BF advice

[Ben]

Hi,

We are expecting our second child soon. My wife had trouble
breastfeeding our son when he was born so he was formula fed. There were
many problems - my wife was anemic, the hospital screwed up the delivery
in more ways than one, she had an inverted nipple, she had no support in
the BF area, had PPD and the milk just didn't seem to come. We are
hoping that this time around things have settled down a bit and perhaps
our next child could be breastfed for at least the first 6 months. My
wife will be working after 3 months or so, so if it was successful she
we would have to some how manage with that.

Is there anything anyone here could advice to help make this time around
a success?

Thanks,
Ben

[Beth Kevles]

Hi -

The best thing you can do to help your wife is find a good source of
breastfeeding support NOW, someone who can visit in the hospital and at
home if necessary for the first week or two. Meet with an IBCLC
(Internationally Board Certified Lactation Consultant). As you did when
choosing a pediatrician, look for one you like and you feel you can work
with. Your wife can also attend La Leche League meetings right now, if
she can find a group that meets at a convenient time.

Both you and your wife can learn a great deal by reading this
newsgroup. I can't think of any question that's NEVER been asked here,
and you'll get a variety of responses leading to a consensus and
excellent advice. You can continue reading it after the baby arrives,
post questions on your wife's behalf, etc.

I hope this helps, and I wish you all good luck and a smiling infant!
--Beth Kevles

http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic
Disclaimer: Nothing in this message should be construed as medical
advice. Please consult with your own medical practicioner.

[Larry McMahan]

Ben > writes:
: Hi,

: We are expecting our second child soon. My wife had trouble
: breastfeeding our son when he was born so he was formula fed. There were
: many problems - my wife was anemic, the hospital screwed up the delivery
: in more ways than one, she had an inverted nipple, she had no support in
: the BF area, had PPD and the milk just didn't seem to come. We are
: hoping that this time around things have settled down a bit and perhaps
: our next child could be breastfed for at least the first 6 months. My
: wife will be working after 3 months or so, so if it was successful she
: we would have to some how manage with that.

: Is there anything anyone here could advice to help make this time around
: a success?

: Thanks,
: Ben

Hi Ben,

Welcome to mkb. My first advice for successful breastfeeding is to read
this newsgroup. No kidding. The solution to every possbile problem is
discussed here over a time of a couple of months.

Second, if and when you have any problems, post the problems here and ask
if anyone has seen this problem. In most cases, they have.

Third, regarding getting started on breastfeeding well, the best thing is
to try to achieve the best birth experience. You might well consider
also subscribing to misc.kids.pregnancy and posting and reading over there
for a while. PND is often the result of a birth than is not managed well
by the caregivers.

Fourth, regarding the inverted nipple, my wife Monika suffered from the
same problem before Clara was born. This was a problem we were able to
solve. I am including in this post a FAQ I wrote up based on that
experience.

Larry


Subject: Larry's Sore/Inverted Nipple FAQ
Newsgroups: misc.kids.pregnancy

Larry's Flat/Inverted Nipple FAQ.

I have posted this FAQ on numerous occasions in both
misc.kids.pregnancy and misc.kids.breastfeeding.
I have received a number of responses thanking me for raising
consciousness about this possible problem.

I have also received questions asking whether nipple stimulation
could cause pre-term labor.

The kind of nipple stimulation described in this article is
less intense than, for example, orgasm from engaging in sex
while pregnant. It is generally accepted medical practice
practice NOT to contraindicate sex during pregnancy. For that
reason, it is my opinion that there is no more reason to
contraindicate the techniques I describe for correcting flat
or inverted nipples.

If pre-term labor has been identified as a preexisting
problem or if you have a condition (multiples, for example)
that predisposes you to pre-term labor, you may want to avoid the
nipple stimulation described in this article. In this case,
check with your care provider.

On the other hand, if you are having a normal pregnancy
and have no known disposition to pre-term labor, there is
no reason not to use the methods described in this article.

Newsgroups: misc.kids.breastfeeding
Subject: Re: inverted nipples-success stories? (long)

Yet another inverted nipple sufferer posts asking advice and if anyone
has had success solving the problem. I respond for three reasons.

1. To say there ought to be a FAQ on this, it IS a frequently asked
question.
2. To say YES, Monika had severely inverted nipples before Clara was
born. We recognized the problem WHEN she got pregnant, and we
solved it.
3. To say that solving the problem is not rocket science. Solving the
problem is quite simple, but like all issues of reshaping the body,
it takes time! You can't go into it expecting to change overnight!

