Troubleshooting Breastfeeding Difficulties Part 1
Learning to breastfeed can be a difficult and frustrating time for first-time mothers AND their babies. Under the best circumstances, most of us have patience and determination to learn a new skill. However, after the physically draining effects of labour and birth, breastfeeding can be frustrating if the baby is slower to learn to latch at the breast.
Birthing a baby is the most energy draining, intense physical and mental marathon of your life. And while it is exhilarating to hold your baby after all the anticipation, wait and worry, you are then obligated to pick yourself up and respond to the needs of your newborn at the expense of your own. Your body aches, you are exhausted, peeing is uncomfortable, and the menstrual-like discharge can be messy.
During this period just after birth, your internal resources are fragile and you can be vulnerable to outside criticism or disapproval. With respect to breastfeeding, “well intentioned help” can easily sabotage the breastfeeding process. Many new mothers are offered suggestions from people who truly believe that they are providing great advice, when the advice is dated and can actually interfere with the breastfeeding process.
Here are a few situations that can arise, the problems that they can create, and suggestions on how to handle them.
You are so very tired. Why don’t you sleep and let us take care of your baby?
Yes, it is true that you are tired after giving birth. However, if you let your nurse or someone else watch your baby while you sleep, you won’t know if they decide to feed your baby formula to give you a longer rest. The colostrum that your breasts produce just after birth is extremely concentrated with nutrients, immune factors and energy-rich natural sugars, and a newborn baby drinks colostrum approximately a teaspoon at a time. Because his stomach is extremely small, this amount of colostrum is a normal and healthy amount for your baby to ingest per feeding in the first few days of his life. If your baby is fed an ounce or more of formula, his stomach will become used to a larger volume and suddenly the colostrum that your breasts produce is not enough.
To counter this approach, keep your baby in your room with you, sleep when he sleeps and feed him on demand. If you can sleep while a family member or a friend is visiting, ask him or her to wake you as soon as the baby starts to stir so that you have time to pee, grab a water bottle AND latch him to your breast before he becomes wide awake and angry. It is difficult to breastfeed a hungry, angry, crying baby. In context, have you ever tried to eat when you are supremely upset?
The baby is losing body weight and we are going to have to supplement him with formula
Actually, it is normal for a baby to lose weight after birth. When a baby is growing inside his mother’s uterus, he is constantly fed nutrients and liquids through his umbilical cord. After birth, the constant stream of food and drink ends and breastfeeding begins. However, a baby can be really tired after birth, and it can be difficult for him to stay awake long enough to have a good feed. The answer is to let him breastfeed often and to do your best to keep him alert while he eats. You might want to wake him every two hours to feed to ensure that he’s getting a good supply of breast milk. Unwrap your baby, place him naked onto your bare chest and snuggle under the covers together. He is then able to breastfeed more easily and the smell of mom helps him to relax and feel secure. Keep offering the breast and encourage him to suckle even if it is a gulp at a time. Once your milk comes in, it will be easier for him to get more fluids and nutrients in each breastfeeding session. It can take up to three weeks for a newborn to regain his birth weight.
There is a point, however, when a baby can become dehydrated and that is cause for concern. At 7% loss of body weight, your health care practitioner will want to monitor your baby’s breastfeeding times and whether or not he pees and poops regularly. Supplementation may become necessary, but offer the breast first and then supplement afterwards. This allows your baby to continue to practice learning a proper latch and helps to establish a good supply of breast milk. It can take time for the baby to learn the physical act of breastfeeding, and once he does, supplementation will no longer be required.
You should feed your baby on a schedule
Our mothers and grandmothers were advised since 1946 by Dr. Spock’s Baby and Child Care book to bottle-feed their babies and put them on rigid schedules because it was “more sanitary and more scientific.” At that time in history, scientists and pediatricians did not realize how much more breast milk offered besides nourishment—Secretory IgA that coats the lining of the baby’s intestines to provide better immunity from bacteria, viruses and parasites; Bifidus Factor that helps to establish good bacteria in the baby’s large intestine, natural fats that promote brain and nerve development; and the exactly perfect proportion of fats, proteins, carbohydrates, vitamins and minerals that the baby needs.
