Transcript: New Mom Breastfeeding Manual: First 24 Hours

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The Boob Group
New Mom Breastfeeding Manual: First 24 Hours

Robin Kaplan: So you are about to have a baby, congratulations! Whether you are a first-time mom or this is your second or third time around, what happens during those first 24 hours after your baby is born can make an impact on your breastfeeding relationship. What can you do during those first 24 hours to maximize your success?

Today we have launched the first episode in our brand new series, ‘The New Breast Feeding Mom Manual.’ Our episode today focuses on the first 24 hours and I'm thrilled to welcome back one of our experts Veronica Tingzon an International Board Certified Lactation Consultant and owner of the Original Comfort Food in San Diego, California.

[Theme Music/Intro]

Robin Kaplan: Welcome to The Boob Group, Broadcasting from the Birth Education Centre of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I am your host Robin Kaplan. I am also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre.

Thanks to all of our loyal listeners who have joined The Boob Group Club, our members get all of our archived 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. So we are joined today with two lovely panelists in the studio, would you like to introduce yourselves, please?
Melanie: Hi, I’m Melanie. I am 34 and I have got two kids, two boys one is 5 years old and the other one is going to be seven weeks old on Tuesday.

Robin Kaplan: Fantastic! And, Stephanie?

Stephanie: I’m Stephanie. I am 36. I am a very part time teacher and I have two boys, a 2-year old and a six week old.

Robin Kaplan: Awesome. Welcome ladies to the show it’s so nice to have you. I also want to introduce The Boob Group new producer. I’d like to in traduce MJ. So MJ you want to introduce yourself and tell us little about what you do for the show?

MJ: Well, my name is MJ and I have a son who is just 22, my one and only. I’m coordinating getting all you moms here today and just basically social media chatting with everybody and trying to get everybody coordinated together so that we can have you all talk and come share.

Robin Kaplan: Absolutely, so one of the things MJ is doing is she is going to be posting little bits to bits from our episode as we are recording and so whenever we are doing our recording days you can always check on our Facebook pages and Twitter and follow along with the conversation so nice to have you MJ.

MJ: Thank you!

[Theme Music]

Robin Kaplan: So we are here with Ysabel Lopez, the owner of Nurture-Elle and we are so excited to have you on the show, Ysabella so, thanks for joining us.

Ysabel Lopez: Thank you very much for having me on the show.

Robin Kaplan: Sure, can you tell us a little bit about your company? When did you first start Nurture-Elle and what was the inspiration for creating it?

Ysabel Lopez: Yeah, it all started back in 2010, with the birth of my first child. I had bought breastfeeding clothing available at that time and I realize the clothing was not giving me the discretion I wanted when nursing in public places or in front of other people. I always had to hide myself from the public places or remain in private room and the openings were too small and very difficult to access. They were also very evident that the tops were nursing tops and out of fashion.

So having that experience and also my professional experience of 17 years in the textile sector I decided to create my company and design my own breastfeeding clothing. I designed my nursing tops with advice of my lactation consultant as well as opinion of breastfeeding mothers so that I could really capture the needs of real moms looking for comfortable, elegant and stylish nursing tops. And this is how Nurture-Elle started and of course my inspiration was my first son Oliver.

Robin Kaplan: That’s so cool. So tell us about Nurture-Elle’s product.

Ysabel Lopez: You know, Nurture-Elle is a Canadian company and I am also a designer of Nurture-Elle clothing and all the styles are designed here in Canada. Before designing every collection I got information on color and style. Everything that is trendy in the women fashion industry. Then based on that information I design the nursing tops with accessible openings that provides two basic things, one it’s an easy way for the baby to access the breast and the second one is the design that is also discreet for the mom. So another important factor here is the fabric, we use cotton and viscose. Both type of fabric are very soft and also and also have between 5% and 10% of spandex as a component and these will adapt to fit your body shape and will establish your pre-pregnancy weight. So because of the styles are very stretchy they can also be worn during pregnancy.

Robin Kaplan: That’s terrific! So, I was looking on your website and I saw that Nurture-Elle has a passion for helping developing countries. Can you tell us a little bit more about that?

Ysabel Lopez: Yes, our garments are 100% manufactured in Peru and through my company we are creating a team of support for women and I will tell you how. Our garment supplier has more companies led by women and spinner who are the only financial support to their families. We are very careful when we choose our suppliers and the criteria is not only based in the quality side but also we want to work with people that are helping other people, specially, women.

Robin Kaplan: That’s amazing, oh my gosh. It provides a whole another aspect of a company where you can hear the passion in the owner’s voice about what they are doing. You also sponsor some breastfeeding events as well, don’t you?

Ysabel Lopez: Yeah, we sponsor many events in Canada and The United States, the most important ones are The Big Latch On that is going to be on August 2 and the Breast Feeding Challenge that will be on October 5. If any of your listeners is hosting a site for one of these events or any other breastfeeding events please contact me through my website and we’ll be more than happy to sponsor the event. We always want to support any type of activity just to help women or encourage women to keep breastfeeding their babies.

Robin Kaplan: That’s terrific. So Ysabel, where can our listeners find Nurture-Elle products?

Ysabel Lopez: Your listeners can find Nurture-Elle products in more than 40 stores throughout Canada and The US. Also the products can be found and purchased 24/7 at our website that’s www.nurture-elle.com and the spelling is W-W-W.N-U-R-T-U-R-E-hyphen-E-L-L-E.com. On our website you will see a detail information of every product also picture of their openings and video testimonials from moms that have purchased our products.

Robin Kaplan: That’s terrific; well we also have two fun little events going on with you as well, we have for our listeners, Ysabel has given us a promo code where you get fifteen that’s 15% off on any of the products on the Nurture-Elle website just using the promo code “Boob Media” which is so apropos for us. So that’s B-O-O-B M-E-D-I-A, which you will also find this on our website as well and then she will also be hosting a giveaway running from the time this episode launches through July 31, 2013 and this giveaway is for a $50 gift card to be used on a nursing top where you can choose your size and your color of your choice. So go ahead and visit our website the boobgroup.com for more links to Nurture-Elle and for the promo code as well as the giveaway. So, thanks so much Ysabel, it was a pleasure having you on our show.

Ysabel Lopez: Thank you very much all of you for having me.

Robin Kaplan: We appreciate yeah, we appreciate all the things your company is doing to really promote not only breastfeeding women but women all over the world, so thanks you so much.

[Theme Music]

Robin Kaplan: Today on The Boob Group we are discussing breastfeeding in those first 24 hours such a critical, critical time of breastfeeding. So our expert Veronica Tingzon is an International Board Certified Lactation Consultant and owner of the Original Comfort Food in San Diego, California. Thanks for joining us Veronica and welcome back to the show.

Veronica Tingzon: Thank you Robin and thank you, everybody, here at The Boob Group, I am so happy to be back.

Robin Kaplan: Absolutely, we’ve missed you.

Veronica Tingzon: I know it has.

Robin Kaplan: So this is -- we’re really excited to launch this new series. We’re going to be looking at the first 24 hours today and then moving on to the first week, first two weeks, first couple of months, and so that way moms who are dealing with all of this stuff right then or if they want to preemptively listen to what they have to look forward to and that will be broken down that way. So, Veronica, just to get started you know a baby’s birth story can definitely impact breastfeeding and we actually have an entire episode dedicated to this topic, so what should mom do during labor to optimize her breastfeeding success in the first 24 hours?

Veronica Tingzon: This one is kind of what I call the first step to the rest of your lactation experience because all of the birth choices that we make happen to be impacting our lactation outcome. I’ve had many discussions with anesthesiologists where they tell me where they tell me, an epidural doesn’t do anything wrong, and yeah it may not hurt the baby per se but it can make it so that it’s a more difficult start to breastfeeding. Fentanyl and Stadol are okay in the IV. Yeah, but again it could make it more difficult, may be natural birth is not for everyone, maybe trying to avoid a C-section is not for everyone granted.

But what we do in that timeframe when we are laboring does impact the breastfeeding story. So one other thing is that I tell moms is just really get into that breathing, changing position, don’t be stationary, try to avoid being tied down to the bed specially the IV. If you can just get a sailing lock or something so that you can have the port in you and not actually having the IV in you and you can walk around, use a birthing ball, if you have access to a birthing tab, if you have access to a warm shower, trying to avoid coming to the hospital too soon, all of those things where you’re working in that really good labor and really working your own hormones to make things happen for you, is going to be what’s best for you not only during this birth process but to also later on during the breastfeeding process.

