Category: Newborn Nursing

Breastfeeding While Separated From Baby

hollymilkowski April 4, 2020

“In the early years the baby has an intense need to be with his mother, which is as basic as his need for food.” – La Leche League International

Babies are separated from their birth parents at varying degrees for many reasons, including maternal or infant contagious disease, traumatic birth, surgical birth, adoption or surrogacy, NICU stay, travel, return to work, quarantine, imprisonment, detainment, natural disaster, maternal medical emergency, and more.

I’ll expand upon a few of these here, but in general I hope the resources and tips can be adapted as needed. I intend to update this article with attention to other reasons for separation and their respective resources.

For the purpose of this post, I’m focusing on the effects of separation in infancy specifically on breastfeeding / feeding. Read More

Breastfeeding After a Cesarean

hollymilkowski April 1, 2020

Many studies have noticed the comparative difficulties in breastfeeding between those who experienced surgical and natural births.

One study found that “women who had a cesarean section experienced a significant delay in initiating breastfeeding compared with women giving birth vaginally, with or without instrumental assistance.”

Another paper concluded that “the inability of women who have undergone a cesarean section to breastfeed comfortably in the delivery room and in the immediate postpartum period seems to be the most likely explanation” for decreased rates of exclusive breastfeeding among surgical births.

The key to a sustained future with breastfeeding might be getting through the recovery period, which is usually more grueling and physically limiting for those who have undergone major surgery. That said, those wishing to breastfeed can feel encouraged that an emergency or elective surgical delivery mustn’t necessarily and negatively interfere with their plans.

In fact, Dr. William Sears believes a cesarean section should not dramatically impact breastfeeding, and those who birthed surgically can be as successful as vaginal birthers “as long as their commitment to breastfeeding remains high” (see these other Dr. Sears tips). In other words, breastfeeding people need to be thoroughly informed about what they can expect. Read More

Tips For Breastfeeding Under Quarantine

hollymilkowski March 23, 2020

1. Ease your mind with knowledge.

Thus far, COVID-19 has not been detected in breast milk of infected mothers, though data is still limited. Infectious spread is mainly caused by person-to-person contact through respiratory droplets.

The CDC advises that those confirmed or suspected of having a COVID-19 infection and are planning to breastfeed or are currently breastfeeding should CONTINUE to do so. There are very few medical conditions in which breastfeeding is currently considered contraindicated.

Frequent hand-washing, limiting visitor interaction, and adhering to proper pumping hygiene can decrease risks of acquiring or spreading the virus. CDC recommends infected mothers wear a face mask while breastfeeding, if possible.

In an immediate postpartum setting, follow the infection control guidelines found at CDC.gov.

For archives of updated information regarding C-19 and breastfeeding, see KellyMom.

Responsive Breastfeeding: Watch Your Baby, Not The Clock

hollymilkowski January 5, 2020

Once upon a time, scheduled feeding was the norm for infants. You may have heard of breastfeeding “on-cue” or “on demand,” also known as “responsive breastfeeding.” So what’s the difference? Why is this difference important and why does it matter?

First, absorb this couldn’t-be-truer quote by Dr. Nils Bergman: “Breastfeeding’s worst enemy is separation.” Read More

Breastfeeding a Premature Baby

hollymilkowski February 22, 2019

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Breastfeeding a premature baby is a tough job of importance that cannot be minimized. Should your feeding relationship include your own breast milk, donor milk, formula, or a combination, the whole journey will be a meaningful and deeply nourishing one for you and your baby.

This aspect of raising your baby may not have gone exactly as planned or imagined, but remember that unexpected adjustments are a normal part of the feeding routine. Feelings of sadness, disappointment, or fear are valid and worth discussing with supportive loved ones who can be motivated to help you breastfeed despite facing obstacles related to prematurity. Read More

Co-sleeping & Breastfeeding

hollymilkowski February 20, 2019

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Ah, sleep. Between the topics of how parents feed their child and how they medicate their child, somewhere we find the ultra-controversial topic of — dun dun dun (wish I could say zz, zzz, zzzz…) — infant sleep.

Your heart says to keep your baby close at all times, but your head hesitates with concerns about safety. Some authorities are convinced that co-sleeping contributes to infant deaths, while others insist it’s crucial for emotional security and exclusive breastfeeding. Somehow, “co-sleeping” has become a dirty word in our culture.

What to do? A good way to tell which sleeping arrangement is best is to evaluate your own sleeping habits. It’s difficult to make a blanket (see what I did there?) statement recommendation for all families given the range of variance in nighttime behaviors. Take all information into consideration to decide whether co-sleeping is worth the benefits to you and your child.

