Preparing To Breastfeed

This was originally written on Monday, March 24, 2008:
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*Those who are interested in this post may also be interested in reading my other breastfeeding posts, HERE.
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Hope everyone had a happy Easter!

I forgot to mention last week that I experienced the baby's hiccups that I'd heard and read about. It's now occured three times and it reinforced that L.J. is head down--because they're coming from that direction! None of them have lasted more than 2-3 minutes, but they all had the same pattern and feeling. Each time was like a light tapping inside of me--without any movement. Almost like what your heartbeat would feel like if you could feel it from the inside.

However, I'm also confident he is facing front because his feet or knees keep pressing outward from me. When a baby is born it should be facing towards the back (so as not to suffocate), but sometimes the doctor can turn them if they're not, so hopefully that won't become a concern for me.

Lately I've been craving shakes A LOT (ice cream is a common craving during the third trimester) and in less than two weeks of eating it every day (sometimes more than once), it is noticeable: I should have only gained a half a pound since last week. . .but instead gained two! I'm up 30 lbs. now, which means I officially weigh more than Joe. (He already lost the few pounds he had gained during my pregnancy.) So, no more shakes for me--I still have six weeks to go--i.e. only 3 more pounds!

I also had to try a Runza last week. Ever since I moved to Nebraska almost five years ago, I've been hearing about their trademark sandwich: the Runza, found at the fast food restaurant with the same name. I've always thought it looked good from commercials, as well as sounded good from the description. . .but I have to say I was disappointed. Can you say FALSE ADVERTISING? The sandwich didn't look anything like it did on TV (rather than on fluffy, fresh-looking bread, it was flat and looked burnt), it was put together rather sloppily and the flavor wasn't anything special. Also, the color was bland rather than seasony-looking. Oh well, at least I can say I've had one now.

Over the weekend my mom and stepdad visited for Easter. Fortunately, the recliner fit in their Blazer so it is now in our nursery, making the room officially complete (along with my great-grandmother's dresser)! :-) (My mom also gave us a rug)We went out to supper on Saturday night and then to church on Sunday, followed by lunch.

At church there were a couple of songs that L.J. really danced along to :-) My parents enjoyed the service, and although my mom would prefer to see me carry on Catholicism with L.J., she said she accepts that we're going to raise him in a non-denominational church because it's more important that I've found a church to keep up my relationship with God. At least L.J. will be raised in a Christian home.

My parents were able to feel L.J. kicking, so that was fun for them. We also washed L.J.'s clothes & blankets, so everything's definitely ready now :-)

So, now for today's topic: breastfeeding.

As you know, I took a breastfeeding class last month because I am planning to breastfeed. There really doesn't seem like any other option. From every book I've read, every doctor and lay person I've talked to, etc. there's no reason NOT to. According to my HypnoBirthing book:

"In recent years, research has confirmed that breast milk is truly a unique food that cannot be duplicated. Formula is not equal to breast milk. The evidence of this fact became so overwhelming that in 1997 the American Academy of Pediatrics adopted a policy statement recommending that children receive breast milk for twelve months. The World Health Organization recommendations on the priority of infant nutrition are in the following order:

1) mother's own milk directly from the breast
2) expressed mother's milk fed to infant another way
3) other human milk (from a milk bank)
4) infant formula"

I can understand that for some there are valid reasons for not being able to breastfeed, but it doesn't seem like there are any not to pump. I, personally, would feel I was not starting my child off on the best "health" foot if I chose to give formula instead. Therefore, it is important for me to not give up if the going gets tough.

"One of the outstanding benefits of human milk is that it is custom-made for each infant. Mothers with premature infants make milk that is specifically composed for their infant with extra antibodies and proteins. Breast milk contains not only carbohydrates, fats and proteins, but also has growth hormones and special substances that enhance visual and brain development, as well as antibodies to fight infection. Scientists are unable to put these valuable substances into formula. Studies have shown children who breastfeed have fewer instances of ear infections, diarrhea and upper respiratory infections. The advantages carry over into later periods in life. Adults who were breastfed have lower cholesterol and fewer occasions of heart disease. Studies have also shown that women who breastfeed have lower rates of breast cancer and cervical cancer. In addition to experiencing fewer common illnesses and diseases, breastfed children have higher IQ's."

As I mentioned in a previous blog, my hospital has special lactation consultants who will not only work with me while in the hospital after giving birth--but will come to the house afterwards if I'm having trouble. They don't want any of their patients to have an excuse for not being able to breasfeed. According to them, all problems are fixable. And, good thing, because it'll also save you money: if you bottle-feed formula to your infant for a year, cost is $1200-$2700. . .but your body provides your baby the perfect diet for absolutely free.

I took several notes during my breastfeeding class. Here are some tips I found helpful:

*Nurse within the first hour after their birth.

*If your baby is making smacking noises, trying to eat its fist, or sticking out its tongue--they are hungry.

*Make sure they use their tongue when feeding--that is the first key. (You can entice it out with your finger.)

*Vary between three breastfeeding positions and use both breasts.

*Hold the baby's head behind their ears.

*To know if your baby is getting enough, they should have one dirty & one wet diaper on their first day, two on their second, three on their third, etc. up to the sixth or seventh day--then it stays the same.

*Eat oats if you need to stimulate milk prodcution (oatmeal, oatmeal cookies, etc.), as well as garlic. Have 20 g of protein in the morning and drink Mother's Milk Tea (by Nature Sunshin).