Robin Kaplan: Okay and why is it so important to breastfeed your baby during the first two hours after birth? What’s going on with baby at this time?

Veronica Tingzon: Babies are hardwired to find the breast. They like the contrast between the light and dark skin that’s why our areola get darker, that’s why we get the linea nigra of the abdomen. So a baby who normally in olden days, would have been delivered to the abdomen would actually crawl because they have the stepping reflex they will crawl up the abdomen, find the breast and just naturally latch on. So their primal instinct is to imprint to that breast and there is a hormonal and pheromonal receptors that a baby is just drenched in right after birth that allows them to do that. After those first two hours those pheromones start to fade, they start to wane and babies start getting tired, I mean think about when you go out swimming in the ocean and you are being hit by wave after wave after wave and there is no bottom that you can rest at and that’s what birth is like to a baby and so they come out and are like, ‘oh my god, I'm so tired’ and they are exhausted and finally when they go to sleep and those hormonal instincts starts to wear down then when you try to put them to the breast they are like, ‘well hello!’ Those primal instinct starts to wane and then they are like, ‘I know what to do’ and you get them to a breast and it looks like they have no idea what to do with it.

Robin Kaplan: Okay, I love that metaphor that you used about the waves and everything because also when you come out of the water to your - what’s the word I am looking for- you’re so psyched, I mean you’re out. You did this huge thing and so your endorphins are super high and then you crash.

Veronica Tingzon: Absolutely.

Robin Kaplan: It’s like after running a marathon you are like.

Veronica Tingzon: Exactly.

Robin Kaplan: Super psyche, eat a huge meal and then you sleep for hours and so and then you are sore.

Veronica Tingzon: Then you are sore, exactly.

Robin Kaplan: So, how important is skin to skin during the first 24 hours to really help bring in the milk supply?

Veronica Tingzon: Skin to skin is, god it’s so integral. I can’t even tell you how important skin to skin is, I mean let’s start with the physiological impact on the baby itself. When the baby is skin to skin his temperature is maintained in the proper section of temperature ranges for that infant. Its heartbeat is maintained, its breathing rate is maintained, its circadian rhythm - the sleep cycles is maintained, their blood sugars are maintained which is a very big thing because when their blood sugars go down that’s when a lot of untoward supplement can happen.

So, just in that physiological impact right there, that’s really important. The other important thing is that the baby is right there smelling momma getting used to the scent of the cafe and if he is sitting there smelling it he is like, ‘oh gosh, what’s that waft. I mean it smells like cinnabons, let me go down and investigate. And I’m going to go and have a nibble of that,’ so they go down there and he didn’t even know he was hungry until he smelt that waft and then for mom that skin to skin, that pheromone exchange between her and her baby helps to produce more prolactin, it helps to release more oxytocin and then that helps that milk supply just to increase just without even the baby having to latch, just by being there and it’s just such an incredible thing I mean we were designed this way, you go back to the cave man era moms didn’t need swaddling blanket they had themselves to keep their babies warm, they had themselves to nourish their babies, it was pretty darn awesome.

Robin Kaplan: And they smell so good.

Veronica Tingzon: I know.

Robin Kaplan: They smell so good, so ladies did you breast feed your baby in the first two hours and if you did, were you surprised at how alert your little one was at that time, how about you Melanie?

Melanie: I did, I wasn’t surprised because this was my second one, my first baby just wide eyed, looking at me like, ‘hi, I am hungry, feed me.’ And the second one sort of the same he was a little bit more tired but he did latch on right away and I delivered at Pomerado where one of their policies is it’s skin to skin in the first hours.

Robin Kaplan: Yeah

Melanie: They don’t do any tests. They don't wash or nothing, it’s just you and the baby, that was really nice, that was a good experience to have there.

Robin Kaplan: That’s fantastic. How about you Stephanie?

Stephanie: Oh yeah definitely in the first two hours right away but not surprised also because this is my second. He actually was a little bit drowsier and because our birth story had a little bit of some issues getting latched on the first time but we had some excellent help at Kaiser as well with that so.

Robin Kaplan: Yes, some two very baby friendly hospitals in San Diego.

Stephanie: Yeah, very baby friendly.

Robin Kaplan: Which is awesome.

Stephanie: Yeah, we did skin to skin right away.

Melanie: And I love that he’s singing back here too.

Robin Kaplan: I know. What’s his name, again?

Melanie: This is Colin.

Robin Kaplan: This is Colin. Colin’s singing in our studio. It’s always fun to have a baby in the studio so. Veronica, what if a mom is separated from her baby during those first 24 hours and can’t breastfeed obviously that impact without the skin to skin can be really hard but also how else can she start to bring in her milk supply then?

Veronica Tingzon: There’s wonderful ways that she can start to bring in her milk supply. You have them attached at the end of your arm. You can start by just doing some manual stimulation, a lot of moms say, ‘well, the nurses didn’t bring me the pumps soon enough.’ Well you could have started massaging or you could have started doing some hand expression, you yourself can take control of that particular situation.

Back in the day when there weren’t pumps your hands were your pumps if you had to express your own milk. But the studies have shown over and over again that the sooner the pumping does start or the expression does start the better the impact. So within three hours is what’s optimal, no later than six hours and it’s really sad to say that I have seen moms in the hospitals – I've worked at several area hospitals here in San Diego county and I’ll walk into a room and the mom will say, ‘I delivered yesterday’ and I’ll look at the clock and it’s 12 hours later and she doesn’t even have a pump in her room, I am just – my heart just sinks, having been a mom myself my heart sinks because I remember the engorgement that late pumping or expression brings on and it’s really, it just my heart breaks for them.

Robin Kaplan: Absolutely, and we’ll include a link on our website page as well to a great hand expression video out of Stanford University.

Veronica Tingzon: I love that one, yes.

Robin Kaplan: Yeah, Jane Morton.

Veronica Tingzon: Yes

Robin Kaplan: All that does is take about five minutes to watch and you can become quite a pro at expressing your own milk.

Veronica Tingzon: I have to say I just saw a momma in the hospital just a few days ago, she had been checking her breast every month or every two week during her pregnancy and she had already started the milk going and her baby ended up in the NICU and by day two she was expressing like 30 milliliters, which is an ounce. 30 milliliters of breast milk like a first time mom is unheard of, but she was so proactive in the beginning that it was just like rivers of milk coming out it was so cool.

Robin Kaplan: Oh, that’s amazing. So tell us about this colostrums essential that she was -- well she was probably already into transitional mode by then but.

Veronica Tingzon: Yes.

Robin Kaplan: So, what is colostrum, why it is so important and what’s in it?

Veronica Tingzon: Well, colostrum is what we referred to as liquid gold. It’s kind of golden in color, can also be kind of a little bit more clearish amber kind of a color. It’s basically jam packed protein in somewhat liquid form. It’s kind of gooey and sticky and thick kind of the consistency of may be honey or molasses so it doesn’t flow very well and a lot of mom to have to pump for a NICU baby say, ‘oh nothing is coming out I don’t have any milk’ but it’s harder to get it out via the pump than the baby can do it. Rest assured if you do have to go down that road, it’s in there just the pump doesn’t get it out very well.

Robin Kaplan: I liken it to sucking maple syrup out of a straw.

Veronica Tingzon: Exactly. It’s just so viscous, it’s amazing but a lot of moms, even if they are hand expressing and they see a glob of colostrums they’ll say, ‘I have had no milk, I have no milk’ and I'm going, ‘yes it is it’s the first milk, it’s wonderful’ and if you think about a protein bar like something that‘s jam packed with protein you can fill up quite well on a protein bar and then it sustains you for quite a little time but if that’s all you are eating you would have to eat it a lot very frequently whereas the more mature milk has, there is more volume of it. So, it’s not a lot of volume but it is so jam packed with protein and so many anti-bodies and it’s pretty much all there’s wonderful white blood cells that are protecting your baby and giving your baby its first immunities and it’s just, like I said, it’s liquid gold. It’s so cool.

Robin Kaplan: Very cool. Well, when we come back we will be discussing with Veronica and our panelists, how to know if your baby is getting enough of that colostrum in the first 24 hours as well as what to do if your nipples become sore even within those first 24 hours? So we’ll be right back!

[Theme Music]

Robin Kaplan: Welcome back to the show, we are here with Veronica Tingzon, an International Board Certified Lactation Consultant and the owner of the Original Comfort Food in San Diego, California. So Veronica, how often should a baby eat in those first 24 hours and how long does these feeding sessions take?

