Transcript: When Breastfeeding Doesn’t Go As Planned
The Boob Group
When Breastfeeding Doesn’t Go As Planned
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[Theme Music]
Rose deVigne: There are rare occasions when a mother may have done everything she can to prepare to have a successful breastfeeding relationship with her baby, but something causes unavoidable challenges. When plans A, B and C don’t improve the breastfeeding situation, what are plans D, E, F and maybe G? I am Rose deVigne Jackiewicz, an International Board Certified Lactation Consultant and Lactation Consultant at Kaiser Permanente outpatient Lactation Clinic in San Diego, California. Today, we are discussing options for when breastfeeding doesn’t go as planned. This is The Boob Group.
[Theme Music/Intro]
Robin Kaplan: Welcome to the Boob Group, broadcasting from the Birth Education Centre of San Diego. I am your host, Robin Kaplan. I am also a Certified Lactation Consultant and owner of The San Diego Breastfeeding Center. At the Boob Group, we are an online support group for all things related to Breastfeeding. Have you checked out our fabulous articles on our blog yet? We have several moms who have offered to blog about their breastfeeding experiences for The Boob Group and I was completely blown away by their stories.If you are interested in sharing your breastfeeding stories, feel free to contact me through the link on our https://www.theboobgroup.com website. Today, I am joined by three lovely panelists in this studio. Ladies, would you please introduce yourselves?
Tamar Blanco: Hello Robin, my name is Tamar Blanco. I am 34 and I am… for work, I work at the housing commission and I am the mother of two children ages 6 and 2 months old.
Michelle Reed: Hi, I am Michelle Reed, I am 31. I am a wife and a mother that’s kind of my job [Laughs] and I have my important…
Robin Kaplan: This is an important job! [Laughs]
Michelle Reed: Yes! And I have 5 children.
Robin Kaplan: Well, how old are your children?
Michelle Reed: I have an eleven-year-old, nine-year-old, seven-year-old, four-year-old and seven weeks.
Robin Kaplan: Nice!
Michelle Reed: Thank you.
Heidi Runge: Hi I am Heidi Runge, I am 33. I am apparently, I have one child and he’s nine months old.
Robin Kaplan: Alright, welcome to the show ladies!
[Theme Music]
[Featured Segment: Ask The Experts]
Robin Kaplan: Before we get started with today’s topic, here’s a question you all had for one of our experts.
Carine: Hi Boob Group, my name is Carine and I am calling from Santa Claire, California and I have a question about my 4 months. I have recently noticed that her poop has changed color.It’s sort of a green color and it smells different and I have always heard that if the poop was green that’s possibly a bad thing or that’s she has a cold but she seems happy all the time and there really isn’t any issue’s; so I am just wondering if it’s a change in the fact that she’s 4 months or if there is something that I should be concerned about? Please let me know! Thank you.
Dr. Frederick Johnson: Hi this is Dr. Johnson, having green stools isn’t necessarily a sign of an infection or a problem. Certainly, it can be related to what the child is eating although its four months it’s usually pretty limited.But, colors you should worry about what’s your baby’s poop are red, black or almost white. Those are more telling signs of a problem, so as far as the green stools, I wouldn’t be worrying a bit. Keep feeding her and if she’s already started on any salads that can certainly affect the color of her stools and the aroma of that too. So, hope that answers your question and if you have any more let us know. Ba-bye!
Robin Kaplan: If you have a question about one of our topics mentioned on our shows, call The Boob Group Hotline at 619-866-4775.
[Theme Music]
Robin Kaplan: Today on The Boob Group, we are discussing what a mom can do when breastfeeding doesn’t go as planned. Our returning expert Rose deVigne Jackiewicz has been an International Board Certified Lactation Consultant since 1984 and is a Lactation Consultant at the Out-Patient Lactation Clinic at Kaiser Permanente, San Diego which celebrated their 10 year anniversary, correct?
Rose deVigne: Actually 12 years.
Robin Kaplan: Oh 12 years, my goodness!
Rose deVigne: 12 years.
Robin Kaplan: That’s fantastic, so thanks for joining us Rose and welcome back to the show.
Rose deVigne: Well, I am very happy to be here, thank you!
Robin Kaplan: So Rose, what can a pregnant mom do to set herself up for optimal breastfeeding success?
Rose deVigne: Well, actually there’s many things she can do, one of the first things I think is finding good books to read on breastfeeding.But, above and beyond that is when you go in for prenatal visits with your OB make sure that a thorough breast examination is done to identify any potential issues with your breast, your nipples; potential issues with previous breast surgery, also I think prenatal breastfeeding classes as well as a prenatal consult. If you have concerns that maybe something might not be right, go in for a prenatal consult with a lactation consultant and you get a lot of information that way.
[00:05:21]
Robin Kaplan: Absolutely, it’s interesting that you mentioned that talk to your health care provider prenatally about your breast. We just had an episode a couple of weeks ago about insufficient glandular tissue and the women said that the only reason they found out that they had it was after they had their baby, but they always kind of knew that there might be some… an issue but it was never brought by their OB/GYN. I don't any of them had seen mid-wives cos I can’t remember but that’s an interesting thing that you had mentioned that it could be something to talk about before you had your baby.
Rose deVigne: I think over the years, I have had women who said “well,yeah,they looked at my breast but, nobody has ever said anything. Nobody ever addressed my inverted nipples other than the fact my favorite was a woman who had an inverted nipples and her doctor said don’t worry when your baby’s born they will pop out..”[Laughs]
Robin Kaplan: Like they are done, like she can.[Laughs]
Rose deVigne: Exactly, and they will say,“they didn’t pop out…”
Robin Kaplan: Yeah!
Rose deVigne: So!
Robin Kaplan: Ladies, did you do anything prenatally to prepare for breastfeeding?
Tamar Blanco: I had taken a breastfeeding class with my 6 years old daughter before she was born, but this time I just didn’t get her around to it. I just thought it was gonna happen and I thought well I had probably the first time this time it will be different, so I was little naïve [Laughs].
Robin Kaplan: Well no not necessarily, you were hopeful [Laughs].
Tamar Blanco: Yeah!
Robin Kaplan: Thank you Tamar. How about you Michelle?
Michelle Reed: I have read lots of books. Anything that I could get my hands on, inside the doctor’s office I grab things and also I found it very helpful that in magazines when you see the pictures of mothers breastfeeding I started myself with pictures of moms already breastfeeding just to give myself a positive outlook like it’s been done, it can’t be done, I can do it, so…
Robin Kaplan: So, that’s what… I never ever heard of that idea, but I love it. That’s wonderful and another reason also to attend a breastfeeding support group all your pregnant too just surround your…surround yourself with other breastfeeding moms. How about you Heidi?
Heidi Runge: I also attended a, I guess prenatal class on breastfeeding. I had books; I started books and then I slowly finish books [Laughs] which may have been part of the problem [Laughs].
Robin Kaplan: Rose, what are the signs that a mom should look for to indicate that there are some breastfeeding challenges going on because sometimes they are not so obvious?
Rose deVigne: It is a very good question. Some of them things like for example, history of infertility, depending on the reason for infertility, sometimes you may have low milk supply based on the type of infertility like PCOS which is Poly Cystic Ovarian Syndrome which is probably the most common cause of infertility, probably the 50% of those women are known to have low milk supply so knowing that upfront, breast surgery, what type of breast surgery augmentation, reduction, inverted nipples knowing those things as well. Another example is Type-1 diabetes, many moms do not realize or they are not told that it’s common to have a delayed unset milk supply when you have type 1 diabetes. So knowing that upfront you are not so surprised to find out that your baby may have to have a supplement because of low blood sugars or because your milk supply doesn’t fully come in until 5-6-7days.
