bottle refusal

Should You See a Lactation Consultant?

By: Morgan Annandale 

Whether you are in your third trimester, have a newborn, or have a six-month-old baby…do you know when it is time to ask for help with your breastfeeding plan and reach out to a professional?

In my experience, I waited way too long to ask for help. I definitely could have received advice from a certified lactation consultant during prenatal care, and avoided uncomfortable and unnecessary issues while nursing my son. I did not have the slightest clue that lactation consultants were utilised during prenatal care. Looking back, its seems obvious that as with every other plan a pregnant woman makes, that a breastfeeding plan should be one of them. However, I just figured “it would happen naturally” and that “my body and baby will know what to do.” YEAH RIGHT!

Photo by  Dave Clubb  on  Unsplash

Photo by Dave Clubb on Unsplash

My mum did not breastfeed me, nor did my grandmother breastfeed my mother. There was an even more negative stigma regarding breastfeeding back in their days than there is now. They told me that formula was simply the norm when it came to feeding your baby. I believe because of this, many new mums are surprised when they realise breastfeeding can be extremely challenging and nothing like you imagined.

I ran into numerous problems while breastfeeding my son for the beginning of his life. It took me six agonizing weeks to finally reach out to a certified lactation consultant for help. Six weeks of battling infected milk ducts, not enough milk being produced at times, and of course, the wretched bottle refusal issue (the top baby bottles were deemed beneath my son, who only wanted the real deal 100% of the time). I was desperate for someone to tell me what in the world was going on with both myself and my baby. So, I made the appointment to see a lactation consultant that was certified by the International Board of Certified Lactation Consultants (IBCLC). 

 

Prenatal is NOT too early

When speaking to my lactation consultant (LC), I quickly realised that meeting with a LC is not uncommon to do during prenatal care. She told me it does not happen as often as she would like to see, but that many issues and challenges of breastfeeding can be avoided if expecting mothers looking to breastfeed meet with a LC prior to giving birth.

According to a lactation consultant in Santa Barbara, there are also many risk factors a mother may have that would signal to meet with a lactation consultant during the prenatal period.

Some of those risk factors include:

  • Experiencing a high-risk pregnancy
  • Having difficulty conceiving and needing IVF or medications to conceive
  • Being a first-time mother over the age of 35
  • Having multiples
  • Having inverted or flat nipples
  • Having had a breast surgery or procedure such as any cosmetic breast surgery, lumpectomy, mastectomy or radiation treatment to the breast, or a chest surgery or injury
  • Having experienced breastfeeding difficulties with another child
  • High blood pressure during pregnancy
  • Diabetes, type I, type II, or gestational
  • Having very large or very small breasts
  • Having the first menstrual period at age 10 or younger
  • Having polycystic ovary syndrome (PCOS)
  • Experiencing postpartum hemorrhage
  • Having a baby born early, particularly if born before 38 weeks gestation
  • Having a difficult birth such as an induction, a birth where high doses of pitocin were needed, or a cesarean section

This LC goes on to describe how some of her clients created a breastfeeding plan to include with their birthing plan and how she would receive permission to send her client’s breastfeeding history and goals to her OB and nurses. This created a birthing environment where all of the staff and the mother were prepared to start the nursing experience off to the best start possible. She mentions that the mother said the staff fully supported her and it made for a much more positive and motivating birthing and first nursing experience.

  

Where to Find Help to Fit Your Needs

If you decide to go for prenatal care, or once you have reached a point postnatal where you know it’s time to reach out for help, it’s important to look in the right places. The best place to search for a LC in your area is by using the IBCLC directory. 

This helpful directory lets you search to find a certified LC in your area, so you know you are getting the best help available. A certified LC has to go through strenuous training hours and exams to be able to have IBCLC after their name, so they are the best of the best! Not only does this directory let you search by post code, you can also search by LC’s that perform home visits, work with the Government/military, work in community/public health/WIC, volunteer their support, or have a private practice.

It is also a good idea to contact your health insurance and see if consultations with your LC will be covered under your insurance. It is not always covered, but it is definitely worth reaching out to find out if yours does cover it.

  

Don’t Wait…It’s Not Worth It!

Overall, I learned as soon as I decided to reach out for help, that I had already waited too long. I do not know why I pushed myself so hard to accomplish such a challenging task on my own. Breastfeeding does not need to be a period full of frustration, pain, and struggles that a mum goes through alone. Lactation consultants can provide tools to help you overcome obstacles you did not think possible when it comes to feeding your baby. I truly thought I was going to stop breastfeeding if I could ever find a bottle that my son would take, but with the help from my consultant and finding a bottle like mimijumi, that allowed me to easily interchangeably feed, I was able to continue on for many more months!

