How to survive your first weeks with a newborn!

The thought of taking a baby home for the first time is terrifying for most parents. I mean lets be realistic the idea that YOU are responsible for all everything that child needs to survive is so daunting. But rest assured with a few simple tips you will be a confident and capable parent before you know it!

  1. A mothers intuition beats a text book, Facebook and GOOGLE. You might be new to parenting, but trust those mothering instincts and let your instincts and baby guide you. New parents are much more relaxed when they do not compare their baby to what the books say. Baby’s are so individual and will vary hugely in what is still considered normal variations.

  2. There will be minimal time to prepare gourmet meals in the first two weeks. Well lets be honest the first 2 months. Lots of preparation before baby arrives to make casseroles, soups, curries, pasta sauces that nourish you from within will be invaluable. Use the grandparent’s amazing cooking abilities and willingness to help you and stock your freezer up. Get take out (occasionally) and make things easy for you. I even have families I see use services such as Marley Spoon, Lite N Easy and others to take the guess work out of cooking and meal times. Friends and family can bring ready meals or snacks when they visit.

  3. You will forget how good sleep is! Expect chunks of 1-2 hours at a time (and yes this is NORMAL). It is hard to adjust to broken sleep, but nobody decides to have a baby to sleep a whole night through :) Maybe for the morning nap time, have quick shower (this should be your daily goal) and breakfast, then for other naps during the day - jump into bed too. The old adage to sleep when baby is sleeping is imperative and the only way to cope. Even simply being horizontal will rejuvenate you somewhat. Safe co-sleeping is a great way to get more shut eye and can mean you may have a more settled baby. Partners can change and settle baby after feeds, so mums can get a bit of extra sleep.

  4. Don’t forget your partner will be tired and adjusting to new parenthood also. They will need some time away and nourishment too. Be kind to each other, you are each other’s supports during this time. A sneaky kiss on the cheek, hug or praise can go a long way for your relationship.

  5. You will be a hormonal, sweaty mess. This too is normal and expected within the first 2 weeks. If you feel it is continuing beyond that time - then seek help sooner rather than later. There are some amazing perinatal mental health support workers in the community that can help. See your GP first. You will need lots tissues and chocolate.

  6. Breastfeeding sucks at times. You will feel like all you do all day and night is breastfeed, express, top up, burp……. repeat. Cracked and bleeding nipples are variations on normal - but seek help early if you cannot achieve a painless and damage free latch. IBCLC’s are highly skilled professionals who can provide up to date - evidence based guidance to help you succeed. There is help out there, you just need to search. Medicare rebates and private health funds often will cover some of the consultation fee too. Breastfeeding around the clock is necessary within the first 6-12 weeks to fully establish feeding. Do not miss a feed for your partner to give a bottle - this WILL negatively affect your supply. Hold off on the introduction of bottles and missing feeds for at least 6-12 weeks to avoid messing with nature. Partner’s can support mums in many other ways while breastfeeding. They aren’t missing out - there is plenty of time for bottles/feeds when baby is older.

  7. Yellow, runny, slippery, messy poonami’s are normal! Do not Google poo pictures as you will never eat pumpkins soup, peanut butter or Christmas pudding custard again! Breastfed baby poo’s do not smell, they have a sweet aroma to them. Formula makes poo’s firmer consistency and smelly. Babies often struggle with wind and passing bowel actions, but will get there eventually. They may need some help by rubbing their belly, warm baths, cycling legs and other poo relieving actions! Most breastfed babies will have regular bowel actions within the first few weeks - most nappies in fact especially if they are getting an adequate intake. As long as your baby is alert, feeding and putting on weight - all is ok. Obviously there are variations on yellow poo’s such as blood, green and smelly which can be something to be alerted to.

  8. Babies cry… sometimes a lot. It does not necessarily mean something is wrong - just that they cannot communicate in any other way. Hold, rock, pat, shoosh, feed, walk, bath, massage or sing to them to see if that helps. Often each day at some time (generally later in the day/evening) babies will cry for an extended period. This can be hard to deal with especially when tensions are already frayed. It is often referred to as the witching hours and can be emotionally draining. Hang in there it will pass.

  9. Accept help from your network - whatever that looks like. Many families are blessed with supportive families who live close by, others will rely on their friend and each other to get through this tough time. There are support groups in the community that can be a life saver for many isolated families such as the Australian Breastfeeding Association. Find your village and lean on them.

