Nursing pillows- Are they really worth all the fluff?

Photo credit: https://www.flickr.com/photos/17939157@N00/

Nursing pillows. They get mentioned a LOT by seasoned mamas, are on all of the must-have-baby-gear lists, and they tend to get a lot of flack from lactation professionals. Through our practically countless hours working with mamas to establish breastfeeding, we have developed some thoughts on the ('Boppy' vs. 'My Brest Friend' vs. no pillows) controversy, and hopefully can explain what all the hype is about so that you can make the decision that is right for you.

The first question we ask when mamas bring out the nursing pillow during a consult is this: is this currently working for you? Really dig deep on this one (remembering our golden rule that sore nipples and difficulty latching are NOT a normal phase but are a sign that something is not working).

If you think about it, the very idea of a nursing pillow implies that it is THE solution to comfortably positioning baby at the breast. But we know that moms and babies have unique positioning needs based on their anatomy. Factors include the mama's arm length, breast size, breast position on the chest wall, position of the nipple on the breast, torso height, waist size, leg length, chair height and depth, and, of course, the size of the baby. Then consider whatever other issues need to be worked on for comfort, including oral anatomy issues, supply/letdown concerns, craniosacral/chiropractic needs, or incision pain in the case of a cesarean.

Photo credit: https://www.flickr.com/
photos/edenpictures/4135954586

One important positioning tip is that the back of baby's head needs to be free, and sometimes the pillow encourages a mama to put her hand on the back of baby's head. Sometimes the pillow itself is pushing on baby's head, impeding his ability to open wide enough to get a really good latch, which can lead to nipple pain.

For a great latch, we need baby's chest to be close to mama's body so that his chin comes to the breast first and his head tips back. Sometimes, with the nursing pillow (more so with the Boppy than with the My Brest Friend) there tends to be a small trapezoidal gap between the pillow and the mother's torso. If we are trying to keep the baby ON the pillow, then his belly and chest may not be pushed up close to his mom, even if he is otherwise in a good position.

Another important point is that the baby should come to the "natural position" of the mama's breast. So, if your breasts and nipples are up high, then your baby needs to be held there. If the baby is held too low on her mama's lap because of a nursing pillow (as we see with the lovely mama pictured to the right), she will probably have either nipple or shoulder and neck pain from the nipple being pulled out of the baby's mouth or from crouching down for her breast to reach. On the other hand, if the mama's nipple or breast lies lower, or if she has a shorter torso, the pillow can bring the baby up too high, like in the Boppy billboard below.

"WE'RE # 1" Really, Boppy??

Photo credit: https://www.flickr.com/photos/roniweb/

The fact that you probably won't be dragging your nursing pillow around town with you is another reason why we, and most of the other LCs we know, don't put all of our eggs in the Boppy/My Brest Friend basket. We don't want to see you unnecessarily held back by a feeding gadget. If you need to feed your baby, you need to be able to feed your baby. And if you are accustomed to using a pillow in order to get your baby to take the breast, we encourage practicing without the nursing pillow to help you to build confidence in your ability to breastfeed on the go.

Are there times when it works perfectly? Yep!
Some nursing mamas find that the pillow is just the right height for her to feel supported. Or perhaps she is nursing twins and simply needs a soft platform to support the babies' hips during tandem feeds.

Sometimes, it just feels comfortable.

Photo credit: https://www.flickr.com/photos/theminniemoo/

5 things to do (and not do) before a lactation consultation!

We've seen a lot of mamas wonder what to do about their breastfeeding issues, and be it pain, grumpy baby, latch difficulty, colic, weird poops, or supply concerns, the answer should be a resounding "get help as soon as possible!"
It can be easy to feel like breastfeeding is rough in the early weeks for everyone, or that it's not that bad, but we truly want more for you. Once a mama has decided that things can be bettered and she's made the call... well, what next? Here are our suggestions for what to do (and not do) before a lactation appointment. 