*Follow same diet plan that you did while pregnant (do's and don'ts)--be careful and slow when introducing caffeine back in. If you plan to drink more than one alcohol beverage, you must pump in advance or you will be feeding your baby alcohol.

*Feedings usually take 15-25 minutes.

*Feedings will be every 2 hours during the first month.

*Wear breast pads to absorb leaks when not nursing. Throw them away when they're wet--use cream (recommended: PureLan 100 Nipple Lotion) after every feeding to avoid dry or sore nipples.

*Expose your baby to light during the day, keep rooms dark at night.

*For engorgement (happens by day four):
HENRIC--Heat (take a shower before nursing), Expression (do a breast exam), Nurse, Rest, Ice & Ibuprofen (helps with swelling), Cabbage (wear leaves up to eight hours).

*Keep a feeding diary after you leave the hospital--this will help when you go to the pediatrician, as well as if you need to discuss nursing problems with a lacation consultant.

*Medela is the best brand for pumps. The hospital will give me a harmony (manual) pump to have. This is usually good enough for mothers who are at home. Mothers who work outside the home often use electric pumps--always use on minimum setting and always clean after each use.

*For pumping, it is easiest to do while nursing the baby (dad can help).

*Breastmilk can be stored up to 5 days in the fridge and 6 mos in the freezer. Can store flat in zip-lock bags.

*Wait four weeks before introducing the bottle.
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In addition, breastfeeding burns 300-500 extra calories a day (best way to get rid of the fat deposits which stored in the hips & thighs during pregnancy) and is a special bonding experience. Just like with labor, it should be looked at with a positive view. It can help to prepare yourself for common breastfeeding problems:

1) Sore Nipples
Many women find that their nipples not only feel sore after every feeding, they are red and pointy instead of round and smooth -- all indications that your baby is not 'latched on' properly.

The "latch" as experts call it, is the way your baby connects to your breast. When done correctly, your baby will open his or her mouth very wide and take in a good deal of breast tissue. This means that your nipple ends up way in the back of your baby's mouth where the hard and soft palates meet.

If, however, your nipple is sitting in front of your baby's mouth, you're going to feel the pinch every time baby's tongue comes up -- and baby is not going to have an easy time feeding.

The solution is to insert your finger into the corner of your baby's mouth to break the latch as soon as you feel pain -- and then try latching on again. Ideally, your baby should take at least one inch of your areola into the mouth.

Experts say you can further ease pain by avoiding the use of soap on your breasts, which can be drying and irritating. Instead, wash with plain water. You might also want to let some milk air dry on your breast after feeding, which can help reduce some inflammation and soreness.

2) Infections or Painful Lumps
Even when your baby is latched on correctly, you may develop a sore or tender spot in your breast, or even a painful lump. Says lactation expert Carol Huotari, this commonly results from a plugged milk duct, or the beginning of an infection known as mastitis.

"Either problem can be easily remedied, and you don't have to stop breastfeeding in the meantime. It's perfectly safe to continue, even when an infection is present," says Huotari, manager of the Breastfeeding Information Center at La Leche League International in Schaumberg, Ill.

If the pain is from a blocked milk duct, experts at La Leche say you should apply moist or dry heat compresses to your breast for 10 minutes, three times a day. Also, massage your breast in a warm shower. As the duct unplugs, you may express some milk, which helps relieve pain. Continuing to feed on that breast is important because breastfeeding helps further open the milk ducts, says Huotari.

3) Yeast Infections or Thrush
Yeast infection is a less troubling but still uncomfortable condition on the surface of the breast skin. This problem can develop even after weeks or months of successful nursing. The culprit is thrush, a form of yeast infection that thrives on milk. This infection will likely affect both you and your baby.

Signs of thrush include red or pink shiny skin that usually itches, and may flake or peel, says pediatrician Audrey Naylor, MD. To learn if your baby is infected, look for white spots on the inside of the cheeks, or sometimes a persistent diaper rash.

If you do have a breast yeast infection, Naylor says you don't have to stop breastfeeding. But you and your baby do need treatment.

4) Engorged Breasts
Engorgement is normal and can develop when your milk begins to flood your breasts, usually between the second and sixth day after you start nursing your baby.

"Once milk starts to come into the ducts, there is also a flooding of lymph fluid and blood, which causes the tissue in the breast to swell."

Because that swollen tissue pushes down on the milk ducts, the ducts can sometimes clamp shut. When milk can't be expressed, it builds up inside the breast and engorgement occurs.

Your best solution is to place cold packs on the breast for about 20 minutes.

"Right before you are ready to nurse, put a warm pack on your nipples for a few minutes -- this will also help with the 'let down' [milk flow] and can encourage feeding."

"Most important is to keep on nursing," Huotari tells WebMD. "The more milk that is expressed, the less chance you have of engorgement."

The following organizations can help you find a lactation counselor in your area:

Le Leche League International. The oldest name in the breastfeeding arena, this worldwide organization has counselors and group leaders nationally and internationally. To access its huge database of experts, visit the web site: www.laleche.org. Or call (800) LALECHE.You can also try your local telephone directory under La Leche League, where you might find a local chapter.

International Lactation Consultant Association. This group helps train lactation consultants worldwide and provides many of the guidelines and training materials used to teach breastfeeding counselors. Visit its web site, www.ILCA.org, to access a national database of experts. You can also email info@ilca.org or call (919) 861-5577.