service given to “breast is best.”  So it’s not a big surprise that socially speaking most people don’t even have a basic idea of what’s normal or healthy with breastfeeding.  With this in mind much of what is unsupportive support comes from this place of ignorance and lack of exposure to normal, healthy breastfeeding.  It is my hope that time will change this problem because we have allowed our emphasis on the sexual nature of breasts to replace a general understanding of normal human biology.  However, waiting won’t change the unsupportive support spreading as a result of this collective ignorance of society so those unintentional acts must be addressed.  Continuing the series on unsupportive support, let’s take a look at a few of these common issues stemming from society’s lack of understanding of normal and healthy breastfeeding.

Does this one weird you out too?

 

How not to support and how to avoid being unintentionally unsupportive- part 6.

Unsupportive support is…

Ever asking “Isn’t he too old for that?” or “If they can ask for it they’re too old, it’s just gross.”

First thought that goes through my mind when I hear this: “Aren’t you too old to be so rude?”  Manners, people, try them.  This is not your child, this is not your choice.  Plus, the answer is no, the child isn’t too old.  Wherever you draw the imaginary cut off line for breastfeeding, it’s just that, imaginary.  What is it you’re really afraid of anyway?  That it somehow becomes sexual?  Remember, that fear is founded in an adult perception of breasts, not a child’s.  Are you concerned that the child will grow overly dependent on breastfeeding and need to breastfeed when they are in college?  Please, in cultures where it is common for children to wean on their own timeline, this is unheard of.  And even if it were to happen, wouldn’t that make it their problem, not yours?  Still, I’m not going to give this concern any more energy, I’ve never once met someone that had a college-age child breastfeeding.  You may be out of touch with what normal duration breastfeeding looks like, sometimes called “extended breastfeeding” but I have to ask, extended beyond what?  The minimum recommendations?  Extended beyond society’s distorted perception of normal breastfeeding?  Extended beyond your personal comfort level?  Extended beyond the imaginary cut off line for breastfeeding  The major health organizations in the world encourage mothers to breastfeed for at least 2 years and they recommend women continue as long as it is mutually agreeable.  Mutually.  Between the breastfeeding mother and the breastfeeding child.  Not you.  It’s up to them so butt out.  Babies start using the only communicating tools they know to start asking for it as soon as they are born, you can read here about normal newborn behavior.  A mother responding to her child’s signs of hunger = good parenting, not a bad habit.  It’s important that you recognize and get comfortable now with this thought: “My opinions aren’t always right for everyone and sometimes I should just keep them to myself.”

Sneaking food to a small child without asking their parents permission or arguing with them about their choice to wait to introduce foods.

It boggles my mind how often I read “I can’t trust my mother-in-law/uncle/brother/grandpa/etc. with my 3 month old, they insist on giving him tastes of food, even stuff like ice cream or dangerous choking hazards!”  People, it’s not your kid, not your turn to make these kind of decisions.  Grandparents, aunts, uncles, shoot, friends get to spoil a kid, it’s true.  When my kids are older I don’t care if my parents take them out for ice cream for breakfast when they get to have them on their own.  It’s their grandparent prerogative and I support it on occasion.  But that has to be something discussed and approved (even with disapproval) and the limits recognized and respected.  Giving a baby foods that their parents, you know, the people that are responsible for them, take them to the doctor, are reading the most up to date information on what babies need, and are up at night with them, haven’t approved is not only disrespectful but it’s dangerous.  Between ruining a virgin gut (google it), risking allergen exposure, and introducing textures they may not be physically developed enough to handle and thus pose a potential choking risk, there is absolutely no good reason EVER to sneak food to another parent’s child.  And arguing with them about their decision for the health and safety of their child, even if you think they are wrong or extreme, is not helping either the parent or the child.  If you’re truly concerned do your research before bringing it up.  In order to offer support that’s actually helpful, you need to be familiar with current information and research as well as possible controversy.  In the end you have to respect their decision or you will remain that person they can’t trust.  And yes, they can’t trust you which means they will never be comfortable leaving their child in your hands.  Coming to terms with “I am not the person(s) ultimately responsible for this child, I do not have the authority or position to make this decision and must respect the people that do.”  By the way, this goes for formula fed babies too.  Allergies, food sensitivities, immature digestive tracts, and choking hazards are real concerns for them as well.  This is their long term health you’re messing around with and you don’t have that right or responsibility.

 

Breastfeeding is the biologically normal way to feed a small infant and child.  Just because we’re not used to it as a society does not mean that there is something wrong with it.  Before critiquing the mother willing to go against societal norms to do what she truly believes is best for her child, please educate yourself as to why she would do that in the first place.  Or at least express your thoughts and concerns by asking respectfully why she has chosen a certain path over another.  When it comes to decisions regarding that child’s health step carefully.  There is controversy surrounding just about every health decision parents are faced with today, cut them some slack and just respect that they are thinking people that may be ok with discussing their decision but deserve to be respected in them even if you disagree.  Please don’t let cultural ignorance determine how you feel about something or how you respond to something.  Challenge yourself, is the problem really what that mother is doing or is the problem that as a society we just can’t imagine anything other than what we’ve grown accustomed to.  Push yourself outside of your comfort zone and offer real support, not ignorant social judgments.

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Have you received comments about your child being “too old” to breastfeed?  How did you respond?

Are there people around you that you can’t trust because they don’t respect your parenting choices?

Have you ever had someone feed or almost feed your child something you felt was dangerous?