Keep in mind: many parents who didn’t originally plan to cosleep end up doing so anyway (the process of repeatedly getting up to tend to baby, then voyaging back to bed and trying to slip into slumber again, starts to feel like an unnecessary task when a nearby baby proves far more practical). Alas, it’s prudent to get acquainted with how cosleeping works regardless of your nighttime intentions. Read More

For When You’ve Sprung a Breast Milk Leak

hollymilkowski September 28, 2018

Leaky boobs are more of an imposition upon convenience rather than a condition needing a “cure.” If your faucets just don’t seem to turn off, know that although your shirts will get damp, it shouldn’t put a damper on your breastfeeding success. Read More

Jaundice & the Breastfed Baby

hollymilkowski June 10, 2018

Newborn jaundice is normal in most cases, appearing within 2-3 days post-birth, and affecting up to 60% of full-term babies.

Physiologic jaundice is caused by a buildup of bilirubin, which is produced when red blood cells are broken down. The liver is responsible for eliminating the bilirubin, but a newborn’s liver is often too immature to efficiently handle this process yet. This causes a yellow cast on the skin (which can be trickier to detect in dark-skinned babies) and the eyeballs. This resolves itself in a week or two as the baby matures further and red blood cell levels have lowered.

In a breastfed baby, jaundice is more common and tends to persist longer than a formula-fed baby (as breastfed babies are the standard, this means it’s the norm). True breastmilk jaundice, which only affects 0.5% to 2.4% of newborns, sticks around longer than one or two weeks, sometimes up to twelve (now, this shouldn’t be confused with breastfeeding jaundice, which is caused by starvation/lack of proper milk intake). Bilirubin levels might even increase at the two-week mark. None of this is a cause for concern in an otherwise healthy baby.

On how breastmilk and formula compare in causality of newborn jaundice, Dr. Sears says:

“The difference is thought to be due to an as-yet unidentified factor in breastmilk that promotes increased intestinal absorption of bilirubin, so that it goes back into the bloodstream rather than moving on to the liver. Higher rates of jaundice in breastfed infants may also be related to lower milk intakes in the first days after birth, because of infrequent or inefficient feeding.”

Hence, why medical treatments should be avoided unless truly necessary because they threaten to interrupt breastfeeding further. As breastmilk helps move the baby’s bowels to remove excess bilirubin, frequent feedings will hasten the normal bodily process.

If bilirubin levels have reached more than 20 milligrams, a health provider might recommend treatment with phototherapy (ask about fiber optic blankets, an especially good option for nursing moms).

What not to do: do not supplement with sugar water, and do not restrict the baby from breastfeeding.

Links:

“Breastfeeding and Jaundice” – Jack Newman, MD, FRCPC, International Breastfeeding Centre

“Babies with Jaundice” – Dr. Sears

“Guidelines for Management of Jaundice in the Breastfeeding Infant Equal to or Greater Than 35 Weeks’ Gestation” – The Academy of Breastfeeding Medicine Protocol Committee

Vegan While Breastfeeding

hollymilkowski May 22, 2018

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Photo credit: Bloom Photography & Design

Is your little bean sprout kind of literally a bean sprout, thanks to your meat-free milk? Many women remove animal products from their diets in hopes of improved health, and thankfully it has been shown that animal-friendly lifestyles are not only perfectly safe but also as beneficial to a breastfed baby as his mother.

I read about maternal vegan diets while breastfeeding and had no concerns that my milk would still be perfectly healthy (in fact, likely more so). When my baby was exclusively consuming vegan breast milk, he was in the 94th percentile for weight, delightfully roll-y, meeting all milestones, and clearly not starved for nutrients. Read More

7 Tips For Nursing With Large Breasts

hollymilkowski February 14, 2018

Women with large breasts (and those who are also heavier all around) may face special challenges when it comes to breastfeeding.

Plus-sized women are less likely to breastfeed than normal-weight mothers, a study found. This may begin soon after birth as plus-sized mothers’ milk is often delayed to come in, causing these mothers to abandon it. Even if a mother is not curvy all around but simply has very large (DD-cup or bigger) breasts, she may struggle with unique problems that are typically not discussed in breastfeeding classes.

Unless you believe you might have gigantomastia (read about it in the links below), here are a few tips that can help.*

*Please note, I’m not plus-sized or large breasted. These tips were compiled from other sources that attest to their reliability, not from my own personal experience.

If You’re Haunted By Recurrent Mastitis: Help & Tips

hollymilkowski October 28, 2017

It comes on suddenly and leaves without a trace. I always forget how bad mastitis is until I get it again, then I’m surprised I’ve lasted this long with breastfeeding because I’ve felt hounded by those ‘quitting feelings’ during many a run with this illness.

I just recovered from my 8th (in 5 years) and hopefully final battle with mastitis; my second bout of the “boob flu” in two weeks.

Thankfully I’ve learned something new with each run of the boob flu madness… Read More

No More Babies: How I Really Feel (Last Child Grief)

hollymilkowski September 25, 2017

Thoughts at 4 Months Postpartum

I only have two children, and two will be my only. We always planned to have two kids for the usual reasons: financial resources, practicality, health reasons, familiarity, and so on.