First, the human body is quite elastic (stretchable) and quite plastic
(reshapable) with the exception of bone, which is quite rigid. This is
the first thing to note.

Inverted nipples are usually a result of the ligaments along the milk
ducts which run to the nipples (and the ducts themselves) as shorter
than the distance from from the center of the breast where they
originate to the nipple. Hence they pull in end of the nipple in
toward the center of the breast, inverting it. This is the second
thing to note.

Since the tissue is stretchable, if you can get hold of the end of
the nipple, you can pull it out to a protruding position. The problem
is that as soon as you let go, it goes back to the inverted position.
However, each time it goes a little less far. Pull it out 100 times
and it stays out a while, pull it out 1000 times and it may stay out
permanently. Ths is the third thing to note.

These facts suggest a simple treatment. Pull the nipple out and hold
it in a protruding position as LONG as is comfortable, then rest and
do it again as soon as it is recovered from the exertion. Repeat over
a period of time. And this is like both orthodontia and politics:
A small force over a long period of time accomplishes more than a
large force over a short period of time.

Now. Some practical ways to accomplish this treatment...

A. Get a hospital grade breast pump (ie: one with a strong pull) and pump
on the inverted nipples. 1. You need to pump long enough to stretch
the nipple out and hold it in the stretched position long enough for
the internal ligaments to stretch somewhat. I would suggest at least
15-20 minutes per nipple (this is much longer than you need to pump
to obtain milk after the baby is born). 2. I would suggest observing
to see if the pump is pulling the nipple out to a protruding position.
If not, you need to get a stronger pump or use another method.
3. I would suggest starting no later than your 30th week. This gives
you 10 weeks to uninvert the nipple. 4. I would suggest at least 2
to 3 pumpings per day. If you have more time, go for it. 5. If you
have not made SIGNIFICANT progress by week 36, then increase both pumping
time and frequency or add another method.

B. Get DH to provide the same suction. Some people may find this
offensive, but I think it is more effective for two reasons. 1. It
can be modified to suit the needs of the individual. 2. It is more
like what the baby will do than any other method.

Here is the way I would suggest proceeding, if DH helps. 1. Since
this is more effective DH can suck 10-15 minutes on each breast.
2. DH should make sure to get the entire nipple and at least half
of the areole in his mouth and stretch out the nipple as far as
is comfortable, while massaging the deep tissue under the areole
with his tongue. This encourages the ligaments and ducts to stretch
out more easily. 3. Again, start by your 30th week. 4. In this
case you can start with once every second or third day, and work
up to every day by 33 weeks and twice a day by 36 weeks, etc.
5. I can't imagine not making progress by week 36 with this method.
But again, to increase progress, increase sucking time and frequency.

C. Breast Shields. This is the LEAST effective way to uninvert
nipples. Why? Because it does not apply ANY force to stretch the
nipple out to a protuding position, it simply presses the rest of
the breast mass back. For that reason, if you choose to use this
method, I would suggest starting MUCH EARLIER than with the other two.

Both methods A and B can lead to sore nipples or tender breasts,
expecially if they are not used to contact. In both cases I would
suggest applying Lansinoh cream and waiting until the soreness
subsides, at least from weeks 30 through 36. Beyond week 36 you
have to trade off how much progress you have made in uninverting
the nipple versus how tender you are. Another consideration is
that the baby will want to nurse 8 - 10 times a day. If you can't
stand sucking or pumping three times a day, you may well have
pain problems feeding the baby. Better to endure a little discomfort
early than a lot later on.

Monika and I used method B. We actually started earlier than 30 wks
because Monika was quite anxious about being able to latch the baby
on if her nipples were inverted. It took us about 10 weeks to "turn
them right side out." Monika had the added benefit that she suffered
no nipple soreness when the baby came. This was in contrast to the
5th or 6th week of turning her out when we had to rest a day because
of a tender spot or hairline crack.

Why do I feel so strongly about this?
1. I am a strong breastfeeding advocate, and I hate to hear of
women who want to breastfeed but can't because
a. The baby can't latch onto the inverted nipple, or
b. The nipple is so painful the mother can't stand to feed.
I know both of the conditions can be avoided.
2. Even though we had reversed Monika's inverted nipples, Clara
had difficulty latching on at first. This was quite stressful
for both of us. If the nipples were still inverted it would
have made the problem worse, and we may be in group 1, above.

This works! If you don't believe me ask Monika ( mmcmahan at home dot com).

