LAURA KENT-DAVIDSON, ND, IBCLC
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The Most Important thing to Remember when Assessing Breastfeeding in the First Week

5/20/2016

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There is a lot going on during the first week of a new baby's life! Between the sleep deprivation we experience as parents and the work sometimes needed to get feeding established, it's a good thing the little one's are so darn cute!  It's an important time for everyone as the baby starts to orient to their new surroundings and their caregivers begin to bond and respond. Breastfeeding becomes this new skill that both the baby and the parents need to learn to do together.  For some the process unfolds without much effort, while for others it takes a lot more work and perseverance before things feel on track.

The first week is an especially important time as we want to make sure meconium passes out of the baby's system, that they remain well hydrated, and that they can start gaining weight when expected.  So how can we tell if breastfeeding is going well in that first week? Well, the most important thing we need to remember is that we can't rely on the numbers alone to tell us if things are going well. 

"He's feeding 10 times a day so things must be ok!"

"She's on for 50 minutes each time so she must be getting lots!"

"He's lost almost 10% of his birthweight so you should start topping up with formula"

I have heard these comments over and over again in my years supporting families.  And while numbers can be helpful in the overall assessment, they by themselves don't give us enough information.

​Numbers can give us a false sense of security or be a cause for unnecessary intervention. This is something Dr. Jack Newman and his team have been educating families on for years. The number of feeds, length of feedings, and the % weight loss don't tell us if a baby is feeding well at the breast. We need to look at the baby and see whether they are actually drinking or not and then manage the feeding to support the baby's drinking.  This is done by using breast compressions and switching breasts when the baby is no longer drinking. The clock and scale have nothing to do with that part. 

​Looking for a motion in the jaw where the chin drops down deeper and pauses before coming back up again tells us a mouthful of milk was swallowed.  This is much easier to understand by seeing it in person or by watching a video.  The International Breastfeeding Centre has some great videos of what "drinking" looks like so check it out if you need to. 

The number of diapers (pees, poos, and their colour) are more reflective of what is actually going in, and for that reason, are important to be aware of in that first week.  Check out the chart below - for any parents to be out there, it will give you some guidance.  (It was made in collaboration with two lovely women and fellow IBCLCs, Ashley Pickett and Kristi Prince).

Of course when in doubt or if you need assistance, reach out to your local Lactation Consultant!

In health,
​Laura

Breastfeeding chart
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Breastfeeding Latch 101: REACH

3/1/2016

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Breastfeeding Latch, baby, drinking, how to latch
A good breastfeeding latch is one that doesn't hurt and allows baby to drink well. To help you get there, remember the word REACH!
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The 3 B's for Breastfeeding...

10/28/2015

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Picture

Breast Access - Best Latch Possible - Be Kind

While living in Bangkok this year, I had the great pleasure of sharing with a big group of parents-to-be at Bumrungrad International Hospital. The topic of conversation was getting off to the best start possible with breastfeeding- a topic close to my heart of course!

To make it fun I came up with the very simplified 3 B's... here we go!

1) Breast Access- Sounds simple but there are a lot of potential barriers that can be put up in those early days while we are establishing the breastfeeding relationship.  Things like not rooming in/having baby sleep far from you, swaddling (which can decrease an infant's alertness and ability to self wake when hungry), and waiting until the baby is crying before offering the breast, can all be potential barriers to breast access. Instead, let's get lots of skin-to-skin time in so we can respond to the early hunger cues like hands to mouth when a baby is just about to wake up.

2) Best Latch Possible- Of course any breastfeeding resource you read will talk about the "latch".  A good latch is one that doesn't hurt and one that helps the baby drink well.  

​Support the baby in a way so they can reach for the breast. Reaching will open the jaw wide and allow for more breast tissue into the baby's mouth (a good thing!).  The baby should have his or her little chin far from his or her own chest, with the chin pushing into moms breast while the nose does not touch the breast.  With the Best latch possible we then watch for whether the baby is actually drinking or not by the movement in their jaw.  A deeper drop down (with a slight pause before it rises up again) tells us the baby's mouth filled with milk and swallowed it.  Breast compressions can help babies get those drinks when they are just nibbling away, and if that doesn't help after a bunch of tries we switch to the other breast! 

3) Be Kind! You have never breastfed this baby before, nor has this baby ever breastfed before- breastfeeding is a learned process that can take some time. Something I talk to all moms about is the importance of BEING KIND TO YOURSELF! Remember, you are doing one of the most important jobs on the planet but it's also the hardest.  The way you measure progress, productivity, and success as a mom (especially a new mom) is about to shift so give yourself the space and time to adapt to all the changes.

​If you and your little one are experiencing challenges with breastfeeding, I encourage you to access the help of an IBCLC (certified lactation consultant). Do this early as they can help you assess the situation, rule out any other barriers (like tongue tie for example), and help you create a plan ​that will aim to move things in the right direction!
​
In health,
Laura


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