There are many ways to help mothers with breastfeeding
This week I have been told (after and introduction including "I am a FAN", that I am doing everything wrong by teaching mothers with breastfeeding problems the asymmetric latch and breast compressions to help them with breastfeeding problems. This lactation consultant states that she had learned the "laid back latching on of a baby" and that it works beautifully, . I have no doubt of this being true.
However, the mothers and babies I see at the International Breastfeeding Centre in Toronto, are not the same as the mothers and babies she sees usually in the first days up to a perhaps 3 weeks of age..
Only rarely, when the mothers birth with midwives, are the mothers and babies that we see in our clinic started off breastfeeding as she describes. Often the “primitive neonatal instincts” have been extinguished, because the mothers and babies are usually two or three weeks old or often even older, not rarely 6 or more weeks old when first seen at our clinic. For our patients, the “golden hour” does not apply and the primitive instincts she mentions were lost or extinguished weeks ago. The babies are frequently not getting enough milk from the breast and are being supplemented with bottles and artificial baby milk. Indeed, some of the babies we see have been taken off the breast completely, sometimes for weeks at a time. By the time we see them in our clinic, most mothers have completely lost confidence that breastfeeding can work.
Many of the babies we see have significant tongue ties, which have not been addressed or even diagnosed because the major pediatric hospital in Toronto has stated that there is no such thing as tongue tie or that a tongue tie does not interfere with breastfeeding. Perhaps it is true that if the mothers and babies had started off as she wrote me, the tongue tie might not have had a negative effect on breastfeeding. But that is not the case in our patients. Only last week, we saw a baby with a tongue tie so tight, it was almost impossible for the tongue to move. Why was it not released in hospital on day 1 or 2?
As for the cross-cradle hold, in our situation it works extremely well. The idea is to help the baby get an asymmetric latch, which, works very well for eliminating or diminishing nipple pain and, at the same time, increasing milk transfer to the baby. The problem is that if the baby is 4 weeks old when first seen, it is difficult to help the mothers to learn this asymmetric latch. They are often amazed how well it helps in the clinic, but often cannot duplicate it at home. We will recommend early follow-up with one of our lactation consultants at home, but many of the mothers in our practice cannot afford the cost of a private lactation consultant visit at home.
In summary, the problem with many things in medicine, and in particular with breastfeeding, is that many “breastfeeding experts” know only how to fix problems in mothers and babies in the specific situations that they encounter. In spite of our situation, we are able to help many mothers. A significant percentage of our patients, achieve a painless latch and able to have their babies exclusively breastfed. I would be very happy if hospital routines became “breastfeeding friendly” but they are not.
One example, if I may. In the major birthing hospital in Toronto, women in labour almost universally receive intravenous IV fluids at a rapid rate. Two or 3 litres in a 24-hour period would not be uncommon. By the time the baby is born, the mother is overhydrated, and her breasts are engorged with fluid. The result? The baby cannot latch on, and the baby is started on bottles, usually with formula.
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?I hope this helps clarifies why understanding our situation is not your “golden hour” situation.
Please consider buying and recommending my new book: What Doctors Don’t Know About Breastfeeding
Print version and ebook version on Amazon:?https://www.amazon.com/dp/B09WC2HCC6
Print version on Praeclarus site:?https://stores.praeclaruspress.com/what-doctors-dont-know-about-breastfeeding-by-jack-newman-and-andrea-polokova/?showHidden=true .
The book has now been translated into French.
#bf #helpwithBF #morethanonwaytohelp
Lactation Consultant - RETIRED
4 个月Amen Dr Newman!! Private clinics and private practice IBCLCs are trying to fix the breastfeeding problems often caused during labor, delivery and immediate postpartum period.
Humour is medicine for the soul
4 个月Not one glove fits all. No two breasts or babies are the same. We should be open to what works for mum and baby to optimise milk transfer with a level or ease and comfort. Empowerment, confidence and reassurance in understanding the process. There are so many options to achieve the desired results we have to cater to the needs of the individual and not what always sits in a text book. When you have had over 40 years in the field of breastfeeding, you have a pretty sound knowledge and wealth of experience to draw upon. Will buy the book. Thank you
Infant Feeding Lead at Wirral Community Health and Care NHS Foundation Trust
4 个月What I believe is it’s all about having enough tools to try the options that work best for an individual feeding pair (or3/4!). Skilled helpers assess and provide support for what works best. We all need to keep learning x
Additionally, laid back latching for some mothers will reduce their milk production and for others it will assist. Other mothers with back, shoulder etc problems may not be able to achieve that position where others will be assisted by it. Also, it will not always be possible to assume that position when breastfeeding in public, in designated breastfeeding areas like breastfeeding rooms at shopping centres etc or at other people's houses etc. Keep being of benefit to mothers and babies/children, Jack. Well done!
CPNP, IBCLC at Baylor Scott&White
4 个月Brilliant lesson for all of us. I am a Pediatric NP and IBCLC. I am constantly battling the tongue tie issue but usually manage to get them referred quickly. I also get very frustrated when a newborn comes in at 2-3 days and has already been given bottles from the hospital because “my milk never came in”. I do my best to work with the parents to remedy the issues and provide education but constantly see the pediatrician that I work with giving out bucket loads of formula. Our hospitals are supposed to be baby friendly so why we even have formula except for a small amount for emergencies is beyond me. Most of the other local female pediatricians and some of the Ob/Gyns in our health system will refer the patient to me as an urgent appointment for feeding problems and I am so grateful for that.