Lactation and Breast Feeding Tips and Benefits
Speaker 2: 00:31 So the basics of it is that I'm a lactation consultant at the birth center, um, with the antepartum postpartum labor and delivery at a Wake Forest Baptist Medical Center.
Speaker 1: 00:44 Okay. And what got you into that field?
Speaker 2: 00:47 You know, uh, initially it was that, uh, I had difficulties with breastfeeding with my own children and I had a lot of help from lactation consultants and support groups like little h j league. And, uh, I really felt like it was important to help me over that hump. And so I went into training myself to do the same thing for others. And what started out as being, um, a mother to mother support group when on to me getting the clinical certifications and such to become actually a, a board certified lactation consultant.
Speaker 1: 01:26 Wonderful. So what are some of the services that you offer at Wake Forest Baptist Health?
Speaker 2: 01:31 So initially we offer really for going in order breastfeeding classes. So preparation they can sign up for monthly breastfeeding classes to come in and kind of get a good foundation and then we have inpatient consultation. So when you're in the hospital we come and see you if you, um, have, you know, well we really see everybody that indicates that they plan to breastfeed and um, even mothers that don't, we talk to them about some of the, um, what to expect if they plan on, on not breastfeeding as far as in gorge men and, and um, remedies for that. We have, uh, our outpatient services. So once you go home, a lot of people feel like, well, I'm kind of on my own, what am I going to do after that? So you can always call us and make an appointment to come back in if you have any questions, concerns, and that goes, um, through the duration of, of breastfeeding. And, uh, we have the MA mothers nursing nook, which has supplies like pumping supplies. We, uh, we carry Mudela to being and, and various things. We have a nursing bras, we have pump rentals, we have pumps, sales, nursing pillows. So we have a pretty wide variety of services. And you can see it goes from inpatient to outpatient and retail.
Speaker 1: 02:53 Okay. So let's just say you're a first time mom. Um, are you thinking about having kids and you want to breastfeed? You know, that's something that is a natural and you know, it's very healthy for the baby. Um, are there any things that mothers need to be aware of when breastfeeding?
Speaker 2: 03:09 So really the, the first place I, I encourage mothers to start is to take a breastfeeding class before you have your baby so that you're not trying to get all the basics in, in that postpartum period where you're already, you have a lot going on. So preparation is really a key as far as building foundation. And then, um, you know, good latch. We talk a lot about latch and anybody who's breastfed knows that. We're always talking about how's the latch. I was like, you know, that's really important, um, that we, and, and we can assess that as lactation consultants while you're in the hospital. So that really helps. Uh, frequency of feedings should be every two to three hours and, um, watching for hunger cues. So early hunger cues would be pretty much for a baby waking up. Um, you know, they, they tend to want to eat when they wake up and are conscious. Um, so, you know, watching for some of the others like lip smacking, uh, rooting, which has kind of them almost looks like sniffing around a little bit. Uh, you know, hands to the mouth, those type of things. Those are kind of key for, you know, the basics of, of, you know, what to look at first.
Speaker 1: 04:20 So if someone goes to a breastfeeding class, they're able to see the signs and symptoms of what the baby needs to in order to breastfeed.
Speaker 2: 04:26 Yes, we go all the way, you know, we, we really, um, strive to give you all the information you need to at least be prepared for the first, you know, several days. And then of course you have that inpatient support if you need it.
Speaker 1: 04:39 Okay. So what would you say the advantages are of breastfeeding?
Speaker 2: 04:43 So breastfed babies, you know, uh, tend to be sick less often. Um, mothers tend to have lower incidents of postpartum depression. Also, uh, mothers who have, and we talk a lot about babies, uh, and there their benefits, but I think we don't talk enough about the maternal benefits and long term and long term being things like, um, a mother who is breastfed and the longer you breastfeed, the risk goes down. Your risk of a reproductive cancers like uterine cancer and breast cancer, um, cervical, uh, ovarian, all those go down tremendously. If you breastfed, and like I said, the longer you've breastfed or the number of children you breastfed, uh, kind of coincides with that correlates.
