Geraldine's 'Lets BreastFeed' Blog

Found yourself 'tongue tied' recently?

noreply@blogger.com (Geraldine) — Wed, 02 Jul 2008 15:34:00 +0000

Isn't it funny how a phrase that is so commonly used, can actually denote quite a serious problem for breastfeeding mothers! What is more interesting, is that even though the phrase is used to describe one's inability to speak properly or at all, due to the tongue not able to move, it is still not considered a viable threat to the breastfeeding infant - many doctors shrugging it off as an 'opportunity to move with life and get baby onto a bottle if you can't breastfeed'.

I have seen 4 tongue tied babies this week, with various degrees of the tongue being tied and held down in the floor of baby's mouth, but guess what? Not one of them was diagnosed by either the midwife or paediatrician who checked the baby's oral cavity after delivery. So, I began to wonder, how many mums are out there, struggling to understand why breastfeeding is so difficult, why feeds go on for hours and then baby glugs down an entire bottle of formula, why their nipples are chewed to pieces?

I want to highlight some of the problems a tongue tie can cause. If you suffer from one or more of these symptoms, find a breastfeeding specialist who can help you and refer you to the right place to have it divided. It may not be a tongue tie that is causing your problems, but at least you know what to ask for.

Problems a tongue tie can cause are as follows:

Baby
Long and frequent feeds - resulting in an unsatisfied fractious baby
Slow weight gain - or a sharp drop in weight after birth
Spinach green poos - this tells us that your baby is not getting to the hind milk
Breast refusal and fractiousness at the breast due to low milk supply and a hungry baby

Mom
Sore cracked or bleeding nipples - though the positioning and attachment looks right
Full breasts that don't seem any emptier after long feeds
Mastitis
Eventually a low milk supply as your baby has not been able to drain milk from the breast, so the less your baby takes off the breast, the less you produce!

What does a tongue tie look like? When you baby cries, have a look under your baby's tongue. if your baby is not able to lift his/her tongue right up to touch the roof of the mouth, and you can see a membrane that runs vertically, from the floor of baby's mouth to the base of the tongue, your baby has a tongue tie.

It usually runs in families, though it may be difficult to spot now, as many tongue ties were divided by a midwife's long jagged nail many years ago. As it is only a membrane, it has no feeling and having it divided, is a 2 second procedure and is not painful at all.

If you think your baby has a tongue tie, or would like to have one divided, feel free to contact me at blog@letsbreastfeed.com

Let's Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program!

If you feel like a FAILURE, this one is for you!

noreply@blogger.com (Geraldine) — Fri, 27 Jun 2008 13:54:00 +0000

It has been a couple of weeks now since I have been able to sit down and write.

Work has kept me busy these last few weeks, I have worked with mums who needed to increase their supply, or decrease their supply, mums who struggled to get baby onto the breast or off the breast and onto the bottle, some mums have had thrush, some mastitis, 2 had to have abscesses drained.

The incredible commonality these very different mums share, is that they all feel like FAILURES!

FAILURES?! REALLY?! WHY?

I sit back and just can't imagine how mums who have been so let down by poor advice, support or teaching can place such a huge burden on themselves and feel responsible for the problems they have encountered.

Breastfeeding is wonderful when it is going well, but just like you need to learn how to drive a car before you go cruising with music blearing and the wind in your hair, you need to learn skills that will set you up for breastfeeding success and enjoyment. The people who teach you these skills, need teaching themselves by somebody who knows what they are talking about, or your skills will ultimately be faulty.

If the skills you have acquired have been faulty, it is not your fault things have gone pear shaped. How on earth should you know about an area that has become so specialized it is considered a medical science?

So, for all you wonderful women out there who feel like it is your fault that your baby is not gaining weight, or who are suffering painful feeds, or quite frankly just don't know which way is up any more, you have come to the right place.

Please take a deep breath and think about it for a minute. You would do anything for your baby, right.
You want the best for your baby which is one of the reasons you are so keen to get breastfeeding right for both of you. If your baby could talk, he/she would urge your to try for both of you, as apart from all the benefits, there is very little a baby would like to do more than breastfeed and be close to you.

Over the next few weeks, I will be releasing Bite Size eBooks that specifically cover the most common problems mums face in detail, in a bid to help as many mums out there, discover how truly fantastic and flexible breastfeeding can be.

In the mean time, you are welcome to touch base with me if there is something I can help with.

With love,

Geraldine

Let's Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program!

Feeling HOT HOT HOT!!

noreply@blogger.com (Geraldine) — Wed, 11 Jun 2008 06:25:00 +0000

Thank you for all your emails and comments. I have been receiving quite a few emails from moms whose breastfeeding patterns have gone crazy with the onset of the hot weather, so I thought a few more of you may benefit from a little advice about feeding in the heat.

As the temperature rises, your milk will dilute slightly, to ensure that your baby is getting all the fluid he/she needs. You will notice that your milk is more 'watery' when you express. This is not a sign that the quality of your milk is poor, is is just nature's way of looking after you and little one.

The heat may aslo make your baby feel more sleepy while feeding at the breast, so use your breast compression to help push the milk down toward the nipple, so that it is easier for your baby to access. Undress your baby to the nappy. As you both become hot, you will also become sticky, so it may be easier to drape a muslin over your arm before picking baby up to feed. This will make moving him/her easier, a lot more comfortable and less sticky!

If your baby asks for feeds more frequently than his/her usual feeding pattern, this is absolutely fine. Most babies will ask for food and then only feed for 5 minutes before falling asleep. This feed should be considered as a thirst quenching feed, not a full feed. So, don't worry about pushing your baby to feed longer as these feeds, pop them down. They will wake soon enough for their full feed.

This may play havoc with routines, but just go with it. Ensure that your baby is always in a cool part of the house and lightly dressed. During the day, you could even just have him/her in a little short sleeve vest or nappy.

If you are out, don't leave your baby in the stroller unless it is parked in the shade. Most strollers are dark and this will attract heat. Many moms are hanging a blanket over the hood of the stroller to stop the sun from piercing baby's eyes, just remember that this is creating oven conditions in the stroller and will result in a very hot, thirsty and unhappy baby. Use something incredibly light, such as a muslin, if anything at all and remove as quickly as possible once you are out of sunlight.

Crying makes your baby thirsty, so if your little one is crying for whatever reason, you may find that offering the breast will calm and settle him/her well before putting down.

SUNNY SIDE UP!

Let's Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program!

Don't be blinded by rose tinted glasses

noreply@blogger.com (Geraldine) — Tue, 27 May 2008 14:13:00 +0000

I sometimes wonder whether rose tinted glasses are part of a standard uniform issued to breastfeeding antenatal teachers or whether we are just very optimistic people?

Don't get me wrong, it is important to be positive about your possible breastfeeding outcome, but I wouldn't try driving a bus, having watched an 80's version "HOW TO.." 10 minute DVD, sooped up on 10 tons of positive thinking and the fact that having driven a car for years, it should come naturally.

Surely I would need a little practical advice, preferably offered in bite size chunks, focussing on getting the basics right - before being expected to nip down Kings Road picking up paying customers, without any squashing, crashing, scraping, squishing of cars and padestrians - from day 1!!

So, why do we think that by telling moms everything is going to be alright, they are not going to find themselves stressed out and frazzled and most possibly in a lot of pain very early on?

Is it because breastfeeding is so incredibly natural for all, or that we have such brilliant support in the hospitals where midwives have endless hours to sit and teach them how to get things right, or is it that we just hope that by installing a little confidence in the new mom, she will persist until everything eventually falls into place?

Well whatever the reason, I think we should change the way we prepare moms for breastfeeding by telling them how to get their positioning and attachment right to suit their individual needs from day one! This needs to be practical, easy to remember and simple enough, so that we not at risk of conjuring up conflicting advice!

With so many babies being born each day and hospitals and midwives stretched to capacity, surely we can teach moms what they need to know before they have their baby, so that they can merely benefit from additional support once the baby arrives, rather than being totally reliant on health professional and completely in the dark about the practicalities of breastfeeding!

If you are a mom who has breastfed and would like to make changes or are happy with a service you received, please drop me a line. I would love to hear from you!

Let's breastfeed is dedicated to making your breastfeeding dreams a reality. If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program. www.letsbreastfeed.com

Sore nipples and conflicting advice...Going nowhere fast?

noreply@blogger.com (Geraldine) — Mon, 19 May 2008 16:02:00 +0000

Many moms are asking me why so many moms are experiencing sore nipples when breastfeeding is supposed to be such a natural activity for both mom and baby. This is a good question and one that really needs to be addressed!

It is inevitable that you are going to receive a degree of conflicting advice, as individuals have their own way of interpreting studies, techniques or information a mother will give at a particular time regarding a particular problem. However, the scale of variation between one midwife and another regarding breastfeeding techniques or timings, is leading to a lot of confusion and frustration. Often, the combination of all the conflicting advice, does very little to support or teach the new mom anything! So moms struggle to see the point and ultimately give up searching, feeling sad at failing to establish breastfeeding!

Don't be mistaken about breastfeeding and pain, they do not go hand in hand. If you are experiencing pain, there is a problem, and there will be any alternative to what you are currently doing, if you would like to reduce pain but continue giving your baby the benefits of your breast milk! Breastfeeding is not as black and white as some people imply it is. Many of my clients combine a bit of breastfeeding, a bit of pumping, a bit of bottle feeding and enjoy full and rewarding months feeding their baby! The good news is that you can too!

Let's breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program! www letsbreastfeed.com

Let's explore sore nipples a little...

noreply@blogger.com (Geraldine) — Thu, 08 May 2008 16:32:00 +0000

If you are a breastfeeding mom and suffering with sore nipples, please believe me when I say that it is NOT normal! It may be a common occurrence, but any pain you are experiencing, should indicate that there is something wrong!

You may already have bought the Let's Breastfeed Program, but I just wanted to highlight certain aspects that are very real in everyday breastfeeding episodes, and touch on how and what the primary causes are!

For the next few days, I will answer some of the questions that have been coming through regarding sore nipples, as well as short informative articles, in the hope that this will help as many other moms out there that are suffering too!

Thank you for all your wonderful emails! Please do keep them coming at blog@letsbreastfeed.com!

Let's Breastfeed is dedicated to making your breastfeeding dreams become a reality! If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program. www.letsbreastfeed.com/blog

Causes of sore nipples...

noreply@blogger.com (Geraldine) — Thu, 08 May 2008 16:27:00 +0000

When breastfeeding is a new and undeveloped skill, minor mistakes can very quickly lead to complicated breastfeeding problems, leaving a new mom and hungry baby, frustrated and on the brink of tears!

Sore nipples are often overlooked by professionals, as they are considered part of the breastfeeding course. I believe this is where many moms are being let down as sore nipples can indicate that the breast is not being drained well, leading to blockages and mastitis for mom and a less than satisfactory meal for little one, resulting in frequent feeds!

Sore nipples do not only result from poor positioning or attachment. Often combining elements of your breast tissue with your baby’s oral cavity, can result in soreness of the nipples and breast pain. For instance, a mom with inverted nipples or flat nipples, may find that mastering the art of breastfeeding is a little more challenging than other moms. Whilst your baby is more reliant on scooping up the areola when breastfeeding, rather than the nipple, you may feel that having flat or inverted nipples mean your baby slips off the breast more easily, creating feeding problems.

This is quickly and simply corrected with careful and tailored positioning and attachment skills which you will find in my Let’s Breastfeed Program!

If you have sought breastfeeding help and have corrected and modified your technique, you can expect your nipples to feel a little tender at the beginning of the feed for up to 60 seconds. Provided your nipples are round at the end of a feed, you can rest assured that your sore nipples will soon be a thing of the past, as with the correct attachment, you can expect your nipples to heal in a couple of days!

If you are experiencing sore nipples, seek professional help. Pain is a good indicator that there is something wrong and ignoring your pain, will just lead to further complications.

Let's Breastfeed is dedicated to making your breastfeeding dreams become a reality! If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program! www.letsbreastfeed.com/blog

Treating sore nipples!

noreply@blogger.com (Geraldine) — Thu, 08 May 2008 16:22:00 +0000

There are no words to describe the raw pain one experiences when breastfeeding results in sore nipples. So, what is the most effective way of treating sore nipples?

There are so many lotions and potions moms are advised to buy to help prevent and treat sore nipples, but most of the time, the relief they seem to provide is minimal and in some cases, they actually exacerbate the problem, leading to a longer recovery time and a lot more pain.

Many professionals are dubious about recommending one particular brand of cream or gel, as nothing seems to have resounding results every time. Are there really creams that can help soothe sore nipples, or is it better to save your money and use some of the old fashioned tricks of years gone by.

You could argue that with the research that goes into the development of new products, one can assume that they will be effective. The lanolin products are incredibly popular at most of the breastfeeding networks and cafes, but they should be used sparingly, as overuse, will not only lead to the whole areola becoming lubricated and difficult for baby to grasp, but it can also lead to blockages of the pores, or cell growth over the pores. For a practical problem solving guide, visit www.letsbreastfeed.com

The once popular Camilosan, seems to be enjoying something of a rebirth, which gently hydrates and soothes the sore cracked area. Camomile is also known as a mild antifungal remedy, so this natural remedy has more than one useful quality.

The not so glamorous use of cabbage leaves to soothe hot and heavy breasts, is also enjoying a comeback. Many moms have found that by cutting out the base/stalk of the cabbage leaf, that has been cooled in the fridge and gently crushed before applying directly onto the nipple, provides a great amount of relief, not only to the nipple, but to the breast as well.

Other moms have found the humble used , slightly wet camomile tea bag applied to tender nipples, another source of comfort.

noreply@blogger.com (Geraldine) — Tue, 06 May 2008 16:26:00 +0000

There is so much conflicting advice out there regarding breastfeeding practices and from your emails, I can see that some of the information you are being given is not always true, however well intentioned. I hope you are all learning and benefiting from the practical advice you are finding on my Blog!

Keeping with the inverted nipple theme - as there are so many questions being asked, you can read about alternate breastfeeding options when faced with inverted nipples!

As always, I hope this is useful and look forward to receiving more questions and emails!

Happy feeding,

Geraldine

www.letsbreastfeed.com/blog

Inverted nipples and the use of nipple shields

noreply@blogger.com (Geraldine) — Tue, 06 May 2008 16:23:00 +0000

When moms first start reading up about breastfeeding, there seems to be a lot of bad press surrounding the introduction of bottles and nipple shields, as this could lead to sore nipples as well as nipple/teat confusion. However, for some moms, the introduction of nipple shields could be what saves breastfeeding in the long term, so if you have inverted nipples, keep an open mind.

It is really important that your baby has an opportunity to learn to breastfeed well before the introduction of nipple shields, as many moms with inverted nipples find they are able to breastfeed well, with the correct attachment technique as well as a comfortable position that optimises baby’s ability to scoop up as much breast tissue as possible.

If you do choose to use nipple shields during breastfeeds and you are able to feed well with little breast or nipple pain, make sure to keep an eye on your baby’s poos. Breastfeeding moms are usually able to tell whether baby is latched and feeding well by assessing how breastfeeding feels, but as you will have a breastfeeding tool which may prevent sore nipples, you will need to use additional tools to assess how well your baby is emptying the breast.

The colour and frequency of poos will help you gauge how much food your baby is getting through the nipple shield at each feed. You should be seeing between 6-8 yellow poos a day until your baby is roughly 3-4 weeks old. As your baby gets bigger, you may find that dirty nappies are a less frequent event. This is normal, provided your baby is gaining weight and has plenty clear, heavy wet nappies throughout the day.

Many moms are told that the use of nipple shields should only be considered a temporary measure as it can lead to your milk drying up, however I have not found this to be true in my practice!

Let's Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program! www.letsbreastfeed.com/blog

Cup feeding whilst establishing breastfeeding with inverted nipples

noreply@blogger.com (Geraldine) — Tue, 06 May 2008 16:17:00 +0000

When breastfeeding doesn’t go well from the beginning, there many ways that you can protect your baby’s milking reflex, so that when you are both more confident, you can reintroduce breastfeeding with little trouble.

One way of protecting your baby’s milking reflex is to cup feed instead of introducing a bottle or nipple shield. Introducing a cup feed will ensure that your baby is still milking or lapping the milk from a little cup, instead of learning a whole new sucking action, commonly associated with bottle feeds.

Moms who would usually consider the introduction of cup feeds, would be moms experiencing breastfeeding problems, sore breasts, sore nipples, or even moms with inverted nipples.

As there are various degrees of inverted nipples, we can expect various time frames in which a baby and mom will master breastfeeding. For example, a mom with slightly inverted nipples, may only have minimal breastfeeding challenges in the early days. The use of a cup, will ensure that baby is able to get enough food and maintain interest in breastfeeding, until he/she is able to master latching onto the breast and milking it efficiently.

Moms who are presenting with true inverted nipples, may take a longer to master breastfeeding and so it is not uncommon for these moms to consider the use of a cup in the early days. Usually by day 5 or 6 as the baby starts to demand more food, moms will explore feeding with a nipple shield or possibly even nipple shields. Many moms do persist with cup feeding until their baby is 2 weeks or older before moving onto a Dr Browns bottle to save time and protect the baby’s milking action, whilst trying to master breastfeeding with inverted nipples.

Ultimately, I believe that you need to do what is right for your family as you will naturally want what is best for your baby!

Let's Breastfeed is dedicated to making your breastfeeding dreams a reality. If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program! www.letsbreastfeed.com/blog

noreply@blogger.com (Geraldine) — Fri, 02 May 2008 06:03:00 +0000

In keeping with the inverted nipple theme, I thought I would share this case study with you as it seems to be one of the more common struggles moms with inverted nipples encounter. The characters in this next Q&A are fictional but the problem very real.

Hi Geraldine,

I hope you can help me as I am at my wits end. Breastfeeding has been really tricky from day one as my baby struggled to latch onto the breast. This resulted in hours of frustration and a number of midwives trying to help my, all with different techniques and advice, unfortunately non of which resulted in baby latching onto my breast. As Luke wasn't feeding, I was advised to give him formula by cup feeding to protect his milking reflex, but the formula went everywhere and in the end, I gave in a offered him a bottle which he drained within minutes.

Feeling guilty for starving him, I decided to try him on the breast at each feed and then give him a bottle of formula afterwards. Luke manages to latch onto the breast, but then the breast quickly slips out of his mouth, so I know he is struggling to hold onto the breast during feeds. I have inverted nipples and was told I may not be able to breastfeed, but I am hoping that there is a way I could get around this.

I would also feel much happier if I knew that he was getting my breast milk instead of formula at each feed, instead of formula. My milk came in on day 3 and I was very engorged, which made latching on more difficult for Luke. Unfortunately, I am not sure whether my supply is still high enough to satisfy him if he were to ever latch onto my breast.

Please help.

Jenny.

Hi Jenny,

It is not easy to learn a skill if you don't have clear and effective guidelines. Breastfeeding is a learned skill and as we are all individuals, we each face different challenges when learning how to feed our babies. There are many moms who have been very successful at breastfeeding even with inverted nipples, so I would like to share some of the techniques we used to get those babies onto the breast.

Inverted nipples retract when pressure is applied to the areola, the darkened area around the nipple. When Luke latches onto the breast, he will apply pressure to the areola with his upper and lower gum and this causes you nipple to retract, making it harder for him to hold onto and milk the breast tissue. Often feeding him in the underarm position or rugby hold, with him lying on his back and coming up onto the breast is helpful as gravity will pull the breast tissue down and allow it to fall into his mouth.

If you have smaller breasts, this may not work for you as your nipples will point forward. You may find the use of nipple shields more successful, as the shield sits over the nipple and creates a firm teat for your baby to hold onto. Over time, the use of a nipple shield may help to stretch the nipple tissue and result in a degree of protrusion.

The other option you do have is to express and bottle feed your baby, as you currently are. Expressing will ensure that your breasts are well drained and this will protect or increase your supply as you creating a greater demand. Be sure to express both breasts every 3 hours from the beginning of one feed to the beginning of the next. This should synchronise your supply cycle with Luke's feeds, so that when you do offer him the breast, there is enough milk to keep him interested and focused.

With the increase of your supply, you may find that latching him onto the breast becomes a little trickier as your milk starts to flow and causes the breast to become slippery. Stay calm, place a muslin over the nipple and apply firm pressure with your hand, pushing into the breast. This will stop the flow temporarily.

I hope this helps.

Geraldine

Let's Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program! www.letsbreastfeed.com/blog

Inverted nipples - could I express and bottle feed?

noreply@blogger.com (Geraldine) — Fri, 25 Apr 2008 16:52:00 +0000

There are many moms who breastfeed their babies successfully with inverted nipples. However, many moms assume there is no point in trying to breastfeed, as they believe they will experience extreme pain and give up breastfeeding after weeks of guilt and tears!

If you are considering this option, I would like to offer you a couple of options. Naturally you may be more concerned about your baby’s well being – as often mothers are, but there is a way that you can still give your baby the benefits of your amazing milk without the tears and long nights.

Whilst your baby will drain the breast more efficiently than any breast pump, this is true for baby’s who are breastfeeding without any problems. So, once you have had your baby, still get your baby onto your chest as soon as possible and see what happens. If your baby latches and the nipple pain is bearable, you may be able to correct your nipple over time and enjoy pain free breastfeeding. If your nipples begin to crack and bleed within a couple of feeds, you could start to hand express both breasts every 2-3 hours. Your midwife will show you how to do this if you ask her. Collect your droplets of colostrum in a syringe and give this to your baby.

As your supply increases, you can start to express using a double pump. This will reduce the amount of time required and will also increase your supply substantially as you are stimulating both breasts simultaneously! The more you express, either by hand or pump in the first 2 weeks, the more you will produce long term. This is good to remember, as your baby will grow and will be able to scoop up more breast tissue over time.

Ultimately, the more breast tissue your baby can scoop up, the more milk he/she will be able to drain from the breast and the less pain you will experience!

There are many reasons for breastfeeding, but one that is often overlooked is that breastfeeding can be extremely enjoyable!

Inverted nipples and slow weight gain

noreply@blogger.com (Geraldine) — Fri, 25 Apr 2008 16:35:00 +0000

There are many reasons why a baby is not able to gain as much weight as he should. When I visit a mom who is presenting with this particular problem, I ask myself, is there really a milk supply issue, or is there a problem with the transfer of breast milk from the breast into baby’s tummy.

Low milk supply is often a result of poor milk transfer, so if your baby is having problems gaining weight and you have inverted nipples, read on and let’s see if I can help.

Naturally, I would start by saying that positioning and attachment is key, so that your baby is in the best possible position to maximise his/her milking of the breast. As you have inverted nipples, you may struggle to get baby to latch onto the breast well and then keep it in place with his/her tongue, as your nipple pulls back when the breast is compressed. Remember that yellow poos tell you he/she is getting to the hind milk – so as long as this is the case, don’t worry about feeding from both breasts, just get as much into your baby as possible. The more he/she eats, the quicker he/she will grow and the simpler your feeds will become!

If your baby is little and tires easily, you will need to express after feeds to ensure that your breast has been drained completely, so that your supply increases. You may consider hiring/purchasing a double pump. As your baby gets older and stronger, he/she will be able to latch onto the breast and feed more efficiently – so this is more than likely only going to be a temporary option.

Feeding from both breasts will stimulate your breasts more frequently and so lead to an increase in supply as well. You can offer this to your baby after feeding either from a cup, or I find the Dr Browns bottle breastfeeding mothers first choice.

I hope this helps. Remember, you are more than welcome to email me directly at g@letsbreastfeed.com if you would like me to answer your question in my blog.

Let's Breastfeed is dedicated to making your breastfeeding dream become a reality. If I can't see you in person, you can still have me in your living room with my Let's Breastfeed Program! www.letsbreastfeed.com/blog

Treating inverted nipples - how, when and what with?

noreply@blogger.com (Geraldine) — Thu, 24 Apr 2008 17:48:00 +0000

You know, I do find it amazing that there is such an emphasis on inverted nipples and all the breastfeeding difficulties you are likely to face. As I point out to my clients though, it is only a problem if your baby is not able to manage to latch on. As your baby is more reliant on getting the breast tissue into his/her mouth rather than the nipple, I do feel that we are getting into a sweat about this unnecessarily.

Your baby has not been chilling in the womb for the last 9 months, dreaming up ideas of what your nipples will look like, or the size and shape of your breast, so when he/she is presented with an inverted nipple, he/she is neither going to be impressed or annoyed, babies just get on with the job to hand – breastfeeding.

But what if you were unable to feed your first baby because you had inverted nipples, what can I tell you to do in preparation for the next little friend?

Well, if you wanted help your nipples protrude more, you could use a little tool called the Nipplette. You would use this when you were neither breastfeeding nor pregnant. To use properly, you will apply the little device to your nipple for roughly 6 hours a day, on the days in between your period. This will help to pull the nipple out, stretching the little filaments that pull the nipple back into the breast. Using in the first or third trimester can induce an early labour – be sure to read the instructions carefully.

If you are trying to manage breastfeeding with inverted nipples, expressing for a few minutes just before a feed will help to pull the nipple out, as well as rolling the nipple between your thumb and fore finger. Overtime you should start to see that the pain dissipates during/after feeds and the nipples remain ‘out’ in between feeds.

Let’s Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can’t see you in person, you can still have me in your living room with my Let’s Breastfeed Program! www.letsbreastfeed.com/blog

Variations of inverted nipples

noreply@blogger.com (Geraldine) — Thu, 24 Apr 2008 17:46:00 +0000

Just as there are many shades of blond or brown hair, you will always have a variety in types of nipples, each carrying with it a new or different challenge. Having worked with thousands of breastfeeding mothers over the years, I have come across 4 main variations of inverted nipples. They include: true inverted nipples, pseudo inverted nipples, folded nipples and dimpled nipples.

True inverted nipples are diagnosed when you pinch the areola just behind the nipple and the nipple pulls back into the breast, rather than popping forward.

Pseudo inverted nipples, look inverted and drawn into the breast, but when you pinch the areola just behind the nipple, they actually pop forward.

Folded nipples and dimpled nipples vary only in their appearance. What has often happened in these nipples is that the center bit of the nipple is inverted and is pulled into the breast right down the middle, giving the nipple a straight crease in the middle of the nipple, or the appearance of a donut where only a small section is inverted.

Ultimately, the better you are able to latch baby onto the breast, the less pain you will experience. However, this is one area where I do feel breastfeeding can be expected to be a little painful from the start. The inversion is caused by little filaments in the nipple, remaining really tightly wound and are not very stretchy.

There are two likely outcomes with inverted nipples. Either the filaments pulling the nipple back into the breast will start to stretch and so allow the nipple to pull out during a feed or after a number of feeds, which is great.

Secondly, the filaments can remain tight and the skin on the tip of the nipple will begin to pull away – this is not pleasant and can lead to bleeding nipples but will heal over time.

I don’t like to shy away from the truth when it comes to pain and breastfeeding as there are many options you can choose from once you know what they are!

Don’t be put off breastfeeding, as many moms breastfeed perfectly well. Be prepared and get off to a sound footing from the start!

How easy is it to breastfeed with inverted nipples?

noreply@blogger.com (Geraldine) — Thu, 24 Apr 2008 17:43:00 +0000

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.

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.

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 i.e. 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 be better 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 mom’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, or whether you would be better off using a nipple shield temporarily or expressing and bottle feeding as a last resort!

Let's look at inverted nipples!

noreply@blogger.com (Geraldine) — Thu, 24 Apr 2008 17:17:00 +0000

Isn't it amazing how we put ourselves under the microscope when trying to get breastfeeding right! We really give ourselves a hard time if our breasts aren't quite the right size or our nipples are too big or small or heaven forbid...inverted!

I wanted to run a theme to teach you about different breastfeeding areas, starting with inverted nipples! Please drop me a line if you breastfed beautifully with inverted nipples, or if you struggled to breastfeed with inverted nipples - remember, there is no right or wrong. I want to prove that there is no stereotype - and pleasurable breastfeeding is always possible regardless of the pitfalls we think we need to overcome!

Look forward to hearing from you,

Geraldine

www.letsbreastfeed.com/blog

noreply@blogger.com (Geraldine) — Tue, 22 Apr 2008 16:33:00 +0000

Hi Everyone,

I wanted to share this question with you as I am seeing very similar cases popping up all the time. Often when you are first learning how to breastfeed, you get your positioning and attachment wrong. The skin on the nipple is so sensitive, it is easily damaged and that will naturally equate to pain. But what happens if the cracks have healed? Surely there is no reason for you to have sore nipples, right? So what is going on, have a read below and see if this relates to you.

Hi Geraldine,

I really hope you can help me....I have had sore nipples right from the start. I can’t believe that anyone could possibly say they enjoy breastfeeding, but I want to breastfeed my baby for at least 6 weeks!! Longer would be brilliant, but I need to be realistic!

My baby was born 2 weeks ago and right from the start I had sore nipples. Naturally with the initial cracks I expected it to hurt, but the cracks have gone and I still have incredibly sore nipples. The midwife at my baby clinic says the positioning is great and that some moms just are very sensitive to sore nipples because I have fair hair?

I have looked at your website and my nipples are round after feeds not pinched like you said it would be for bad positioning. My nipples burn the whole time and I can’t even wear a bra or shirt without wanting to cry. When Harry is feeding, it is really painful to begin with, but then it calms down a little. I can only describe what a feel as sand paper or broken prickly glass being rubbed on my nipple.

Am I just being too sensitive as this is normal or is there anything I can do to fix this?

Please help.

Josie Piper

Wandsworth

Hi Josie,

It just isn’t fun when breastfeeding is not as easy as everyone says it will be. I think you are right in saying that pain with bleeding nipples is understandable! What I am more concerned about, is why you are still experiencing pain even though the nipples have healed.

There are two things I think you need to explore;

Have the cracks on your nipples completely healed, or have they just stopped bleeding? If you still have cracks on the nipple that are not bleeding nor healing, I would suggest that you pay your GP a visit to assess whether you have a slight bacterial infection that will slow down the healing process. If your GP feels you have a slight infection, he may prescribe you a course of antibiotics such as flucloxicilin. Be sure to get some acidophilus capsules to take if you start your antibiotics course as I wouldn’t want you to develop thrush.
The second possible diagnosis is that you have thrush, though it is difficult to assess without taking a full history. The sand paper/broken glass sensation is classic thrush symptoms, so I would suggest you visit your GP and discuss possible treatment with antifungal creams with him.

Just so that you are aware, if your nipples are round after feeds – or the same shape as they were when baby went onto the breast, your positioning is fine. If your nipples are pinched, your positioning is not good.

I hope this helps and please do let me know how you are getting on.

Geraldine

Let’s Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can’t see you in person, you can still have me in your living room with my Let’s Breastfeed Program!

Baby arching at the breast - please save my nipples!

noreply@blogger.com (Geraldine) — Fri, 18 Apr 2008 08:34:00 +0000

Hi Geraldine,

I have been breastfeeding my baby well for 2 weeks now with no cracked or bleeding nipples my friends all seem to suffer. My problem is that my baby keeps arching backwards and pulling at the nipple. It is so painful and I feel nervous that he is going to snap it right off as he is quite strong! I guess my other concern is that I don’t want my nipples to stretch beyond recognition either – sorry to be so vain....

Why is he pulling at the breast and what I can do to stop him doing this during feeds?

Thank you in advance.

Jessica Brown

Seven Oaks

Hi there Jessica,

Ouch! As I know most little ones have an incredibly strong suck, I do sympathise with your dilemma!

Firstly, you need to practice breaking his latch quickly so as to restrict the damage he is doing to your nipple. To do this, get your finger into the corner of his mouth, wiggle it pushing forward until you are between his gums, on top of his tongue and heading toward the roof of his mouth! Don’t let him pull back whilst you are doing this, so apply gentle pressure just behind his shoulders and keep him close to the breast until you have broken the seal!

Now that you feel confident you can take him off really quickly, we need to investigate why he is pulling back from the breast.

Answer these questions for me:

Are your breasts really full before feeds?

Does your baby make a lot of gulping noises at the breast at the beginning of the feed?

Does your baby only feed for short periods?

Is your baby gaining weight really well?

Do your breasts feel empty before feeds?

Does your baby have to work really hard to get enough milk in his mouth to swallow?

Does your baby get frustrated and cry during feeds?

Is your baby struggling to gain weight each week?

If you answered yes to the first 4 questions, I would assume that you have a very fast let down that your baby is struggling to cope with. So he prefers to nipple feed and pulls back. A fast let down can also lead to baby swallowing a lot of wind during the feed. What goes in must come out and usually bubbles travel upward, forcing baby to arch back away from the breast.

If you answered yes to the last 4 questions, your baby is probably trying to tell you that he is not positioned well enough to drain the entire breast, or that your supply is slightly low and needs a boost.

My Let’s Breastfeed Program is packed with practical tips to manage both these challenges. If you are still struggling, I would suggest that you find help locally to assess your breastfeeds by sitting with you whilst you feed. Sue Saunders – a fantastic Lactation Consultant, is in your neck of the woods, so contact me directly for her details if you like.

Let me know how you get on.

Kind regards,

Geraldine

Let’s Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can’t see you in person, you can still have me in your living room with my Let’s Breastfeed Program!

Third course of antibiotics in 2 weeks! Help!

noreply@blogger.com (Geraldine) — Thu, 17 Apr 2008 06:37:00 +0000

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

Let’s Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can’t see you in person, you can still have me in your living room with my Let’s Breastfeed Program!

Exhausted and confused!

noreply@blogger.com (Geraldine) — Wed, 16 Apr 2008 08:05:00 +0000

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:

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.

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!

You are feeding him from one breast for roughly 15 minutes before he falls asleep – Are you assuming that he has not drained the breast as he falls asleep after 15 minutes,and so you keep him on one side for long periods so that he gets to the hind milk? I will clear this up for you in a minute – but I think this is the deal breaker!

You are thinking of introducing formula - HMMM

I am going to summarize this for you as I suspect you can see quite clearly where you have gone astray and please let me know if you agree.

It seems to me that your little one is hungry, not because you don’t have enough milk, but that you have not been given the basic tools to work with. 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!

I don’t think there is any need to introduce formula just yet. Do this for a few days and then let me know how you are getting on.

Kind regards,

Geraldine

Let’s Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can’t see you in person, you can still have me in your living room with my Let’s Breastfeed Program!

Too painful to feed or pump - HELP!

noreply@blogger.com (Geraldine) — Wed, 16 Apr 2008 07:18:00 +0000

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. L

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:

Baby’s lower lip needs to be away from the base of the nipple when coming onto the breast.
Both cheeks should touch the breast throughout the feed.
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

Let’s Breastfeed is dedicated to making your breastfeeding dreams become a reality. If I can’t see you in person, you can still have me in your living room with my Let’s Breastfeed Program!

And then there was light.....

noreply@blogger.com (Geraldine) — Tue, 15 Apr 2008 16:21:00 +0000

Hello everyone!

Thank you for visiting my website! I am so excited to finally have my blog up and running and look forward to touching base with you all on a regular basis. My aim is to help you to enjoy parenting right from the start, making it feel more natural and less like the steepest learning curve you have ever encountered! Naturally, I will share a lot of breastfeeding advice, but as I have worked with families for nearly 15 years, I will also share other tips and tricks I have accumulated over the years! I am happy to answer your individual questions, just email them to me at g@letsbreastfeed.com.

With love,

Geraldine