The Boob Group
Breastfeeding The Jaundiced Baby
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ROSE DEVIGNE JACKIEWICZ: When a breastfeeding mother’s baby becomes jaundiced it often means she will need a supplement or be separated from her baby for a short period of time. How can a mother help her baby get rid of jaundice without compromising her milk supply? I’m Rose deVigne Jackiewicz, an International Board Certified Lactation Consultant at the at The Kaiser Permanente Outpatient lactation clinic in San Diego, California.
Today, we are discussing Breastfeeding the Jaundiced Baby. This is The Boob Group, episode 56.
ROBIN KAPLAN: Welcome to The Boob Group, Broadcasting from the Birth Education Center of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I’m your host Robin Kaplan. I’m also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Center.
Thanks to all of our loyal listeners who have joined the Boob Group club. Our members get all of our archive episodes, bonus content after each new show plus special giveaways and discounts. Subscribe to our monthly newsletter for a chance to win a membership to our club each month. Another way for you to stay connected is by downloading our free app available in the android and iTunes marketplaces.
Today we are joined by two panelists, one in the studio and one over the phone. So, Stephanie will you please introduce yourself?
STEPANNIE TOWNS: My name is Stephannie, I am 22, I am a stay-at-home mom. I have one eleven week-old little boy.
ROBIN KAPLAN: And what’s his name?
STEPANNIE TOWNS: His name is Micah.
ROBIN KAPLAN: Micah! Alright! Fantastic! And Heather will you please introduce yourself?
HEATHER GARETY: My name is Heather, I’m 26 years-old, and I have a seven and a half months daughter named Lili. And I am a stay-at-home mom.
ROBIN KAPLAN: And heather where are you joining us from?
HEATHER GARETY: Illinois, sorry.
ROBIN KAPLAN: Awesome! Thanks for joining us over the phone. That’s awesome!
ROBIN KAPLAN: Before we get started with today’s topic, here’s Lara Audelo talking about ways to overcome societal booby traps.
LARA AUDELO: Hi Boob Group listeners, I’m Lara Audelo, a Certified Lactation Educator, volunteer at Best for Babes and author of the Virtual Breastfeeding Culture. I’m here to answer some of your most common questions about how you can achieve your personal breastfeeding goals without being undermined by cultural and institutional booby traps. Such as, what to do when your child care provider is not supportive of breastfeeding?
Child care support for breastfeeding isn’t talked about as much as the other breastfeeding issues, but a recent incident in Toronto brought to life about how much of a factory it is in mom’s ability to sustain breastfeeding. A recent study from the CDC examined the relationship between child care provider support for breastfeeding and mother’s breastfeeding duration.
It found that breastfeeding at six months was significantly associated with child care provider support to feed expressed breast milk and allow mother’s to breastfeed at the child care place before or after work compared to mothers who reported fewer than three total supports. Mother’s who reported five supports or three times as likely to be breastfeeding at six months.
Our findings suggest that child care provider’s breastfeeding support in the early months may help mothers maintain breastfeeding for longer durations. And it’s compelling enough that the surgeon general, in her call to action to support breastfeeding makes the recommendation “Ensure that all child care providers accommodate the needs of breastfeeding mothers and infants”.
The CDC also found that only 6 of the 50 states have child care regulations requiring the centers “Encouragement for breastfeeding and feeding of breast milk by making arrangements for mothers to feed their children comfortably on site”. Just six, now, it’s almost certainly the case that many child care provider support nursing moms on their own without being required to by the state but doesn’t the absence of regulation say something about the lack of recognition of this is an issue. We think that is a booby trap.
A special thank you to Tanya Lieberman, IBCLC, for writing The Booby Trap series for Best for Babes. Visit www.bestforbabes.org for more great information about how to meet your personal breastfeeding goals and check out my book The Virtual Breastfeeding Culture for collection of breastfeeding stories. And be sure to listen to the Boob Group for fantastic conversations about breastfeeding and breastfeeding support.