Speaker 1: 05:31 Okay, so what is the proper way to breastfeed? Because I know when mothers have their baby, they're like, okay, what do I do next? So how are, what's the proper way to breastfeed your baby
Speaker 2: 05:41 early and often? Uh, yeah, I'll be more specific. Yeah. Yeah. Early and often. Um, yeah, to be more specific, uh, some of the first things that I'll look at and kind of help adjust to start with is having good position, body positioning for the, for first of all, the mother to be well supported, to not be hunching over, to be comfortable cause you might be there a while, um, have good arm support and then for babies to really always be turned where their tummies are to your tummy or in the football hold tummies are to your side. So if you want to know a visual what that looks like, you're looking at the ear lining up with the shoulder lining up with the hip. So pretty much, you know, because even, uh, if they are kind of tipped toward, you know, outward, that can change the way their jaw works. Um, even those little physiological, uh, things. Um, so that would be the, the start. Um, certainly on swaddling a baby so they can get as close as possible and undressing, um, really is probably optimal to have baby skin to skin, but at the very least to an swaddle so that there's less between you and your baby.
Speaker 1: 06:49 Okay. So when you do all of that, what happens if the baby doesn't latch on? How long does that process take for the baby to latch on?
Speaker 2: 06:58 Well, and that, that's kind of a, that's kind of a, I guess a loaded question, right? Because it depends on why, you know, we have babies that are in, um, the, the neonatal intensive care unit and maybe they can't for oxygenation purposes and that kind of as a, you know, as we go, um, you know, we kind of evaluate that as we go. But for a, for a healthy, full term baby and you know, no major maternal issues really, um, it just takes practice and patience and it's, at first it can feel a little bit scary when you have someone coming in every couple of hours asking you, you know, has baby, breastfed Yaz baby latching. But getting that help early is really important. So saying, you know, I need help with this, um, is really one of the keys and you know, with good lactation help in all of our nurses are trained really well to um, you know, the really, it shouldn't take as long as if you were trying to figure it out yourself. Um, so yeah, it just kind of depends, you know, why it is, um, that baby's not latching.
Speaker 1: 08:02 So what advice would you give to the frustrated mother that is just still patiently waiting? What would you tell her to do during that time
Speaker 2: 08:10 to get that help to, you know, to ask for help and, and to be willing to kind of accept that because every baby's different to you. Um, we, you know, we have mothers that maybe it's not their first baby and their first one, everything went well and no problems. And then, you know, they sometimes will feel like they shouldn't have to ask for help because they've done this before and have a little bit of a, an embarrassment about not knowing, but every baby's so different.
Speaker 1: 08:36 And let's talk about the Diet for the mother. If the mother tends to eat certain foods, does that, while breastfeeding, does that bring our promote gas for the baby? Like what types of food does the mom need to eat while she's breastfeeding?
Speaker 2: 08:50 So that's always an interesting question because we have a lot of, mostly what is a or wives' tale type of stuff out there, right? You'll hear, don't eat onions or don't, uh, eat chocolate or you know, certain foods. Most foods won't directly impact your baby because they're not coming out the way they went in for a baby. You know that your milk is pretty much always the same. Uh, you know, there are certainly babies that are an exception. Perhaps you, they are, you know, gluten intolerant or lactose intolerant, but that's not as common as you would think. Usually there's a different issue of baby's Fussy. Um, because we really have no clinical evidence that there are foods that, uh, negatively impact breastfeeding. It's all, you know, like I said, it's all, somebody noticed it and assume that it was food, but we don't tell mothers to give up, uh, anything. And that includes caffeine, you know, if they have a moderate amount of caffeine, two cups a day of coffee, that's okay. We don't want moms to feel like they have to give up their favorite things in order to breastfeed because that isn't much of a promotion.
Speaker 1: 09:54 Okay. Um, so as far as breastfeeding, I know that you said once the baby comes out the mother's womb, that's probably the best time to start breastfeeding. So what would you say is a good time to stop? Okay.