This pregnancy and postpartum were much different than the first. I suspect it has much to do with knowing they’ll be my last.

I feel the postpartum slipping away. My youngest is now four months old, which means a little more than a trimester ago he was playing, breathing, wriggling, and listening in my womb.

For these past months I’ve watched my body turn into something blooming and abundant to swollen and rumpling to deflated and limp, stressed from constant demands upon it and weak from the the endless drill of late nights and early mornings. I’ve felt unmotivated to move into a new chapter, for I know once that happens, I won’t get to call myself ‘newly postpartum.’ In my case, not ever again.

This is now the body I’m left with. Rather, this is the body I get to keep. I’ve got more skin than I had before, a herniated navel, and my hair seems to be grieving with me as it sheds like a willow in the fall.

I think I’ll say I’m no longer ‘postpartum’ when my linea nigra disappears. The first time it took a year. I think that’s when I’ll stop telling people “I just had a baby…”

Right now my body is a signpost of declarations that say this shop is closed, be back soon. I know better because my intentions are steps ahead; I know the shop is closed indefinitely. Read More

When You Feel Awkward Seeing Breastfeeding in Public

hollymilkowski September 16, 2017

For one reason or another, some people feel awkward when they see a woman breastfeeding her child in public. This does not necessarily make them bad people. Their feelings can be perfectly valid; it takes a unique set of nature and nurture to arrive at the point of feeling awkward with a specific trigger such as this.

For those who aren’t accustomed to seeing breastfeeding in public and are largely uninformed about how it all works, a little patience may be needed as they adjust. After all, few of us have been spared from American culture’s mixed messages about women’s roles and heavy promotion of both infant formula and breasts as sex objects.

That said, misunderstanding and ignorance are acceptable; projection of fears and lashing out with harassing or discriminatory behavior are not.

Here are a few ideas about what to do and not do if you’re not yet comfortable seeing breastfeeding in public (but you’re working on it, right?).

Breastfeeding Concerns During a Natural Disaster: Babies Still Need To Eat

hollymilkowski August 30, 2017

Via Associated Press

As I write this*, I’m taking note of the tornado warnings that have made my phone beep seemingly every hour for the past few days. The sound of rain pelting the windows. Bayous and reservoirs cresting over. I’m watching friends’ and neighbors’ homes flood in real time. Reading about pleas for rescue as families seek refuge from rising water in their attics and on their roofs. You could say things are out of control.

Amid all of this, babies still need to eat. Newborn babies who took their first breath at a Houston area birth center after tropical storm Harvey made landfall. Older babies who nurse around the clock or drink expressed or powdered milk or formula supplements.

The stores are closed and roads are crumbling or underwater. Formula is now largely inaccessible. But babies still need to eat.

Pumping moms need to continue pumping to avoid mastitis, supply issues, and maintain production. What about when the power goes out? Or when the house floods and the circuit board must be shut off? Hopefully they have a manual pump or have been taught how to hand express… because babies still need to eat.

New mothers, welcomed into motherhood with all the terrific drama Mother Nature herself could muster: I hope you have a (relatively) easy time getting started. The well-trained eye of a lactation consultant in your home, personally assessing latch and other tricky spots, cannot compare to scouring the internet for emergency breastfeeding help in the early days. But no one is risking travel across town for ‘work’ in a deluge. A lucky mother has her phone fully charged and ready to go with breastfeeding apps right now because, of course, babies still need to eat.

*(Flood waters have since receded from my neighborhood and we’re doing fine now. However, eleven million people in the southeast counties of Texas are still trying to get a grip on the continued consequences of this historic flooding). Read More

For The Breastfeeding Mom With Body Mods

hollymilkowski January 30, 2017

Last year at a La Leche League Conference, a woman held a seminar called “Babies, Breasts, and Body Mods: Where Body Art and Breastfeeding Collide.” Robyn Roche-Paull, BSN, RNC, MNN, IBCLC, LLLL, USN veteran (say all that ten times fast!) was herself clearly no stranger to permanent and semi-permanent body decor.

The room was packed with Leaders, lactation specialists, medical workers, and breastfeeding advocates who all wanted to know: What’s a mama need to know about body art and possible impact upon her boobie monsters?

Roche-Paull’s lecture got me thinking… especially since I’ve had my eye on the prize of a new tattoo since before my last pregnancy, and waiting until weaning years from now sounds a tiny, wee bit torturous.

These days, there’s not such a strong stigma or taboo attached to mothers who have body modifications, but many women find themselves wondering what’s the best protocol for fresh body mods during the lactation period. When they consult their care providers, many really haven’t the faintest clue how to answer.

What exactly are body modifications? Popular types include branding (3rd degree burns to create scars), piercing, scarification (cutting), and tattooing. Here we’ll focus on the most prevalent: piercings and tattoos.

Now a little crash course for you curious body art geeks…