ROBIN KAPLAN: Alright, well today on the Boob Group, we’re discussing Breastfeeding the Jaundiced Baby. Our returning expert, Rose deVigne Jackiewicz, has been an International Board Certified Lactation Consultant since 1984 and works at the Outpatient Lactation Clinic at Kaiser Permanente in San Diego, California. Thanks so much for joining Rose and welcome back to the show.
ROSE DEVIGNE-JACKIEWICZ: I am glad to be here.
ROBIN KAPLAN: So Rose, what is Jaundice?
ROSE DEVIGNE-JACKIEWICZ: Jaundice. Most people when they think of jaundice, they think of Hepatitis C or hepatitis in general when their skin gets yellow. What we’re talking about is jaundice in the newborn and it’s still a yellowness of the skin. And without getting into the deep medical terms, basically it is a build up in the blood of bilirubin which is the breakdown of red blood cells.
Newborns have more red blood cells than adults do at birth because before birth it’s the placenta that’s kind of breaking down the blood cells and when the baby’s born they kind of have to do it on their own and so, there’s this fetal blood cells that have to breakdown and be eliminated from the body. Newborns become jaundiced in the first few days because the enzyme in the liver maybe immature and does a process of breaking down these red blood cells as rapidly. There’s different types of jaundice but that’s basically what jaundice is.
ROBIN KAPLAN: Ok. Fantastic and what causes a baby to become jaundiced?
ROSE DEVIGNE-JACKIEWICZ: Overall there are different types of jaundice which have different causes. Physiologic jaundice which is your normal, most babies, 80% of baby’s maybe will get a little bit of jaundice; it’s that breakdown of those red blood cells. That’s Physiologic jaundice. Pathologic jaundice is something or maybe, the baby, there’s an AB, O, incompatibility.
Your blood type differs. If there’s illness, if there’s an unusual reason for jaundice that is due to a medical illness, that’s Pathologic jaundice. There’s also a couple other things that related to my field in lactation is there’s what we called the breastfeeding jaundice with the emphasis on feeding a baby that’s not feeding enough therefore he is not getting enough Calories in and the baby’s not peeing or pooping and so that can cause elevated jaundice.
Then the other one is breast milk jaundice when the emphasis is on the milk and they really don’t know exactly what it is but usually it’s after ten days, babies stayed jaundiced and they think there’s something in the milk that causes the baby to be jaundiced. But, those babies are growing and thriving and active and doing great so it’s usually not an issue and they may stay jaundiced for weeks maybe even a couple of months when it’s breast milk jaundice.
ROBIN KAPLAN: And you had mention some of these symptoms we have are the yellowness of the skin, what are some other symptoms of jaundice and how is it tested to see what those levels are?
ROSE DEVIGNE-JACKIEWICZ: Some of the other symptoms of jaundice, first of all it’s the color, babies will look more yellow. It starts at the head and goes down so they may see yellowness in the eyes as the jaundice levels increased the jaundice level goes down. So it starts in the head and it goes to the chest then it may go down to the extremities. Whereas when you get rid of jaundice, it’s the reverse. It’s less in the legs, the chest and the last to go is the face and the eyes.
Other symptoms of jaundice are if we see a jaundiced baby, what I see is typically they can become very sleepy. Jaundice babies don’t want to feed very well which then potentially decreases how much milk they take in and so which makes them more jaundiced. It’s kind of like a vicious cycle, they get a little jaundice they don’t feed well. And certain situations can cause more jaundice like a baby born early, a stressful birth.
Mothers who have diabetes and like I mentioned earlier, the blood incompatibility if your O and baby’s A and again symptoms are the yellowness of the skin and the eyes. Testing is done several ways in the hospital they have what they call the transcutaneous device that they just kind of put it on the baby’s head and they can kind of read it. That’s fairly good for mild jaundice. However, it doesn’t tell what the serum jaundice levels are which requires a blood test.
And as moms, I can remember my second one have been taken to the lab to have a blood drawn and actually no, back then she’s 3 right now, they did an anus, they drew it from the vein
ROBIN KAPLAN: Oh! Which is so hard to find on little ones. That’s miserable
ROSE DEVIGNE-JACKIEWICZ: And was one of those moms that said ok you get one try. You might as well get the supervisor because you know, I just was such an anxious mom. So they can use the transcutaneous monitor or more often than not it is a heal poke to see what the serum levels are.