Veronica Tingzon: Well, the verbiage that we use at the hospital that I work at is that a new born baby can eat anywhere from 8 to 20 times or more even especially like in hotter days in the first 24 hours. Now, the very, very first 24 hours are kind of their own little weird subset of hours because baby does not behave in any way that --

Robin Kaplan: Predictable.

Veronica Tingzon: Yeah, that you would expect them to as they would, may be, on day two, day three or day four. So what they do is they do a lot of snacking and then a lot of long stretches of sleeping. So they might bunch up or what we call cluster feed two, three, four times and then zonked out for a long time and then another two, three, four times and zonked out, and if you take from the birth time that they are born at and when they feed to the birth time the next day in those 24 hours, how many times did your baby do those cluster feedings. You’d be surprised that how many they actually do but because people are trying to wake them up every two to three hours and the baby is not ready at that time. It’s like me telling you, ‘Hey Robin, you have to eat right now’ and you are like, ‘hold on a second I just ate an hour ago, I am not hungry at this moment.’ I can’t force you to eat when you are not hungry I’ll eat when I actually have the appetite and as soon as mom start just kind of giving in to that and letting their baby do this thing and not watching the clock and not watching every three hours go by and, ‘oh my god, he is not waking up,’ then they kind of do it a little bit better. And it does add up.

Robin Kaplan: Melanie you were shaking your head with that, nodding your head, when you said eight to 20 times, so do you remember feeding very frequently?

Melanie: Oh yeah, and I still do.

Veronica Tingzon: Which is normal, it’s normal.

Melanie: Yeah.

Robin Kaplan: Exactly. I remember hearing the study of somewhere in Africa, and the name was—a hospital in Africa so, very similar situation birthing practices in the United States. But the women they didn’t have little cubicles they put their babies in and they bed shared in the hospital and the babies fed about 16 times in the 24 hours period in those first 24 hours and the mom milk came in within 36 hours. Her fuller milk came in.

Veronica Tingzon: Yes.

Robin Kaplan: So it already had transitioned into that transitional milk where it start to drip a little bit and because babies had free access and they weren’t – maybe didn’t have clocks in the room or something where they were looking at it but every time -- and some of those were probably five minutes long other milk times may be 20 minutes but they were just kind of bouncing back and forth between the breast and that stimulation really helped the supply come in much more quickly.

Veronica Tingzon: Many years ago I was in Guatemala with a missionary group with my father and what not, and we did some medical stuff and there was a mother there who had just birthed a baby and the midwife or as they call the ‘Partera’ was telling her just go ahead and feed the baby but the grandmother of the baby was saying, ‘no, no, no you don’t want the baby to get used to the arms’ and I said, ‘listen to the partera’ and that mom was lactating probably within a little bit under two days also.

Robin Kaplan: It’s amazing, so how important is for the baby to feed from both breast during a feeding if we’re kind of following baby’s lead on how sleepy they are in the first 24 hours?

Veronica Tingzon: I always say offer. If the baby takes it he takes and if he doesn’t he doesn’t. It’s kind of like when the guy comes by in the restaurant with the dessert tray and says, do you want any? And you are like okay, you know, and sometimes you are like no, I’ve had enough and that’s kind of what the baby will do, he’ll guide you and tell you I have had enough or yeah a little desert sound like, might be good.

Robin Kaplan: Yeah, kind of what I recommend too is also just having access to both breast, look at over 24 hours period are we having equal access here and so that way but maybe not looking at it each time.

Veronica Tingzon: Yeah, it’s you want to alternate which one you offer each time. But you don’t have to be so rigid about, okay 10 minutes here or 10 minutes there, or 15 here and 15 there. No, it’s just kind of like let the baby do something on the right this time around and then maybe the next time I will do something on the left.

Robin Kaplan: Okay and how will a mom know if her baby’s getting enough colostrum in those first 24 hours and how much is actually normal for a baby to get per feeding?

Veronica Tingzon: A baby in a new, new, new born phase shouldn’t get more than about 7 milliliters, which is a tea spoon may be of colostomy and so they are eating so frequently but they’ve got little tiny little marble sized bellies so they are not eating a whole bunch at each feed, it’s just kind of like little nibbles here and there. Like I said they are power packed they are protein packed, so they are more packed for the punch. But a lot of mom said, I don't think my baby is eating enough, because they are crying, they are hysterical they are this or that.

One of the ways that we can tell that they have done well enough is looking at the body cues, they start out tight and throughout the feed they become more limp and more relaxed and more flaccid and then they look kind of like they are a little drunk after the feed I mean you remember those, yeah? Milk drunk we call it, yeah. Somebody else used to say milk fated. They get that kind of drunk tone and then the other thing is that you if we write down or if you keep a log of baby’s pees and poops, the baby only needs to have one pee and one poop in the first day of life and in the second 24 hours only two pees, two poops and third 24 hours only three pees and three poops, I mean that’s, it’s like, per day of life you are going to increase the pees and poops. Once the full mature milk is in and flowing they should have somewhere about six to eight pees a day and about three to four poops a day and if they are really eating well, they are going to be pooping and peeing every single time that they eat. It’s like how many diapers can I get through. Oh and then you change one and they poop more, so really honestly I mean tracking the pees and poops, looking at the baby’s body and looking for those cues of the satiety and everything, that’s what is going to tell you that they are doing well. Crying, crying just mean I have a need, that’s it, they are just talking to you.

Robin Kaplan: So, ladies, what did breastfeeding look like for you, if you can remember back to those first 24 hours. Stephanie, how about you?

Stephanie: Like we mentioned before, he latched on right away, still in that first hour. And then because we had a problem. We discovered that my son have a tongue tied and within the first 24 hours and had to have that dealt with. It sort of my cues that I something was wrong was, how much it was already hurting and that the pain I was experiencing and just how difficult and how discontent he seemed at the breast kind of what Veronica was saying and so we got some help for that right away. And then another funny issue we had that he wouldn’t nurse in the cradle position on my left side so we have to come up with other way so, to make sure that breast was getting stimulated as well.

Robin Kaplan: Common, common.

Stephanie: Yeah, but definitely wanted to eat, it felt like all the time but then we also dealt with the issue that Veronica was mentioning where he want to sleep for a really long time but he was really big baby and they wanted to test his blood sugars all the time and I felt like things were really disrupted and not necessarily the way we would have just naturally flowed with them.

Robin Kaplan: Okay, how about you Melanie?

Melanie: Well, between the two experiences I’ve had, my first son had real difficult time latching on so the first 24 hours was just painful. And with the second, I was so happy because my little boy was bigger than the first and he managed to latch real easily and I thought, ‘yay! We are not going to have problem’ we did have some later on when my milk finally came in. But he did really well, he would eat every hour or so and then he would take a long naps since he was at a fine weight they weren’t bugging me to feed him constantly and wake him up so I just kind of let him guide the conversation between the two us.

Veronica Tingzon: I liked the way you said that, that’s awesome.

Robin Kaplan: Veronica, what are your top five tips for new breastfeeding moms to make breastfeeding comfortable in those first 24 hours for both her and baby?

Veronica Tingzon: Well, Number one, I love to live on the pillow island in those first 24 hours because moms will have – I just crack up where moms will have like a pillow and she will squish it all the way down to her waist and that’s it. That’s how she is going to hold her baby at. And how much did your baby weigh at birth?

Melanie: Almost 10 pounds.

Veronica Tingzon: Almost 10 pounds. So try to hold --

Robin Kaplan: The size of a two-month-old.

Veronica Tingzon: Exactly, the size of a – try to hold up even an eight pound baby for let’s say 30 to 45 minutes, which is around the typical time frame that they will eat and hold that baby up with the pillows down at your waist, your boobs are not down at your waist, your breasts are up here, okay and so you have to just build this pillow nest, this pillow island around you and have lots of support for floating elbow, floating babies and don’t be afraid to build that nest up so that you can get your baby really, really, really, really close to you and tummy to tummy and chest to chest so that’s number one first and foremost. Number two, don't be afraid to be skin to skin all day, all night. I don’t care how long it takes, be skin to skin with your baby. Have your shirt off, have baby down to their diaper and just go skin to skin put them in their, what we call the niche, which is the little area right in the cleavage right between your breast where your baby would just get to snuggle up and if you don’t know how to do that go to the zoo and look at a gorilla and see how the gorillas do it because they know what to do.

Robin Kaplan: They have mastered it.