Speaker 2: 10:06 Well, the American Academy of Pediatrics recommends a exclusive breastfeeding for the first six months. And then introduction of complimentary solid foods, what, you know, whatever your baby is ready for developmentally at that point. Um, after that with breastfeeding still being offered first because, um, the babies can't really take in as much solid food as they need for their full nutrition. So, um, you know, breastfeeding is still going to provide all of their nutrition and then they go on to recommend that you breastfeed for a year. So six months exclusively. And then, uh, you know, onto the year with complimentary foods added in with breast milk still being the primary source of nutrition.
Speaker 1: 10:49 Okay. Um, so I know that there are a lot of working moms out there and they have to go back to work. So what would you say for those, um, working mothers that are still in the process of breastfeeding, what, uh, what would you tell them to do while they're at work or to make sure that they keep the schedule going?
Speaker 2: 11:07 Well, one of the things I like to really impress upon mothers that plan on going back to work, and I tried to do this early while they're in the hospital, is that you really don't need to start pumping for supply in, you know, for when you're going back to work until about a week before. Because for a couple of reasons. One is that the milk that you're, you're making for your baby when they're an immediate newborn in the first days or weeks of their life isn't necessarily what they need nutritionally when they're six weeks or eight weeks or 12 weeks old. Um, the other side of that coin is that it adds pressure and stress to mothers that are just trying to get breastfeeding. Right. You know, um, and it can cause them to have sort of what we call an oversupply if they're exclusively breastfeeding and they're pumping. Um, and you know, once they go back to work, the pumping takes place of the breastfeeding's right at those times. So you don't have that much of an issue. But if you're doing that while you're baby while you're still at home with your baby and they're breastfeeding a lot, um, over supply sounds great until it happens and then it's not so great. So I say just, you know, give it some time. Don't, you know, don't start pumping too early because it's just a lot.
Speaker 1: 12:19 Okay. Um, and is it common to have an even multiply
Speaker 2: 12:24 and even being [inaudible]
Speaker 1: 12:26 supply? There's one, like the right breast may have more than the left breast. Is that common?
Speaker 2: 12:30 It's not uncommon. Um, certainly we, we get that reported quite a bit and you can have completely different shape of breasts and that you didn't notice until you were pregnant. And, and when you're lactating, the nipples can be different shapes. And so sometimes you'll have one that the baby prefers over the other and maybe it gets nursed on more often. So yes, that's a thing.
Speaker 1: 12:49 Okay. Um, and as far as a in gorge meant, are there certain types of things I say cabbage can help relieve that? Is that true or is there anything else that you feel like would help relieve the engorgement?
Speaker 2: 13:01 Well, um, you know, cabbage leaves, that's actually one of the old wives tales that works and it works really well and it almost works too well. Uh, and, and the reason I say that is it's something I would recommend for mothers who don't plan to continue breastfeeding. Like if they did never, if they never planned to breastfeed and they want to stave off in gorge men after the first few days when their milk comes in, cabbage leaves work really well and they should be cold. And basically you try to peel off, you know, as much of it whole as you can or even in pieces and you put it inside of a Bra. Um, all the way around the breast and, uh, take it out when it's warm and replace it with cold. It works really well. I don't recommend it for mothers who plan to continue breastfeeding and might have concerns about supply because, um, it can, it can happen really rapidly.
Speaker 2: 13:49 Um, as far as encouragement, the best way really that we know to manage and gorge meant is to nurse on, you know, often. But also, um, if you do have a baby that maybe they only nurse on one side and the other side gets in gorged and now what, um, you can either hand express or just pump enough where it's softened so you don't end up with plugged ducks and mastitis and uh, just that discomfort. I know it's really in, when it happens it's really uncomfortable. So I know that it's a desperate feeling when it happens and sometimes you can't get baby. It's really hard to get out of that cycle once it starts because babies don't often want to drain that much milk. So pumping just to comfort, um, because you know, our, our supply is, is really a simple supply and demand that whatever we're telling our body it needs to mate, whether it's baby or a pump, um, it's, it's going to do that. So if we could pump that completely, it's just going to fill right back up with the same, you know, we're trying to give the message that we don't need quite so much perhaps.
