Saturday, July 17, 2010

Pearls, part 2.

I figured I should make this into two posts since it would be so long that no one would want to read it otherwise. (Of course, no one may want to read it anyway....) A few more thoughts:

1. Nursing can take a long time. Judah has always been a leisurely eater. He's gotten much better, but especially right after he was born he'd always fall asleep mid feed. So sometimes it would take me 45 minutes to nurse him. That's ok. But there is also nothing wrong with stripping the baby down, thumping on his feet, or doing whatever you can to keep him awake while he's eating.

2. To help Judah finish faster and get all the good hindmilk (that's the milk that comes later in the feeding - it's higher in fat so it helps keep him fuller longer), I often will squeeze the breast when his sucking has slowed down. At the beginning of the feed, the milk comes out fast, but when the flow gets slower, that's when he's most likely to drift off. So I'll get him to start sucking by rubbing his head or cheek, then squeeze. This makes it come out faster again, and he starts to suck more, and helps him empty the breast more completely.

3. Breastfeeding is all about supply and demand. The more your breasts are emptied, the more milk you will make. That's why I think that at the beginning, it's better to feed the baby when he seems hungry, rather than focus on getting him on a schedule. I'm not going to wade into the demand-feed vs. schedule feeding debate too much, but I think that when you are establishing your supply, it's good to nurse as much as the baby needs. I also started pumping after Judah would finish. This helped me get a little freezer stash plus helped ensure I had a good supply.

4. Breast milk can be stored safely for 8 hours at room temperature, 5 days in the fridge, and 3-4 months in a freezer. (6 months in a deep freeze). I was really worried about going back to work, so I made a big freezer stash. The other day we tried to use some of the oldest milk since it's about to expire, but Judah didn't really like the taste of it anymore. So I'd say get enough for a 3-4 day supply, but maybe don't worry about much more than that. Your milk's composition actually changes as the baby grows, so they may not want the milk you made several months ago.

5. You can't make him eat if he's not hungry. Some mornings, Judah will randomly eat a little less that I expect. I can tell I still have plenty of milk he could eat and I'll usually try to burp him and then see if he wants more. But sometimes he just doesn't want it. I have learned that it is ok. There is no reason to stress out about it. If he wanted more, he'd eat more.

6. If you are having trouble, call or go see a lactation consultant. I actually looked into what it takes to be a lactation consultant - I was thinking it would be something that could add to my abilities as a physician - and it really takes a lot. You have to log like 1000 hours doing breastfeeding support work before you are even eligible to take a test. Then you have to pass the test. So basically I'm saying that they have lots of experience and will almost certainly know more than your doctor about trouble-shooting problems. Sadly, we just don't learn tons about breastfeeding in med school. Don't be afraid to ask for help.

7. My best advice is just to try and relax. If you are stressed out about something, it's going to make nursing that much harder.

2 comments:

Emilie said...

very good pearls. I've learned that it was much easier the second time around. I know some people have a really hard time so I am thankful that there are very healthy alternatives for them as well. Joseph was a much slower eater like Judah but Jacob is a greedy little one. He took the normal amount of time at first when we were working out the kinks but once he got it down. . . . well, he is super fast now.

Melanie said...

This is all great, Aubrey. And what's even greater is how helpful you'll be to your patients now. I've yet to have a pediatrician that has children (since we mostly see residents) ... we love the two we've been through (since we're here longer than they are), but it's just not the same as getting first-hand advice.