Veronica Tingzon: They have really, like they have no pretences about swaddling their babies or anything like that. And then, really honestly the one you were telling me over here is that your baby doesn’t’ open up his mouth very wide to eat and that’s actually you driven and how to get the mouth open is just, don’t be trying to shove your nipple into your baby’s mouth. I always use the analogy of if the car goes into the garage before the garage door is all the way up, you are going to damage your car right, so it’s the same thing with your nipples. If your nipples go into the mouth/garage it’s going to damage your nipple, so you have got to wait till that garage is all the way open. So the baby’s mouth has to be completely open, you’ve got to move swiftly and keenly to bring the baby into the breast before the garage door starts closing again. So that’s really important to me because with sore nipples comes the idea of I don’t want to eat – I don’t want to feed that often sorry, because it hurts to feed. And let’s see, don’t have your baby in the box, have your baby with you all the time. Swaddling depresses the desire to eat so once again being skin to skin, not swaddling them, having them right there with you at all times is really going to have them open up and want to be there and like I said they start smelling the cinnabons, they want to eat them.

Robin Kaplan: That’s terrific, Stephanie, you kind of already talked about some breast feeding challenges that you had in the first 24 hours so definitely nipple pain.

Stephanie: Yeah.

Robin Kaplan: And you said your son had a tongue tie as well, it’s actually it’s quite rare to have it caught so soon so.

Stephanie: We had experience with my older son it’s the same issue.

Robin Kaplan: Yeah, so you were ready to look into it. Any other challenges that you had in the first 24 hours?

Stephanie: One of my challengers was actually more related to the hospital, Kaiser’s a very baby friendly hospital but they had a very busy postpartum department while I was there and getting the help that we needed and so delaying feedings because I was trying to get a nurse to come and help me figure out what is going on and like I said I think it disrupted the flow of what naturally should have been going on and like I said just the funny not latching, refusing to lay a certain way and we needed to get some help with that.

Robin Kaplan: Yeah. How about you Melanie?

Melanie: Yeah, the soreness the normal over use of soreness and interruptions obviously, in the hospital, you have people coming in and checking on you constantly so never knowing who is going to walk in at the door they ended up changing a light in my room and they’re like, is it okay a man comes in here? I'm like, if he’s okay with me nursing! I really don't. But I know for some people that might be a big issue.

Robin Kaplan: Yeah, that’s true.

Melanie: You don't want some stranger walking in your room while you’re trying to feed your child, try to bounce the baby.

Robin Kaplan: Absolutely, one thing I want to mention too with Stephanie mentioning favoring one side over the other. We definitely see the slot I am sure you do Veronica.

Veronica Tingzon: Yes.

Robin Kaplan: Kind of depending on the way the baby was sitting in utero, sometimes they have a little crick in their neck and so if you think about when you are driving a car and it hurts to turn left and so every time you try to look out of your mirror you have to turn your entire body to turn around but then when you turn the other way you have free range of motion until sometimes that just need to kind of work itself out to have a little body work and also becoming creative with the position like Stephanie was talking about. So where if your baby feels comfortable on cradle hold on one side just kind of shifting it into like a football hold on the other so they’re always facing the same direction until that little kink in the neck can kind of work itself out. Did you find that was helpful?

Veronica Tingzon: Definitely, that’s the position we ended up doing. The other thing that I would add that I wish I had known the first time in first 24 hours was asking for help and that it’s okay to admit that you are having a hard time and that there are people there to help you and to seek out that help.

Melanie: I totally buzz the nurses every time I was going to latch and they would come in and they are like, ‘are you serious?’ but my first son was, it was so painful in the hospital as well and I was like if I am going to do this I would like someone to take a look at it and just may be possibly make it more comfortable so I will continue to do this and so and, yeah my husband was like we totally like, it was worth our money, we made sure that we got everything we need by the time we left, it’s like every amenity that you get in a hotel, in the hospital it’s the same way.

Veronica Tingzon: Well, I would even say even if it seems like everything is going okay because until your milk comes in, there are some things that you might not even know so maybe have somebody look at it just to make sure.
Robin Kaplan: Absolutely, absolutely. All right, well thank you so much Veronica and our panelists for sharing this incredibly valuable information about breastfeeding in the first 24 hours and for our Boob Group Club members our conversation will continue after the end of the show as Veronica will discuss how delaying baby’s first stuff can also help with breast feeding. For more information about our Boob Group Club please visit our website at the boobgroup.com.

[Theme Music]

Robin Kaplan: All right, so we are reviewing a brand new app. In this app is called Nuunest, it’s N-U-U-N-E-S-T and so just a little brief synopsis of this app is that not only does it have the information about tracking for example that a lot of these apps have about breastfeeding and diaper count and weight and all that kind of stuff. But it goes a little bit beyond that because the creators are actually registered nurses and International Board Certified Lactation Consultants and so some of the things that they’ve included in here, they are about, for example, the importance of breast milk, its affects on mother’s health as well as, I love this section, I know I'm supposed to share what I love about it later. But it has an all about mom section so, for example, different things about nutrition while you are breastfeeding, what is normal for breast tenderness, nipple tenderness and then when maybe you should seek a lactation consultant. And it also gets into other things, like after having a baby for example what’s normal blood flow after you’ve had your baby and what are some signs that maybe you should call your midwife or your OB, it talks about swollen feet which I am sure everyone remembers those swollen feet after your kiddos have been born and exercise fatigue. So it really has a lot, it’s almost like a website in an app. So I know that the ladies in the studio actually haven’t been able to look at this app yet so we were just kind of ask you all is this something that you thought maybe you would use? Melanie, how about you?

Melanie: Definitely, I wish I had an iPhone so I could try the app out. It definitely would have helped in the beginning to be able to count when I am nursing, when we’re changing diapers, because there you go through so many and you are so tired you don’t remember, you’ve had it on your left on your right, well what’s happening?

Robin Kaplan: Exactly, how about you Stephanie?

Stephanie: Yeah, I think I had an app that I was using but I loved I had so much more to it other than just the count. The resources that are available in terms of what’s normal because we did have some issues so it would have been nice to have had that right at my fingertips.

Robin Kaplan: Yeah, absolutely, how about you MJ, I know you looked at it?

MJ: Yeah, I loved, we did a lot of milk donating so I liked the – or not donating but I was a recipient so I liked the area of giving information about breast milk and then about the milk banks which is really cool. We did actually milk sharing and not milk banks but it’s nice to have information out there for everyone.

Robin Kaplan: Absolutely. We are also are having a couple of bloggers review this app as well and so this is what they had to say.

Blogger: Hey mommas, this is Anna from Indianapolis. I just tried out the Nuunest app, this is a great app for breastfeeding mommas or bottle feeding mommas who are looking for ways to freckles their life and I think this is a great app if you’re looking for an app to track with the last time you set on and the last diaper change and the last nap anything like that so I highly recommend it but don’t forget anytime you are questioning anything about your baby you should just trust your momma gut, talk to you later, Bye.

Jessica: Hey, everyone, this is Jessica from Oklahoma and I just had a chance to review the Nuunest app. I love that this app was created by registered nurses and board certified lactation consultants. To me that means that there is a lot of thought put behind in information in that app and it’s something you can really rely on and as a new mom I really do appreciate that. One of the things that I forget to do sometimes with my baby is give my baby Vitamin B and they even have a section for Vitamin B and when was the last time you gave your baby Vitamin B. I thought this was great. They also have a great section for expressing your breast milk. It has a timer in it, things that I would use on a daily basis. Also for bottle feeding, you can track how much breast milk you gave as well as formula and I think that’s really important too because even as breastfeeding moms that are really passionate about it sometimes we have to supplement and I am really glad that the creators of this app recognized that and appreciated that so I highly recommend this app for other new mommies out there, thanks so much.

Robin Kaplan: If you are interested in downloading this app you would go to iTunes and it is called Nuunest, N-U-U-N-E-S-T and while you are there don’t forget to download our free Boob Group app and either the iTunes marketplace as well as amazon’s market place. So we’ll be reviewing this and giving it our thumbs up.

[Theme Music]

Robin Kaplan: That wraps up our show for today. We appreciate you listening to The Boob Group. Don’t forget to check out our sister shows, Preggie Pals’ for Expecting Parents and our show Parent Savers for Moms and Dads with Newborns, Infants and Toddlers. Coming up next week we have Catherine Watson Genna discussing Reflux and GERD in a Breast Fed Baby.
Thanks for listening to The Boob Group; Your Judgment Free Breastfeeding Resource.

[Disclaimer]
This has been a New Mommy Media production. The 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 such information in these areas are believed 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.