ROBIN KAPLAN: Okay. And is there a timeframe when a baby can or will become jaundiced?
ROSE DEVIGNE-JACKIEWICZ: Physiologic jaundice occurs in the first few days you know maybe up to a week whereas breast milk jaundice can occur, it can be an exaggerated physiologic jaundice or it continues after ten days. But if it’s the normal physiologic jaundice it usually resolves in a few days. Jaundice doesn’t can last a week or longer.
ROBIN KAPLAN: So, I’d love to open this up to our panelists now. So Stephannie, when did you or your pediatrician first noticed that your son was jaundiced?
STEPANNIE TOWNS: I think it was the second day in the hospital.
ROBIN KAPLAN: How did they notice?
STEPANNIE TOWNS: It was a blood test. I wasn’t actually there when they came and told us because I was having my own complications. But I think it was a blood test.
ROBIN KAPLAN: How about you Heather?
HEATHER GARETY: Same thing, we were in the hospital, I think it was her second day and they brought her back from a hearing test and said that they test her for jaundice that she had it was just really mild so they’re just going to monitor while we were there.
ROBIN KAPLAN: Rose, when parents find out that it’s okay my baby has jaundice and so what are typically the ways that are recommended to get rid of this jaundice?
ROSE DEVIGNE-JACKIEWICZ: One of the first ways for breastfeeding moms is nurse, nurse, and then nurse some more. Because you get rid of jaundice in three ways: through the urine, through poop and through skin. And so the more baby nurses the more they can pee and poop the more you’re going to get rid of it. Conversely with baby that’s really sleepy and doesn’t nurse, they don’t pee and poop as much which can cause a re-absorption of the bile. So, the first thing that we would do when we see jaundice is nurse, nurse, nurse, nurse, nurse, nurse. And if the baby is a poor nurser then we might even have moms start using a breast pump to stimulate her milk supply and feed that colostrum to the baby if needed.
ROBIN KAPLAN: Stephannie, did your baby end up going under lights, or did you need to supplement him?
STEPANNIE TOWNS: He went under the lights, I didn’t need to supplement. The hospital I was at had this, it’s a baby friendly hospital so they had a newer technology where I could nurse while he was under the lights. It was really cool. There were like fiber optic lights and it was like it looked like a heating pad type thing
ROBIN KAPLAN: Oh cool! Did they attach to him?
STEPANNIE TOWNS: No. I could just hold it up against him. I could have him against my skin and then it right behind him. And it was really cool because I could hold him, I could do skin to skin contact. I could nurse as often as I wanted and as often as I needed him. Like she said everyone was telling me, put him on the breast as much as possible it’ll help get rid of it and so is under the lights less.
ROBIN KAPLAN: That’s terrific! So no separation between the two of you while he was getting those bile lights
STEPANNIE TOWNS: Exactly and that was really important to me and obviously being at the best baby friendly hospital, it was important for them too.
ROBIN KAPLAN: Very cool. How about you Heather? What was your experience like?
HEATHER GARETY: It took her a while to have her levels elevate to a point that she would need a bile light. She actually, we ended up being re-admitted to the hospital about 24 hours after we were discharged upon delivery. And because her levels have gone from a 12 to a 70 basically overnight and so they wanted to start treating it and she was really-really-really lethargic and she wouldn’t nurse, I mean, we had to wake her up and make her eat and even though then she was just, I mean, she would be at the breast for a couple of minutes she’ll be out. We did everything we could to keep her awake and so she was under the bile lights about 12 hrs I think and her levels has started going down but being in that state in the hospital you loss like 17% of her birth rate in 3 days and so it’s kind of scary for a while.
ROBIN KAPLAN: It’s so hard when, you know when, I obviously give the recommendation as well like nurse as much as you can but I’ve seen many babies like the one’s you’re describing with your own daughter Heather where you try everything you can, you’re putting wash cloths on them and then you’re pumping their arms like a bicycle and rubbing their back and they are just wearing their diaper and they’re so tired that it’s impossible to keep them awake and so that can be very-very scary absolutely.
