Breast Feeding Plan - Suggestions / Comments

[Danielle_NZ]

I should have done this before my last appointment but I thought it was going to be with an OB... ended up being with a midwife so I could have talked about it... but now I don't have another appointment before my little man arrives so I was wondering if you breast feeding mothers could give me a hand with comments and suggestions on my current plan...


• Skin to skin in theatre once baby cleaned up & weighed - Josh to support baby in place if shakes cause problems (The reason for cleaning up first is I won't be able to get up and shower at least until afternoon and would prefer to be uninterrupted skin to skin once started. )

• Skin to skin in recovery - Josh to support

• Once in room Josh to have cuddles skin to skin

• Constant skin to skin for first 4 hours with breast on offer as required (sounds like a milk bar nut means bare chested for baby to find)

• First sign of cracks (not sure how I'll know yet) I'll start using nipple shields (cracks HUGE last two attempts) – Although I read this morning that you shouldn’t use them until your milk has come in???

Still not sure if demand feeding or a routine to try and ensure I'm feeding enough is the better option.

I'm a little worried about making DH (Josh) feel left out so not sure on the constant skin to skin. Also I know my family (mum) will most likely visit as soon as possible and she will basically make me feel like crap if I don't let her cuddle if it's in those first few hours and those feelings aren't worth the pain so I'll end up giving in. My sister won’t be visiting until late afternoon by which time I’ll be happy to share cuddles.


Still to source information for:
Problems with left breast on last two attempts – ways to improve using this side (it doesn't leak at the moment like the right hand side does)

Reasons for it not working on earlier attempts
DS1 - Induced turned Emergency C-Section due to failure to progress - Milk didn't come in, two bouts of Mastitis in the first three weeks results in one 3 day hospital stay and one 12 hour hospital stay. Huge cracks, thrush, un-supportive partner (I drove 2 weeks after c-section to get formula at 10pm)

DS2 - Waters broke, planned c-section brought forward to that day - Milk arrived but still got cracked nipples - HEAPS of milk that I was throwing down the skin day 9 after his arrival ended up in hospital for 3 1/2 weeks with a severe infection, HEAPS of drugs, two more operations, drugs weren't good for milk supply and it dried up, was too weak to fight milk supply.


So any information or helpful hints would be greatly valued... I so want this... and I PROMISE not to throw anything down the skin

[*Efjay*]

Have you had a nipple shield fitted? If you are going to resort to those make sure you have ones that fit YOU. They often do more harm then good.
Really look at your attachment/position if you are getting any damage at all.
I would put in your plan
FIRST SIGNS of nipple damage that the LC comes & helps assess whats causing it. Don't jump to nipple shields straight off. Make them help you figure it out as to WHY there is damage happening.

Oh and feed on demand with the idea of not going longer then 3 hours between feeds.

[Danielle_NZ]

I didn't even know you could get ones fitted.

I've been referred to the LC at the hospital already so they will make an effort to come and see me once on the ward. And once I'm able to I will attend the hospitals educational class. I've watched lots of videos on attachment and book marked them so I can rewatch on my phone / laptop if need be.

[Yeddi]

You could also take bub to see an osteo. Sometimes breastfeeding issues can be about an inefficient suck, so they have to be on the nipple longer...

[HotI]

I found lansinoh to be great for cracks when they happened. Paying attention to attachment, especially when you are tired (this is when i got my damage) can help prevent/reduce getting cracks in the first place.

Have you seen the breastfeeding plan on the ABA site? Australian Breastfeeding Association - My Breastfeeding Plan

Good luck with it all!

[mummajj]

DS barely fed at all for the first few days. i wish i was told to express more. it may have prevented mastitis and MAJOR blockages. it ultimately led to me stopping breastfeeing.
so theres my tip: if you have a sleepy baby for the first few days, that would rather sleep than eat, express.express.express.
i too, hope to be much better prepared next time

good luck!!!

[onthefly]

Have you attended the ABA's breastfeeding class, or are you a member? Your local group may be able to provide a lot of practical and moral support.
Does your hospital have a lactation consultant on staff? Getting an LC to come and be with you while you feed can be invaluable, especially if you've had issues with cracks in the past, as this suggests the latch or your technique may need some adjustment. A good LC will watch you feed and make some suggestions. She can also advise you on different holds (sometimes trying a football hold helps with the dodgy side), nipple care, and even osteo recommendations and that sort of thing. If you don't have access to an LC at the hospital, I would strongly suggest finding a private one - meet her, make a plan together and arrange for her to visit you in hoospital for those early feeds. I'm thinking also you might need extra help after a c/s? I know after DD's birth and the pph I couldn't sit up and that first night DD's latch was terrible as she was also tired and I couldn't sit up to hold her properly, and I had to spend the next couple of weeks reteaching her.

Good luck!

[Danielle_NZ]

HotI – I have already purchased some Iansinoh in preparation. I have been to the ABA site and yes I did see that plan… however it was a while ago, I couldn’t seem to find it yesterday when I was writing mine, will have a good read and add things.

Mummajj – I will keep in mind about the expressing if baby is sleepy, I’ve read that drugs have those kinda affects on little people.