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Help, my milk supply is low! Or is it?

By Tanya Lieberman, IBCLC

Ever wish your breasts had little ounce markings? If so, you’re not alone. One of the more confusing things about breastfeeding is determining how much milk you’re making. You can’t see how much is going into your baby, so how can you tell if your milk supply is enough for your baby?

On this page we share the best ways to determine if your milk supply is in fact low, and describe the many things that can make you think that your supply is low when it actually isn’t.

 

Below are some normal experiences that can trick you into believing that your supply is low:

“My baby wants to eat all the time.” It’s normal for babies to eat frequently, generally in the range of 8 to 12 times in 24 hours for many months. This means many hours of feeding a day, and it may feel constant at times. It’s also normal for babies to “cluster feed” at times during the day. If your baby is feeding significantly outside of the 8-12 times range, contact a lactation consultant or other breastfeeding support person.

“My breasts feel softer than they used to.” Toward the end of the first month of breastfeeding many women notice that their breasts have decreased from the size they were when their mature milk came in. This is normal, and does not indicate anything about milk supply.

“I don’t feel that ‘let down’ sensation.” Some women have a “let down” sensation when they make milk, and some don’t. It doesn’t seem to have any bearing on the amount of milk a mother makes, so don’t worry if you don’t feel anything.

“My baby suddenly wants to eat all the time.” Babies go through growth spurts. They do this in order to increase your milk supply to meet an increased need for calories. To do this, they go on a feeding rampage for a few days – eating more often than usual and sometimes acting unsatisfied and fussy after feedings. During a growth spurt it’s common to question your supply. After a growth spurt you’ll find that you have more milk than ever!

“I can’t pump very much.” Pumping output is usually not a good measure of milk supply. Why? Because your body doesn’t always make milk for the pump (it has to be tricked into believing that the pump is your baby!) and when it does the pump doesn’t remove milk as well as your baby does. So don’t gauge your milk supply based on your pumping output. You almost always have more than you pump.

“My baby is fussy when she nurses.” There are many causes of fussiness at the breast. And while hunger is one of them, your baby may be fussy because of gas, pooping, a flow that is too fast or too slow, or a host of other reasons. If you believe that your baby is fussy because he or she isn’t getting enough milk, or if the fussiness is causing you distress, consult a lactation consultant or other breastfeeding support person.

“My baby is suddenly waking up at night a lot.” Night waking can be due to hunger, but it can also be due to teething or “reverse cycling,” (when babies eat less during the day and more at night, often due to a change in routine like a return to work, or distracted behavior during the day).

 

Here’s how to tell if your milk supply is actually low:

1) Your baby’s weight. The best measure of whether your baby is getting enough milk is his or her weight gain.

If you are concerned about your milk supply, have your baby weighed and re-weighed using a baby scale. Scales will always be a little different, so be sure to compare only weights taken on the same scale. Except in critical situations, weight checks every few days or weekly is generally sufficient.

In the first three months of life babies gain an average of 1 ounce per day. That slows to at least approximately a half an ounce per day between 4 and 6 months. 

Occasionally your health care provider may suggest a “test weight,” in which your baby is weighed on a sensitive scale before and after a feeding (with the same clothes on) to determine how much milk the baby received at that feeding. This can give you a snapshot of a feeding, but be cautious in drawing conclusions from the data. The amount of milk babies take in at different feedings can vary widely, so bear this in mind if you do a test weight of your baby.

 

2) Diaper output. You can get a sense of how much your baby is taking in by what comes out. After the first few days, babies generally have at least three poops that are bigger than a quarter in size each day. This frequency may decline after several weeks. And your baby should have five very wet diapers per day. It can be difficult to measure output in very absorbent diapers, which is why your baby’s weight is considered the ‘bottom line.’

 

3) Swallowing. You may also take comfort in how much your baby is swallowing when nursing. This is not a definitive measure of your supply and should be confirmed with information about your baby’s growth, but a period of rapid swallowing (one swallow per one or two sucks) during a feeding shows you that your baby is getting milk. To check out your baby’s swallowing, listen for a ‘cah’ sound or a squeak or gulp, and look for a longer and slower movement of the jaw, often with a brief pause at the widest point. 

 

What to do if your milk supply is indeed low:

If your milk supply is low, be sure to get help from a lactation consultant (IBCLC) or other qualified breastfeeding support person. There are many steps you can take to build your milk supply, and these support people will be able to guide you through that process. You can find a lactation consultant by going to www.ilca.org.

 

Resources:

The Breastfeeding Mother’s Guide to Making More Milk. Diana West and Lisa Marasco, McGraw Hill, 2009.

La Leche League, International: www.llli.org

Kellymom: www.kellymom.com

Find a lactation consultant: www.ilca.org

 

Tanya Lieberman is a lactation consultant (IBCLC) who has helped nursing moms in hospital and pediatric settings.  She writes and produces podcasts for several breastfeeding websites, including MotherwearMotherlove Herbal Company, and the Best for Babes Foundation.  Tanya recently authored Spanish for Breastfeeding Support, a guide to help lactation consultants support Spanish-speaking moms.  Prior to becoming a lactation consultant she was senior education policy staff to the California legislature and Governor, and served as a UN civilian peacekeeper.  Tanya is passionate about supporting nursing moms, and especially to eliminating the barriers so many moms face in meeting their breastfeeding goals. She lives in Massachusetts with her husband, her 8 year old son and her 1 year old daughter.

This resource page was made possible by Motherlove Herbal Company.