1) Take lots of notes before your appointment. A lactation professional is going to be best able to help you get to where you want to be if she knows where you are today. Jot down some information about baby's feeds, sleeps, weights, medical events, pumping sessions, and supplements. Knowing how many diapers you have changed in the 24 or 48 hours before your appointment is also helpful.

2) Don't clean your house! Seriously, we've seen it all. If you are scheduling a home visit for lactation, nine times out of ten you are in crisis mode and we want you to be spending those precious moments with your baby or recharging your own batteries.

3) Don't change your feeding routine. Not just yet! Wait until after we have a chance to discuss the situation as it stands before starting an elimination diet, new formula, or supplement etc.

4) "Should I hold off on feeding her before the appointment time?" is actually the number one question we get after an appointment is scheduled! DO feed your baby whenever she or he cues you before the appointment. There is no need to worry about the baby being "full" when we arrive. We like to do LONG appointments for several reasons, but one of those is being sure of catching a complete feeding cycle, sometimes two. So if you are expecting us in half an hour and baby is starting to squirm, nurse away!

5) Do schedule your appointment during a time that is the most challenging part of the day for you. For example, if your baby rejects the breast every morning, schedule a morning appointment. And if latch is hardest in the evenings, have us come at that time. We want to see how things are going at their worst so that we can properly assess.




So, what other tips would you add to this list?
As always, if you have any other questions, feel free to send them our way. 

What really worries us about informal milk sharing- and it's not what you'd think!

We have to start off by saying that we unequivocally recommend breast milk. As they say, "human milk for human babies"- it just makes sense. If a mama's own milk isn't available, donor milk from another mama is the very next best thing, and yes it's better than formula. The debate in the lactation consultant world tends to be over "informal" versus "formal" milk sharing. Formal being through an official milk bank (which blends, pasteurizes, and homogenizes... making breast milk prohibitively expensive and turning women's efforts into big business profits).

Informal milk sharing is everything else.

It's manually expressing colostrum for a friend's toddler who keeps getting sick in daycare. It's giving half of your frozen pumped stash to a mom who is going back to work and doesn't have milk saved. It's food for babies who can't tolerate artificial formula but never latched on to their mother's breast. It's cross-nursing and wet-nursing, and yes, both of those things really happen!


Informal milk sharing has some risks, and moms should be and are generally aware of them. An improper donor could pass along a disease, could have incorrectly stored the milk, or could be taking drugs. All of these reasons are why milk sharing communities widely discourage purchasing breast milk. Freely giving milk is a time consuming process, and is a labor of love. The World Health Organization recommends milk from a "healthy donor", yet some lactation consultants will universally discourage milk sharing unless the mothers are participating in the formal milk bank system because of those (admittedly rare) risks.

What really worries us about informal milk sharing is not any of those things. It's what may be happening behind all of that beautiful sharing for both the donor and the recipient. Are they getting the support that they need?

Mamas who have hundreds and thousands of bags of milk frozen may be pumping like crazy because they are suffering with an oversupply problem. They are at risk of mastitis and plugged ducts if they were to suddenly stop pumping, and may not know how to get out of this situation. Or they might not be feeding their milk to their own baby because he or she has symptoms of intestinal distress and their pediatrician or GI specialist has advised them to stop nursing and switch to a specialty formula. These women need support.

Mamas who are supplementing with donor milk may have a baby who never latched. Or they struggled with low milk supply. Or they are returning to work and don't have the appropriate tools and support in place to provide milk for their baby.

All of those things can be compounded by the continuation of the milk sharing cycle, because supplementing with breastmilk is still supplementing and still reduces supply. It can throw the whole system out of balance. The best thing women can do when they are milk sharing is to contact a lactation professional and talk over whatever concerns they might be having. And if the lactation professional gives them a lecture about the dangers of milk sharing instead of lending an ear and offering real support, we hope they have the courage to pick up the phone one more time and call someone else. 

The Fourth Trimester  is honored to be your advocate!