Rose, can you talk a little bit of, I was planning on talking about a little bit later but since Heather mentioned it, what are the levels when we talk about you know what their bilirubin level is and I know that it correlates with how old the baby is, how high comfortable of letting it go, what are we looking for with these levels?
ROSE DEVIGNE-JACKIEWICZ: It’s very individualized from babies to baby, you can actually Google this the American Academy of Pediatrics has online where you can see it’s a scale based on gestational age and day of age so like a 12 for a 4 or 5 day old baby is probably no big deal or just mild but a 12 for a premature baby is very-very different. So and part of the two is, how was the baby doing? I’ve seen jaundiced babies at its been a 12 or a 13 and it’s kind of by the Academy of Pediatrics guidelines it’s kind of intermediate or mild but the baby is so sleepy that if we don’t intervene to help the baby at this point. It’s going to go downhill fast, it’s going to go within 24 hrs it could climb very high and then the baby may have to go back in the hospital and that’s really-really tough for new moms to have a baby, go home from the hospital and then be told you got to go back to the hospital. The re-hospitalizations are usually short but that doesn’t matter, the babies in the hospital and moms at home.
ROBIN KAPLAN: Absolutely, it’s so scary. Ok, well when we comeback, Rose will be discussing how a breastfeeding mother can protect her milk supply when her baby is jaundiced and sometimes it’s a little bit hard for them to really stimulate that milk supply the way that we need them to so, we’ll be right back
ROBIN KAPLAN: Alright welcome back, today we are talking about Breastfeeding the jaundiced baby with Rose deVigne-Jackiewicz, and so Rose, what should a breastfeeding mom do if the pediatrician is recommending that she supplement and she really-really wants to breastfeed.
ROSE DEVIGNE-JACKIEWICZ: First thing is clarify with the pediatrician what they mean by supplement. Most moms, when I use the term supplement they’re almost in tears because they automatically assume supplement means formula. So in most of the time these babies are for catching it early, supplement means they just need more breast milk. Ok. Now sometimes if the levels are high enough and mom’s full milk supply has not come in, she may need to use a formula.
But the first thing would be to clarify. I had a mom not too long ago, the baby’s jaundice was like almost 21 but she actually had quite a bit of milk, so we were able to pump and supplement the baby with her breast milk. Usually when it gets that high it is not uncommon for the pediatrician to recommend formula. Formula has a tendency to reduce the jaundice, sometimes up to 20 to 50 percent within a 24 hr period. Specially if its breast milk related jaundice and the levels are really high but again, if you have to supplement with formula based on the baby’s condition or the jaundice levels, then I would recommend that moms use a hospital grade breast pump to pump, to stimulate the milk supply because again we want the breast to think the babies nursing great and therefore her full milk supply comes in, in volume at the same time that the baby would normally be nursing.
ROBIN KAPLAN: And what happens if the jaundice level gets too high?
ROSE DEVIGNE-JACKIEWICZ: If the jaundice levels gets too high, you mean from a baby’s standpoint, there is something and I don’t know that maybe I’ve seen it once in 30 years. Thank goodness but jaundice levels that get way high and after 20 is when they really get, doctors get anxious. It gets 20, 21 and up and higher there is the potential that it could go into the brain and develop what we call the Kernicterus which can cause some kind of brain damage. Which is why your pediatrician might be a little anxious about getting the jaundice treated because he wants to prevent that at all cause which we do too. So high levels of jaundice can be very dangerous, so that’s why they do check the babies early and if they do have jaundice we’ll check them often until they see that those levels have stop rising and then starting to go down.
ROBIN KAPLAN: Maybe even tests that we’re they’re checking the heel stick and stuff like that once a day
ROSE DEVIGNE-JACKIEWICZ: Absolutely, it could be once a day, maybe twice a day if they’re hospitalized because they want to make sure that those levels are going down.
ROBIN KAPLAN: Stephannie, how often was your baby being checked? Were they just doing the sub q?