[42:56]
[End of Audio]

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Episode Transcript

The Boob Group
New Mom Breastfeeding Manual: First 24 Hours

Robin Kaplan: So you are about to have a baby, congratulations! Whether you are a first-time mom or this is your second or third time around, what happens during those first 24 hours after your baby is born can make an impact on your breastfeeding relationship. What can you do during those first 24 hours to maximize your success?

Today we have launched the first episode in our brand new series, ‘The New Breast Feeding Mom Manual.’ Our episode today focuses on the first 24 hours and I'm thrilled to welcome back one of our experts Veronica Tingzon an International Board Certified Lactation Consultant and owner of the Original Comfort Food in San Diego, California.

[Theme Music/Intro]

Robin Kaplan: Welcome to The Boob Group, Broadcasting from the Birth Education Centre of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I am your host Robin Kaplan. I am also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre.

Thanks to all of our loyal listeners who have joined The Boob Group Club, our members get all of our archived 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. So we are joined today with two lovely panelists in the studio, would you like to introduce yourselves, please?
Melanie: Hi, I’m Melanie. I am 34 and I have got two kids, two boys one is 5 years old and the other one is going to be seven weeks old on Tuesday.

Robin Kaplan: Fantastic! And, Stephanie?

Stephanie: I’m Stephanie. I am 36. I am a very part time teacher and I have two boys, a 2-year old and a six week old.

Robin Kaplan: Awesome. Welcome ladies to the show it’s so nice to have you. I also want to introduce The Boob Group new producer. I’d like to in traduce MJ. So MJ you want to introduce yourself and tell us little about what you do for the show?

MJ: Well, my name is MJ and I have a son who is just 22, my one and only. I’m coordinating getting all you moms here today and just basically social media chatting with everybody and trying to get everybody coordinated together so that we can have you all talk and come share.

Robin Kaplan: Absolutely, so one of the things MJ is doing is she is going to be posting little bits to bits from our episode as we are recording and so whenever we are doing our recording days you can always check on our Facebook pages and Twitter and follow along with the conversation so nice to have you MJ.

MJ: Thank you!

[Theme Music]

Robin Kaplan: So we are here with Ysabel Lopez, the owner of Nurture-Elle and we are so excited to have you on the show, Ysabella so, thanks for joining us.

Ysabel Lopez: Thank you very much for having me on the show.

Robin Kaplan: Sure, can you tell us a little bit about your company? When did you first start Nurture-Elle and what was the inspiration for creating it?

Ysabel Lopez: Yeah, it all started back in 2010, with the birth of my first child. I had bought breastfeeding clothing available at that time and I realize the clothing was not giving me the discretion I wanted when nursing in public places or in front of other people. I always had to hide myself from the public places or remain in private room and the openings were too small and very difficult to access. They were also very evident that the tops were nursing tops and out of fashion.

So having that experience and also my professional experience of 17 years in the textile sector I decided to create my company and design my own breastfeeding clothing. I designed my nursing tops with advice of my lactation consultant as well as opinion of breastfeeding mothers so that I could really capture the needs of real moms looking for comfortable, elegant and stylish nursing tops. And this is how Nurture-Elle started and of course my inspiration was my first son Oliver.

Robin Kaplan: That’s so cool. So tell us about Nurture-Elle’s product.

Ysabel Lopez: You know, Nurture-Elle is a Canadian company and I am also a designer of Nurture-Elle clothing and all the styles are designed here in Canada. Before designing every collection I got information on color and style. Everything that is trendy in the women fashion industry. Then based on that information I design the nursing tops with accessible openings that provides two basic things, one it’s an easy way for the baby to access the breast and the second one is the design that is also discreet for the mom. So another important factor here is the fabric, we use cotton and viscose. Both type of fabric are very soft and also and also have between 5% and 10% of spandex as a component and these will adapt to fit your body shape and will establish your pre-pregnancy weight. So because of the styles are very stretchy they can also be worn during pregnancy.

Robin Kaplan: That’s terrific! So, I was looking on your website and I saw that Nurture-Elle has a passion for helping developing countries. Can you tell us a little bit more about that?

Ysabel Lopez: Yes, our garments are 100% manufactured in Peru and through my company we are creating a team of support for women and I will tell you how. Our garment supplier has more companies led by women and spinner who are the only financial support to their families. We are very careful when we choose our suppliers and the criteria is not only based in the quality side but also we want to work with people that are helping other people, specially, women.

Robin Kaplan: That’s amazing, oh my gosh. It provides a whole another aspect of a company where you can hear the passion in the owner’s voice about what they are doing. You also sponsor some breastfeeding events as well, don’t you?

Ysabel Lopez: Yeah, we sponsor many events in Canada and The United States, the most important ones are The Big Latch On that is going to be on August 2 and the Breast Feeding Challenge that will be on October 5. If any of your listeners is hosting a site for one of these events or any other breastfeeding events please contact me through my website and we’ll be more than happy to sponsor the event. We always want to support any type of activity just to help women or encourage women to keep breastfeeding their babies.

Robin Kaplan: That’s terrific. So Ysabel, where can our listeners find Nurture-Elle products?

Ysabel Lopez: Your listeners can find Nurture-Elle products in more than 40 stores throughout Canada and The US. Also the products can be found and purchased 24/7 at our website that’s www.nurture-elle.com and the spelling is W-W-W.N-U-R-T-U-R-E-hyphen-E-L-L-E.com. On our website you will see a detail information of every product also picture of their openings and video testimonials from moms that have purchased our products.

Robin Kaplan: That’s terrific; well we also have two fun little events going on with you as well, we have for our listeners, Ysabel has given us a promo code where you get fifteen that’s 15% off on any of the products on the Nurture-Elle website just using the promo code “Boob Media” which is so apropos for us. So that’s B-O-O-B M-E-D-I-A, which you will also find this on our website as well and then she will also be hosting a giveaway running from the time this episode launches through July 31, 2013 and this giveaway is for a $50 gift card to be used on a nursing top where you can choose your size and your color of your choice. So go ahead and visit our website the boobgroup.com for more links to Nurture-Elle and for the promo code as well as the giveaway. So, thanks so much Ysabel, it was a pleasure having you on our show.

Ysabel Lopez: Thank you very much all of you for having me.

Robin Kaplan: We appreciate yeah, we appreciate all the things your company is doing to really promote not only breastfeeding women but women all over the world, so thanks you so much.

[Theme Music]

Robin Kaplan: Today on The Boob Group we are discussing breastfeeding in those first 24 hours such a critical, critical time of breastfeeding. So our expert Veronica Tingzon is an International Board Certified Lactation Consultant and owner of the Original Comfort Food in San Diego, California. Thanks for joining us Veronica and welcome back to the show.

Veronica Tingzon: Thank you Robin and thank you, everybody, here at The Boob Group, I am so happy to be back.

Robin Kaplan: Absolutely, we’ve missed you.

Veronica Tingzon: I know it has.

Robin Kaplan: So this is -- we’re really excited to launch this new series. We’re going to be looking at the first 24 hours today and then moving on to the first week, first two weeks, first couple of months, and so that way moms who are dealing with all of this stuff right then or if they want to preemptively listen to what they have to look forward to and that will be broken down that way. So, Veronica, just to get started you know a baby’s birth story can definitely impact breastfeeding and we actually have an entire episode dedicated to this topic, so what should mom do during labor to optimize her breastfeeding success in the first 24 hours?

Veronica Tingzon: This one is kind of what I call the first step to the rest of your lactation experience because all of the birth choices that we make happen to be impacting our lactation outcome. I’ve had many discussions with anesthesiologists where they tell me where they tell me, an epidural doesn’t do anything wrong, and yeah it may not hurt the baby per se but it can make it so that it’s a more difficult start to breastfeeding. Fentanyl and Stadol are okay in the IV. Yeah, but again it could make it more difficult, may be natural birth is not for everyone, maybe trying to avoid a C-section is not for everyone granted.

But what we do in that timeframe when we are laboring does impact the breastfeeding story. So one other thing is that I tell moms is just really get into that breathing, changing position, don’t be stationary, try to avoid being tied down to the bed specially the IV. If you can just get a sailing lock or something so that you can have the port in you and not actually having the IV in you and you can walk around, use a birthing ball, if you have access to a birthing tab, if you have access to a warm shower, trying to avoid coming to the hospital too soon, all of those things where you’re working in that really good labor and really working your own hormones to make things happen for you, is going to be what’s best for you not only during this birth process but to also later on during the breastfeeding process.