*If you have any concerns regarding feeding please reach out to a certified LC or your doctor immediately.

The Confusion about “Nipple Confusion”

By: Katie Coyne, MS, IBCLC

No, babies do not confuse a bottle for their mom’s breast—which is why the term itself is rather confusing. But as with anything in the lactation world, it’s not that black and white. Let’s dig in to why…

There is a lot of controversy around the term “nipple confusion”—experts have been warning parents to avoid pacifiers and bottles for the first 4-6 weeks of the baby’s life because of the potential of nipple confusion. What does nipple confusion even mean? Many experts have a slightly different definition of nipple confusion but the traditional definition is “a phenomenon that refers to an infant's difficulty in achieving the correct configuration, latch technique and sucking pattern necessary for successful breastfeeding after bottle-feeding or exposure to an artificial nipple.”  Some babies will have no problem going back and forth between the bottle and the breast.  This is usually only a problem if the baby has not quite gotten the practice of nursing down. 

Nipple confusion versus bottle preference: the battle of the terminology

While lactation consultants generally don’t use the term nipple confusion anymore, we do know that babies feed differently at the bottle than they do at the breast. Everything from the motion of their tongue to the muscles used, are different. 

When babies breastfeed, they control the amount of milk flowing from the breast, but most bottle nipples have flow rates which baby does not have control over.  The problem is not that babies will get “confused” by this change in flow, it’s that they may form a preference. Even with the use of slow flow nipples, a bottle generally flows much quicker than a breast does. In layman's terms, this means that bottle feeding can seem easier to babies than breastfeeding. And who wouldn’t prefer any easier way to eat?!

It is really important to note that babies who are already struggling with breastfeeding—maybe they have a disorganized suck, oral anatomy issues, or are just having a hard time with forming a latch – these babies are at high risk of developing a preference for the bottle (because it’s easier).

Later we will talk about how to best prevent these issues when introducing the bottle.

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So what about pacifiers? Does that mean I can use them?

Although nipple confusion isn’t a concern, we still recommend waiting (or at least being cautious) on the use of pacifiers. The reason for this is because in those early days, your baby is going to be hungry pretty much around the clock. We recommend feeding your baby every time they show hunger cues rather than feeding them by the clock. It can be very hard to catch hunger cues if your baby is using a pacifier all the time, which is when we get concerned of missing those hunger cues. Not only does it lead to a fussy, hangry baby who can then be difficult to latch, but it could decrease your milk supply as well. Some babies are happy sucking on a pacifier for hours—which then can lead to missed feedings and lower milk supply.

On the flip side, let’s get real… some infants soothe really well with a pacifier. If your baby cannot be soothed without their paci, then I would recommend using it, but short term. Once the baby is calm, remove the pacifier, rather than letting them go to town for hours on end. And again, we are talking about the first 4 weeks or so. After that, it shouldn’t be an issue.

How can you prevent breastfeeding issues from the use of bottles or pacifiers?

It’s not realistic for most modern moms to avoid bottles their entire nursing career. Many women return to work and will need to pump and provide breastmilk in a bottle. And for moms who stay home, they also want the opportunity to pump and provide breastmilk in the bottle—that way they can maintain their sense of independence by running errands, grabbing coffee with girlfriends, or having a date night with their partner, all the while not worrying about their baby needing to nurse because they have a stash at home. So how do you balance bottle-feeding and breastfeeding?

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If your baby doesn’t quite have nursing down yet, then postpone introducing the bottle. It really is best for the baby to be doing well with the breast before we bottle-feed. Unless there is a medical reason to supplement with the bottle or you’re going back to work right away, there isn’t a huge rush. The average baby may be ready to try a bottle around 3 weeks. When you do start bottle-feeding, either use a bottle that allows baby to control the flow or try to pace the feed. There are plenty of great videos on You Tube explaining paced bottle-feeding. In a nutshell, with paced feeding you are slowing the rate in which the infant feeds from the bottle. This will help prevent that flow preference we mentioned earlier.  And anytime you can, breastfeed the baby. When you are home from work at night and on the weekend, nurse as often as possible.

Any time you sense that breastfeeding isn’t going very well, your local lactation consultant can become your new hero. Don’t wait until you hit rock bottom to reach out for help!