As for the ones who have the problem, but only read this message just
before the due date (or even after the baby is born), my heart goes
out to you. Depending on the severity of your inversion, you may have
to choose between enduring relatively more pain or not breastfeeding.
However, anything you do NOW to solve the problem will be gentler
than what the baby does.

If the baby is already here, I would suggest using the pumping method
immediately after a feeding. If the baby is latching on at all, you
are probably getting all the sucking you need, and any addition may
well increase the soreness. The pump can hold the nipple in place
with a little less force.

Good luck,
Larry

[KC]

There is a device called the nipplette that you can find if you search
for it online that will pull out flat or inverted nipples. It says
not to wear it in late pg, but I did with no ill effects, and it did
draw out my flat nipples.

As for milk not coming in, if you do have to supplement with formula
at first because the initial weight loss is too much or if the baby
gets dehydrated give the supplement with a cup, syringe or
supplemental nursing system. Don't use a bottle. Then, if her supply
is very low there are medications you can try (domperidone or reglan).

Good luck,

KC


Ben > wrote in message >...
> Hi,
>
> We are expecting our second child soon. My wife had trouble
> breastfeeding our son when he was born so he was formula fed. There were
> many problems - my wife was anemic, the hospital screwed up the delivery
> in more ways than one, she had an inverted nipple, she had no support in
> the BF area, had PPD and the milk just didn't seem to come. We are
> hoping that this time around things have settled down a bit and perhaps
> our next child could be breastfed for at least the first 6 months. My
> wife will be working after 3 months or so, so if it was successful she
> we would have to some how manage with that.
>
> Is there anything anyone here could advice to help make this time around
> a success?
>
> Thanks,
> Ben

[Laurie]

Ben wrote in message ...
>Hi,
>
>We are expecting our second child soon. My wife had trouble
>breastfeeding our son when he was born so he was formula fed. There were
>many problems - my wife was anemic, the hospital screwed up the delivery
>in more ways than one, she had an inverted nipple, she had no support in
>the BF area, had PPD and the milk just didn't seem to come. We are
>hoping that this time around things have settled down a bit and perhaps
>our next child could be breastfed for at least the first 6 months. My
>wife will be working after 3 months or so, so if it was successful she
>we would have to some how manage with that.
>
>Is there anything anyone here could advice to help make this time around
>a success?
>
>Thanks,
>Ben


Yup. First, your wife should have the attitude that she is *going* to
breastfeed. Not that she's going to try. It's all mental, but a positive
attitued makes a big difference. Have her get a great bfding resource book;
"The Nursing Mother's Companion" and "So That's What They're For!" are both
excellent choices. Have her seen a lactation consultant, in the hospital if
possible, they are invaluable. And, tell her that the first several weeks
can be VERY hard and not to give up; it DOES get better!

Good luck!

laurie
mommy to Jessica, 27 months
and Christopher, 14 weeks

*This email address is now valid*

[Ben]

Laurie wrote:
> Yup. First, your wife should have the attitude that she is *going* to
> breastfeed. Not that she's going to try. It's all mental, but a positive
> attitued makes a big difference. Have her get a great bfding resource book;
> "The Nursing Mother's Companion" and "So That's What They're For!" are both
> excellent choices. Have her seen a lactation consultant, in the hospital if
> possible, they are invaluable. And, tell her that the first several weeks
> can be VERY hard and not to give up; it DOES get better!

How do you find these lactation specialists? They are available in the
hospital or do you have to find them before hand and they come in specially?

thanks,
Ben

--
BTW. I can be contacted at Username:newsgroup4.replies.benaltw
Domain:xoxy.net

[Ben]

Laurie wrote:
> Yup. First, your wife should have the attitude that she is *going* to
> breastfeed. Not that she's going to try. It's all mental, but a positive
> attitued makes a big difference. Have her get a great bfding resource book;
> "The Nursing Mother's Companion" and "So That's What They're For!" are both
> excellent choices. Have her seen a lactation consultant, in the hospital if
> possible, they are invaluable. And, tell her that the first several weeks
> can be VERY hard and not to give up; it DOES get better!

How do you find these lactation consultants? Are they available in the
hospital or do you have to find them before hand and they come in specially?

thanks,
Ben
--
BTW. I can be contacted at Username:newsgroup4.replies.benaltw
Domain:xoxy.net

[Beth Kevles]

Hi -

A great place to find a lactation consultant is through your
pediatrician. This serves two purposes: you'll get a choice of a
couple of LCs, and you'll find out whether your ped. is actually
BF-friendly. (Many peds. aren't really accustomed to infants who
breastfeed, so have all kinds of misinformed expectations and advice.
Finding a ped. who's well-informed and supported of breastfeeding is
important if you want to Bf past six weeks. Our ped. is supportive even
of breastfeeding that extends for several YEARS.)

--Beth Kevles

http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic
Disclaimer: Nothing in this message should be construed as medical
advice. Please consult with your own medical practicioner.

[Ben]

Larry McMahan wrote:
> Ben > writes:
>
> : How do you find these lactation consultants? Are they available in the
> : hospital or do you have to find them before hand and they come in specially?
>
> A couple of comments. The LCs associated with hospitals are often nurses
> will little additional training, and won't be able to help with serious
> problems. You could try the local La Leche League chapter, or even the
> yellow pages. You should look for an IBCLC certified LC, and when you
> find one, ask if she is IBCLC certified. This, at least, ensure a certain
> minimum training requirement and supervised consulting before they practice.

I'll have to look into what LLLs are close by perhaps and call. Or
perhaps call the hospital and ask about their qualifications there.

Thanks again,
Ben

--
BTW. I can be contacted at Username:newsgroup4.replies.benaltw
Domain:xoxy.net

[Mary W.]

Ben wrote:

> Larry McMahan wrote:
> > Ben > writes:
> >
> > : How do you find these lactation consultants? Are they available in the
> > : hospital or do you have to find them before hand and they come in specially?
> >
> > A couple of comments. The LCs associated with hospitals are often nurses
> > will little additional training, and won't be able to help with serious
> > problems. You could try the local La Leche League chapter, or even the
> > yellow pages. You should look for an IBCLC certified LC, and when you
> > find one, ask if she is IBCLC certified. This, at least, ensure a certain
> > minimum training requirement and supervised consulting before they practice.
>
> I'll have to look into what LLLs are close by perhaps and call. Or
> perhaps call the hospital and ask about their qualifications there.

I found the LC that finally fixed our problem via LLL. I had attended
a meeting while pregnant. There were two women there with newborns.
Both had used the same LC and raved about her. I got the number and
when we were in trouble, she was a tremendous help. Of the two LCs
we saw at the hospital, the first was OK, the second was lousy. The
LLL leader I saw after birth was pretty good, although she missed what
ended up being our big problem (poor tongue positioning by DD).

Good luck,

Mary

[Larry McMahan]

Ben > writes:

: How do you find these lactation consultants? Are they available in the
: hospital or do you have to find them before hand and they come in specially?

A couple of comments. The LCs associated with hospitals are often nurses
will little additional training, and won't be able to help with serious
problems. You could try the local La Leche League chapter, or even the
yellow pages. You should look for an IBCLC certified LC, and when you
find one, ask if she is IBCLC certified. This, at least, ensure a certain
minimum training requirement and supervised consulting before they practice.

Larry

[Ben]

Mary W. wrote:
> I found the LC that finally fixed our problem via LLL. I had attended
> a meeting while pregnant. There were two women there with newborns.
> Both had used the same LC and raved about her. I got the number and
> when we were in trouble, she was a tremendous help. Of the two LCs
> we saw at the hospital, the first was OK, the second was lousy. The
> LLL leader I saw after birth was pretty good, although she missed what
> ended up being our big problem (poor tongue positioning by DD).

Anyone have recommendations for DC Metro area? I still have to find the
number of the LLL here.

Ben

--
BTW. I can be contacted at Username:newsgroup4.replies.benaltw
Domain:xoxy.net

[P. G. Chavez]

Ben wrote and I snipped:
>
> Anyone have [LC] recommendations for DC Metro area? I still have to
> find the number of the LLL here.
>
> Ben

Lauri Clark, IBCLC of Breastfeeding Consultants of Northern Virginia
(http://www.breastfeeding-nova.com/breastfeeding.nsf) is truly
awesome!!!

Also, there are La Leche League groups all over the metro area. Try
http://www.lalecheleague.org/WebUS.html and click on Maryland, Virginia,
or Wash., DC to find a group near you.

Where do you live?

HTH,
-Patty, mom to Corinne [Mar-98] and Nathan [May-00]
and stepmom to Victoria [Apr-90]

[Ben]

P. G. Chavez wrote:
> Lauri Clark, IBCLC of Breastfeeding Consultants of Northern Virginia
> (http://www.breastfeeding-nova.com/breastfeeding.nsf) is truly
> awesome!!!
>
> Also, there are La Leche League groups all over the metro area. Try
> http://www.lalecheleague.org/WebUS.html and click on Maryland, Virginia,
> or Wash., DC to find a group near you.
>
> Where do you live?

Actually, my wife isn't giving birth in a hospital near us, but in
Baltimore since her OB/GYN practices in the hospitals there and she
doesn't want to change since we moved.

regards,
Ben



--
BTW. I can be contacted at Username:newsgroup4.replies.benaltw
Domain:xoxy.net

[Beth Kevles]

DC Metro area? There are some GREAT LC's here. Where exactly are you
located? If you're in NW or Bethesda, call my ped, the Pediatric
Villate (202-244-1553). The doctors are GREAT and very BF friendly.
They have an LC as part of the practice, too. I wish I'd had them as
our peds when the kids were babies, but we didn't find them until my
youngest was two years old. They may also be able to refer you to a
good LC in your more immediate area.

I'm afraid I don't remember any particular names from when I used an LC
myself. I remember getting good advice ... no details, though.

--Beth Kevles

http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic
Disclaimer: Nothing in this message should be construed as medical
advice. Please consult with your own medical practicioner.

[Ducky Lawyer]

Larry McMahan wrote:
> Ben > writes:
>
> : How do you find these lactation consultants? Are they available in the
> : hospital or do you have to find them before hand and they come in specially?
>
> A couple of comments. The LCs associated with hospitals are often nurses
> will little additional training, and won't be able to help with serious
> problems. You could try the local La Leche League chapter, or even the
> yellow pages. You should look for an IBCLC certified LC, and when you
> find one, ask if she is IBCLC certified. This, at least, ensure a certain
> minimum training requirement and supervised consulting before they practice.
>
I just wanted to add here, that the situation is different in other
parts (ie Larry's advice may be right on the money for most/all of the
US but not elsewhere). My experience in Toronto, Ontario (Canada) is
that Lactation Consultants here *are* registered nurses with trainign
and experience, and usually int'l certification. And, at my particular
hospital, even the 'regular' nurses on the L&D/OB floor were very well
trained in breastfeeding and very helpful, supportive and informative.
Not every hospital calls a nurse a "LC"; atleast here in Ontario, it
varies from one hospital to the next.
So, depending on where you are, it's not necessary to check for IBCLC
credentials...but of course it's good to get 'good help'!
--Barbara, who is ever so grateful that her local hospital runs an
excellent drop in BF clinic, funded by public health care, and who
thinks there ought to be more programs like it elsewhere :-)

[P. G. Chavez]

Ben wrote and I snipped:
>
> P. G. Chavez wrote:
> > Lauri Clark, IBCLC of Breastfeeding Consultants of Northern Virginia
> > (http://www.breastfeeding-nova.com/breastfeeding.nsf) is truly
> > awesome!!!
> >
> > Also, there are La Leche League groups all over the metro area. Try
> > http://www.lalecheleague.org/WebUS.html and click on Maryland, Virginia,
> > or Wash., DC to find a group near you.
> >
> > Where do you live?
>
> Actually, my wife isn't giving birth in a hospital near us, but in
> Baltimore since her OB/GYN practices in the hospitals there and she
> doesn't want to change since we moved.

I'm sorry, Ben, but I don't understand the relevance of the hospital's
location. The LLL group your wife attends should be convenient to your
home, not the hospital. I suggest she begin attending their monthly
meetings while pregnant. And, except for having an LC help with
breastfeeding while your wife is in the hospital, I'd assume it's also
easier if the IBCLC you call is convenient to your home as well. The
LCs I used were both hospital-based and independent consultants
available over the phone. With my DD, I used several, probably as many
as 6 or 7, and paid for none of them except the $15 required for one
visit at a drop-in clinic available at a hospital other than where I
delivered. Most of the time I either asked questions over the phone or
attended a weekly breastfeeding support group at a third hospital (all
in noVA).

BTW, I'm not suggesting that every breastfeeding mother requires an LC,
but given that I was a first-time, nervous mom with PPD, flat nipples,
and eventually a breast abscess, I needed all the support I could get.

Good luck,
-Patty, mom to Corinne [Mar-98] and Nathan [May-00]
and stepmom to Victoria [Apr-90]

[Meredith Edwards-Cornwall]

In > KC wrote:

> As for milk not coming in, if you do have to supplement with formula
> at first because the initial weight loss is too much or if the baby
> gets dehydrated give the supplement with a cup, syringe or
> supplemental nursing system. Don't use a bottle. Then, if her supply
> is very low there are medications you can try (domperidone or reglan).


I haven't read ahead, but hopefully someone else has mentioned that
supplementing with formula for a dehydration problem isn't recommended.
Formula isn't the best choice for a dehydrated infant.

Meredith