STEPANNIE TOWNS: He was in the hospital because he also had another complication that kept him in the hospital so, he was there and he was getting blood drops twice a day and I’m pretty sure most of them were also being test for the jaundice as well as the other
ROBIN KAPLAN: How about you Heather, how often was your baby being checked?
HEATHER GARETY: When we were at the hospital it was twice a day and then when we got discharged and re-admitted again it was like two or three times a day usually
ROBIN KAPLAN: And then did you have to follow up when she was released from the hospital? Did you have to follow up for a couple of days?
HEATHER GARETY: Yes, we did. Actually when we were first discharged from the hospital we have to follow up that’s why we found out that her levels has risen, and then when we got discharged the second time then a follow up with our pediatrician for the next 3 days.
ROBIN KAPLAN: Rose, as the babies being tested and they’re checking their levels is there a typical amount of supplementation that a mother should use as she’s trying to bring down her baby’s jaundice levels?
ROSE DEVIGNE-JACKIEWICZ: This will depend on how alert and how well the baby nurses versus how sleepy, some of the babies that are like the one panelist said so sleepy you did everything, you couldn’t wake her up or him up and so those babies are going to require most likely a full feeding and depending on the age that could be an ounce to two to three ounces depending on the age of the baby. Now some babies that are still latching and feeding fairly well but maybe tiring quickly and the option is to supplement them while they’re nursing at the breast using a supplemental type system. But if they can’t nurse and get enough of the breast they may require a bottle to supplement, and again, it’s going to vary from half an ounce to two to three ounces, depending on the age absolutely.
ROBIN KAPLAN: Stephannie, did you have to do any supplementation or he was able to bring it down all on his own?
STEPANNIE TOWNS: Yeah especially with that technology that we had, he was just at the breast almost constantly so that was…
ROBIN KAPLAN: That helped a lot.
ROSE DEVIGNE-JACKIEWICZ: That is awesome because your baby was awake enough that he would go to the breast.
STEPANNIE TOWNS: He was sleeping a lot, he was very sleepy but he was also only two days old, I’m not sure if that was normal
ROBIN KAPLAN: Heather, how about you? How much supplement? Did you have to give any?
HEATHER GARETY: We didn’t have to give some, but because she wouldn’t latch to me, by the time we got rid of her in the hospital she wouldn’t latch at all. All she would do was suck on my finger so we actually like tube fed her with my finger. My husband would stick a tube and I pump what I could which at that time we were only 3 or 4 days post partum so I getting a quarter of an ounce to a half ounce at that time and so then we had to make that up so that I have to give her an ounce and a half of formula then to help fight the jaundice and also to help fight the significant weight loss that she had have and so we were doing that then after we would feed her then I would pump as much of I could then again usually a quarter of an ounce to half ounce and an hour and a half later we would start the process all over again
ROBIN KAPLAN: Yeah, I appreciate that you’re health care provider actually gave you a very nice rationale of why you were’ giving so much for a baby at that age because I think a lot of, sometimes we don’t understand that the amount that the baby’s getting is probably a lot more than she would have been taking from you had she had just been breastfeeding but because of that significant weight loss in getting rid of the jaundice that the amount she was getting was a little bit higher than maybe she would have gotten if a breastfeed didn’t go well
HEATHER GARETY: Well I have to say, that wasn’t the pediatrician, what we had was an amazing nurse and an amazing lactation consultant who really came in and supported us
ROBIN KAPLAN: That’s wonderful, that’s wonderful. Rose, when can a mom stop supplementing and how can she transfer from this supplementation back to exclusive breastfeeding?