Robin Kaplan: Absolutely, and what assistants is typically available in the hospital or once the mom is back at home?
Rose deVigne: In the hospital there should be a lactation consultant that is available to assess you and who would go through your history, asking you questions such as any promise getting pregnant, did your breast get bigger during pregnancy, any history of breast surgery, any medical problems, allergies, things like that to fully assess are you at risk for having breastfeeding problems or milk supply issues and then if you are identifiedas having these issues maybe your baby is born early and your milk supply hasn’t fully come in by the time you go home hopefully, there is a lactation clinic or lactation consultant like Robin that you can go to see after going home from the hospital. Most moms and babies are seeing their pediatricians within 24 to 48 hours of going home from the hospital, should almost be the same for lactation if you’re identified it is having, what I call risk factors.
Robin Kaplan: Absolutely! Ladies, when did you first know that you needed some extra breastfeeding assistants, some additional support?
Tamar Blanco: Well, my baby was four days old and in the hospital they said that he had lost already more than 8% and that was really scary for me. So, they just automatically assigned a lactation nurse to me and she was able to come by and assess the problem and how I could solve the problem with spoon feeding and by pumping, so that was a very good help.
[00:10:12]
Robin Kaplan: That’s fantastic Tamar, Thank you. How about you Michelle?
Michelle Reed: Day three when we have to go back for the well- baby check, she already lost weight too much and they kept having those come back every three days or so and they checked her suck in, she was tongue tied so she had to go in for that like,we went in on day three and day four she was clipped so then we kept going back to Lactation specialist, we were at the hospital a lot [Laughs]…
Robin Kaplan: Yeah, yeah, were you going back for weight checks at the hospital?
Michelle Reed: Yes!
Robin Kaplan: Okay, how about you Heidi?
Heidi Runge: Day three, we had a doctor’s appointment and that was a Friday and he had lost I believe over 10% of his weight; he was born at 8 pounds 9 ounces. 8:01 he was discharged the hospital and then 7:10 on day three which is quite bit so, my milk still hadn’t started to come in and when is there an issue, so he suggested supplementing but then of course it was a weekend and I had a meltdown and I called them puke [Laughs] and day six I got help, so….
Robin Kaplan: Yeah, Rose, and just to clarify too because we are talking about lactation educators and specialists in the hospital and what is it difference between a lactation educator, LaLeche League Leader and an International Board Certified Lactation Consultant?
Rose deVigne: A lactation educator is could be a child with an educator or it could be a postpartum nurse, is somebody who’s taken a course on basic management of breastfeeding. They can help you with positioning and latch and your common problems of minor sore nipples, engorgement. A LaLeche League Leader is just by history is been like Le consultants, a layperson who has knowledge of helping you with breastfeeding and some of the LaLeche League Leaders are-oh my gosh wonderful. They have been doing this so long that some of them have more experience than I do, okay.It’s just that they are more of the grassroots. You know, I have been doing this for thirty years and I have been helping moms. An International Board Certified Lactation Consultant is somebody who has sit for an exam. It’s an all-day exam, very intense exam that test her skills for lactation but the other thing about the International Board Certified Lactation Consultant is, there are specialized in your more complicated cases for breastfeeding. They go beyond your normal sore nipples, beyond your engorgement. They specialize in problem-oriented situations.
Robin Kaplan: So what should a mom expect in working with someone with those 3 different types of qualifications?
Rose deVigne: Well, first of all asking, you know, asking them what they’re, you know, experience is and if it’s a lactation educator and you’re having major problems, you might ask for a referral to a board-certified lactation consultant, asking her have you worked with this kind of problem before and if she hasn’t, hopefully, she will, you know, be open and say you know what I am not as experienced in this and let me refer you, but again the lactation educator is more for basic common problems as well as LaLeche League Leader and then the IBCLC is much more problem-oriented and generally has a lot more experience in dealing with complicated cases.
Robin Kaplan: Okay! And then kind of getting in to those complicated cases now, so when dealing with low milk supply what options does a mom have to increase her supply and what should she feed her baby until her supply increases, and I realizes this is an own topic in itself but just kind of a basic overall?
Rose deVigne: It’s definitely a topic in itself and how long do you have to talk [Laughs] and again as an international board-certified lactation consultant it kind depends on why the milk supply is low. There is various herbs, there is various medications that can be taken but it’s gonna depend on the individual moms history, what she is allergic to, what she is, you know, what she is capable of taking. But, you know, she… the first thing that moms typically needs to do is additional pumping. Hospital-grade pump is my preference because it’s designed to help establish a milk supply and then adding either herbs or medications depending on the individual situation and as far as what to feed the baby in the meantime, whatever milk you get absolutely, feed them, any amount of breast milk is gonna benefit the baby and the World Health Organization says number two choice should be donor milk and we’ve had more moms that have had sisters, best friends that have donated milk. There are issues with making sure there health is good because you are, you know, taking others, somebody else’s milk and donor milk is always available. The donor milk banks, its about 3 dollar an ounce and that’s really reserved more for preemiesor very sick babies but that is still an option and then the final option is artificial baby milk or formula and again depending on family history, milk allergies, things like that you might need to pick the one that’s best and most appropriate for the baby and you may need supplement with a little bit of that until your full milk supply increases and that’s okay, that’s okay to do. A lot of moms feel like they are failing if they have to use formula and I don’t want them to feel that way. We’ve got a special situation here and you wanna feed our babies first thing and fore most is feed the baby and work on your milk supply as your feeding the baby.
[00:16:08]
Robin Kaplan: Absolutely, and so Heidi and Tamar, I know that you both kind of dealt with different milk supply issues and so Heidi how did you deal with situation with your son?
Heidi Runge: Yeah, we started off after a consultation we had. My husband helped and we did the finger feeding with either the milk that I had pumped if we weren’t able to get him to latch cos we had latching problems in addition to low supply. So we did finger feeding, we did some supplemental nursing where with it kind of tube and everything and then we did eventually when he was three weeks old use a low flow bottle to also give him either pumped milk and all formula. So it’s kind of combination of those things. I also was taking some supplements also to try to increase my milk supplies as well so it’s kind of several things [Laughs], we tried everything [Laughs].
Robin Kaplan: Yeah, how about you Tamar?
Tamar Blanco: Well, one other things that really devasted me was at two weeks his weight had still not gone up and so I immediately saw a lactation consultant and she gave me some great tips. Pumping and using a low flow bottle, using a hospital grade pump, pumping every two to three hours and she also recommended some herbs that I could take. Well, a week later I really hadn’t an improved and so that was just very, very stressful and very…. it just was very discouraging. So, when she took a second look at me she said that it looked like I might have insufficient glandular tissue that I may be… Imay have hypoplasia, so that was something new for me. My daughter, I was unable to breastfeed her. I was able to pump about 5 ounces for about 7 months and I couldn’t understand why that was happening and so when she told me about the hypoplasia then it all made sense. I went on the internet and looked up as much information as I could with that was the problem.
