Category: Nursing Support

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.

hollymilkowski February 27, 2019

48398179_3489939537732_7215284507383955456_n copy

Do you hate breastfeeding your toddler?

I actually don’t. Hate breastfeeding, that is. Maybe you can tell from the near-thousand breastfeeding photos I’ve shared on Instagram or the tens-of-thousands of words I’ve pressed into my keyboard about it here. But have I been enamored with every second? Certainly not. My love for breastfeeding is, in my own experience, a synchronized dance that swings along with the lyrical back-and-forth love I have for parenthood.

By now, the days of early nursing awkwardness seem so ancient, I might require a paleontologist to dig up those bones. I’m stuck like a thumb in a door jamb in a progressed era of breastfeeding, one that’s rarely talked about. I’m doing the nursing aversion thing… again. Read More

Help For Sore, Bleeding, or Cracked Nipples

hollymilkowski November 12, 2018

At some point in your breastfeeding journey, you will probably have sore nipples. Your nipples can feel sore from virtually any reason under the sun: postpartum hormonal changes, early engorgement, shallow latch, dryness, medical conditions such as thrush and vasospasm, suction trauma, a biting baby, allergic reaction to a lotion or fragrance, even sunburn if you’ve been spending your summer beach days European-style. Sore nipples is also one of the first signs of pregnancy for many women.

“The best treatment for sore nipples is prevention.” Probably not what you wanted to hear, but it’s true, says Dr. Jack Newman. The most important part of treating sore nipples is to target the cause of the pain and effectively treating that. Read More

Breastfeeding With a History of Sexual Abuse: Women Speak

hollymilkowski October 4, 2018

A few things you might not know, starting with the numbers:

A reported 27% of childbearing-aged women were sexually abused in childhood, and an estimated 40% including adolescent/teen years. According to LLLI, 90% of abusers are male, 70-90% are known to their victims; and for girls, 30-50% of abusers are family members.

These are just numbers. Numbers don’t speak, but many of the individuals behind the statistics are doing just that. Sexual abuse causes lasting trauma that cannot be isolated by a number; it follows the victim throughout life, and if this person is a woman on a path to motherhood it has many specific, new chances for recall of its memory. Pregnancy, birth, and breastfeeding bring enhanced susceptibility to a woman’s life, leaving her in jeopardy of rewounding.

Karen Wood, PhD, who notes that 1 in 3 to 1 in 5 Canadian girls are sexually abused in childhood, observed in her paper “Infant feeding experiences of women who were sexually abused in childhood”:

“A history of [childhood sexual abuse] can affect a woman’s experience of breastfeeding, including acting as a trigger for remembering or re[-]experiencing the abuse. Women who were sexually abused as children need to experience a sense of safety, acceptance, sensitivity, and understanding.”

You might assume that women who were sexually abused would be more hesitant to attempt breastfeeding than other mothers, but in fact the opposite has been found to be true. In a nationally representative sample study, women who self-reported past sexual abuse were more than twice as likely to initiate breastfeeding. They also were found to breastfeed at the same rate as those without a history of past abuse.

However, women who were or are currently sexually abused are at greater risk for postpartum depression, disturbed sleep, and perinatal complications. Interestingly, exclusive breastfeeding has been shown in a study to reduce rates of depression and poor sleep among survivors, as compared with formula feedings and mixed feedings (read about the study’s background and a podcast interview with the author here).

Still, night feedings are often especially frightening for survivors of abuse. They may have an especially difficult time managing views of breasts as both sources of nourishment and sexual objects. They may also have significant anxiety around the exposure and vulnerability brought on by public nursing. Read More

Encouragement For Full-Term & Tandem Breastfeeders

hollymilkowski April 17, 2018

🌻 These two milk siblings, blood brothers, M and J. Just over 5 years and almost 2 years old, respectively — the former the same age as my nursing journey overall and the latter the same as my experience in tandem nursing. Such tiny numbers really. Hard to imagine we were nothing and growing and birthing and birthed and empty and nourished more than once over in that amount of time.

M and J don’t like to be separated. Though they annoy each other and feel overwhelmed with the art of sharing from time to time, as siblings do, they prefer each other’s close company. J learns a lot from his big brother (like how to get dressed and sing) and M never hesitates to include J in his activities.

Their bond began when J was in my womb, every day growing stronger until one day he’d feel ready for life Earthside. From age 2.5 to 3.5 years, M watched my belly swell bigger and bigger. He knew his little brother was inside ‘swimming in water.’ He knew J could hear him so he spoke to him often. He said “Good morning!,” and “Good night!” every day for months, with a morning kiss and night kiss (and lots of extras in between).

He saw J for the first time around midnight, about an hour after he was born. I was laying in our bed with J on my breast. M gave J a kiss — a real, live, salty, good morning and good night kiss — right on his freshly born little head.

M had the honor of separating his little brother’s cord. We chose a Sacred Severance ceremony involving quiet, meditation, and burning of the cord instead of cutting. M, his dad, and our doula held candles to the cord in gentle recognition of this significant alteration. M was not present for the birth so this was his special contribution to our welcoming of J into the land of lung breathers.

J has known M his whole life. Though M was Earthside 3.5 years longer, it seems he’s known J just as long. 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

Four Years Later, I Still Get Nervous Breastfeeding in Public

hollymilkowski September 17, 2017

“Bless you, ma’am.”

“What?”

“Bless you,” he repeated, with a nod toward my nursing baby. “Traveling with your family…”

Then a young woman on the train offered me her seat as I nursed baby Julep again. I smiled and declined with a thank you. She mouthed a silent “Okay,” hands clutching to her heart and a whispered “Aww, it’s just so cute!”

Later a United airline employee noticed Julep in the carrier busy with something. She peeked down at his face obscured by a chubby hand.