ROSE DEVIGNE-JACKIEWICZ: As the jaundice goes down, moms notice babies are much more awake and alert and they feed better, as they feed better we gradually decrease the supplement, and that’s one of the benefits of working with a lactation consultant is you can do pre-and-post-weights, if you do a pre-and-post-weight and see wow he took in a good amount, that’s a feeding he doesn’t need to supplement. If the next feeding he doesn’t nurse as well then he may need a little bit, so it’s a gradual decrease of supplementation as the babies feeding better and many times that supplementation at that point if mom is using a breast pump is breast milk and so if it’s formula to begin with then as her milk supply increases in volume we switch it over, Some moms are under the impression that it’s the formula that treats it, no, it’s the milk in general, the feeding that treats it, it’s not that breast milk is better than formula, I mean, we know that breast milk is better than formula but it’s not that formula is better, it’s just that sometimes the quantity is the key, absolutely
ROBIN KAPLAN: Stephannie, since you didn’t have to do any supplementation did you notice that your nursing sessions got easier and easier as he became less yellow?
STEPANNIE TOWNS: Definitely
ROBIN KAPLAN: How long did he have to stay under the light?
STEPANNIE TOWNS: I think it was 48 hrs as they were being generous because he was already in the hospital anyways so they just wanted to be extra generous
ROBIN KAPLAN: Wonderful. You didn’t have to bring home a then?
STEPANNIE TOWNS: No.
ROBIN KAPLAN: Okay, did you end up doing pre-and-post weights with a lactation consultant after you went home to make sure that he was on the right track?
STEPANNIE TOWNS: He already was at and above birth weight by the time we were out of the hospital so we didn’t need to see any outside lactation consultant
ROBIN KAPLAN: Absolutely correct
ROSE DEVIGNE-JACKIEWICZ: That is great. The other thing that I’m finding too is as far as the treatment of jaundice, is more physicians, pediatricians are supportive of home phototherapy. So if the levels aren’t too high that require hospitalizations but high enough that they require treatment many will recommend any insurance most likely covers home phototherapy’s so your baby can get to stay at home with you
ROBIN KAPLAN: Yeah, how about you Heather, how long did you have to supplement for before you were able to go back to breastfeeding?
HEATHER GARETY: Well we got discharged from the hospital the second time on a Wednesday and then we were still supplementing and then the following morning she actually initiated her first feeding that she ever initiated in her life. That was a week post partum exactly a week old she gets that. She started eating more and eating more often and initiating everything so we weren’t having to make her eat every 3 hours. I would give her some a little bit throughout the day and then the following Saturday we thought that was the lactation consultant and I fed her there for ten minutes, and in that ten minutes she transferred an ounce and so we were told that in ten minutes for a week old baby to transfer an ounce was really good. We were told to take her off the formula, we hadn’t any ever since
ROBIN KAPLAN: That’s awesome
ROSE DEVIGNE-JACKIEWICZ: That is great and I think and what you notice when the jaundice level went down she became more awake I think she started waking up asking for feedings and that was the key.
ROBIN KAPLAN: Heather did you continue pumping for a little bit longer to kind of keep up your supply, did you find that she was able to kind of maintain it on her own?
HEATHER GARETY: I pumped for, I think a couple of months and after that a stash in my freezer and help with the supply and everything but after she was a couple of months old, I stopped worrying about it and we were able, I mean, I was confident in her, I think she could feel that maybe I need a little bit too, and she just nurse like a champ and she still does and it’s been pretty great.
ROBIN KAPLAN: That’s awesome and then I would love to ask Stephannie and Heather one question just as if you know speaking to moms who are going through this kind of jaundice experience which can be very scary when you’re told that there’s something going on with your child. Specially right after she was just been born, do you have any tips or things that you felt were very helpful to help you kind of get past that and move on to where you guys are doing now with exclusively breastfeeding?
STEPANNIE TOWNS: Just put him to breast as often as possible was all that I did. It was like what you guys are saying, the more he gets in the faster he can process it, the more he poops it gets out and that’s exactly what I did
ROBIN KAPLAN: Awesome. How about you Heather?