Speaker 1: 14:48 So what are some things that can help increase the supply if you're not producing a lot of milk? Breastfeeding, it really is like pills or like any, it says oatmeal or beer can help increase. I've heard.
Speaker 2: 15:01 Yeah, no, I've heard that to you. And you know, again, most of that's anecdotal as far as you know, meaning that there are people that certainly report that, um, those, uh, breastfeeding cookies and all the t's and all those things. As far as I know, they can't hurt. Um, I think they're all breastfeeding safe. The thing about it is there are things we call galactic dogs, which are herbs and other, uh, you know, some medications that are known to increase supply in large amounts, but those amounts aren't going to be fine in a tea that you can buy over the counter. So like I said, they, those products can't hurt but they're not going to do, um, uh enough if really the problem usually might be that baby maybe isn't nursing enough or um, you know, we're not pumping often enough if we went back to work or you know, sending that basic signal of supply and demand.
Speaker 2: 15:52 So sometimes babies will go through a period where they won't nurse as much, but they usually pick up on the other side of it by nursing a little more than they than they would. And if you feel like you have low milk supply, certainly getting evaluated by a lactation consultant, you know, in one of our outpatient offices is not a bad idea because really most of the time when mothers come to me with that concern, they actually don't have a low milk supply. Sometimes they do. But we can really tell by doing things like a pre feed, wait watching mother, uh, breastfeed her baby and then post feed weight and we can tell how much they got.
Speaker 1: 16:28 So what would you say is a normal amount of milk?
Speaker 2: 16:32 No, every baby is really different, you know, right. At first, um, baby's stomachs are about the size of a marble. Um, and that's for about a week. And then at about seven days, it's the size of maybe a shooter, marble. And you know, at a couple of weeks it's more like an egg. So we tend to overfeed babies and there is some anxiety about not knowing what they're getting. Certainly, you know, as a mother you kind of want to know like, what is my baby getting? But we look more for output. Like w you know, how many wet diapers do they have a day? Um, how many, you know, bowel movements, do they have a day and are they gaining weight? Um, you know, and, and those things really are only best measured after the first few days when we see my mom's milk supply in and we can really evaluate that better.
Speaker 1: 17:18 Okay. Um, so when would you say introducing solid foods to our breastfed baby? What's the earliest that you feel like you can introduce solid foods to the baby?
Speaker 2: 17:28 Well, according to the American Academy of Pediatrics, six months is really optimal. You don't really want to start the much before that because first of all they don't need it. Um, a lot of times, especially with first babies, we get kind of excited and family members want to feed the baby. It's, it sounds really exciting, but often times, um, that's when we'll find milk supply dips is when babies getting full on something else. And so they're not nursing as much and it happens gradually sometimes where we don't notice it until it starts to happen. So that's one of the reasons to wait until six months. The other is that starting babies on solid foods too early, there is some clinical correlation between that and babies having food allergies and particularly, um, cows milk. And you know, things containing grain, you know, certain like gluten and, and all of those things. That usually is where we see more of the culprit of, um, you know, just the co the correlation. There's not a lot of really hard clinical evidence, but we see a lot of correlation in studies between babies with food allergies and starting solid foods too early.
Speaker 1: 18:32 Um, is breastfeeding painful?
Speaker 2: 18:34 It should not be painful. It's a good question though. Um, and a lot of people think, oh, I'm suffering and I'm supposed to, you're not. Um, it can be, it can make you a little tender, particularly mothers that have sensitive skin, um, and, and tend toward that and in most instances of, of other things. But it should not be painful if you find that you're dreading nursing because it hurts. Um, we really want to evaluate that and we try to nip that in the bud in the hospital. And you know, if you didn't have your baby, uh, at, at, uh, the birth center, then, you know, certainly schedule an outpatient visit because really we want to get to the root of it. A lot of people will use the hydro gel pads and the lanolin cream and all those things. And those are all great for soothing and healing and, and they help promote it, but they don't get to the root of why does this hurt? Because most of the time we're looking at a bad latch, um, that can really easily be corrected with, with a few little tweaks.
