Protecting BFing those first few days

[Sillygirl]

I talk up the benefits of BFing to every new mom in my extended circle of friends. I give out info, show off my chunkamuffin, etc. The one resource I haven't found yet addresses those critical first few days in the hospital. I know from personal experience how many ways the BFing relationship can be undermined - from taking the baby away during the first hour, placing pacifiers in the bassinet, downright bad advice from nurses and doctors regarding formula, "needing" to supplement for mild jaundice - the list goes on. So I'd like a list of common myths and bad practices that new moms might encounter, and the real BFing friendly answers.

Examples:
1) A pacifier won't hurt.
FALSE: Avoid pacifiers or artificial nipples the first six weeks
2) We need to weigh the baby and put drops in his eyes right away.
FALSE: The first hour is the best time to initiate BFing. Those things can almost always wait in a healthy newborn.
3) The baby is crying - he's hungry and your milk hasn't come in, so we need to give formula.
FALSE: Babies are meant to only get colostrum the first 48 or 72 hours. They do not need supplemental food or fluids during that time.

Others? Citations are always helpful. I am thinking I'd like my list to be as broadly applicable as possible, so I'm purposefully not addressing decisions about birthing options such as anesthesia. Just want to focus on protecting the BFing relationship once the baby is born.

[SnuggleBuggles]

I have a 8 day old nursing baby sleeping on my lap right now and can think of one that you did address but I want elaborate on.

-Nurse often. It will help your milk come in (supply and demand). Night 3 was extremely long for us because ds wanted to nurse just about every hour for about 4-6 hours. I knew my milk was coming in (starting to feel some fullness). Ds just kept nursing. In the middle of the night my milk arrived and all of a sudden the feedings spread out to about 2-2.5 hours. It can be really discouraging when you just keep nursing and nursing but it really does have a purpose.

2 others:
-Don't let baby sleep big stretches in those early days. I went to take a nap and 3 hours later baby was still asleep. It was hard to wake him up. This can be even worse if baby is jaundiced- vicious cycle of lethargy.

-Follow baby's lead, not the clock.

Beth

[Sillygirl]

So, when the LC and the nurse tell you "don't let the baby use you as a pacifier" what's the response? I personally always offered but if there was a lot of nun-nutritive sucking I would stop the nursing session after a little while. I haven't come across a good well-validated response to that particular chestnut.

[SnuggleBuggles]

These are just a few more of the myths and they are pretty common. They might be worth flushing out and adding to your list.

"Your nipples shouldn't be sore if you are doing it right."
~I think some soreness is normal just because of all the action they are getting.

Don't assume that your pediatrician knows about breastfeeding. Not all of them do. Nor are all truly supportive of it, especially long term. [I'm sure there are lists of key questions you can use to determine your ped's knowledge and level of support.] Same thing goes with the LCs at the hospital.

If you have small breasts or your breasts didn't grow (or leak) during pregnancy means that you won't be able to breastfeed.

Beth

[egoldber]

So, when the LC and the nurse tell you "don't let the baby use you as a pacifier" what's the response?

In the early days, constant stimulation of the breast is how the baby brings in your milk and establishes supply. It is important to nurse as often as possible the first several weeks and for as long as baby wants. Its actually the sucking that is done after the breast is emptied that stimulates your baby to produce more.

[mamicka]

"Your nipples shouldn't be sore if you are doing it right."
~I think some soreness is normal just because of all the action they are getting.

If you have small breasts or your breasts didn't grow (or leak) during pregnancy means that you won't be able to breastfeed.


Yes to both of those.

I've now successfully nursed 3 children & I can tell you without a doubt that even when the latch is perfect, IT HURTS. It passes after a few weeks.

My boobs grew ginormous... but my mother successfully nursed 4 children for 6+ months each & she never changed bra sizes. Started a C, stayed a C.

[annex]

I would also add a note about bad ways to determine how much breastmilk the baby is getting, #1 being - pump and see how much milk you get in the bottle!

[kimbe]

"Your nipples shouldn't be sore if you are doing it right."
~I think some soreness is normal just because of all the action they are getting.

I totally agree! With my kids it was awful when they first latched on for about a week and then it just went away. AND letdown was pretty uncomfortable for me for awhile too. I always worry that when people hear that it shouldn't hurt, they get super scared that they are doing it wrong when it does hurt. When you really think about what your nipples are going through, you should be surprised if it doesn't hurt a little.

I also agree with don't watch the clock. Let your baby tell you what he/she needs, but do watch the scale and outputs. If they are gaining and have enough poops and pees -- your're good! DD was such a quick nurser, if she nursed one side for five minutes that was a lot. We were so worried she wasn't getting enough -- she didn't drop below 90% in weight until after she was 1 year.

Also want to add:

Make sure that you are tummy to tummy with your baby
Make sure that the lower lip is out

[erosenst]

Examples:
1) A pacifier won't hurt.
FALSE: Avoid pacifiers or artificial nipples the first six weeks
2) We need to weigh the baby and put drops in his eyes right away.
FALSE: The first hour is the best time to initiate BFing. Those things can almost always wait in a healthy newborn.
3) The baby is crying - he's hungry and your milk hasn't come in, so we need to give formula.
FALSE: Babies are meant to only get colostrum the first 48 or 72 hours. They do not need supplemental food or fluids during that time.

Just to provide another point of view from someone VERY pro BF'ing. There are a lot of people who believe that babies who intuitively latch well will not get nipple confusion if offered a paci early. Abby had one from day one, and never had an issue. I wasn't able to "comfort nurse" her often - if I did, my nipples would get red and raw. (Not just at the beginning - even the few times she was sick when she was older.) So for me, using a paci actually enabled a better BF'ing relationship.

Similarly, Abby was somewhat small at birth (6 lbs 13 oz), lost more weight than they'd like (was down to 6 lbs 1 oz, so more than the 10% threshold) and was pretty jaundiced. They wanted me to supplement, and I resisted...til I finally listened long enough to hear that they were talking about an SNS. (Supplemental nursing system that allows the baby to nurse and get formula at the same time. Still stimulates the breast, etc.) I fought it for longer than I should have, and had I not finally understood what they were suggesting, may have not allowed it. I only did it for a day, but it allowed us to continue establishing good BF'ing while making sure her sucks were actually working (there was a little question after a couple of days) and getting needed fluids through her to help with the jaundice.

Just to be clear - the above points are in addition to what you've already said...

HTH -

Emily

[trales]

Examples:
1) A pacifier won't hurt.
FALSE: Avoid pacifiers or artificial nipples the first six weeks


I would say that this is not always true. We are at 8 months exclusively BF, but it was a long road to get here. She pushed my nipple forward in her mouth and we had use finger feed with an SNS system and pump and give a bottle with a long nipple to train her to latch. We did this from weeks 2 -6, slowly working our way to healed nipples and BF all the time. We reached that at 10 weeks, and have done well from there.

She has never had formula, but has had BM many, many different ways.

Every kid is different and the key is to make informed and not rash decisions. We had a lot of support and asked a million questions of many sources.

[Davids-Coco]

I agree that pacis have a possibility, but they don't necessary mean that your breastfeeding will be undermined. DS still breastfeeds at 15.5 months at least 5x a day. He always ate well and was exclusively bfed for 8 months.

Also, postponing certain things to get the baby to the breast can't always happen. If you have a c/s, there are certain procalls that the hospital has set. The baby does make it to you within the first hour of life... and eye drops and weight may delay 5-10 minutes, but shouldn't take an hour anyway.

The key to anything is to do what your child needs. If they are losing weight DRASTICALLY, they probably need supplementing. If they are rooting, feed them. If they need comfort, give it. But you have to do right given the circumstances.

[Sillygirl]

Of course there are no absolutes. I have just heard waaay too many stories of flat-out bad advice being given in the hospital. It happened to me and I was able to fight against it, but that was with my second child and I am very comfortable in a hospital setting. Not the case for everyone. It's a lot easier to advocate for yourself if you know in advance about things like SNS, and that lots of times jaundice can be treated without formula, and that babies don't need extra fluids or food if it takes two days for your milk to come in. So thsoe are the things I am trying to collect.

[o_mom]

I think you have hit some of the major ones.

Separation is just not necessary for a healthy baby at all, but especially for the first few hours. Even in the case of (a normal) c-section, any separation is just for the staff convenience. If they won't budge on separation, go with or send Dad along to make sure no bottles or other supplementation. I also notice that they are much quicker to return babies if someone is standing there pacing anxiously ;) Many times all it takes is asking for the peds to make rounds in your room, for example.

Skin-to-skin contact is a great way to encourage interest in eating. Skin-to-skin means just that: nothing but a diaper on the baby and nothing but a bra on you. Warm blankets can be placed over both of you if they are afraid the baby will be cold.

All the newborn procedures can be delayed until after first feeding - weighing, meds, bath, etc.

If the baby has low blood sugar, BF first and then recheck before supplementing.

Supplementing does not have to be by bottle.

Artificial nipples should be discouraged for the first weeks - yes, some people have not had problems after using them, but there is no way to know ahead of time if your baby is one of them. No reason to risk it.

That's all I can think of right now!

[CiderLogan]

Another vote here on emphasizing that BFing likely WILL hurt. I was in serious pain (using those breastshield things between feedings, bleeding, using Lansinoh all the time, wincing in the shower, actually dreading feedings because of the pain) for the entire first month of DD1's life. I seriously considered giving up because I was convinced something was wrong. I had to see a few different LCs, but in the end we had a fabulous BFing relationship, and I was sad when it ended at 13 months. BFing DD2 was much easier but still presented challenges - so, remind the new moms not to give up!!

[Lexy M]

Keeping your baby with you is very important to successful BFing. The hosp staff seems to come up w/ many reasons to separate you, like the weighing/eye ointment/bath routine. One way to keep your baby with you is to tell the staff you want to do your baby’s first bath yourself. If the hospital gives the bath they will then keep the baby for a few hours under the warmers. We did it this way when our DS was born approx 4 mos ago. We went to the nursery w/ him and waited outside while they weighed and measured and we got him right back (we also delayed the Hep B shot). We gave him a sponge bath a little later (after we all got a nap). It worked out great.