Call us for a free breastfeeding phone consultation-

 Gladis- 727-657-7370     Emily- 727-452-4809

Email- fourthtri@gmail.com

www.TheFourthTrimester.net

Photo courtesy of Aurimas!

Twins breastfeeding story!

 

Nursing twins can be a handful, but it is absolutely possible. If the babies won't latch- get help immediately. One twin-mom that we worked with posted this awesome love note on our Facebook wall: 

"I was ready to give up attempting to breastfeeding my twins. I had been pumping for 8 weeks and I couldn't handle it. Then I met the ladies at The Fourth Trimester and things started to change. They recognized oral anatomy issues right away. Once that was fixed they stayed in touch with me and came for a couple more visits as determined as I was to make sure my twins would latch. 

I can not thank them enough for their help." 

Seeing this mom's joy in her success makes it all worth it.



image courtesy of MultiplesParent!

What to do if you need professional lactation support but can't afford it

     

        Photo credit: https://www.flickr.com/photos/17939157@N00/  

If you are having difficulty breastfeeding, it's important to get help early to get things back on track as quickly as possible. Newborn babies nurse very often and follow instinctual feeding cues which establish the foundation for a solid breastfeeding dynamic. Not reaching out for help during the early postpartum period can have unintended consequences for the future of your breastfeeding relationship. But this doesn't just apply to the newborn period- sometimes problems crop up later on down the road as well. Delaying getting help when you have sore or cracked nipples can lead to infection on the nipple, or even mastitis.

We believe that all mamas and babies deserve the vital support that lactation professionals provide. Please do not let your financial situation stand in your way of reaching out for support. When a stumbling block is encountered and it seems like hiring an LC is financially impossible, consider these potential solutions!

• Ask your insurance company to cover the fee. That is their obligation under the Affordable Care Act. Lactation services are categorized under preventative health care and should be covered with no co pay or cost sharing. Because this legislation is still new, your mileage may vary.

• Use your HSA card!

• Or, pay first and seek reimbursement from your insurance provider after. We always provide a coded bill to our clients so that they can be reimbursed after a lactation visit.

• Consider a payment plan. This could be an arrangement with your LC herself to spread out the fee over time, or using Paypal to "Buy Now Pay Later". Rest assured that she has probably been asked before if she would take the fee for a lactation visit in installments and, while she may or may not offer that service, she won't think less of you for asking.

• Ask for it as a baby gift from friends and relatives. Someone wants to shower you with more baby stuff? Your coworkers want to go in on a "big gift" together? Ask for the funds you need to cover these valuable services.

• If possible, plan ahead and save a little money each month during your pregnancy that is ear-marked for getting breastfeeding off the ground. This might include lactation visits, breastfeeding supplies, or chiropractic care. You may never need to spend the money in your "lactation fund", but if you do need to, you'll know it's there. 

• Sell items you have been meaning to get rid of. I can personally think of at least 3 things in my home that we aren't using or loving but that have real value to someone else. Bonus to selling these items to pay for a lactation consultant is that you will free up valuable space in your home!

• Temporarily rearrange some categories in your budget. Can you give up 2 date nights or cut your grocery budget in half one week? Do you have both Hula and Netflix, and could you give up your subscription to one of them? 

• Borrow the money, or collect on money that a family member might owe to you! Did your sister's family say that they would pay half for a vacation rental you shared and you both said you'd get the money back "later"? Now is a great time.

• Offer a barter of services. Are you a web designer or math tutor? Does your partner have his own business doing landscaping, accounting, or catering? We truly believe that everyone has something to offer, and while the LC you are trying to schedule with might not be interested in a barter, it is worth it to ask! It is, at any rate, more respectful to all parties to offer to trade the equivalent value of your time and skills for her time and skills than to simply ask for her to waive or lower her prices.

