Lisa’s First Visit with a Lactation Consultant
Beautiful baby Sophie and Lisa met me at the door with a bouncing excited newly big sister Anna.
Lisa told me that the feeding had been going better overnight since she was able to soften the left breast by expressing her milk. At the same time, she was still finding the feeding sore and not sure if Sophie was draining the milk properly...
Fortunately, Sophie Was Ready to Feed
We sat down together just in time as Sophie was very soon awake and looking for food. As Lisa had said that her nipples were sore I had asked Lisa to show me how she had been helping Sophie to feed on the breast. I wanted to get a better idea of how to help them achieve a more comfortable feed together.
At this stage, Sophie is just under 3 kg and quite petite with a smallish mouth. Lisa has normal nipples, which are on the larger size. As a result, like many mums, she will find that it can take practice to get feeding comfortable for both mum and baby. This is especially true when the breasts are very full!
Practice Makes Perfect!
Watching Sophie and Lisa feed, I could see that Sophie still needed to have a deeper attachment to the breast. This was due, in part, to the breast still being quite overly full and also down to the normal adjustment to getting a perfect latch at first. All of us need some practice and time at first to get it down pat.
Lisa was happy for me to give her some suggestions to help Sophie get a deeper attachment. These involved holding Sophie with her lips and nose opposite the nipple, turning Sophie further in towards Lisa, so they were tummy to tummy and helping Lisa shape her breast just whilst Sophie attached and started sucking.
Not all mums need to shape their breasts to aid attachment, but sometimes it can be helpful. Once Sophie was sucking well Lisa stopped shaping her breast and rested her arm around Sophie and relaxed to help the milk flow.
Sophie fed on the left side, but, with infrequent swallowing. When she fed on the right side. we instantly heard Sophie gulping loudly as the milk flowed, suck, swallow, suck, swallow!
As the milk was not yet flowing as well on the left side for Sophie, despite improved attachment, I advised Lisa to express off the left side to really soften the breast and then try feeding Sophie again on this side.
With the improved attachment techniques and a softer breast Lisa felt more comfortable and Sophie could drain the breast much easier on the left side. Lisa stated that her breasts felt nice and soft after the feed, so we knew Sophie had drunk a lot of milk. Plus the lovely drunk look on her face gave it away too!
We discussed how Lisa could keep doing this process until Sophie could attach and feed well without prior expressing. Normally engorgement settles within 24-48 hours. I could already see that Lisa’s breast were starting to settle down and were not as hard and full as Lisa had described to me on the phone yesterday.
Here Are a Few Suggestions I Gave to Lisa
Feed as Sophie cues, at least 8 times in 24 hours though.
Soften the breast before a feed if it is still too full for Sophie to get a good attachment.
If the breast is settling down and no longer too full, just feed as normal and stop expressing.
Ensure that, when helping Sophie attach to the breast, she is facing you and held close. Also, ensure that the nipple is close to her mouth and nose just before she feeds.
The midwives are weighing Sophie in a few days, but, until then, keep observing her wet and dirty nappies as this will advise us if she is having enough milk. Sophie should be having yellow poos at least twice daily now and at least 5 heavy wet nappies every 24 hours from day 5.
What has your breastfeeding experience been like? What questions do you have for our lactation consultant? Please join the conversation here or on our Medela Australia Facebook page.