It’s World Breastfeeding Week! To celebrate, we invited Johanna Sargeant, International Board Certified Lactation Consultant and founder of Milk & Motherhood, to chat to VIP mums on the app about all things breastfeeding.
Johanna was on hand yesterday to answer questions from Supermushers – VIP Mush users who subscribe to the app to get expert advice, personalised content and access to exclusive live chats (you can give it a whirl here). Here are a few highlights. The bit about putting six nappies out has actually blown our tiny little minds…
Q: How can I know whether I am making enough milk for my baby?
Johanna: It’s good to start this by pointing out that unfounded fears about low milk supply are the number one reason for early weaning – so know these facts! The ONLY totally accurate way that you can tell if your baby is getting enough is by looking at weight gain and at nappies. It is not about ANYTHING else! About weight gain: Your bubba will almost always lose some weight after birth — average for breastfed babies is between 5.5 and 6.6% weight loss. If you had a lot of IV fluids throughout your labour, then there is a high chance your baby will be carrying extra fluid and will pee a lot of this out in the first 24 hours, so keep this in mind also when considering newborn weight loss. You would ideally then want them to be back at birth weight by 2 weeks, though some can take a little longer, and they should be then gaining 140-210g a week up until 4 months of age, when their weight gain then slows down (don’t freak out!).
About nappies: In the early days, if you’re concerned about supply, you can start counting nappies. Once your milk has come in, you want to be seeing a minimum of six wet nappies in a 24 hour period. Instead of having to track these with an app or a spreadsheet, which can cause a lot of anxiety for many mums, I suggest putting six nappies next to the change table each morning and ensuring that these are all used in the 24hours, hopefully more. That means that if you go out, you take your out-of-the-house nappies from that stack of six and then put the unused ones back when yu get home. You won’t need to do this forever, at all, but is a good way to track when needed.
There are many many other things that make people worry abut low supply, and whenever you’re unsure of whether it’s enough, go back to basics to check how things are going — nappies and weight gain.
Q: I’ve heard that breastfeeding shouldn’t hurt! Why are my nipples so sore?
Johanna: Do you remember the first time you joined a pilates class? Or attempted a run, or went to a class at the gym? Afterwards, you probably felt a little sore. This is the process of your body adjusting and strengthening — and you know that this is productive! But as soon as things would be described more as ‘pain’ than just ‘a bit sore’, we need to check some things out. Tenderness, discomfort and a little pain at the very beginning of a feed is evidence that you and your baby are learning, and these are ok. But toe curling pain, or in the case of one of my mamas, tooth cracking pain three times over, is NOT okay in any way.
Step one when anyone complains of nipple pain is to look at the ‘positioning and attachment’. That is really just about the way that you are holding your baby, and the way that they latch onto your breast. This is BY FAR the main cause of nipple pain, and can be then progress to become the main cause of a whole bunch of breastfeeding problems. So, in a way, we could say that sore nipples are a super handy (but seriously awful) symptom to be able to tell us that something needs tweaking, before problems develop further. Usually pain is being caused because your baby is squeezing your nipple between their tongue and their hard palate — the bony part at the front of the roof of your mouth (you can feel this in your own mouth with your own tongue — do it!). Your nipple should actually be stretched all the way back to their soft palate, the squishy muscular bit on the roof of your mouth, at the back, behind the hard palate (feel it?). If your baby is not latched effectively, then they are squishing your nipple repeatedly against bone (ouch!), which, yep, is going to cause pain and injury.
My favourite way to ‘fix’ positioning is to get mums to feed in a laid-back position. If you do this, then you shouldn’t have to think about any of the other rules of latching (have you heard them? Baby’s tummy to your tummy. Baby’s nose to your nipple. Ear, shoulder and hip aligned. But you don’t have to worry about these at ALL with laid-back positioning!). So step one, make sure your baby is not to hungry. Get your bubba in only their nappy, take off your shirt and bra and lie down on the bed or the couch in a semi-reclined position — as if you were in the bath, or chilling out in a lounge chair on the beach (just the same, right?!). Pop them on top of you, with their head resting on the inside of one of your breasts, and then just leave them. You can put a little blanket over the both of you if you’re worried about them getting cold. Leave them, and watch their behaviour — it will astound you! Your baby will wiggle themselves around, push up, lunge and manage to latch on themselves. Don’t touch anything! Keep your arm as a support to the side of your breast, and if your bubba overshoots, you can help them out by repositioning them back to the inside of your breast again. This requires patience, but your bubba should be pretty happy bobbing about and latching on! If things are getting too tricky, you can move your baby to a point where their NOSE touches your nipple, and allow them to latch from there, but don’t ever put your nipple into your baby’s mouth. Ever. If you find that you are often putting your nipple in their mouth, or bringing their lips directly to your nipple instead of their nose, their latch WILL be shallow, and is likely to be painful and cause injury. Give this position and technique a try! It is astounding at how it can immediately reduce pain for so many mothers, and can be so incredibly empowering to watch your baby’s abilities to position themselves and latch on really well, without any help whatsoever.
Q. Will giving my baby a dummy somehow mess with my breastfeeding?
Johanna: This is a tricky one. Many lactation consultants advise against using a dummy in the first few weeks. These first weeks are critical for a mother to securely establish a good milk supply for her baby, so we want them to be doing all of their sucking at the breast — flutter sucks, comfort suck and strong, nutritive sucks. If we continually use a dummy to delay feeds, even for ten minutes, then a vulnerable milk supply during the first stages of postpartum can be affected and might then take a LOT of work to get back up. I’d want to ensure that a woman isn’t at risk of developing a low supply, and that baby’s growth is going wonderfully. If things are going really well with no issues, you can try one at around week three, but ideally you’d wait until after the first six weeks.
All that being said, I think that they can be an amazing parenting tool! Personally, my first baby adored his, but my second baby would never keep one in his mouth and totally refused it! So sometimes, giving a dummy is actually not always our decision — These little people have minds of their own too 🙂
Every Monday night we do a live chat for Supermushers with an expert (and a few special guests you might have heard of) on the topics that are keeping you awake at night (sometimes literally…). Find out more and sign up here.