MadB – No I haven’t attended a class or been able to become a member of ABA, our finances won’t allow it at this time which is why I thought I’d take advantage of the services they provide at the hospital while you’re an in patient. I have however added the ABA 24 hour phone number and will call on them if need be and find a LC if things get rocky. I’ve asked to stay in hospital until my milk has arrived so I’m hoping to be able tackle the attachment / hold issues before I leave. I used the football hold last time and plan on using it again. I watched a video yesterday about the baby led attachment and planning on trying that also.

[Danielle_NZ]

Oh the other thing I will not be doing this time is taking different advice from different midwives on different shifts... I found last time that each midwife had a different technique... fingers crossed I will be able to get the LC in my room the day bub is born (he's scheduled for 9am) otherwise I'm thinking of using the technique applied in this thread A Perfect Latch

[onthefly]

DO they have LCs there? THey are about a million times better than your average midwife (some of whom know next to nothing about breastfeeding unfortunately)
Could you start putting aside a little money each week that you would have to spend on formula if this doesn't work to put towards an LC or classes?
If you're private I guess you can stay as long as you want.

[helle]

marcallen cream was the bomb for sore nipples.... (same as lansinoh. anything that is pure lanolin, really) make sure you get two tubes. one for home, one for the nappy bag

[Danielle_NZ]

They have a Breastfeeding Support Centre (Mater Mothers) and they say that they have LCs so I'm guessing so. They classes there after you've left are $80 but I think that after I've left if I still need help then I'll do an ABA so I get a membership also.

I'm not private unfortunately but after discussion with the midwife in my second to last appointment the type of dressing that will be used on my c-section might require me staying 4 - 5 days at least. She seemed to think my milk would arrive on day 4... but I'm not so confident as it didn't come in at all the first time... but I will stay as long as possible.. and if it doesn't come in I will just have to find the $'s for a private LC

[onthefly]

That sounds good. So can you make an appoitnment to talk to an LC before you have your baby? I realise you're due to have him in a few days, but it's worth a try.
It's not possible to predict when your milk will come in, but it does generally come quicker with each baby. Sometimes with subsequent babies you don't get the engorgement either, but the milk still comes in, it's just that your breasts get more efficient over time (just something to be aware of).
Do you have a copy of Breastfeeding Naturally? It's a great resource for all things breastfeeding.

[Mum2Romone]

Just a thought

my dh had skin to skin contact with bubs before me... It certainly helped them to bond alot.....

[*Efjay*]

I didn't even know you could get ones fitted.

I've been referred to the LC at the hospital already so they will make an effort to come and see me once on the ward. And once I'm able to I will attend the hospitals educational class. I've watched lots of videos on attachment and book marked them so I can rewatch on my phone / laptop if need be.

The LC should be able to make sure you have the correct size/shape for you. Its hard because I doubt anyone would have a set of all available to make sure you have the best fit for you. I will see if I can find anything to link you too that will help you with making sure you are getting a good fit.

[Beach Mama]

Some great advice! I had 2 c/s, with my first my milk didn't come in until day 5 and it was awful waiting and DD had to be topped up with formula. With DS I didn't want it to take quite so long to come in if I could so the advice of demand feeding with no more than 3 hours between feeds was what we did, we also as of day 2 expressed after every 2nd feed during the day. About an hour or so after a feed and all through the night. The midwife would come in and I would be half asleep while she helped me hand express to give to DS if he needed it and also to bring my milk in earlier. It worked for me and it came in by the night of day 3. Talk to them about strategies like that, that you can do to assist with helping stimulate your supply - I was pretty tired but very determined not to wait 5 days.

[Danielle_NZ]

DS barely fed at all for the first few days. i wish i was told to express more. it may have prevented mastitis and MAJOR blockages. it ultimately led to me stopping breastfeeing.
so theres my tip: if you have a sleepy baby for the first few days, that would rather sleep than eat, express.express.express.
i too, hope to be much better prepared next time

good luck!!!

Would have hospital supplied the breast pump or should I pack my manual one?

[Danielle_NZ]

Breast Feeding Plan

• Skin to skin in theatre once baby cleaned up & weighed - Josh to support baby in place if shakes cause problems. Baby is to be placed under a blanket but bare on my chest (only wearing a nappy)

• Continue skin to skin in recovery - Josh to support

• I would like our baby to remain with me on my chest to encourage him/her to self-attach for his/her first breastfeed (with assistance from me as I feel is appropriate).

• If I am unable to hold our baby skin to skin after birth, I would like my partner to hold our baby until I am able. This is to be skin to skin, again under a blanket wearing only a nappy

• Once in our room Josh to have cuddles skin to skin

• Constant skin to skin for first 4 hours with breast on offer as required

• I wish to follow a demand feed approach but no longer than 3 hours apart, if baby isn’t interested then I wish to express to encourage my milk to come in

• If baby requires expressed milk I wish for it to be administered via a syringe, not a bottle / teat

• First sign of nipple damage I would like to arrange a visit from a lactation consultant to prevent further damage. Next step is to use nipple shields.



Problems with left breast on last two attempts – ways to improve using this side
• Use football hold
• Pay special attention to latching on to ensure that it’s correct