There wasn’t that much information and I was astounded at how many medical professionals had never mentioned this to me and how, they were many lactation specialists that didn’t even really know about this, IGT. So, the way it was explained to me is breastfeeding with IGT is like trying to produce milk without the milk factory [Laughs] so, it made perfect sense and I knew at that point if I really wanted to make it happen I had to try everything and so that’s when I met you Robin [Laughs] few weeks later. I asked… you were great you came over and so between what you mentioned to meand other lactation consultants mentioned to me. I tried everything from acupuncture to the Chiropractic, it actually take my baby to Chiropractic to help with latching. We even tried, you know, medication and supplements and I think besides trying everything I think what really helped was the support of my spouse and really surrounded myself with people that were going to be supportive and although people meant well they didn’t understand… may not have understood what I was I going through so when they would tell me, it’s okay you can just bottle feed , that was the why worst thing that could have told me because there was feeding the purpose, so I would say just surrounding yourself with positive people and just try everything cos you just never know what’s gonna work and I could say that, you know, nine weeks later I met now successfully breastfeeding my babies so, I am really happy about that.
Robin Kaplan: Absolutely, so Rose when dealing with the baby who has latching difficulties then which, you know, it’s a whole different beast than a you know the milk supply what options does a mom have to feed her baby and protect her milk supply while the latch issues are been resolved?
[00:20:08]
Rose deVigne: Well, again hopefully she’s working with her lactation specialist who has knowledge in this but there is various options in helping the baby to learn to latch but, if the baby actually is not latching the important part would be for you to be using a pump, an effective pump that is stimulating your breast to establish the milk supply in your feeding baby, feeding baby either by bottle or finger feeding and that’s where the lactation consultant will sit down with you and go these are the options that’s you can have for feeding your baby. You get to decide what those options are and what is gonna work well for you. For some the feeding tube does not work on the finger. The feeding tube doesn’t work at the breast unless baby’s able to latch.
Robin Kaplan: Sure.
Rose deVigne: So it’s kind of frustrating when mom are taught how to use the tube at the breast if the baby is not latching on and so finding out what the various options are but, basically its establishing you milk supply by pumping, feeding your baby, giving your baby time to learn and some babies just take little more time to catch on than others.
Robin Kaplan: Yeah! Michelle, I know that you have been working on some latch challenges with your baby right now and so, what have you done to kind of work on resolving these latching challenges?
Michelle Reed: The first thing that I knew I had to do was is to increase my milk supply. So, I pumped around the clock. In the evening I follow her schedule but whatever she is doing throughout the day is what am I doing. Every 2-3 hours I am pumping, I made sure like, I have to give her bottle through. I have to give her bottle and if she, if I notice she has some cues and she’s calm if I can latch her, I latch her. It’s never forever long but just that I can’t still bring her back to the breast. It’s encouraging, that’s the only thing keeps me going hoping that maybe we can continue doing that.
Robin Kaplan: Absolutely, And I mean,I recommend that often as well Rose, would you say this kind of almost non-nutritive sucking sometimes where the baby gets on and they are just falling back in love with the breast and so it may not be that she is getting all of her nutrition from it at this point. Well she is- but just not directly from the tap essentially [Laughs] but that you know, having the baby spend time skin to skin and at the breast and just trying and trying and trying can be really beneficial.
Rose deVigne: Absolutely, I refer to a discomfort nursing…
Robin Kaplan: Yeah, oh I like that!
Rose deVigne: You know, if the baby is willing to comfort nurse at the breast in place of a pacifier, it’s a great way to transition in back to the breast for them to realize, hey this is a nice place to be and as they get better at nursing or has the milk supply increases their coming just getting better at it, but yes absolutely.
Robin Kaplan: Well great! When we get back Rose will discuss what to do when plans A, B, C aren’t working at, to solve the breastfeeding situation, so we’ll be right back!
[Theme Music]
Robin Kaplan: And we are back! So Rose what is a mom to do when these initial breastfeeding plans don’t work and for some reason these breastfeeding challenges are difficult to resolve essentially when plans A, B, C haven’t worked; what can plans D, E, F and G be and what’s the most important thing to keep in to perspective?
Rose deVigne: The most important thing I think to keep in perspective again is, it takes time for some of these babies and to be patient, feed the baby and again you are working with a specialist who is given you options on how to feed your baby, how to help the baby get to that plan A. Plan A is we are going to feed the baby at the breast. Plan B may be some breastfeeding but we have to supplement. Plan C you know, so, it gets all the way down to, okay, I am just pumping and feeding. How long does it take? It varies from baby to baby and I have seen more babies over the last few years at for some reason seem to take anywhere from 4 to 6-7, 8 weeks to just to really click and just realize that it’s not you in many situations cos as a new mom we think it’s us, what am I not doing when sometimes it’s a baby who hasn’t learned to suck correctly. A baby who hasn’t learnt to bring his tongue forward, a premature baby who needs time to mature but again our number one goal is feed the baby and protect the milk supply and increase at milk supply and then just be patience with yourself and with your baby.
Robin Kaplan: And I get this question a lot especially from moms who are working to increase their milk supply but, is there an answer to how much breast milk does a baby need per day for it to truly make a difference in his health… his or her health in nutrition?
[00:25:09]
Rose deVigne: I get these questions also frequently and any amount of breast milk is absolutely going to benefit the baby. It can be one bottle a day when I weaned my last daughter and she would only be nursing and she was a little older too but she’d only been nursing once a day maybe twice if she fell and got hurt within three months we tripled her ear infections so one feeding a day, one bottle a day, one ounce, any amount of breast milk if you are in to the chemistry or biology you can go and look at the millions of properties, infection-fighting properties and cells that’s are in one ounce of breast milk and when you are going to go, wow, one ounce will benefit my baby. So, don’t let anybody say it has to be 50% or whatever, and again it also goes back to you and your husband what is gonna work well for you. Recently somebody said you know, if its 10% of his intake is worth it, well from a medical perspective absolutely but from your perspective you are doing a lot of work, is it worth it for you and that’s where I frequently sit back and ask moms tell me what your goal is, tell me what you want to do. We’ve been doing this and this and this, tell me how are you feeling now. My job is don’t make it work for you.
Robin Kaplan: Okay, thank you so much, Heidi kind of getting in to our… guess for everyone at the moment, ask Heidi but just you know kind of looking at so these challenges there a lots of different stages of them and kind of finally hitting your stride, so Heidi what did you say-what would you say your finally plan look like when you had hit your stride with breastfeeding and bottle feeding and all that kind of stuff?
Heidi Runge: I think it all began when part of the plan was to me just accepting what I could do and just come in terms with okay, I am never going to be the one that’s going to have an oversupply. I am not going to have a hundred ounces of frozen breast milk in my freezer, that’s not in the cards that were dealt to me. I have to just do the best of what I have and so I guess at the peak of mine [Laughs] was Asher was latching. He would latch, you know, I don’t know, maybe once side one day once side the other sometimes both sides and I would pump and I would give him anywhere from 4 to 6 ounces a day which was really good and so I gave him basically, he got one less bottle of formula a day which in the grand scheme of things a lot of people may not think as a lot but like you said it’s something and that is one less you know bottle formula that he had and it was a lot of nutrients, it was what I could give him. But, a lot of it was just me not stressing out over what I could do,could not do and just and I think that helped me enjoy breastfeeding a lot more too. It’s just coming to terms in you know, letting the relationship be what it was and just accepting it. See it just was really accepting that and then you know, pumping and then having him latch whenever I could get him to latch and we definitely did the comfort nursing like you said whenever I could. I know a lot of people say or would say you know don’t let them for sleepy wise just like you know, sit at the breast and I am like you know what [Laughs] if that’s what I get then I am going to take it and I am going to run with it cos [Laughs] I mean for me that was like one of the most special times and like bonding times since like I didn’t feel like I got that’s as much in the beginning.