While ill-advised, it is possible to achieve a schedule for a bottle-fed baby because the cow’s milk proteins found in formula take more time to digest than the proteins found in human breast milk. An example of the difference would be eating a serving of tofu compared to a New York Steak. Tofu digests more easily than steak just as human breast milk is more easily digested than cow’s milk formula. Breastfed babies are supposed to eat often---the baby leads the “breastfeed on demand” process because his sole purpose at this beginning stage of his life is to ensure his survival by establishing a good and abundant milk supply.
You always get to feed the baby and I can’t. Couldn’t you let me give him one bottle at night?
The problems with introducing bottles into a baby’s schedule when he is busy establishing his milk supply are twofold:
First: a new baby can become confused with the two different types of feeding. Breastfeeding is a very active process. A baby draws a good amount of breast tissue into his mouth (more than you realize) to form a teat. He has to suck for quite a few seconds before the letdown reflex begins and the milk begins to flow. When a baby is feeding well, the rhythm that develops is to suck a few times and then to gulp the milk that pools in his mouth.
Bottle-feeding is a totally different process. A bottle-fed baby doesn’t have to work at all to get milk. The milk dribbles from the nipple of the bottle and the baby gulps away to his heart’s content. If a breastfeeding baby encounters two types of feeding, one that he has to work at and one that is incredibly simple, he might just opt for the easier one, especially if he is having difficulties learning how to latch.
Second: it is the physical act of sucking at the breast that stimulates the brain to increase milk production. If a baby is using one of his feeds to drink formula, the mother does not get the stimulus to produce more milk. This results in less milk available for the baby, which causes him to be hungry and fussy. The same problem arises when soothers are introduced into a newborn’s life before the breast milk supply is firmly established. A soother can provide comfort, but it interferes with the baby sucking at his mother’s breast. Soothers and bottles should only be introduced after the breastfeeding process is comfortable for both mother and baby, not before.
One way to satisfy the needs of your partner, your parents, your in-laws and other family members who want to feed your baby is to give them an activity to do that is special just for them. Partners can take over bath time and actually climb into the bath with the babies to enjoy skin-on-skin closeness. Other family members can be shown infant massage techniques that promote the bonding process between themselves and the baby:
Please sign up for our infant massage kit and I’ll send you my videos that will teach you how to massage your baby for free!
Another suggestion for your family members is to strip the baby down to his diaper and for them to hold the baby on their chests and drape a warm blanket around them both to provide the satisfaction of a good cuddle. Be creative, there are lots of ways to show love that don’t involve bottle-feeding.
Stay tuned next week for part two where I will discuss how to make things easier moving forward.
Do You Have a Fussy Baby in Your Life?
Oftentimes, fussy breastfeeding babies are either experiencing physical pain from birth, they are reacting negatively to the foods that their breastfeeding mom is eating, OR BOTH!
Birth is a very difficult process for babies to experience. If you suspect that your baby is in physical pain when you feed or diaper him or her, take your baby to see a pediatric focused chiropractor in your area. We are trained to gently relieve irritations to muscles and joints.
If your baby is fussy after breastfeeding or cries inconsolably in the evenings and won’t settle easily, chances are that your baby is reacting to foods in your diet.
If this is the case, please consider purchasing the Calm Baby Cookbook – it outlines the foods that commonly cause problems for babies to digest and offers 100+ delicious breastfeeding recipes to get started! It has helped to calm many babies in my practice and I sincerely hope that it will calm your fussy baby as well.
Dr. Melanie Beingessner
Dr. Melanie Beingessner is a pregnancy and pediatric-focussed chiropractor, a breastfeeding counselor, a certified infant massage instructor and a mom of three awesome kids.