Believe it or not, breastfeeding with inverted nipples can be as simple as breastfeeding with protruding nipples! You do however need good support when learning how to position and attach your baby to the breast, right from the beginning.

If you are a mum with inverted nipples, you may already have been told that breastfeeding will be problematic. Mums are often told they have inverted nipples when actually their nipples are pseudo inverted – which means that they will pop out when a little suction is applied. So check your nipples before you become all worried and confused with all the conflicting advice.

SO if you do have true inverted nipples, what tools are available to help you breastfeed well?

Many mothers are told that the only way to breastfeed when they have inverted nipples, is to use nipple shields. Nipple shields are useful, if the nipple is totally inverted and baby has a weak suck and is not able to draw the nipple out. It is important to at least try to latch baby onto the breast without a nipple shield a few times a day, as babies do become stronger and will actively try to latch onto the breast providing they are albe to scoop up breast tissue as well as the nipple.

Often, using nipple shields too frequently in the early days, can alter the manner in which the baby milks the breast, which could lead to breastfeeding problems and sore nipples later on.

If you are trying to latch your baby onto the breast, make sure that your baby is positioned properly to start with, i.e. that he/she is positioned nose to nipple. This will ensure that your breast tissue ( the areola), will be able to fall into baby’s mouth and the nipple will inevitably follow.

Depending on the size of your breast, if you have a pronounced inverted nipple, you may find latching easier by having baby positioned in the underarm or rugby hold, lying more on his/her back and coming up onto the breast. Nature and gravity will naturally pull the nipple down further to the back of baby’s mouth and thus protecting the nipple from becoming sore and cracked.

Whilst there is a lot of attention paid to the size and shape of mum’s breast, it is also important to remember that there are two people involved in the act of breastfeeding. So be sure to ask a professional to have a look in your baby’s mouth, to assess how far back the nipple will be able to go into baby’s mouth, and/or whether you would be better off using a nipple shield temporarily or expressing and bottle feeding as a last resort!

It is important to remember that you have options and with the right practical guidance, breastfeeding should be a satisfying experience for you and your baby.

With Mother’s Day around the corner, it is great opportunity to go shopping for fabulous gifts – not that I generally need an excuse!

SO apart from all the wonderful treatments and spa days that many mums will be getting, here are a few other bits that I think are just lovely!

The finger print jewellery from Precious Memories. Tiny fingers prints are moulded into beautiful silver and gold jewellery, charms and pendents. Have a quick squizz at Precious Memories for some special treats.

The personal touch is always going to go down well. Whilst calenders can seem a little cheesy, by adding special dates, birthdays, first kiss, wedding day, birthdays of babies, this is quickly and easily turned into a lovely keepsake. Have a look at http://www.gettingpersonal.co.uk/personalised-calendars/my-mum-personalised-calendar.htm for more ideas.

If you are treating a mum to be, a 4D image of the little one is a lovely gift. The Birth Company in Harley street offer this and boasts a truely luxurious ambiance with tropical fish in the reception and a bright and airy upper reception room, which looks out over London roof tops.

The Birth Company

Happy Mother’s Day to all the mums out there. You may not be aware of it, but your gentle touch and soothing voice can calm any storm in your loved ones lives. You are special and hope you are all spoilt rotten on the 15 March.

Dear Geraldine,

I hope you can help me! I am at my wits end and exhausted to say the least!

My baby is 5 weeks old and feeds all day!! Feeds usually last for an hour and a half (with lots of sleep time at the breast) but then he won’t let me put him down after feed, he starts crying (sometimes I feel like joining him!) and so I put him back onto the breast. SIGH!

I am feeding him from one breast so that he gets to the hind milk, but he goes to sleep after 15 minutes and I can’t keep him awake, even though I tickle is toes, blow on him and undress him completely! My health visitor has suggested that I give him formula after each feed as I may not have enough milk. I just don’t want to as I have worked so hard to get this far on breast milk alone. There has to be a better way of doing things!

Janet White London

Hi there Janet,

You have done well to get to 5 weeks and I agree that there has to be a better way! So let’s have a quick look at what we can do for you.

There are a few things to mention:

1. Your baby is 5 weeks old – he could be going through a growth spurt which does lead them to feed ‘all day’. This should only last for a few days though, but we will keep this in the back of our minds.
2. Your feeds are lasting for an hour and a half – WOW! Did you know that your baby’s tummy is practically empty an hour and a half from the beginning of the feed? This means that he will not go to sleep easily – on an empty tummy, so will need to feed again before you can put him down. This is quite likely why the feeds are running into each other! We need to get your feeds shorter and more efficient!
3. You are feeding him from one breast for roughly 15 minutes before he falls asleep.
4. You are thinking of introducing formula.

It seems to me that your little one IS hungry,  but not because you have a low milk supply issue.

Most 3 week old babies need to feed from both breasts at each feed. As your little boy is 5 weeks old – I definitely think he should be feeding from both at each feed.

We know that your baby is getting to the hind milk if his poos are yellow.If he was not getting enough hind milk, his poos would be spinach green.

Babies can drain the breast pretty quickly and effectively within minutes, so I would suggest that once your little boy has fed from the first breast, do a little breast massage or compression so see if you can encourage him to swallow a little more.

If he is asleep, take him off, wind him – nappy change him if needed and offer him the second breast.

When he goes to sleep on that side, take him off, wind him and offer the first side again. He will either take it or not depending on how hungry he is.

If he is nice and relaxed, put him DOWN QUICKLY, so that he can go to sleep with a full tummy. Offer him a feed every 3 hours – from the beginning of one feed to the beginning of the next, starting on the side you fed from last!

You want to see that your baby gains 20-30g each day. If he is gaining this and is still crying, we need to explore what else could be causing the crying spurts – as it won’t be hunger. I don’t think there is any need to introduce formula just yet.

• FEED 20minutes with compression throughout – or feed for longer if you can see him swallowing.
• Wind and nappy change to wake
• FEED from second breast for 20 minutes with compression. Small wind.
• BED

Follow this routine for a few days and then let me know how you are getting on.

Kind regards,

Geraldine

Hi Geraldine,

I am desperate to breastfeed my 2 week old baby but I don’t know how much longer I can bare the pain!!!! My nipples were cracked and bleeding by day 2 as Emily fed constantly for the first day. The midwife said she was attached properly, but it hurt like mad and I was told to feed through it for it to get better. I stopped breastfeeding her yesterday and have given her formula as it is too painful to even pump.

PLEASE HELP!

Karen Waters, Bristol

Hi Karen,

Oh dear! You sound like you have had a tough couple of weeks! Please don’t give up hope yet, there is quite a lot we can do to get you back on track to pain free breastfeeding.

Firstly, I think you have made the right decision to stop breastfeeding for now, as you are not able to get the attachment right, but you do need to express your breasts frequently to drain your breasts (to avoid developing mastitis) and to maintain your supply, so that once your nipples have healed, you can get Emily back onto the breast without further complications!

Step one

As your nipples are cracked and bleeding, I would suggest that you soften the scabs before pumping. To do this, apply a warm wet flannel/face cloth for about 5 minutes before pumping. You may need to reheat with warm water a few times during your 5 minutes. Now that your nipples feel relaxed and open, attach the pump so that your nipple is centre to the cylinder. Keep the suction on minimum and be sure not to dig the pump into the breast as this will cut off the flow of milk to the nipple!

Pump both breasts every 3 hours for roughly 15 minutes on each or longer if you are still able to get some milk. Do this for a few days until your nipples are feeling a lot better. You can also wear breast shells in a very lose bra during the day, so that your nipples don’t stick to your breast pads.

Step two

Okay, so we have now healed your nipples and you are ready to get Emily back onto the breast – what do you need to know?

Well, I just don’t believe that Emily was positioned or attached properly, or your nipples would not have become so chewed so early on. Provided your baby is on properly, your nipple will be right at the back of your baby’s mouth and out of harms’ way!

The size of your nipple indicates which attachment technique is best for you – i.e. getting baby onto the breast. The size of your breast indicates which position is most suitable for you and Emily. There is no point having baby ‘tummy to mummy’ if your nipples point down slightly, as both cheeks need to touch the breast throughout the feed and this is simply not possible unless baby is tilted back slightly and looking slightly upward. (if your nipples point down)

Basic rules:

1. Baby’s lower lip needs to be away from the base of the nipple when coming onto the breast.
2. Both cheeks should touch the breast throughout the feed.
3. You should feel a tugging feeling which indicates a good position and latch.

Now, if I were to do an in home visit, I would look at your breast and Emily’s oral cavity. This would tell me which position or attachment technique would be best for you. But I can’t nip down to Bristol, which is why I created the Let’s Breastfeed Program. I have a dedicated section to making positioning and attachment easy, but with the size of your nipple and breast in mind. All you have to do, is read the section relevant to the size of your breast and nipple, and find the technique and position that would be most successful for you. Then follow the step by step diagram to get this right. It is very simple and easy!

I hope this has helped. Please drop me a line and let me know how you get on.

Kind regards,

Geraldine

Dear Geraldine,

My baby is 2 weeks old and I am on my third course of antibiotics for mastitis! My husband says that I should give up breastfeeding as he can’t stand to see me is so much pain, but I really want to breastfeed my baby – my mother breastfed 4 of us for nearly 18months each! Please tell me what I should do as I can’t seem to shift this lump/mastitis and I can’t cope with the pain for much longer.

Poppy Gehl Surrey

Hi Poppy,

Your baby is still very young, which means that you are still very new to mothering. It is such a pity that you have discovered your first steps to mothering through a cloud of pain, but I am pretty sure that we can guide you all the way to the ‘silver lining’.

I just want to clarify that you are on your third course of antibiotics for one bout of mastitis which has not cleared?

There are a few of things I would need to know, for instance, does the lump in your breast get bigger and smaller during the day – say before feeds and after feeds? Is the mastitis/lump still in the same area in the breast or does it stay in one breast but move to different areas? Does your GP know that the antibiotics aren’t helping to clear the infection – or have you seen 3 different GPs?

If the lump or inflammation is variable during the day and is moving to different parts of the breast, it sounds like you are not draining the breast properly – so check your positioning and attachment. Make sure that you are drinking enough water to ensure your milk is not getting too sticky and leading to blockages and blocked pores.

If the lump/mastitis is still in the same area that it was when you originally went to the doctor, I would suggest that you ask to go for an ultra sound. Sometimes the inflamed area can close off and become a capsule – either containing milk or puss – due to the infection. If you have developed a capsule of fluid/abscess, you will need to have this drained before it is resolved and you can continue feeding.

I would also recommend that you have this checked out by a Breastfeeding Specialist for a second opinion, as I can only advice you on what you have told me.

Either way, it is possible to enjoy breastfeeding – pain free breastfeeding. To summarize, you either have recurring mastitis – due to poor drainage or possibly even over supply, or you have developed a fluid containing capsule which is preventing you from healing completely.

I hope this has given you some fresh insight. Please drop me a line and let me know how you get on.

Geraldine

I love the Baby Shows, the hussle and bussle and just plain madness of it all. But then I am not pregnant, nor am I pushing a hot, bored and irritable toddler around little stalls, dodging exhibitors and other parents alike.

So, if you are considering braving the Baby Show at Excel this weekend, you may want to have a quick read of my surivival tips below.

• If you only have a little baby, leave the stroller or buggy at home. The lifts are slow and overused and the stairs up are a complete nightmare to negotiate.
• If you have a shopping bag on wheels or something similar – take that instead. This will give you lots of room for all those freebies.
• Make sure you have enough water for your family as it is hot hot hot.
• As an exhibitor, I found grapes just briliant as just one refreshes your desert like mouth and is quick and easy to swallow when an somebody magically appears to ask you a question.
• Sign up for everything that you can right there and then. You can easily delete when you get home, take advantage of show specials and have one less bag to carry home!
• Make sure you know how to use the goodies that you buy before you leave the show. If you are buying breastfeeding cushions etc, speak to a breastfeeding specialist to check that it will be right for you. Things are harder to return and you may just be wasting your money!

I have to shoot back to the show now, so if you are coming down, come and have a chat at the Greatvine stand M36.

See you there.

Your baby has finally arrived safely after months of ‘baking’ in the womb and hopefully a decent delivery. To your frustration though, the hard work and worry is far from over, as your baby struggles to wake and feed regularly, or latch onto the breast and feed effectively. Many mums find themselves in a difficult position as their baby gradually loses weight and becomes more yellow in colour or jaundiced.

So, what is jaundice? and how can you prevent it from taking such a hold on your baby, that you need phyto therapy to help flush it out?

When a baby is in the womb, red blood cells transport oxygen around your baby’s body. To be effective, there are many more red blood cells pumping around your baby’s body. When your baby takes his or her first breath, the lungs kick into action and take over the role of respiration and the excess red blood cells (which are no longer needed) are broken down and discarded.

When the red blood cells are broken down, a waste product called bili-rubin is produced. Bili-ribin needs to be expelled from the body, but can only do so via your baby’s bowl movements or poos. Your early milk called colostrum is a very effective laxative, so the more your baby is able to feed, the more your baby will poo and the more bili-rubin will be flushed out of the body.

What goes in, must come out right?

If you are struggling to breastfeed, for whatever reason, your baby will not be getting the laxative properties of the colostrum and if your baby is not getting food, not much will come out and the bili-rubin is re-absorbed by the body.

Now there is a catch 22 here. Your baby needs to be awake and feeding effectively to get rid of the accumulating levels of bili-rubin, but the more bili-rubin floating around your baby’s body, the more sleepy your baby becomes and the harder it is to wake him or her.

So to summarize, the more milk particularly colostrum your baby is able to access, the quicker he or she will be able to flush out the bili-rubin. If your baby is not able to get to the milk, you need to find a way to get enough fluids into him or her, to start the process and keep it going, until you are out of the woods.

How do you do this?

You take control of your situation and arm yourself with as much practical advice/information as possible before you have your baby. Please don’t rely on midwives to come to your rescue in hospital, they are simply too over stretched to give you the one to one, calm care and attention this deserves, through no fault of their own.

Join me for a workshop where I will teach you everything you need to know and do from day one, or if you live on the other side of the country, get yourself a copy of the Beginners Guide to Breastfeeding and start reading www.letsbreastfeed.com/instantonlinehelp/

Not sure if that is delicately put, but it is a question that I am asked most days by breastfeeding mums, and the answer is yes!

You have been told that your body will produce enough milk for your baby regardless of cup size, so why do you feel like your baby is never satisfied or is not gaining enough weight each week?

The answer lies in how you take the size of your breast into account in relation to the size of your baby. A mum with a smaller cup size and a larger baby, will need to feed more frequently than a mum with a small cup size and a little baby.

A mum with a larger cup size will probably only need to feed 3 hourly, but depending on the size of her baby, she may need to nurse from one or both sides to ensure that her baby gets enough to eat and is left with that milk drunk feeling.

The reason I am addressing this, is that too many mums are given the same advice, regardless of their individuality. The general rule will work for some mums and will cause problems for other mums. The primary problem being low milk supply.

Milk production is determined by demand, so the more milk baby demands and stimulates the breast, the more milk your breast will produce.

If you are small breasted and have been told to ‘only feed from one breast at each feed so that your baby gets to the hind milk’, you may find that your baby is not satisfied, is not gaining weight and may need to top up with formula. Now, if you start topping up with formula, your baby will breastfeed less and so your supply decreases further until you see little point in breastfeeding and your baby is totally formula fed.

To avoid landing yourself in this catch 22, look at your breast size and your baby. If your baby is 4kg and you are an A cup, you will need to feed from both breasts, probably switching back and forth between the two at least every 3 hours, if not a little sooner. Your body will produce your baby’s daily quota of breast milk, but rather than having 4 large meals a day, may need 10 little ones.

The opposite is true for a mum with a E cup and a 3kg baby. You will have a larger storage capacity and as your baby’s tummy is so little, you may only need to feed from one breast every 3-3.5hours.

Either way, you want to see that your baby gains between 20-30g each day, produces lots of yellow poos and clear wees. If you are not hitting these targets, you may need to alter your feeding pattern to suit.

A few practical tips can go a long way when it comes to breastfeeding – practical being the operative word! Things that are so simple or obvious but need to be pointed out because you are just too tired, teary or traumatised to work out for yourself! So I am here to point out those tips for you, as I am sure they will make a huge difference. You may be asking yourself these very questions as we speak!

• How do I keep my baby awake during the feed?
  Compress your the outer edge or ‘rim’ of the breast. By flattening the breast tissue furthest away from the nipple, you will create a manual let-down or flush of milk. Your baby will have to start swallowing again or come off the breast.
• How do I know that my breast is empty?
  If you are compressing the breast (go right the way around) and your baby is sucking but not swallowing – the breast is empty.
• How do I know if my baby has had enough milk?
  Always offer a 2 part feed, separated with a winding/burping session and nappy change. It is normal for babies to fall asleep after 15minutes of feeding. So doing a nappy change here will wake your baby before continuing the feed.
  If after the second part your baby allows you to take the breast out of his/her mouth without going into melt down – he/she has had enough.
• How do I know that my baby is getting to the hind milk?
  His/her poos will be yellow. If poos are spinach green, your baby is getting too much foremilk.
• How do I know if I am producing enough milk?
  You are producing enough and feeding well enough if your baby is gaining between 20-30g each day.
• How will I know that I am not producing enough milk before baby gets weighed?
  If your baby’s poos are green or your nipples are sore, your baby may not be getting enough food, and may be asking to be fed more frequently. You will need help with your positioning and attachment so that your baby latches well and drains the breast to increase your supply.

Happy feeding!

]]> http://www.letsbreastfeed.com/blog/breastfeeding-tips-everyone-should-know/feed/ 0 http://www.letsbreastfeed.com/blog/sleeping-like-a-baby/ http://www.letsbreastfeed.com/blog/sleeping-like-a-baby/#comments Mon, 01 Feb 2010 16:06:25 +0000 Geraldine http://www.letsbreastfeed.com/?p=1670

One of the first questions I am usually asked at my Antenatal Breastfeeding Workshops, is ‘how can I get my baby to sleep?’
After months of broken sleep for both the expectant mum and dad, my clients are quite (very/desperately) keen to get their tiny tot into good habits from the start.

So this is what I advise them to do and 9 out of 10 times it works wonders! (There will always be one that simply won’t conform – but then you have to remember, baby is going to take after one of its parents)

How do baby’s work with regards to food and sleep? This is best illustrated in a story.

In the cavemen days, a new mum and baby would feed according to their clans routine. During the day, the men would go out hunting and leave the new mum in the capable hands of the elderly women. Mum and baby would sleep most of the day, particularly in the afternoon when her milk supply was low.

Why would her milk supply be low? you may ask. Well, in the afternoon between 1pm-4pm give or take, wild animals move toward watering holes. If a mum was feeding her newborn, she would be vulnerable to being eaten by one of the wild beasts.

At night, the new mum and baby would co-sleep and nurse all night. She and her little one would be safe as the men would have returned from their days hunting and so this is when most women find their supply peaks and is most abundant.

So when your little baby is born into the world, he or she will follow their instinctual behavioural pattern and sleep all day and then want to feed all night! Sound familiar?

You are not going to change this behaviour in a day, week or aften a month but if you put a few strategies into place from the start, you will get to that peaceful period of sleep a lot quicker.

Firstly, feed your baby as often as possible during the day – at least every 3 hours (start to start). The more calories your baby acquires during the day, the less she will need to take at night – when your supply peaks.

Feed according to your breast size – small breasts need to be fed from more frequently (maybe 2 hourly), larger breasts less frequently (still 3 hourly). Small breasts will need 2 breasts at each feed, larger breasts may only need one per feed.

Keep an eye on the output – yes –what goes in must come out! The more that comes out the better! You are looking for a chain reaction with each feed. If you are not achieving this, your baby may be older than 3 wks or you need more input!

Basically, the more calories your baby takes in during the day, the less he or she will need to take in at night! Quite simple whenyou understand how.

The Beginners Guide to Breastfeeding is jam packed with this kind of advice if you are interested or expecting a baby and want to be properly prepared.

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