Robin Kaplan: Yeah! I find those are the hardest ones to wean from at the end too because…
Heidi Runge: Yeah!
Robin Kaplan: The first at the morning right after the nap or right before the nap or right before bed because that’s the quiet space that you are in with your children and so even if it is, when it is comfort nursing it’s still it’s so beneficial for both mom and baby so…
Heidi Runge: Yeah!
Robin Kaplan: Yeah, absolutely.
Rose deVigne: If you think about it, mother’s breast are nature’s pacifiers. Pacifiers worn around [Laughs] how long ago? Mother’s breasts have been baby’s comfort nursing forever and if that’s what is working then that is the best thing, absolutely!
Robin Kaplan: Yeah, definitely Tamar how to, going back to kind of what you have described how long did it take you to finally built this full milk supply for your son?
Tamar Blanco: Nine very long weeks [Laughs], I went through a lot of emotions and there was a point where in the beginning I felt like I failed like I went through what you would the call the five stages of grief cos I thought that there was a real possibility that may not have exclusive breastfeeding relationship. I didn’t with my daughter and I was happy and proud of everything that I gave to her that one bottle per day for the seven months but it was like re-living those emotions all over again and I read this on the internet, a mom said that like all nursing moms, a mom needs to define for herself with successful nursing relationship is going to be. This may mean I will give my baby as much as I can and I will rejoice in my ability to give it. So I read that and that inspired me and I thought I just keep going until I can give my baby whatever I can give my baby. I am gonna give it to my baby.
[00:30:51]
Robin Kaplan: That’s a wonderful quote!
Rose deVigne: That’s beautiful.
Robin Kaplan: Yes, it is. And then Michelle I know that you are baby is quite young still and so your definitely in this process of figuring out what’s your stride essentially, so where are you at now and what do you working towards?
Michelle Reed: I was very excited to come today because this part of my plan, part of just being here today is super helpful and what I want everything to look like. Right now I am still, she’s a little bit older so she’s able to latch, It shouldn’t be so much not any issue as it was in the very beginning. So I am hoping to get back to the breast right now, I am just pumping and giving it to her in a bottle and comfort nursing when possible which I can go days without doing that and then all of a sudden she will surprise me and like she showed a cue, she was sucking on my arm and I just put her at the breast because I figured that she can suck on my arm then she will do this and she did so and it wasn’t very long, it was very short amount time but she was happy, wasn’t fighting her. It was joyful for me because I wasn’t- I get nervous and stressful and tense when she’s screaming and I am trying to latch her and that wasn’t working but doing it just you know hopefully I am trying, I really would like to have some sort of maybe more than 5 minutes of nursing [Laughs].
Robin Kaplan: Absolutely ladies, how important was it for you to set short term goals rather than just long term, I want to exclusively breastfeed that kind of these defining moments of okay I got here now what, what we do next- Heidi?
Heidi Runge: I think that’s the only thing that kept me going [Laughs] honestly! Because, I went in to breastfeeding and it look like went into you know before giving birth just been oh! Okay did the class, I read a couple of books or part of couple books [Laughs] this will be you know, everyone said its easy, its natural you know, and then I you know my world shattered [Laughs] and everything although the ground fell off from underneath me. So, I just had to keep going like okay-Robins come in Monday, its Sunday morning I will just make it till its Monday you know, and then it was okay I have made it 6 days but let’s make it to Friday [Laughs]. You know and then it made it till next week and then it would vary too, he might be latching really good for couple days and I am like okay we are going great and then you know, he stops and I am like you had another wall- you’re like okay let’s not give up today, you just today is what it is- let’s keep going and let’s see where we are in two days and then it would be better and then I am like okay, let’s try to make it to two months- he’d make it two, three, four months.
Last time I was here the week before was like horrible [Laughs] I am like great- I am not even gonna breastfeeding at three months you know, but you just have keep holding on and just get through the day and just know that some as in life in everything there are good days and bad days and it’s how it’s gonna be at the breastfeeding too with everything, so you just have to keep holding on and just you know grin and bear it really and try to work through to it in; it usually happens where it does get better, like you’re going to be in like maybe in a lot of pain you may you know the whole of all that it gets better and you know you both are learning- it’s you both learning you know so, yeah, I did 4- 6 next week [Laughs]next feeding you know but it was honestly the only thing that kept me going.
Robin Kaplan: Is it short-term goal?
Heidi Runge: Yeah!
Robin Kaplan: Okay, how about you Tamar?
Tamar Blanco: I have to agree with Heidi. It was struggle whenever I would like at the big picture and it was overwhelming to think well you have to completely breastfeed so it was small goal. I am gonna pump every two three hours a day and then the next day would be okay, I am going to pump and then I am going to drink this amount of liquid to help with my breastfeeding so every day it had a new goal. I didn’t want to overwhelm myself I know how easily stress out and I can be I just I had a baby so I know those hormones are a little crazy sometimes[Laughs]. So it was those small goals that made it, those bite size goals that helped me to feel like I am in control with the situation. I don’t want feel out of control and I just knew that even in ounce like Rose says, any bit of breast milk that you can give your baby is a success, so that’s how I looked at it and I didn’t want to overwhelm myself with too many goals so the smaller the goal, the easier was to have success.
Robin Kaplan: Thank you, how about you Michelle?
Michelle Reed: A lot of what they are saying is exactly how I felt. I think one thing that really made me start looking at the shorter goals is I had mastitis turning to an abscess and I had an emergency surgery where my baby was taken from me for that night and I had to stay the night in the hospital, at that point I had surgeons telling me not to pump my left side at all and then once they seen the wound and how engorged they are like you have to express it, it has come out because this is gonna get worse, so once I had to do those things then it was… I felt like you know what I am may not be able to breastfeed but I am injured and they were telling me an unhealthy mom is not a good mom, you need to be healthy for your children. So that point it really slowed me down, I didn’t even look at the huge picture at that point, I just focused on healing. I need to heal and I need the milk out, so the baby’s getting the milk because I have to get it out but so I am still on the right track and my focus at that point was healthy baby- a healthy mom and that’s what got me through that.
Robin Kaplan: Absolutely, absolutely! Well, thank you so much Rose for your insight in to this complicated and emotional issue for breastfeeding moms and thank you so much for panelist for sharing your story and giving hope to so many other moms who are out there that they can make breastfeeding work for themselves, so thank you so much!
[00:36:57]
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[Featured Segment: From The Listeners]
Robin Kaplan: So here’s the comment from one our listeners, her name is Jean and she’s from Riverdale Park, Maryland. Hi Boob Group, I just love your ongoing series about you following three new breastfeeding moms for the first year. I recently had my first baby and I have been listening to these episodes to get an idea about what to expect in the upcoming months, it’s really nice to know that I am not the only mom out there having issues. I recommend your show to the women of my breastfeeding support group all the time. Thanks for the great resources and thanks so much Jean for writing this in.
[Theme Music]
Robin Kaplan: Thank you so much to our expert, panelist and all of our listeners. If you have any questions about today’s show with the topic that we have discussed, call our Boob Group Hotline at 619-866-4775 and we’ll answer your question on our upcoming episode. If you have a breastfeeding topic you’d like to suggest, we’d love to hear it. Simply visit our website at https://www.newmommymedia.com and send us an email through our contact link or you may visit our Facebook or Twitter pages and suggest at there as well. Thanks for listening to the Boob Group, because Mothers know breast!
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[Disclaimer]
This has been a New Mommy Media Production. The information and materials 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 and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical and advice or care and should not be used for diagnosing or treating healthcare problem or disease or prescribing any medications. If you’ve questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified healthcare provider.