HEATHER GARETY: Well for me because I had to bring my supply and my pump and the lactation consultant and they were really helpful were great about educating me and also my husband because he was my support first time we got home and so he was supportive and after we have feed her the 2 ounces after finger feeding I have to pump then and when I found what’s really helpful for me more, he actually held our daughter while sitting right next to me while I was pumping and I was able to pump more probably because I was releasing all my hormones. That was what really helped me do that and just having that support, it’s fine as much support as possibly you can people are going to be there for you and work with you through that
ROSE DEVIGNE-JACKIEWICZ: I think you hit on a couple things. Heather is, when a baby is jaundiced and the level start going down so many new moms were so nervous that they may continue to supplement especially a formula you started because they, what I hear often is “I want to make sure she doesn’t jaundiced again”. That’s the one of the benefits of working with a trained lactation consultant to work with you and identify that the baby is feeding well, also that you can see based on pre-and-post-weights the baby’s feeding well and once the jaundice level goes down rarely does it ever go back up again. Rarely!
ROBIN KAPLAN: Yeah I don’t think I’ve seen that actually
ROSE DEVIGNE-JACKIEWICZ: Just to be able to re-assure new moms that this isn’t going to happen again that’s the benefit of working with a lactation consultant
ROBIN KAPLAN: Absolutely! Well thank you so much Rose for your insight in Breastfeeding the Jaundiced baby and to our panelists as well for sharing their experience. And for our Boob Group club members our conversation will continue after the end of the show as Rose will discuss which babies are at a higher risk for having jaundice.
For more information about our Boob Group club please visit our website at www.theboobgroup.com
ROBIN KAPLAN: So here’s a question from one of our listeners, this is from Heather Nichols and this is what she wrote to us: “I hope that you can help me with this, I have tried and tried since the beginning to get a good latch with my son. He is now five weeks old and I’m still trying although I’m not quite sure if it’s even doable at this point. He will latch for a moment but it’s really short he seems very excited at first and then gets really frustrated and stops and I know that there’s milk readily available because I can see it. I think the problem is the shape of my nipple. It’s very flat and I’ve tried ice massage, nipple shield to get it to stand into tension and nothing seems to work. Right now I am pumping but my milk doesn’t seem to flow very well with the pump as it does when my baby latches, so I’m trying [unclear] grip to help with that. I am becoming very frustrated and outright sad because I can’t seem to get this. Please help”.
Well Heather, thank you so much for your question I really appreciate you writing. And I can understand why you must be so absolutely frustrated with this whole process. First and foremost when I read this, the first thing that came to mind was, it’s definitely worth your time to look for an International Board and Certified lactation consultant in your community to help assess the situation more fully. I’m not being able to see your baby in person.
I really can only give general advice, but, it definitely won’t solve every issue. I would imagine. So, the first thing I would recommend is having an International Board Certified Lactation consultant, assess your son for tongue tie. While some babies have difficulties latching on when a mom has flat nipples because often can be remedied with a nipple shield. And if you son is having a challenging time creating an effective suction with the nipple shield, it could actually be caused by a tongue tie which limits a babies range of motion and sucking effectiveness.
It is also possible that your little guy has figured out that if he fusses enough he’ll receive a bottle which will totally satisfy him and of course the main goal is to feed the baby so sometimes bottles in the case of supplementation are really helpful if the baby’s having a challenging time at breast. However babies are incredibly smart and often figure out how to hold out for the bottle making it very frustrating for mom so depending on if he does have a tongue tie or if he’s just holding up for the bottle will definitely determine what will be the best course of action.
So again I can’t highly recommend enough of seeing an International Board and Certified lactation consultant for this situation as there are many reasons why this maybe occurring which will really help you get the bottom of, my advice is only that this IBCLC should be looking for the tongue tie during this feeding time with your baby especially since I can’t give an accurate advice without having seeing you and your baby. I hope that this is somewhat helpful, we do have an episode called breastfeeding and tight formula and it would be definitely worth it to take a look at to see if the symptoms that are described in this episode are accurately describing your son as well so, I hope that’s helpful and thanks so much.
ROBIN KAPLAN: Well this wraps up our show for today, we appreciate you listening to The Boob Group don’t forget to check out our sister show Preggie Pals, “for expecting parents” and our show Parents Savers, “for moms and dads with newborns, infants and toddlers”. Coming up next week we have Lara Audelo from MamaPearDesigns, discussing social media connections for the breastfeeding mom. Thanks for listening to The Boob Group, your judgment for your breastfeeding resource.
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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