The Trials and Tribulations of Breastfeeding

 I thought this was supposed to be natural. Doesn't the baby just find your nipple, latch, and feast?

Immediately after you endure the most intense workout of your life, labor, the lactation consultant comes in your room to help facilitate feeding your newborn. In the first few days after birth, the baby receives colostrum from your breasts. Colostrum is yellow colored and contains Immunoglobulin A (your antibodies to help make the baby's immune system STRONG!). After two to five days, your milk should come in. Your breasts will become engorged, and it might be a little painful.

Breastfeeding is not for the faint of heart. It can be painful. It requires sacrifice of time and sleep on the mother's part. It can be restrictive on the mother's diet (less restrictive than while pregnant). However, once you get it down, it is WONDERFUL! You have an amazing relationship with your child and have food-to-go all the time!
First, how are mother and child just supposed to know what to do? The mother has just gone through intensely painful and exhausting labor. The baby has just gone through an intense journey from the inside of your warm womb to the scary outside world of Planet Earth. That is why there are lactation consultants! Amelia, my daughter, had problems latching. My nipples were flat, and her gums would not sense the nipple. After trying to play with my nipples or "roll them out" or suck them out with a nipple inverter, the lactation consultant decided to give me a nipple shield to use. Nipple shields are a dirty word to most in the breastfeeding world. They are thin pieces of silicone that fit the shape of your nipple and draw it in beneath the shield. This allowed Amelia to breastfeed and thrive. I have no regrets about using it. The downside is the risk of infection if you don't wash it and the possible effect of it decreasing your supply.


Being a future pediatrician, I know all the benefits of breast milk and breastfeeding. It gives your baby all the nutrients they need (minus vitamin D), it builds their immunity through IgA and colostrum, it helps decrease their risk for obesity and type 2 diabetes in the future, and finally it decreases their risk of having allergies in the future. It is also your baby’s first connection with you. Knowing all of this, there were times in the first few weeks of breastfeeding I wanted to give up, throw in the towel, and start bottle-feeding.  Today, there is so much help in the hospital and outside for breastfeeding. Do NOT GIVE UP without a fight. Lactation consultants are abundant in the hospital and more than likely at your obstetrician’s office. Latching is hard for some babies. My baby girl was so tiny, weighing 6 pounds and 2 ounces at birth. She was also jaundice. Thus, it was essential for her to get proper nutrition in order to pee and poop out that bilirubin. I had to use a nipple shield for the first few weeks. It hurt at first, but after using a special nipple cream, my nipples healed, and breastfeeding got so much better. I recommend doing some reading beforehand if you are going to breastfeed. A great read is La Leche League International, “The Womanly Art of Breastfeeding.” http://www.amazon.com/The-Womanly-Breastfeeding-Diane-Wiessinger/dp/0345518446


Weaning an infant off the nipple shield
    If you want to breastfeed and end up using a nipple shield, DO NOT feel guilty! I used one for the first month of breastfeeding my daughter. I continuously sterilized it,  made sure I had it when I went out in public, and panicked when I could not find it (they are clear and easy to lose)! While I was at the hospital, the lactation consultant showed me many methods of trying to get my daughter to latch. We tried the football hold and the across the lap hold. We tried making my breast into a taco shape, a pizza shape, and a teacup shape. Nothing worked in the hospital. The lactation consultant recommended me to the lactation queen, Lavawn Souther (http://lavawnsouther.com/). When I arrived in her office the Monday after delivering on Friday, she escorted me to a comfortable couch. Amelia was stripped to her diaper and weighed. Lavawn helped me to get comfortable and to get Amelia to latch. In that one feeding, she gained 4 ounces! It was encouraging knowing that my supply was adequate. Upon leaving her office, she told me to throw away the shield. I kept it as a crutch for a few weeks. However, around week 3-4, Amelia was on my breast all day and only using the nipple shield occasionally at night.
   I believe your child will stop using the shield when they are ready. However,  in order to facilitate getting rid of the shield, I recommend removing the shield halfway through feeds. I had Amelia lay across my lap, held my boob in the U-hold (http://www.llli.org/llleaderweb/lv/lvfebmar04p3.html), and put the nipple on her upper lip. I would squeeze a bit of milk out to entice her. Once she opened her mouth including her lower jaw wide, I would present the nipple and she would latch. If it takes multiple attempts for your baby to latch, don't get frustrated. Let your infant monkey around at the breast until he or she latches. If you are worried about your supply while using the nipple shield, use your breast pump. Another bit of advice if your baby is having trouble latching, try pumping a bit before breastfeeding. It will evert your nipple and the milk coming out will entice your baby.

So now that breastfeeding was going smoothly, around week 5, Amelia became more fussy than usual and started having green mucousy stools. Up next, what do the different types of stools mean? Should you be concerned if your child has green mucousy stools? What is colic and at what age does it peak?


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