[00:38:54] [End Of Audio]
Episode Transcript
The Boob Group
When Breastfeeding Doesn’t Go As Planned
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[Theme Music]
Rose deVigne: There are rare occasions when a mother may have done everything she can to prepare to have a successful breastfeeding relationship with her baby, but something causes unavoidable challenges. When plans A, B and C don’t improve the breastfeeding situation, what are plans D, E, F and maybe G? I am Rose deVigne Jackiewicz, an International Board Certified Lactation Consultant and Lactation Consultant at Kaiser Permanente outpatient Lactation Clinic in San Diego, California. Today, we are discussing options for when breastfeeding doesn’t go as planned. This is The Boob Group.
[Theme Music/Intro]
Robin Kaplan: Welcome to the Boob Group, broadcasting from the Birth Education Centre of San Diego. I am your host, Robin Kaplan. I am also a Certified Lactation Consultant and owner of The San Diego Breastfeeding Center. At the Boob Group, we are an online support group for all things related to Breastfeeding. Have you checked out our fabulous articles on our blog yet? We have several moms who have offered to blog about their breastfeeding experiences for The Boob Group and I was completely blown away by their stories.If you are interested in sharing your breastfeeding stories, feel free to contact me through the link on our https://www.theboobgroup.com website. Today, I am joined by three lovely panelists in this studio. Ladies, would you please introduce yourselves?
Tamar Blanco: Hello Robin, my name is Tamar Blanco. I am 34 and I am… for work, I work at the housing commission and I am the mother of two children ages 6 and 2 months old.
Michelle Reed: Hi, I am Michelle Reed, I am 31. I am a wife and a mother that’s kind of my job [Laughs] and I have my important…
Robin Kaplan: This is an important job! [Laughs]
Michelle Reed: Yes! And I have 5 children.
Robin Kaplan: Well, how old are your children?
Michelle Reed: I have an eleven-year-old, nine-year-old, seven-year-old, four-year-old and seven weeks.
Robin Kaplan: Nice!
Michelle Reed: Thank you.
Heidi Runge: Hi I am Heidi Runge, I am 33. I am apparently, I have one child and he’s nine months old.
Robin Kaplan: Alright, welcome to the show ladies!
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[Featured Segment: Ask The Experts]
Robin Kaplan: Before we get started with today’s topic, here’s a question you all had for one of our experts.
Carine: Hi Boob Group, my name is Carine and I am calling from Santa Claire, California and I have a question about my 4 months. I have recently noticed that her poop has changed color.It’s sort of a green color and it smells different and I have always heard that if the poop was green that’s possibly a bad thing or that’s she has a cold but she seems happy all the time and there really isn’t any issue’s; so I am just wondering if it’s a change in the fact that she’s 4 months or if there is something that I should be concerned about? Please let me know! Thank you.
Dr. Frederick Johnson: Hi this is Dr. Johnson, having green stools isn’t necessarily a sign of an infection or a problem. Certainly, it can be related to what the child is eating although its four months it’s usually pretty limited.But, colors you should worry about what’s your baby’s poop are red, black or almost white. Those are more telling signs of a problem, so as far as the green stools, I wouldn’t be worrying a bit. Keep feeding her and if she’s already started on any salads that can certainly affect the color of her stools and the aroma of that too. So, hope that answers your question and if you have any more let us know. Ba-bye!
Robin Kaplan: If you have a question about one of our topics mentioned on our shows, call The Boob Group Hotline at 619-866-4775.
[Theme Music]
Robin Kaplan: Today on The Boob Group, we are discussing what a mom can do when breastfeeding doesn’t go as planned. Our returning expert Rose deVigne Jackiewicz has been an International Board Certified Lactation Consultant since 1984 and is a Lactation Consultant at the Out-Patient Lactation Clinic at Kaiser Permanente, San Diego which celebrated their 10 year anniversary, correct?
Rose deVigne: Actually 12 years.
Robin Kaplan: Oh 12 years, my goodness!
Rose deVigne: 12 years.
Robin Kaplan: That’s fantastic, so thanks for joining us Rose and welcome back to the show.
Rose deVigne: Well, I am very happy to be here, thank you!
Robin Kaplan: So Rose, what can a pregnant mom do to set herself up for optimal breastfeeding success?
Rose deVigne: Well, actually there’s many things she can do, one of the first things I think is finding good books to read on breastfeeding.But, above and beyond that is when you go in for prenatal visits with your OB make sure that a thorough breast examination is done to identify any potential issues with your breast, your nipples; potential issues with previous breast surgery, also I think prenatal breastfeeding classes as well as a prenatal consult. If you have concerns that maybe something might not be right, go in for a prenatal consult with a lactation consultant and you get a lot of information that way.
[00:05:21]
Robin Kaplan: Absolutely, it’s interesting that you mentioned that talk to your health care provider prenatally about your breast. We just had an episode a couple of weeks ago about insufficient glandular tissue and the women said that the only reason they found out that they had it was after they had their baby, but they always kind of knew that there might be some… an issue but it was never brought by their OB/GYN. I don't any of them had seen mid-wives cos I can’t remember but that’s an interesting thing that you had mentioned that it could be something to talk about before you had your baby.
Rose deVigne: I think over the years, I have had women who said “well,yeah,they looked at my breast but, nobody has ever said anything. Nobody ever addressed my inverted nipples other than the fact my favorite was a woman who had an inverted nipples and her doctor said don’t worry when your baby’s born they will pop out..”[Laughs]
Robin Kaplan: Like they are done, like she can.[Laughs]
Rose deVigne: Exactly, and they will say,“they didn’t pop out…”
Robin Kaplan: Yeah!
Rose deVigne: So!
Robin Kaplan: Ladies, did you do anything prenatally to prepare for breastfeeding?
Tamar Blanco: I had taken a breastfeeding class with my 6 years old daughter before she was born, but this time I just didn’t get her around to it. I just thought it was gonna happen and I thought well I had probably the first time this time it will be different, so I was little naïve [Laughs].
Robin Kaplan: Well no not necessarily, you were hopeful [Laughs].
Tamar Blanco: Yeah!
Robin Kaplan: Thank you Tamar. How about you Michelle?
Michelle Reed: I have read lots of books. Anything that I could get my hands on, inside the doctor’s office I grab things and also I found it very helpful that in magazines when you see the pictures of mothers breastfeeding I started myself with pictures of moms already breastfeeding just to give myself a positive outlook like it’s been done, it can’t be done, I can do it, so…
Robin Kaplan: So, that’s what… I never ever heard of that idea, but I love it. That’s wonderful and another reason also to attend a breastfeeding support group all your pregnant too just surround your…surround yourself with other breastfeeding moms. How about you Heidi?
Heidi Runge: I also attended a, I guess prenatal class on breastfeeding. I had books; I started books and then I slowly finish books [Laughs] which may have been part of the problem [Laughs].
Robin Kaplan: Rose, what are the signs that a mom should look for to indicate that there are some breastfeeding challenges going on because sometimes they are not so obvious?
Rose deVigne: It is a very good question. Some of them things like for example, history of infertility, depending on the reason for infertility, sometimes you may have low milk supply based on the type of infertility like PCOS which is Poly Cystic Ovarian Syndrome which is probably the most common cause of infertility, probably the 50% of those women are known to have low milk supply so knowing that upfront, breast surgery, what type of breast surgery augmentation, reduction, inverted nipples knowing those things as well. Another example is Type-1 diabetes, many moms do not realize or they are not told that it’s common to have a delayed unset milk supply when you have type 1 diabetes. So knowing that upfront you are not so surprised to find out that your baby may have to have a supplement because of low blood sugars or because your milk supply doesn’t fully come in until 5-6-7days.
Robin Kaplan: Absolutely, and what assistants is typically available in the hospital or once the mom is back at home?
Rose deVigne: In the hospital there should be a lactation consultant that is available to assess you and who would go through your history, asking you questions such as any promise getting pregnant, did your breast get bigger during pregnancy, any history of breast surgery, any medical problems, allergies, things like that to fully assess are you at risk for having breastfeeding problems or milk supply issues and then if you are identifiedas having these issues maybe your baby is born early and your milk supply hasn’t fully come in by the time you go home hopefully, there is a lactation clinic or lactation consultant like Robin that you can go to see after going home from the hospital. Most moms and babies are seeing their pediatricians within 24 to 48 hours of going home from the hospital, should almost be the same for lactation if you’re identified it is having, what I call risk factors.
Robin Kaplan: Absolutely! Ladies, when did you first know that you needed some extra breastfeeding assistants, some additional support?
Tamar Blanco: Well, my baby was four days old and in the hospital they said that he had lost already more than 8% and that was really scary for me. So, they just automatically assigned a lactation nurse to me and she was able to come by and assess the problem and how I could solve the problem with spoon feeding and by pumping, so that was a very good help.
[00:10:12]
Robin Kaplan: That’s fantastic Tamar, Thank you. How about you Michelle?
Michelle Reed: Day three when we have to go back for the well- baby check, she already lost weight too much and they kept having those come back every three days or so and they checked her suck in, she was tongue tied so she had to go in for that like,we went in on day three and day four she was clipped so then we kept going back to Lactation specialist, we were at the hospital a lot [Laughs]…
Robin Kaplan: Yeah, yeah, were you going back for weight checks at the hospital?
Michelle Reed: Yes!
Robin Kaplan: Okay, how about you Heidi?
Heidi Runge: Day three, we had a doctor’s appointment and that was a Friday and he had lost I believe over 10% of his weight; he was born at 8 pounds 9 ounces. 8:01 he was discharged the hospital and then 7:10 on day three which is quite bit so, my milk still hadn’t started to come in and when is there an issue, so he suggested supplementing but then of course it was a weekend and I had a meltdown and I called them puke [Laughs] and day six I got help, so….
Robin Kaplan: Yeah, Rose, and just to clarify too because we are talking about lactation educators and specialists in the hospital and what is it difference between a lactation educator, LaLeche League Leader and an International Board Certified Lactation Consultant?
Rose deVigne: A lactation educator is could be a child with an educator or it could be a postpartum nurse, is somebody who’s taken a course on basic management of breastfeeding. They can help you with positioning and latch and your common problems of minor sore nipples, engorgement. A LaLeche League Leader is just by history is been like Le consultants, a layperson who has knowledge of helping you with breastfeeding and some of the LaLeche League Leaders are-oh my gosh wonderful. They have been doing this so long that some of them have more experience than I do, okay.It’s just that they are more of the grassroots. You know, I have been doing this for thirty years and I have been helping moms. An International Board Certified Lactation Consultant is somebody who has sit for an exam. It’s an all-day exam, very intense exam that test her skills for lactation but the other thing about the International Board Certified Lactation Consultant is, there are specialized in your more complicated cases for breastfeeding. They go beyond your normal sore nipples, beyond your engorgement. They specialize in problem-oriented situations.
Robin Kaplan: So what should a mom expect in working with someone with those 3 different types of qualifications?
Rose deVigne: Well, first of all asking, you know, asking them what they’re, you know, experience is and if it’s a lactation educator and you’re having major problems, you might ask for a referral to a board-certified lactation consultant, asking her have you worked with this kind of problem before and if she hasn’t, hopefully, she will, you know, be open and say you know what I am not as experienced in this and let me refer you, but again the lactation educator is more for basic common problems as well as LaLeche League Leader and then the IBCLC is much more problem-oriented and generally has a lot more experience in dealing with complicated cases.
Robin Kaplan: Okay! And then kind of getting in to those complicated cases now, so when dealing with low milk supply what options does a mom have to increase her supply and what should she feed her baby until her supply increases, and I realizes this is an own topic in itself but just kind of a basic overall?
Rose deVigne: It’s definitely a topic in itself and how long do you have to talk [Laughs] and again as an international board-certified lactation consultant it kind depends on why the milk supply is low. There is various herbs, there is various medications that can be taken but it’s gonna depend on the individual moms history, what she is allergic to, what she is, you know, what she is capable of taking. But, you know, she… the first thing that moms typically needs to do is additional pumping. Hospital-grade pump is my preference because it’s designed to help establish a milk supply and then adding either herbs or medications depending on the individual situation and as far as what to feed the baby in the meantime, whatever milk you get absolutely, feed them, any amount of breast milk is gonna benefit the baby and the World Health Organization says number two choice should be donor milk and we’ve had more moms that have had sisters, best friends that have donated milk. There are issues with making sure there health is good because you are, you know, taking others, somebody else’s milk and donor milk is always available. The donor milk banks, its about 3 dollar an ounce and that’s really reserved more for preemiesor very sick babies but that is still an option and then the final option is artificial baby milk or formula and again depending on family history, milk allergies, things like that you might need to pick the one that’s best and most appropriate for the baby and you may need supplement with a little bit of that until your full milk supply increases and that’s okay, that’s okay to do. A lot of moms feel like they are failing if they have to use formula and I don’t want them to feel that way. We’ve got a special situation here and you wanna feed our babies first thing and fore most is feed the baby and work on your milk supply as your feeding the baby.
[00:16:08]
Robin Kaplan: Absolutely, and so Heidi and Tamar, I know that you both kind of dealt with different milk supply issues and so Heidi how did you deal with situation with your son?
Heidi Runge: Yeah, we started off after a consultation we had. My husband helped and we did the finger feeding with either the milk that I had pumped if we weren’t able to get him to latch cos we had latching problems in addition to low supply. So we did finger feeding, we did some supplemental nursing where with it kind of tube and everything and then we did eventually when he was three weeks old use a low flow bottle to also give him either pumped milk and all formula. So it’s kind of combination of those things. I also was taking some supplements also to try to increase my milk supplies as well so it’s kind of several things [Laughs], we tried everything [Laughs].
Robin Kaplan: Yeah, how about you Tamar?
Tamar Blanco: Well, one other things that really devasted me was at two weeks his weight had still not gone up and so I immediately saw a lactation consultant and she gave me some great tips. Pumping and using a low flow bottle, using a hospital grade pump, pumping every two to three hours and she also recommended some herbs that I could take. Well, a week later I really hadn’t an improved and so that was just very, very stressful and very…. it just was very discouraging. So, when she took a second look at me she said that it looked like I might have insufficient glandular tissue that I may be… Imay have hypoplasia, so that was something new for me. My daughter, I was unable to breastfeed her. I was able to pump about 5 ounces for about 7 months and I couldn’t understand why that was happening and so when she told me about the hypoplasia then it all made sense. I went on the internet and looked up as much information as I could with that was the problem.
There wasn’t that much information and I was astounded at how many medical professionals had never mentioned this to me and how, they were many lactation specialists that didn’t even really know about this, IGT. So, the way it was explained to me is breastfeeding with IGT is like trying to produce milk without the milk factory [Laughs] so, it made perfect sense and I knew at that point if I really wanted to make it happen I had to try everything and so that’s when I met you Robin [Laughs] few weeks later. I asked… you were great you came over and so between what you mentioned to meand other lactation consultants mentioned to me. I tried everything from acupuncture to the Chiropractic, it actually take my baby to Chiropractic to help with latching. We even tried, you know, medication and supplements and I think besides trying everything I think what really helped was the support of my spouse and really surrounded myself with people that were going to be supportive and although people meant well they didn’t understand… may not have understood what I was I going through so when they would tell me, it’s okay you can just bottle feed , that was the why worst thing that could have told me because there was feeding the purpose, so I would say just surrounding yourself with positive people and just try everything cos you just never know what’s gonna work and I could say that, you know, nine weeks later I met now successfully breastfeeding my babies so, I am really happy about that.
Robin Kaplan: Absolutely, so Rose when dealing with the baby who has latching difficulties then which, you know, it’s a whole different beast than a you know the milk supply what options does a mom have to feed her baby and protect her milk supply while the latch issues are been resolved?
[00:20:08]
Rose deVigne: Well, again hopefully she’s working with her lactation specialist who has knowledge in this but there is various options in helping the baby to learn to latch but, if the baby actually is not latching the important part would be for you to be using a pump, an effective pump that is stimulating your breast to establish the milk supply in your feeding baby, feeding baby either by bottle or finger feeding and that’s where the lactation consultant will sit down with you and go these are the options that’s you can have for feeding your baby. You get to decide what those options are and what is gonna work well for you. For some the feeding tube does not work on the finger. The feeding tube doesn’t work at the breast unless baby’s able to latch.
Robin Kaplan: Sure.
Rose deVigne: So it’s kind of frustrating when mom are taught how to use the tube at the breast if the baby is not latching on and so finding out what the various options are but, basically its establishing you milk supply by pumping, feeding your baby, giving your baby time to learn and some babies just take little more time to catch on than others.
Robin Kaplan: Yeah! Michelle, I know that you have been working on some latch challenges with your baby right now and so, what have you done to kind of work on resolving these latching challenges?
Michelle Reed: The first thing that I knew I had to do was is to increase my milk supply. So, I pumped around the clock. In the evening I follow her schedule but whatever she is doing throughout the day is what am I doing. Every 2-3 hours I am pumping, I made sure like, I have to give her bottle through. I have to give her bottle and if she, if I notice she has some cues and she’s calm if I can latch her, I latch her. It’s never forever long but just that I can’t still bring her back to the breast. It’s encouraging, that’s the only thing keeps me going hoping that maybe we can continue doing that.
Robin Kaplan: Absolutely, And I mean,I recommend that often as well Rose, would you say this kind of almost non-nutritive sucking sometimes where the baby gets on and they are just falling back in love with the breast and so it may not be that she is getting all of her nutrition from it at this point. Well she is- but just not directly from the tap essentially [Laughs] but that you know, having the baby spend time skin to skin and at the breast and just trying and trying and trying can be really beneficial.
Rose deVigne: Absolutely, I refer to a discomfort nursing…
Robin Kaplan: Yeah, oh I like that!
Rose deVigne: You know, if the baby is willing to comfort nurse at the breast in place of a pacifier, it’s a great way to transition in back to the breast for them to realize, hey this is a nice place to be and as they get better at nursing or has the milk supply increases their coming just getting better at it, but yes absolutely.
Robin Kaplan: Well great! When we get back Rose will discuss what to do when plans A, B, C aren’t working at, to solve the breastfeeding situation, so we’ll be right back!
[Theme Music]
Robin Kaplan: And we are back! So Rose what is a mom to do when these initial breastfeeding plans don’t work and for some reason these breastfeeding challenges are difficult to resolve essentially when plans A, B, C haven’t worked; what can plans D, E, F and G be and what’s the most important thing to keep in to perspective?
Rose deVigne: The most important thing I think to keep in perspective again is, it takes time for some of these babies and to be patient, feed the baby and again you are working with a specialist who is given you options on how to feed your baby, how to help the baby get to that plan A. Plan A is we are going to feed the baby at the breast. Plan B may be some breastfeeding but we have to supplement. Plan C you know, so, it gets all the way down to, okay, I am just pumping and feeding. How long does it take? It varies from baby to baby and I have seen more babies over the last few years at for some reason seem to take anywhere from 4 to 6-7, 8 weeks to just to really click and just realize that it’s not you in many situations cos as a new mom we think it’s us, what am I not doing when sometimes it’s a baby who hasn’t learned to suck correctly. A baby who hasn’t learnt to bring his tongue forward, a premature baby who needs time to mature but again our number one goal is feed the baby and protect the milk supply and increase at milk supply and then just be patience with yourself and with your baby.
Robin Kaplan: And I get this question a lot especially from moms who are working to increase their milk supply but, is there an answer to how much breast milk does a baby need per day for it to truly make a difference in his health… his or her health in nutrition?
[00:25:09]
Rose deVigne: I get these questions also frequently and any amount of breast milk is absolutely going to benefit the baby. It can be one bottle a day when I weaned my last daughter and she would only be nursing and she was a little older too but she’d only been nursing once a day maybe twice if she fell and got hurt within three months we tripled her ear infections so one feeding a day, one bottle a day, one ounce, any amount of breast milk if you are in to the chemistry or biology you can go and look at the millions of properties, infection-fighting properties and cells that’s are in one ounce of breast milk and when you are going to go, wow, one ounce will benefit my baby. So, don’t let anybody say it has to be 50% or whatever, and again it also goes back to you and your husband what is gonna work well for you. Recently somebody said you know, if its 10% of his intake is worth it, well from a medical perspective absolutely but from your perspective you are doing a lot of work, is it worth it for you and that’s where I frequently sit back and ask moms tell me what your goal is, tell me what you want to do. We’ve been doing this and this and this, tell me how are you feeling now. My job is don’t make it work for you.
Robin Kaplan: Okay, thank you so much, Heidi kind of getting in to our… guess for everyone at the moment, ask Heidi but just you know kind of looking at so these challenges there a lots of different stages of them and kind of finally hitting your stride, so Heidi what did you say-what would you say your finally plan look like when you had hit your stride with breastfeeding and bottle feeding and all that kind of stuff?
Heidi Runge: I think it all began when part of the plan was to me just accepting what I could do and just come in terms with okay, I am never going to be the one that’s going to have an oversupply. I am not going to have a hundred ounces of frozen breast milk in my freezer, that’s not in the cards that were dealt to me. I have to just do the best of what I have and so I guess at the peak of mine [Laughs] was Asher was latching. He would latch, you know, I don’t know, maybe once side one day once side the other sometimes both sides and I would pump and I would give him anywhere from 4 to 6 ounces a day which was really good and so I gave him basically, he got one less bottle of formula a day which in the grand scheme of things a lot of people may not think as a lot but like you said it’s something and that is one less you know bottle formula that he had and it was a lot of nutrients, it was what I could give him. But, a lot of it was just me not stressing out over what I could do,could not do and just and I think that helped me enjoy breastfeeding a lot more too. It’s just coming to terms in you know, letting the relationship be what it was and just accepting it. See it just was really accepting that and then you know, pumping and then having him latch whenever I could get him to latch and we definitely did the comfort nursing like you said whenever I could. I know a lot of people say or would say you know don’t let them for sleepy wise just like you know, sit at the breast and I am like you know what [Laughs] if that’s what I get then I am going to take it and I am going to run with it cos [Laughs] I mean for me that was like one of the most special times and like bonding times since like I didn’t feel like I got that’s as much in the beginning.
Robin Kaplan: Yeah! I find those are the hardest ones to wean from at the end too because…
Heidi Runge: Yeah!
Robin Kaplan: The first at the morning right after the nap or right before the nap or right before bed because that’s the quiet space that you are in with your children and so even if it is, when it is comfort nursing it’s still it’s so beneficial for both mom and baby so…
Heidi Runge: Yeah!
Robin Kaplan: Yeah, absolutely.
Rose deVigne: If you think about it, mother’s breast are nature’s pacifiers. Pacifiers worn around [Laughs] how long ago? Mother’s breasts have been baby’s comfort nursing forever and if that’s what is working then that is the best thing, absolutely!
Robin Kaplan: Yeah, definitely Tamar how to, going back to kind of what you have described how long did it take you to finally built this full milk supply for your son?
Tamar Blanco: Nine very long weeks [Laughs], I went through a lot of emotions and there was a point where in the beginning I felt like I failed like I went through what you would the call the five stages of grief cos I thought that there was a real possibility that may not have exclusive breastfeeding relationship. I didn’t with my daughter and I was happy and proud of everything that I gave to her that one bottle per day for the seven months but it was like re-living those emotions all over again and I read this on the internet, a mom said that like all nursing moms, a mom needs to define for herself with successful nursing relationship is going to be. This may mean I will give my baby as much as I can and I will rejoice in my ability to give it. So I read that and that inspired me and I thought I just keep going until I can give my baby whatever I can give my baby. I am gonna give it to my baby.
[00:30:51]
Robin Kaplan: That’s a wonderful quote!
Rose deVigne: That’s beautiful.
Robin Kaplan: Yes, it is. And then Michelle I know that you are baby is quite young still and so your definitely in this process of figuring out what’s your stride essentially, so where are you at now and what do you working towards?
Michelle Reed: I was very excited to come today because this part of my plan, part of just being here today is super helpful and what I want everything to look like. Right now I am still, she’s a little bit older so she’s able to latch, It shouldn’t be so much not any issue as it was in the very beginning. So I am hoping to get back to the breast right now, I am just pumping and giving it to her in a bottle and comfort nursing when possible which I can go days without doing that and then all of a sudden she will surprise me and like she showed a cue, she was sucking on my arm and I just put her at the breast because I figured that she can suck on my arm then she will do this and she did so and it wasn’t very long, it was very short amount time but she was happy, wasn’t fighting her. It was joyful for me because I wasn’t- I get nervous and stressful and tense when she’s screaming and I am trying to latch her and that wasn’t working but doing it just you know hopefully I am trying, I really would like to have some sort of maybe more than 5 minutes of nursing [Laughs].
Robin Kaplan: Absolutely ladies, how important was it for you to set short term goals rather than just long term, I want to exclusively breastfeed that kind of these defining moments of okay I got here now what, what we do next- Heidi?
Heidi Runge: I think that’s the only thing that kept me going [Laughs] honestly! Because, I went in to breastfeeding and it look like went into you know before giving birth just been oh! Okay did the class, I read a couple of books or part of couple books [Laughs] this will be you know, everyone said its easy, its natural you know, and then I you know my world shattered [Laughs] and everything although the ground fell off from underneath me. So, I just had to keep going like okay-Robins come in Monday, its Sunday morning I will just make it till its Monday you know, and then it was okay I have made it 6 days but let’s make it to Friday [Laughs]. You know and then it made it till next week and then it would vary too, he might be latching really good for couple days and I am like okay we are going great and then you know, he stops and I am like you had another wall- you’re like okay let’s not give up today, you just today is what it is- let’s keep going and let’s see where we are in two days and then it would be better and then I am like okay, let’s try to make it to two months- he’d make it two, three, four months.
Last time I was here the week before was like horrible [Laughs] I am like great- I am not even gonna breastfeeding at three months you know, but you just have keep holding on and just get through the day and just know that some as in life in everything there are good days and bad days and it’s how it’s gonna be at the breastfeeding too with everything, so you just have to keep holding on and just you know grin and bear it really and try to work through to it in; it usually happens where it does get better, like you’re going to be in like maybe in a lot of pain you may you know the whole of all that it gets better and you know you both are learning- it’s you both learning you know so, yeah, I did 4- 6 next week [Laughs]next feeding you know but it was honestly the only thing that kept me going.
Robin Kaplan: Is it short-term goal?
Heidi Runge: Yeah!
Robin Kaplan: Okay, how about you Tamar?
Tamar Blanco: I have to agree with Heidi. It was struggle whenever I would like at the big picture and it was overwhelming to think well you have to completely breastfeed so it was small goal. I am gonna pump every two three hours a day and then the next day would be okay, I am going to pump and then I am going to drink this amount of liquid to help with my breastfeeding so every day it had a new goal. I didn’t want to overwhelm myself I know how easily stress out and I can be I just I had a baby so I know those hormones are a little crazy sometimes[Laughs]. So it was those small goals that made it, those bite size goals that helped me to feel like I am in control with the situation. I don’t want feel out of control and I just knew that even in ounce like Rose says, any bit of breast milk that you can give your baby is a success, so that’s how I looked at it and I didn’t want to overwhelm myself with too many goals so the smaller the goal, the easier was to have success.
Robin Kaplan: Thank you, how about you Michelle?
Michelle Reed: A lot of what they are saying is exactly how I felt. I think one thing that really made me start looking at the shorter goals is I had mastitis turning to an abscess and I had an emergency surgery where my baby was taken from me for that night and I had to stay the night in the hospital, at that point I had surgeons telling me not to pump my left side at all and then once they seen the wound and how engorged they are like you have to express it, it has come out because this is gonna get worse, so once I had to do those things then it was… I felt like you know what I am may not be able to breastfeed but I am injured and they were telling me an unhealthy mom is not a good mom, you need to be healthy for your children. So that point it really slowed me down, I didn’t even look at the huge picture at that point, I just focused on healing. I need to heal and I need the milk out, so the baby’s getting the milk because I have to get it out but so I am still on the right track and my focus at that point was healthy baby- a healthy mom and that’s what got me through that.
Robin Kaplan: Absolutely, absolutely! Well, thank you so much Rose for your insight in to this complicated and emotional issue for breastfeeding moms and thank you so much for panelist for sharing your story and giving hope to so many other moms who are out there that they can make breastfeeding work for themselves, so thank you so much!
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[Featured Segment: From The Listeners]
Robin Kaplan: So here’s the comment from one our listeners, her name is Jean and she’s from Riverdale Park, Maryland. Hi Boob Group, I just love your ongoing series about you following three new breastfeeding moms for the first year. I recently had my first baby and I have been listening to these episodes to get an idea about what to expect in the upcoming months, it’s really nice to know that I am not the only mom out there having issues. I recommend your show to the women of my breastfeeding support group all the time. Thanks for the great resources and thanks so much Jean for writing this in.
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Robin Kaplan: Thank you so much to our expert, panelist and all of our listeners. If you have any questions about today’s show with the topic that we have discussed, call our Boob Group Hotline at 619-866-4775 and we’ll answer your question on our upcoming episode. If you have a breastfeeding topic you’d like to suggest, we’d love to hear it. Simply visit our website at https://www.newmommymedia.com and send us an email through our contact link or you may visit our Facebook or Twitter pages and suggest at there as well. Thanks for listening to the Boob Group, because Mothers know breast!
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[Disclaimer]
This has been a New Mommy Media Production. The information and materials 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 and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical and advice or care and should not be used for diagnosing or treating healthcare problem or disease or prescribing any medications. If you’ve questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified healthcare provider.
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