Speaker 1: 19:33 Okay. And also I was going to go back to the breastfeeding moms that are going to work. Um, if they use a breast pump, how long should they store their breast milk or how long are they able to store the breast milk?
Speaker 2: 19:46 Um, so these questions are always fun cause it really depends on who you ask. Um, but you'll find on, on the Mudela website, um, which is the products we carry in the pumps we carry 'em on their website. There's a lot of information about optimal milk storage. Um, so really breast milk is good out, you know, room temperature for about eight hours, um, in the refrigerator, I want to say at seven days. And then really you probably don't want to store your breast milk in the freezer more than longer than maybe three months.
Speaker 1: 20:21 Um, can you pass the virus or illness through your baby if you breastfeed, if they take your milk,
Speaker 2: 20:27 Gosh, and there are viruses that can be spread through human milk. I'm, one of them is, is HIV. And so breastfeeding is usually contra-indicated and mothers that have that. Um, as far as if you're talking about the common flu, a cold, something like that, the good news is that you're not going to give it to your baby. You are going to give to your baby is um, antibodies to fight that. So say we were sitting here and I'm a breastfeeding mom and you sneezed and it's in the air and I have been exposed to a virus that you have. My breast milk is going to start, it's going to kick in to create antibodies so that when I feed my baby, even if I get sick, my baby's not very likely to get sick because it's, if you think of it like a vaccination, there being, you know, my body has been exposed and now it's making the, you know, what's going to protect my baby against it. So I may get sick, my baby's going to be fine.
Speaker 1: 21:22 Okay. Well moms go through, um, are there any benefits to extended breastfeeding?
Speaker 2: 21:28 Well, certainly I'm extended being past a year. Is that what you mean? Um, well our, our breast milk continues to have nutritional benefit. So the American Academy of Pediatrics, um, their statement also goes on to say that that one year is sort of, um, a minimum ideal, uh, for breastfeeding. And that two years is really, um, of sort of maximum benefit. So some of the, some of the benefits can be obviously continued, um, protection against illnesses. Uh, you know, continued exposure to all the, all the good properties of breast milk. Um, and the things that set us up sort of for the rest of our lives to be a little bit healthier, lower incidences of ear infections if a child starts to go to daycare, um, whether it's before that or at that point, a lot of people start to think about, um, preschool and, and just mom stays out and playgroups, you know, babies are more protected if they, you know, the longer they continue breastfeeding our breast milk continues to be just as important for them. And bonding of course is, is um, something a lot of mothers really enjoy and, and babies do too cause they start walking and hurting themselves and you know, doing things like that. And honestly there's not, there aren't many of many better ways to sue the baby. Uh, or you know, an infant or a toddler then than breastfeeding. It kinda calms them right down usually.
Speaker 1: 22:51 Okay. So when, if people are interested in going to a breastfeeding class or knowing more about, uh, the birth center, what's a good way for them to know more about that? Is there a number or a website that they can go to to either sign up or to, if they had any questions about anything?
Speaker 2: 23:09 Well, um, the best way really for most families I think because the information, there's so much information there is to go to the website, the wakehealth.edu. And if you look, um, on the front page, I think lately there has been, uh, a lot of information about the birth center and the nursing mothers Nook. And if you go to our website and, and put that in the search bar, nursing mothers Nook, you'll find our hours. Um, you'll find our classes. We have breastfeeding classes. We also, uh, our educators also do the childbirth classes, the birth childbirth tours and all of that. So
Speaker 3: 23:46 all of that information is contained in that area of our website.
Speaker 1: 23:49 Sorry. Well, thank you for your time. Again, this is an r, this is Courtney Hayes with Aaron Moore. Um, she is a lactation consultant with the birth center. Um, and again, if you want to schedule an appointment or have any questions, just call the three three, six seven one six week nine two five three or visit our website at www.wakehealth.edu. Thank you again.
Speaker 3: 24:14 Thanks for listening to this episode of the best health podcast brought to you by wake forest baptist health. For more wellness info, check out wakehealth.edu and follow us on social media, wake forest baptist health, the gold standard of healthcare.