Robin Kaplan: Okay and why is it so important to breastfeed your baby during the first two hours after birth? What’s going on with baby at this time?

Veronica Tingzon: Babies are hardwired to find the breast. They like the contrast between the light and dark skin that’s why our areola get darker, that’s why we get the linea nigra of the abdomen. So a baby who normally in olden days, would have been delivered to the abdomen would actually crawl because they have the stepping reflex they will crawl up the abdomen, find the breast and just naturally latch on. So their primal instinct is to imprint to that breast and there is a hormonal and pheromonal receptors that a baby is just drenched in right after birth that allows them to do that. After those first two hours those pheromones start to fade, they start to wane and babies start getting tired, I mean think about when you go out swimming in the ocean and you are being hit by wave after wave after wave and there is no bottom that you can rest at and that’s what birth is like to a baby and so they come out and are like, ‘oh my god, I'm so tired’ and they are exhausted and finally when they go to sleep and those hormonal instincts starts to wear down then when you try to put them to the breast they are like, ‘well hello!’ Those primal instinct starts to wane and then they are like, ‘I know what to do’ and you get them to a breast and it looks like they have no idea what to do with it.

Robin Kaplan: Okay, I love that metaphor that you used about the waves and everything because also when you come out of the water to your - what’s the word I am looking for- you’re so psyched, I mean you’re out. You did this huge thing and so your endorphins are super high and then you crash.

Veronica Tingzon: Absolutely.

Robin Kaplan: It’s like after running a marathon you are like.

Veronica Tingzon: Exactly.

Robin Kaplan: Super psyche, eat a huge meal and then you sleep for hours and so and then you are sore.

Veronica Tingzon: Then you are sore, exactly.

Robin Kaplan: So, how important is skin to skin during the first 24 hours to really help bring in the milk supply?

Veronica Tingzon: Skin to skin is, god it’s so integral. I can’t even tell you how important skin to skin is, I mean let’s start with the physiological impact on the baby itself. When the baby is skin to skin his temperature is maintained in the proper section of temperature ranges for that infant. Its heartbeat is maintained, its breathing rate is maintained, its circadian rhythm - the sleep cycles is maintained, their blood sugars are maintained which is a very big thing because when their blood sugars go down that’s when a lot of untoward supplement can happen.

So, just in that physiological impact right there, that’s really important. The other important thing is that the baby is right there smelling momma getting used to the scent of the cafe and if he is sitting there smelling it he is like, ‘oh gosh, what’s that waft. I mean it smells like cinnabons, let me go down and investigate. And I’m going to go and have a nibble of that,’ so they go down there and he didn’t even know he was hungry until he smelt that waft and then for mom that skin to skin, that pheromone exchange between her and her baby helps to produce more prolactin, it helps to release more oxytocin and then that helps that milk supply just to increase just without even the baby having to latch, just by being there and it’s just such an incredible thing I mean we were designed this way, you go back to the cave man era moms didn’t need swaddling blanket they had themselves to keep their babies warm, they had themselves to nourish their babies, it was pretty darn awesome.

Robin Kaplan: And they smell so good.

Veronica Tingzon: I know.

Robin Kaplan: They smell so good, so ladies did you breast feed your baby in the first two hours and if you did, were you surprised at how alert your little one was at that time, how about you Melanie?

Melanie: I did, I wasn’t surprised because this was my second one, my first baby just wide eyed, looking at me like, ‘hi, I am hungry, feed me.’ And the second one sort of the same he was a little bit more tired but he did latch on right away and I delivered at Pomerado where one of their policies is it’s skin to skin in the first hours.

Robin Kaplan: Yeah

Melanie: They don’t do any tests. They don't wash or nothing, it’s just you and the baby, that was really nice, that was a good experience to have there.

Robin Kaplan: That’s fantastic. How about you Stephanie?

Stephanie: Oh yeah definitely in the first two hours right away but not surprised also because this is my second. He actually was a little bit drowsier and because our birth story had a little bit of some issues getting latched on the first time but we had some excellent help at Kaiser as well with that so.

Robin Kaplan: Yes, some two very baby friendly hospitals in San Diego.

Stephanie: Yeah, very baby friendly.

Robin Kaplan: Which is awesome.

Stephanie: Yeah, we did skin to skin right away.

Melanie: And I love that he’s singing back here too.

Robin Kaplan: I know. What’s his name, again?

Melanie: This is Colin.

Robin Kaplan: This is Colin. Colin’s singing in our studio. It’s always fun to have a baby in the studio so. Veronica, what if a mom is separated from her baby during those first 24 hours and can’t breastfeed obviously that impact without the skin to skin can be really hard but also how else can she start to bring in her milk supply then?

Veronica Tingzon: There’s wonderful ways that she can start to bring in her milk supply. You have them attached at the end of your arm. You can start by just doing some manual stimulation, a lot of moms say, ‘well, the nurses didn’t bring me the pumps soon enough.’ Well you could have started massaging or you could have started doing some hand expression, you yourself can take control of that particular situation.

Back in the day when there weren’t pumps your hands were your pumps if you had to express your own milk. But the studies have shown over and over again that the sooner the pumping does start or the expression does start the better the impact. So within three hours is what’s optimal, no later than six hours and it’s really sad to say that I have seen moms in the hospitals – I've worked at several area hospitals here in San Diego county and I’ll walk into a room and the mom will say, ‘I delivered yesterday’ and I’ll look at the clock and it’s 12 hours later and she doesn’t even have a pump in her room, I am just – my heart just sinks, having been a mom myself my heart sinks because I remember the engorgement that late pumping or expression brings on and it’s really, it just my heart breaks for them.

Robin Kaplan: Absolutely, and we’ll include a link on our website page as well to a great hand expression video out of Stanford University.

Veronica Tingzon: I love that one, yes.

Robin Kaplan: Yeah, Jane Morton.

Veronica Tingzon: Yes

Robin Kaplan: All that does is take about five minutes to watch and you can become quite a pro at expressing your own milk.

Veronica Tingzon: I have to say I just saw a momma in the hospital just a few days ago, she had been checking her breast every month or every two week during her pregnancy and she had already started the milk going and her baby ended up in the NICU and by day two she was expressing like 30 milliliters, which is an ounce. 30 milliliters of breast milk like a first time mom is unheard of, but she was so proactive in the beginning that it was just like rivers of milk coming out it was so cool.

Robin Kaplan: Oh, that’s amazing. So tell us about this colostrums essential that she was -- well she was probably already into transitional mode by then but.

Veronica Tingzon: Yes.

Robin Kaplan: So, what is colostrum, why it is so important and what’s in it?

Veronica Tingzon: Well, colostrum is what we referred to as liquid gold. It’s kind of golden in color, can also be kind of a little bit more clearish amber kind of a color. It’s basically jam packed protein in somewhat liquid form. It’s kind of gooey and sticky and thick kind of the consistency of may be honey or molasses so it doesn’t flow very well and a lot of mom to have to pump for a NICU baby say, ‘oh nothing is coming out I don’t have any milk’ but it’s harder to get it out via the pump than the baby can do it. Rest assured if you do have to go down that road, it’s in there just the pump doesn’t get it out very well.

Robin Kaplan: I liken it to sucking maple syrup out of a straw.

Veronica Tingzon: Exactly. It’s just so viscous, it’s amazing but a lot of moms, even if they are hand expressing and they see a glob of colostrums they’ll say, ‘I have had no milk, I have no milk’ and I'm going, ‘yes it is it’s the first milk, it’s wonderful’ and if you think about a protein bar like something that‘s jam packed with protein you can fill up quite well on a protein bar and then it sustains you for quite a little time but if that’s all you are eating you would have to eat it a lot very frequently whereas the more mature milk has, there is more volume of it. So, it’s not a lot of volume but it is so jam packed with protein and so many anti-bodies and it’s pretty much all there’s wonderful white blood cells that are protecting your baby and giving your baby its first immunities and it’s just, like I said, it’s liquid gold. It’s so cool.

Robin Kaplan: Very cool. Well, when we come back we will be discussing with Veronica and our panelists, how to know if your baby is getting enough of that colostrum in the first 24 hours as well as what to do if your nipples become sore even within those first 24 hours? So we’ll be right back!

[Theme Music]

Robin Kaplan: Welcome back to the show, we are here with Veronica Tingzon, an International Board Certified Lactation Consultant and the owner of the Original Comfort Food in San Diego, California. So Veronica, how often should a baby eat in those first 24 hours and how long does these feeding sessions take?