“I see you’ve got those fingers in your mouth, huh?” she cooed. “Oh!” She laughed as he moved his hand, revealing a tiny mouth latched to me and leaking breast milk. “I see you’ve got something even better.”

Mostly praise and endearing smiles in reflection of Julep nursing in public…

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?).

It Just Needs To Be Said About Full-Term Breastfeeding…

hollymilkowski September 10, 2017

I have two children, an almost 5 year old and an almost 17 month old, who both nurse. They both began nursing just moments after each was born and here we are, still nursing along. I often find myself in the position of explaining this decision (or fate, rather).

Why is an explanation needed and sometimes even demanded from those who choose to do (or simply end up doing) tandem- and full-term breastfeeding?

Now breastfeeding may be less frequent, quicker, less nutritionally vital, more physically active than it was in the newborn days when they had tiny gummy mouths and floppy bodies. Otherwise, it really isn’t much different. They’re the same people they were 17 months and 5 years ago. Still asking to nurse. And one day they won’t.

Continuing to nurse as age advances is no clue that nursing will go on forever, like an evergreen tree of connection to mother. One day, the child will feel differently about this connection and realize the shoe no longer fits. What is the rush or worry until then?

From the looks of many comments on August’s World Breastfeeding Month social media/news threads, it seems there are two kinds of people who weigh in whenever full-term and tandem nursing come up: those who truly fully support breastfeeding and those who don’t (though many kick off their commentary with “I support breastfeeding, but…”). Do the rest just keep quiet to maintain neutrality? I don’t know.

I don’t have the time or concern to respond to or even read every comment/message that aims to preserve the controversy, but I feel it’s necessary to address a few inspired by two videos I recently shared.

Mostly because there aren’t too many tandem nursing, full-term weaning videos and I hope to bust (see what I did there?) some of the myths for other mothers. Also because breastfeeding mothers hear/read these same comments all. the. time. I hope my explanations (not to be mistaken for defenses) will satisfy the wannabe mic-droppers and the apparently ever-curious.

(Links to videos at end of post)

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

Is Nursing in a Beautiful Field at Sunset a Natural, Realistic Depiction of Breastfeeding?

hollymilkowski August 14, 2017

I’ll cut to the chase right now: the answer is both yes and (sometimes) no.

It’s been said that breastfeeding is an art. The art of photography highlights the importance of this honest statement about breastfeeding.

Here we begin to view it as the beautiful, innocent, inherently harmonious and peace-giving activity it is (if we don’t do so already). And we notice it’s more than an activity, really. It’s a relationship.

In this way breastfeeding photos (and other art forms) reflect the many nuances involved in the relationship between a mother and her nursling. One that can’t be negated even when a mermaid costume, computer-generated rainbow, endless fields of lavender, or fog machines help set a more surrealistic scene (I know you’re curious, so just go ahead and Google those already!).

The subject matter is the same regardless of the brand of camera that captured it, or whether natural or artificial lighting was used. What we’re looking at is simply breastfeeding.

Breastfeeding photos are always candid and improvised even if attempts are made to pose. If you watch a breastfeeding photo shoot happen firsthand, you’ll understand the only one directing the scene is the nursling! Read More

For the Breastfeeding ‘Butters’

hollymilkowski May 13, 2017

If you’ve ever said “I support breastfeeding, but [insert almost any phrase],” I must break it to you:

You don’t truly support breastfeeding if you need to put a condition upon it. (This goes for the reluctant “supporters” and passionate advocates alike).

Examples: Read More

22 Tips For Breastfeeding In Public With Confidence

hollymilkowski April 19, 2017

Self-conscious much?

A recent Centers for Disease Control public opinion study found “only 43 percent of U.S. adults believed that women should have the right to breastfeed in public places.” Theoretically, every time I go out with my baby, I can count every two people we pass and justifiably assume the next three people do not approve of my child breastfeeding there.

With this in mind, in my early public nursing days I felt too embarrassed to be seen struggling to breastfeed my little baby, especially with postpartum depression at a high, an anxiety disorder, and being the first among all my friends to become a mother.

I wanted so badly to live in a part of the world that was acclimated to the sight of normal infant feeding.

The sprawling, diverse metropolitan area where I live isn’t even a major hotspot for public breastfeeding oppression. That’s the frightening part. A quick Google search will guide you through countless stories of mothers across the nation being harassed, shamed, bullied, and discriminated against by strangers, coworkers, relatives, acquaintances, anyone with an opinion… because they breastfed their children in public.

With my first baby I started out nursing in my car. At the time, to me it felt pretty ‘public.’ I quickly realized this could only be a temporary solution to calm my nerves. Not only was it terribly inconvenient to retreat to my car for privacy multiple times per excursion, but it was also completely unnecessary. (And far from foolproof! Do you know where we were the first time I was harassed for nursing? Sitting in the front seat of my parked car minding our own business).

Out of the car and into actual buildings I emerged. I only felt at ease enough in low-crowd places and often found the corner of rooms to nurse so I could have privacy. Then I felt like a professional NIPer after working my way up to nursing on-the-go while babywearing.

Things became easier when I expanded my potential nursing spots to, well, anywhere we happened to be. I wore covers at first (I ditched them for good after that car harassment incident, and life got less complicated when I put those annoying things in storage).

It didn’t take long before I wasn’t giving a second thought to when and where I’d nurse my child because it was not an isolated event — it was just part of the flow of life, which doesn’t stop when you become a mother.

Four and a half years later, through babyhood, toddlerhood, another pregnancy, and tandeming, I don’t think a week has gone by that I haven’t nursed in public, and it’s been nearly that long that I’ve done so confidently.

Twenty helpful tips I learned along the way, in no particular order: