Breastfeeding After 'Failure' Part 4: Make a Game Plan January 02 2015 1 Comment
Make a Game Plan
As you have read about breastfeeding, you have more than likely figured out what might have caused your breastfeeding problems with your first child. More than likely one of three things occurred. 1. You were booby-trapped, 2. Your baby had a tongue or lip tie, or 3. You cannot make enough milk due to surgery, medical conditions or IGT.
Here is a good article on booby traps. If you were booby-trapped, then your highest need to be prepared for your next baby is simply education. Knowing what is normal for a breastfed baby will prepare you for what to expect. It will prepare you to ignore bad advice. It will prepare you to trust your body and your baby.
Tongue or Lip Ties
If your baby had a tongue or lip tie, then you will need to get educated on what tongue and lip tie look like. You will need to know how to best latch a baby with a tie so that you can nurse before you have baby’s ties revised. This article by LLL has a short paragraph on latching a tongue tied baby. You will need to know how to find a provider and will need to schedule an appointment for revision as quickly as possible. The best source of information on tongue ties in my opinion is the Tongue Tied Babies Support Group on Facebook. You can join that group and read through as many of the files as you can. They also have a great list of providers in their files section that lists providers well educated on ties and how they affect breastfeeding. I would highly recommend going to one of these providers as they will not brush off your concerns. Trust me, you want to know all of this ahead of time as researching or finding a provider after your baby is born, when you are nursing every 2 hours and have very little sleep, is almost impossible.
You will also need to have a shield and a pump available. Many tied babies have difficulty latching, which causes problems with nipple pain with mom and with milk removal with baby. Improper milk removal by baby can cause pro-longed engorgement. Heat and massage help tremendously with milk removal. If you recognize a tie in your baby, you will be best prepared to use heat on your breasts for 5 minutes before feeding baby, then get a good, deep, asymmetrical latch with baby and try to use massage or compressions during a feeding to maximize how much baby gets at the breast. Then, pump after feedings as much as possible until revision. This will ensure a good milk supply despite baby’s ability to remove milk effectively. It will also give you some milk to supplement with if baby does not gain weight properly due to the ties.
Have a Medela Contact Nipple Shield, Medium nipple shield available, but only use it if you are having nipple pain during feedings or your nipples become damaged from feedings. This will allow you to keep baby at the breast until revision. Make sure you know how to wean baby from the nipple shield as nipple shields can cause problems if used long-term. Here is a good article on how to use a nipple shield.
Low Milk Production
If you were not affected by the other two problems, then you may be a low milk producer. There can be a variety of reasons that you cannot make enough milk to exclusively breastfeed. You could have a history of breast surgery including breast augmentation, breast reduction, or other chest surgeries. You could also have thyroid conditions or insulin resistance which can affect breast milk production. You could also have IGT. IGT stands for Insufficient Glandular Tissue. Here is a link to an excellent article on low milk supply and IGT. You can greatly benefit from joining the IGT/Low Milk Supply group on Facebook. They have many excellent files in their files section that can help you with determining why you have low supply.
If you have a thyroid condition it is important to have your thyroid monitored frequently during pregnancy as well as after the baby is born due to fluctuating hormones. You will also want to avoid any herbal remedies containing Fenugreek as Fenugreek can lower your t3 and cause your thyroid to be out of whack, further lowering your milk supply. Most herbal remedies for increasing breast milk include fenugreek in them. Read your labels carefully! Most women with thyroid disease can breastfeed without needing to take supplements, however, you may want to have one on-hand just in case you find that you need one, especially since finding one without Fenugreek locally may be an issue.
If you have a history of PCOS, are over-weight, or have insulin resistance issues, you will want to get this under control as much as possible while pregnant. I have read that the best way to do this is to eat a very healthy diet, like a Paleo diet, high in protein and veggies and very low in sugar. You may want to have goat’s rue on-hand before your baby is born. Goat’s Rue helps to increase breast milk production. It also has an effect on lowering blood sugar which can help if you have problems with insulin resistance.
Regardless of your reason for low supply, there are several things that you may wish to have ready to use after your baby is born. Many of these can be hard to find locally and you don’t want to have to wait on it to get to your house if you need it. Things that you might want to have are supplements for increasing supply. There are so many things that you can take to increase supply. You can find information on my supplements page here. If you plan on hand-expressing, then you will want to have Monoject Oral Syringe 3ml Clear - Box of 100 to freeze your milk in. If you want to have a really accurate way to know how much to supplement your baby with, you can rent a hospital grade scale from a medical supply company, or buy your own. I bought the Ultrababy Scale on Amazon. If you would like to feed the baby at the breast regardless of your need to supplement, you can use an at the breast supplement system such as the Medela Supplemental Nursing System or the Lact-Aid Deluxe Nursing Trainer System. You will also probably want a pump and a hands free pumping bra.
If you would really like to give your baby breast milk only and feel that you might not be able to make enough milk for your baby, you can look into getting donor breast milk while you are pregnant. You can find milk donors on your local breastfeeding groups or on Eats on Feets or Human Milk for Human Babies. Both groups have a lot of information on donor milk.
Regardless of what affected your breastfeeding success with your first baby, you will likely want to contact a local IBCLC or at least have a list of them handy so that you can call someone if you encounter any problems with your next baby.
A quick note about breast pumps. Hospital grade rentals are the best pump to use for increasing milk supply. Many insurance companies now cover breast pumps. It would be a good idea to contact your insurance company before your baby is born to find out what they will cover and who you have to order from. My insurance would cover rental of a hospital grade pump, but I couldn’t find anyone locally that rented them through insurance. Again, this is something that could cause you a lot of stress if you wait until after baby is born to figure it out! Do it early if you can.
Summary of what you might need if you are affected by:
- Books-The Womanly Art of Breastfeeding and The Breastfeeding Mother’s Guide to Making More Milk
- Find a local IBCLC and be prepared to make an appointment!
- Find out if and how to get a pump through insurance
- Tongue Tie or Lip Tie
- Low Milk Production
- Join the IGT/Low Milk Supply Group on Facebook
- Monoject Oral Syringe 3ml Clear - Box of 100
- Ultrababy Scale
- Medela Supplemental Nursing System or Lact-Aid Deluxe Nursing Trainer System
- Pump-find out if and how to get one through insurance
- Hands-Free Pumping Bra (just makes pumping so much easier!)
- Join Eats on Feets or Human Milk for Human Babies for donor milk
- Find a local IBCLC and be prepared to make an appointment!
Other Posts in this Series:
Part 1: Introduction
Part 2: Getting Educated
Part 3: Finding Support
Part 4: Making a Game Plan
Part 5: Defining Your Success
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