We sat down with the lovely Cynthia Bischoff, of Lactation Life, to ask her the most pressing questions we hear from clients. Cynthia is a Board Certified Lactation Consultant, which means that she is a “healthcare professional who specializes in the clinical management of breastfeeding”. That title sounds super formal, but what she is to the community, is a angel who appears at your home to help you with all of your breastfeeding needs.
Cynthia, is there anything I can prepare with before the baby is born?
You may have heard the old wives’ tale about toughening up your nipples with a rough washcloth. That tale is just that – an old wives’ tale. There is no need to physically prepare your body; the pregnancy is doing that for you. I do highly recommend taking a breastfeeding class, or meeting with an IBCLC prenatally. Just like birth, we don’t know exactly how everything will take place, but it’s good to go into that first breastfeeding session with some basic information about positioning, latch, what to expect, things to watch for, and how to know when to ask for help. Knowledge is always power!
When should I initiate the first feeding?
As long as everyone is healthy, strive to breastfeed within the first hour. Not only is baby usually alert and has the instinct to breastfeed, it also helps establish a robust milk supply. You will often here lactation consultants say to breastfeed “early and often.” Remember that phrase and try to have baby at the breast within the first hour. If you are separated from your baby, either for a couple of hours, or for longer, try hand expression, which will still send a signal to your body to make milk.
How do I know if my baby is latched correctly?
Look for a wide open mouth, taking in breast tissue, not just nipple. We are all different shapes and sizes, and so are our areolas, so how much areola you see is not a gauge of a good latch. Most importantly, we don’t want baby only sucking on the nipple. As I often say, it’s breastfeeding, not nipple feeding! You may feel a tugging, and it is a different sensation than you are used to, however it is true that it should not hurt. Pain is a sign of an issue. Please ask for help if you are in pain. I recommend requesting to see a lactation consultant in the hospital or birth center, whether or not you feel there is an issue.
Is there a breastfeeding hold you prefer for new babies?
Have you seen the videos of the Breast Crawl? Go ahead, google it! The anthropological path for a freshly-born baby is placement on the mother’s abdomen, at which point the baby crawls up the mother’s body, towards the breast, and latches on. While most births don’t follow that routine nowadays, that laid-back position is the biological norm for newborns. Babies bob their heads and lick the nipple, then almost smash their faces into the breast. Have the nurses and lactation consultants at the hospital or birth center help you experiment with laid-back positioning, cross-cradle, and football holds. It’s important you find what works for you and your baby.
Should I use a different hold based on breast size?
Those with generous breasts often like the football hold, as it allows them to see what is happening, and there is more room for breast tissue to spill over. Those with dainty breasts tend to gravitate more towards cross-cradle and laid-back positions. There is no one right way to breastfeed, and as I mentioned above, it’s important that each breastfeeding pair (or more), find what works best for them.
In the first few weeks of life, how often should my baby be eating?
Babies eat often! Strive for at least 10-12 times in 24 hours. That means you may have a baby eating every 2 hours, sometimes going for a 3-hour stretch, and sometimes every hour. All of those time frames are normal throughout the day. When in doubt, put baby to the breast. A baby cannot over-eat breast milk, so let the baby nurse. When you get home, have someone fix you a basket of snacks and a full water bottle to keep nearby, and spend your time on the couch, nursing that sweet baby of yours.
How do I know if I’m producing enough milk?
It is worth reiterating, nurse early and often! That is your first step towards producing enough milk. Breast milk is supply and demand. Your milk supply will grow with frequent and effective milk removal. Your nurses and pediatricians will guide you in watching for wet and dirty diapers, as well as weight gain. Poop will now have a role in your life like never before! Babies will lose weight at first, so don’t let that worry you. With long labors and high use of IV fluids, we sometimes see elevated weights in newborns, so expect those babies to lose a little more weight. Watch for their weight to start heading back up after the first few days.
Should we wake the baby to eat?
I know people say don’t wake a sleeping baby, but I’m going to burst that bubble and say to wake a sleeping baby – at first. Birth is exhausting, and so is this new world of theirs. Some babies will sleep through much-needed feeding times. To ensure adequate caloric intake, weight gain, and establishing a full milk supply, you may need to wake the baby so that s/he is nursing 10-12 times in 24 hours. Once babies are back up to birthweight around 10-12 days, I usually recommend parents move to cue-based feeding (also called feeding on demand). Watch for early hunger cues and continue to strive for frequent nursing.
Does it matter what I eat while breastfeeding?
The short answer is No! The long answer has caveats and exceptions to the rule. Of course I recommend eating a healthy, well-balanced diet and staying hydrated, both for your own health and for your nursing baby, but there are not specific foods to avoid or consume while breastfeeding. Pay attention to your body’s needs; you will probably find that you are hungry and thirsty, so eat and drink to satiety and thirst. Some people find that their babies react to certain foods they eat. If that is the case, address your personal situation with an IBCLC and pediatrician when the issue arises. Be careful of falling into the pitfalls of “magic” breastfeeding foods and drinks that you hear about on the internet. Always consult a physician about supplements and their interactions with your own dietary needs and allergies.
When should I ask for help?
Absolutely reach out for help if you are in pain, your baby is not urinating or defecating, and if the baby is losing weight (or not gaining). I know many people say breastfeeding hurts for the first few weeks and you just have to stick it out, but that is not true. Pain is almost always a sign of an issue. Pain may be the first sign of inefficient milk removal, which will lead to the other concerns noted above, along with low milk supply. Be proactive in seeking help so that you can get to the bottom of it quickly. You can also seek help just to ensure everything is going smoothly. Bringing home baby can be overwhelming, and while breastfeeding is natural, that doesn’t mean there isn’t a learning curve. Sometimes having an IBCLC walk you through everything, check the latch, and weigh the baby can lessen that learning curve and help set your mind at ease.
Can I call you if I have concerns?
Please do! You can call or email me, and I would happy to set up a lactation consult to address your specific concerns. I also have a Breastfeeding Support Group on the 1st & 3rd Tuesdays of the months, 6:30-8:30pm at Wellsview Cottage in Annapolis.
Do you do house calls?
Absolutely! At the moment, I am solely an in-home provider. While I may offer office visits in the future, right now I really enjoy working with breastfeeding families in their own environment. We can find the position that works for you where you will actually be nursing and spending your days. All of your supplies are handy, and you are most comfortable in your own home. Every breastfeeding relationship is unique, and it’s important we find what works for you and your family.
Breastfeeding is empowering! You are making your child’s food – be proud of that! I love helping breastfeeding families reach their goals and feel that empowerment. Notice I said their goals? It is important to me to work with families to find what is best for them, not for myself, their neighbor, or a friend. As it says on my website, No guilt. No pressure. Just personalized care.
Cynthia’s contact:
Lactation Life, LLC
240-800-6455
cynthia@lactationlife.com