• And finally, utilize the many free support options that are available to you. La Leche League groups, Baby Cafes, WIC peer counselors, and free hospital moms groups are great places to start. We tend to refer moms to in person support with a trained leader over internet support simply because breastfeeding advice given online without being able to actually observe the mother and baby can sometimes do more harm than good. But there are so many places moms can get breastfeeding support for free! Remember that volunteer breastfeeding helpers are passionate, but can only do so much because they have families and work of their own. However this option may buy you a bit of time while you figure out one of the other suggestions above.

Know when to ask for help: If it is sometimes difficult to latch your baby on or positioning feels awkward, if you are experiencing nipple, breast, or shoulder pain, if you aren't sure if you have enough milk, if baby is fussy, gassy, spits up frequently, you're considering an elimination diet, baby loses weight during the first few weeks, or isn't having yellow stools by the 4th day of life, we'd like you to know that things could be better!

The Fourth Trimester is honored to be your advocate. Call us for a free breastfeeding consultation. 

Gladis  - 727-657-7370     Emily - 727-452-4809

Email: fourthtri@gmail.com  www.TheFourthTrimester.net

How do I know if my pediatrician TRULY supports breastfeeding?

How do I know if my pediatrician TRULY supports breastfeeding?

Interviewing pediatricians? Start the dialogue

by asking what they know and believe about breastfeeding.

Does this pediatrician...

believe that breastfeeding is the biological norm and formula feeding and even pumping are lifestyle choices?

A doctor that truly supports breastfeeding will never minimize your feelings in an effort to help you feel "better". Saying that "it's not that bad" doesn't help to solve the actual problem. Your pediatrician should always listen and empathize if you share that breastfeeding is not going well.

support the World Health Organization's position on breastfeeding? Or does he/she promote early weaning?

"WHO recommends that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development, and health. Thereafter, infants should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up two years or more."

understand the WHO's definition of exclusive breastfeeding?

"Exclusive breastfeeding means that the infant receives only breast milk -not even water- with the exception of oral re-hydration solution, or drops/syrups of vitamins, minerals, or medicines."

only use the most current published WHO Infant Growth Charts for exclusively breastfed infants?

If the chart is based on breastfed babies and the baby's growth percentile has dropped, this is a red flag to take a closer look and see if breastfeeding can be improved.

understand what is normal for breastfeeding moms and babies?

This includes how much and how frequently breastfed babies typically eat (guess what- it's different from formula feeding babies!), what pumping is generally like, and what some signs of trouble are. For example, if a mom is struggling to pump enough, or if she is experiencing any breast pain or sore nipples.

seem willing to have a discussion about the importance of oral anatomy for pain-free, effective breastfeeding?

We frequently hear of pediatricians suggesting that lip tied or tongue tied babies are "fine" or that feeding "should be okay", yet mama and baby are struggling. Minimizing these issues as a medical fad is not productive or evidence-based.

consider feeding difficulties when making a diagnosis? And make referrals for lactation support?

Working with a lactation professional to rule out common breastfeeding issues that can sometimes masquerade as other problems (such as reflux, colic, constipation, or allergies) is an excellent first step before supplementing or beginning a medical treatment.

 Newborn babies nurse very often and follow instinctual feeding cues which are vital to getting breastfeeding off to the best possible start. Unnecessary disruptions to breastfeeding can have unintended consequences to the nursing relationship. Take care before starting your breastfed baby on supplements by first ruling out breastfeeding problems, but be especially wary of any health professional that suggests stopping breastfeeding without a discussion of the risks and benefits. 

When to Call For Help:

• It is sometimes difficult to latch your baby on or position feels awkward
• You are experiencing nipple, breast, or shoulder pain
• You aren't sure if you have enough milk
• Baby is fussy, gassy, spits up frequently, or you are considering an elimination diet
• Baby loses weight during the first few weeks, or isn't having yellow stools by day 4 of life. 

The Fourth Trimester  is honored to be your advocate!  Call us for a free breastfeeding phone consultation.

 Gladis- 727-657-7370     Emily- 727-452-4809

Email- fourthtri@gmail.com

www.TheFourthTrimester.net

 

 

  

Happy Earth Day!