Veronica Tingzon: Well, the verbiage that we use at the hospital that I work at is that a new born baby can eat anywhere from 8 to 20 times or more even especially like in hotter days in the first 24 hours. Now, the very, very first 24 hours are kind of their own little weird subset of hours because baby does not behave in any way that --

Robin Kaplan: Predictable.

Veronica Tingzon: Yeah, that you would expect them to as they would, may be, on day two, day three or day four. So what they do is they do a lot of snacking and then a lot of long stretches of sleeping. So they might bunch up or what we call cluster feed two, three, four times and then zonked out for a long time and then another two, three, four times and zonked out, and if you take from the birth time that they are born at and when they feed to the birth time the next day in those 24 hours, how many times did your baby do those cluster feedings. You’d be surprised that how many they actually do but because people are trying to wake them up every two to three hours and the baby is not ready at that time. It’s like me telling you, ‘Hey Robin, you have to eat right now’ and you are like, ‘hold on a second I just ate an hour ago, I am not hungry at this moment.’ I can’t force you to eat when you are not hungry I’ll eat when I actually have the appetite and as soon as mom start just kind of giving in to that and letting their baby do this thing and not watching the clock and not watching every three hours go by and, ‘oh my god, he is not waking up,’ then they kind of do it a little bit better. And it does add up.

Robin Kaplan: Melanie you were shaking your head with that, nodding your head, when you said eight to 20 times, so do you remember feeding very frequently?

Melanie: Oh yeah, and I still do.

Veronica Tingzon: Which is normal, it’s normal.

Melanie: Yeah.

Robin Kaplan: Exactly. I remember hearing the study of somewhere in Africa, and the name was—a hospital in Africa so, very similar situation birthing practices in the United States. But the women they didn’t have little cubicles they put their babies in and they bed shared in the hospital and the babies fed about 16 times in the 24 hours period in those first 24 hours and the mom milk came in within 36 hours. Her fuller milk came in.

Veronica Tingzon: Yes.

Robin Kaplan: So it already had transitioned into that transitional milk where it start to drip a little bit and because babies had free access and they weren’t – maybe didn’t have clocks in the room or something where they were looking at it but every time -- and some of those were probably five minutes long other milk times may be 20 minutes but they were just kind of bouncing back and forth between the breast and that stimulation really helped the supply come in much more quickly.

Veronica Tingzon: Many years ago I was in Guatemala with a missionary group with my father and what not, and we did some medical stuff and there was a mother there who had just birthed a baby and the midwife or as they call the ‘Partera’ was telling her just go ahead and feed the baby but the grandmother of the baby was saying, ‘no, no, no you don’t want the baby to get used to the arms’ and I said, ‘listen to the partera’ and that mom was lactating probably within a little bit under two days also.

Robin Kaplan: It’s amazing, so how important is for the baby to feed from both breast during a feeding if we’re kind of following baby’s lead on how sleepy they are in the first 24 hours?

Veronica Tingzon: I always say offer. If the baby takes it he takes and if he doesn’t he doesn’t. It’s kind of like when the guy comes by in the restaurant with the dessert tray and says, do you want any? And you are like okay, you know, and sometimes you are like no, I’ve had enough and that’s kind of what the baby will do, he’ll guide you and tell you I have had enough or yeah a little desert sound like, might be good.

Robin Kaplan: Yeah, kind of what I recommend too is also just having access to both breast, look at over 24 hours period are we having equal access here and so that way but maybe not looking at it each time.

Veronica Tingzon: Yeah, it’s you want to alternate which one you offer each time. But you don’t have to be so rigid about, okay 10 minutes here or 10 minutes there, or 15 here and 15 there. No, it’s just kind of like let the baby do something on the right this time around and then maybe the next time I will do something on the left.

Robin Kaplan: Okay and how will a mom know if her baby’s getting enough colostrum in those first 24 hours and how much is actually normal for a baby to get per feeding?

Veronica Tingzon: A baby in a new, new, new born phase shouldn’t get more than about 7 milliliters, which is a tea spoon may be of colostomy and so they are eating so frequently but they’ve got little tiny little marble sized bellies so they are not eating a whole bunch at each feed, it’s just kind of like little nibbles here and there. Like I said they are power packed they are protein packed, so they are more packed for the punch. But a lot of mom said, I don't think my baby is eating enough, because they are crying, they are hysterical they are this or that.

One of the ways that we can tell that they have done well enough is looking at the body cues, they start out tight and throughout the feed they become more limp and more relaxed and more flaccid and then they look kind of like they are a little drunk after the feed I mean you remember those, yeah? Milk drunk we call it, yeah. Somebody else used to say milk fated. They get that kind of drunk tone and then the other thing is that you if we write down or if you keep a log of baby’s pees and poops, the baby only needs to have one pee and one poop in the first day of life and in the second 24 hours only two pees, two poops and third 24 hours only three pees and three poops, I mean that’s, it’s like, per day of life you are going to increase the pees and poops. Once the full mature milk is in and flowing they should have somewhere about six to eight pees a day and about three to four poops a day and if they are really eating well, they are going to be pooping and peeing every single time that they eat. It’s like how many diapers can I get through. Oh and then you change one and they poop more, so really honestly I mean tracking the pees and poops, looking at the baby’s body and looking for those cues of the satiety and everything, that’s what is going to tell you that they are doing well. Crying, crying just mean I have a need, that’s it, they are just talking to you.

Robin Kaplan: So, ladies, what did breastfeeding look like for you, if you can remember back to those first 24 hours. Stephanie, how about you?

Stephanie: Like we mentioned before, he latched on right away, still in that first hour. And then because we had a problem. We discovered that my son have a tongue tied and within the first 24 hours and had to have that dealt with. It sort of my cues that I something was wrong was, how much it was already hurting and that the pain I was experiencing and just how difficult and how discontent he seemed at the breast kind of what Veronica was saying and so we got some help for that right away. And then another funny issue we had that he wouldn’t nurse in the cradle position on my left side so we have to come up with other way so, to make sure that breast was getting stimulated as well.

Robin Kaplan: Common, common.

Stephanie: Yeah, but definitely wanted to eat, it felt like all the time but then we also dealt with the issue that Veronica was mentioning where he want to sleep for a really long time but he was really big baby and they wanted to test his blood sugars all the time and I felt like things were really disrupted and not necessarily the way we would have just naturally flowed with them.

Robin Kaplan: Okay, how about you Melanie?

Melanie: Well, between the two experiences I’ve had, my first son had real difficult time latching on so the first 24 hours was just painful. And with the second, I was so happy because my little boy was bigger than the first and he managed to latch real easily and I thought, ‘yay! We are not going to have problem’ we did have some later on when my milk finally came in. But he did really well, he would eat every hour or so and then he would take a long naps since he was at a fine weight they weren’t bugging me to feed him constantly and wake him up so I just kind of let him guide the conversation between the two us.

Veronica Tingzon: I liked the way you said that, that’s awesome.

Robin Kaplan: Veronica, what are your top five tips for new breastfeeding moms to make breastfeeding comfortable in those first 24 hours for both her and baby?

Veronica Tingzon: Well, Number one, I love to live on the pillow island in those first 24 hours because moms will have – I just crack up where moms will have like a pillow and she will squish it all the way down to her waist and that’s it. That’s how she is going to hold her baby at. And how much did your baby weigh at birth?

Melanie: Almost 10 pounds.

Veronica Tingzon: Almost 10 pounds. So try to hold --

Robin Kaplan: The size of a two-month-old.

Veronica Tingzon: Exactly, the size of a – try to hold up even an eight pound baby for let’s say 30 to 45 minutes, which is around the typical time frame that they will eat and hold that baby up with the pillows down at your waist, your boobs are not down at your waist, your breasts are up here, okay and so you have to just build this pillow nest, this pillow island around you and have lots of support for floating elbow, floating babies and don’t be afraid to build that nest up so that you can get your baby really, really, really, really close to you and tummy to tummy and chest to chest so that’s number one first and foremost. Number two, don't be afraid to be skin to skin all day, all night. I don’t care how long it takes, be skin to skin with your baby. Have your shirt off, have baby down to their diaper and just go skin to skin put them in their, what we call the niche, which is the little area right in the cleavage right between your breast where your baby would just get to snuggle up and if you don’t know how to do that go to the zoo and look at a gorilla and see how the gorillas do it because they know what to do.

Robin Kaplan: They have mastered it.

Veronica Tingzon: They have really, like they have no pretences about swaddling their babies or anything like that. And then, really honestly the one you were telling me over here is that your baby doesn’t’ open up his mouth very wide to eat and that’s actually you driven and how to get the mouth open is just, don’t be trying to shove your nipple into your baby’s mouth. I always use the analogy of if the car goes into the garage before the garage door is all the way up, you are going to damage your car right, so it’s the same thing with your nipples. If your nipples go into the mouth/garage it’s going to damage your nipple, so you have got to wait till that garage is all the way open. So the baby’s mouth has to be completely open, you’ve got to move swiftly and keenly to bring the baby into the breast before the garage door starts closing again. So that’s really important to me because with sore nipples comes the idea of I don’t want to eat – I don’t want to feed that often sorry, because it hurts to feed. And let’s see, don’t have your baby in the box, have your baby with you all the time. Swaddling depresses the desire to eat so once again being skin to skin, not swaddling them, having them right there with you at all times is really going to have them open up and want to be there and like I said they start smelling the cinnabons, they want to eat them.

Robin Kaplan: That’s terrific, Stephanie, you kind of already talked about some breast feeding challenges that you had in the first 24 hours so definitely nipple pain.

Stephanie: Yeah.

Robin Kaplan: And you said your son had a tongue tie as well, it’s actually it’s quite rare to have it caught so soon so.

Stephanie: We had experience with my older son it’s the same issue.

Robin Kaplan: Yeah, so you were ready to look into it. Any other challenges that you had in the first 24 hours?

Stephanie: One of my challengers was actually more related to the hospital, Kaiser’s a very baby friendly hospital but they had a very busy postpartum department while I was there and getting the help that we needed and so delaying feedings because I was trying to get a nurse to come and help me figure out what is going on and like I said I think it disrupted the flow of what naturally should have been going on and like I said just the funny not latching, refusing to lay a certain way and we needed to get some help with that.

Robin Kaplan: Yeah. How about you Melanie?

Melanie: Yeah, the soreness the normal over use of soreness and interruptions obviously, in the hospital, you have people coming in and checking on you constantly so never knowing who is going to walk in at the door they ended up changing a light in my room and they’re like, is it okay a man comes in here? I'm like, if he’s okay with me nursing! I really don't. But I know for some people that might be a big issue.

Robin Kaplan: Yeah, that’s true.

Melanie: You don't want some stranger walking in your room while you’re trying to feed your child, try to bounce the baby.

Robin Kaplan: Absolutely, one thing I want to mention too with Stephanie mentioning favoring one side over the other. We definitely see the slot I am sure you do Veronica.

Veronica Tingzon: Yes.

Robin Kaplan: Kind of depending on the way the baby was sitting in utero, sometimes they have a little crick in their neck and so if you think about when you are driving a car and it hurts to turn left and so every time you try to look out of your mirror you have to turn your entire body to turn around but then when you turn the other way you have free range of motion until sometimes that just need to kind of work itself out to have a little body work and also becoming creative with the position like Stephanie was talking about. So where if your baby feels comfortable on cradle hold on one side just kind of shifting it into like a football hold on the other so they’re always facing the same direction until that little kink in the neck can kind of work itself out. Did you find that was helpful?

Veronica Tingzon: Definitely, that’s the position we ended up doing. The other thing that I would add that I wish I had known the first time in first 24 hours was asking for help and that it’s okay to admit that you are having a hard time and that there are people there to help you and to seek out that help.

Melanie: I totally buzz the nurses every time I was going to latch and they would come in and they are like, ‘are you serious?’ but my first son was, it was so painful in the hospital as well and I was like if I am going to do this I would like someone to take a look at it and just may be possibly make it more comfortable so I will continue to do this and so and, yeah my husband was like we totally like, it was worth our money, we made sure that we got everything we need by the time we left, it’s like every amenity that you get in a hotel, in the hospital it’s the same way.

Veronica Tingzon: Well, I would even say even if it seems like everything is going okay because until your milk comes in, there are some things that you might not even know so maybe have somebody look at it just to make sure.
Robin Kaplan: Absolutely, absolutely. All right, well thank you so much Veronica and our panelists for sharing this incredibly valuable information about breastfeeding in the first 24 hours and for our Boob Group Club members our conversation will continue after the end of the show as Veronica will discuss how delaying baby’s first stuff can also help with breast feeding. For more information about our Boob Group Club please visit our website at the boobgroup.com.

[Theme Music]

Robin Kaplan: All right, so we are reviewing a brand new app. In this app is called Nuunest, it’s N-U-U-N-E-S-T and so just a little brief synopsis of this app is that not only does it have the information about tracking for example that a lot of these apps have about breastfeeding and diaper count and weight and all that kind of stuff. But it goes a little bit beyond that because the creators are actually registered nurses and International Board Certified Lactation Consultants and so some of the things that they’ve included in here, they are about, for example, the importance of breast milk, its affects on mother’s health as well as, I love this section, I know I'm supposed to share what I love about it later. But it has an all about mom section so, for example, different things about nutrition while you are breastfeeding, what is normal for breast tenderness, nipple tenderness and then when maybe you should seek a lactation consultant. And it also gets into other things, like after having a baby for example what’s normal blood flow after you’ve had your baby and what are some signs that maybe you should call your midwife or your OB, it talks about swollen feet which I am sure everyone remembers those swollen feet after your kiddos have been born and exercise fatigue. So it really has a lot, it’s almost like a website in an app. So I know that the ladies in the studio actually haven’t been able to look at this app yet so we were just kind of ask you all is this something that you thought maybe you would use? Melanie, how about you?

Melanie: Definitely, I wish I had an iPhone so I could try the app out. It definitely would have helped in the beginning to be able to count when I am nursing, when we’re changing diapers, because there you go through so many and you are so tired you don’t remember, you’ve had it on your left on your right, well what’s happening?

Robin Kaplan: Exactly, how about you Stephanie?

Stephanie: Yeah, I think I had an app that I was using but I loved I had so much more to it other than just the count. The resources that are available in terms of what’s normal because we did have some issues so it would have been nice to have had that right at my fingertips.

Robin Kaplan: Yeah, absolutely, how about you MJ, I know you looked at it?

MJ: Yeah, I loved, we did a lot of milk donating so I liked the – or not donating but I was a recipient so I liked the area of giving information about breast milk and then about the milk banks which is really cool. We did actually milk sharing and not milk banks but it’s nice to have information out there for everyone.

Robin Kaplan: Absolutely. We are also are having a couple of bloggers review this app as well and so this is what they had to say.

Blogger: Hey mommas, this is Anna from Indianapolis. I just tried out the Nuunest app, this is a great app for breastfeeding mommas or bottle feeding mommas who are looking for ways to freckles their life and I think this is a great app if you’re looking for an app to track with the last time you set on and the last diaper change and the last nap anything like that so I highly recommend it but don’t forget anytime you are questioning anything about your baby you should just trust your momma gut, talk to you later, Bye.

Jessica: Hey, everyone, this is Jessica from Oklahoma and I just had a chance to review the Nuunest app. I love that this app was created by registered nurses and board certified lactation consultants. To me that means that there is a lot of thought put behind in information in that app and it’s something you can really rely on and as a new mom I really do appreciate that. One of the things that I forget to do sometimes with my baby is give my baby Vitamin B and they even have a section for Vitamin B and when was the last time you gave your baby Vitamin B. I thought this was great. They also have a great section for expressing your breast milk. It has a timer in it, things that I would use on a daily basis. Also for bottle feeding, you can track how much breast milk you gave as well as formula and I think that’s really important too because even as breastfeeding moms that are really passionate about it sometimes we have to supplement and I am really glad that the creators of this app recognized that and appreciated that so I highly recommend this app for other new mommies out there, thanks so much.

Robin Kaplan: If you are interested in downloading this app you would go to iTunes and it is called Nuunest, N-U-U-N-E-S-T and while you are there don’t forget to download our free Boob Group app and either the iTunes marketplace as well as amazon’s market place. So we’ll be reviewing this and giving it our thumbs up.

[Theme Music]

Robin Kaplan: That wraps up our show for today. We appreciate you listening to The Boob Group. Don’t forget to check out our sister shows, Preggie Pals’ for Expecting Parents and our show Parent Savers for Moms and Dads with Newborns, Infants and Toddlers. Coming up next week we have Catherine Watson Genna discussing Reflux and GERD in a Breast Fed Baby.
Thanks for listening to The Boob Group; Your Judgment Free Breastfeeding Resource.

[Disclaimer]
This has been a New Mommy Media production. The 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 such information in these areas are believed 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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