  10. If you have had a difficult birth or a c-section - keep up with regular pain relief and anti-inflammatories to help you recover. Ice pack to your vaginal stitches if you have them, will help reduce the swelling. Drink lots of water, eat lots of fibre rich foods and fruit and veges to eliminate any constipation.

  11. Finally, do not worry about the tidiness of your house! That can wait.

Please seek help if you feel you are not coping, have unanswered questions or need support. IBCLC’s are attuned to new parents and supporting you through this time. Enjoy this precious bundle - it goes so quickly and remember to laugh regularly. At each other, the baby and in general. Also remember why you chose to have a baby in the first place!

Antenatal Expressing

A common question I get asked by mums-to-be is "How will I know I have enough milk for my baby?"  In most circumstances, Lactogenesis II and III (milk coming in and ongoing production) happen seamlessly, but for a rare few - milk supply does not come in as it is meant to.

In these cases, antenatal preparation in the form of education, expressing and storage of breastmilk during the pregnancy (from 36 weeks) may of been beneficial for those women.  The recently published DAME study in the LANCET 2017, indicated a benefit to those women particularly with gestational diabetes, but also dairy/food intolerances, Polycystic Ovarian Syndrome (PCOS), maternal breast surgery, known cleft lip and/or palate and other conditions that may indicate the possibility of early feeding problems such as kidney or heart issues.  

Knowing what is right for you and when/how to express should be done under the guidance of an International Board Certified Lactation Consultant (IBCLC).  There are some instances where antenatal expressing is not recommended, therefore a thorough history and education should be part of your care.

Make an appointment today with Adelaide Lactation Consultants to discuss your breastfeeding plan.  Antenatal preparation is vital for long term breastfeeding success.  We offer antenatal breastfeeding education which will include information about expression and storage of breastmilk.

 

Low milk supply

                                                                                        Adelaide Lactation Consultants © 2017

Most mothers produce enough milk for their babies.  Your milk supply is considered low when there is not enough breast milk being produced to meet your baby’s growth needs.

Many mothers worry about their milk supply, especially in the early stages of breastfeeding.  In fact, women who have stopped breastfeeding will most commonly say it was because they ‘didn't have enough milk.’  However, most mothers do produce enough milk for their babies.  Often the reason for ceasing breastfeeding is lack of support or knowledge about what is considered normal and expectations surrounding breastfeeding.  The support of close family and friends is important to guarantee success.  Sometimes well meaning relatives make mums doubt their abilities unnecessarily. 

If the breast milk supply is genuinely low it is usually a temporary solution and can be improved with appropriate support from a Lactation Consultant.

There are some common reasons why women may think their milk supply is low:

My baby feeds often, sometimes every 2 hours

Babies naturally feed frequently (between 8-12 times in 24 hours), and in the early postnatal period babies can be very unsettled as they try to figure life out.

My breasts always feel soft

When your milk supply adjusts to your baby’s needs your breasts may not feel as full (generally this is 6-12 weeks after birth).  As long as your baby continues to feed well, your breasts will produce enough milk.

My baby has started to feed more frequently

Your baby may want to feed more frequently during ‘growth spurts’ or ‘wonder weeks,’ but this increase in feeds over a few days/week will increase your overall supply and meet baby’s requirements for growth.

My baby feeds for a short time

This is no cause for concern as long as your baby is happy and continues to grow.  After two or three months your baby becomes more efficient at feeding therefore will take less time at the breast.

Signs your baby is getting enough milk:

After the first week following birth, your baby should:

  • Wake and demand for feeds by themselves
  •  Have at least 6-8 soaked nappies (4-5 heavy disposables) in 24 hours
  •   Settled between most feeds
  • Pass soft yellow stools at least once per day

Your baby should be back to birth weight around 2 weeks of age and gaining approximately 150grams per week for the first 3 months of their life.  Growth can slow after this time.

Possible causes of low milk supply

  •  Your baby is not attaching well at the breast.  This may also cause nipple pain and damage.
  • Your baby does not feed often enough       
  • Your baby does not feed effectively at the breast
  • You have recently had mastitis or have been unwell
  • Baby may have an issue with their mouth/tongue e.g. thrush, tongue, lip ties
  • Your are taking oral contraceptive pills containing oestrogen
  • You have started using formula (for even one feed) as well as breastfeeding.
  • You have had breast surgery that is effecting your milk supply e.g. breast reduction/augmentation
  • You may have some medical conditions that can affect the amount of milk you produce (occurs in less than 5% of mothers) such as Poly Cystic Ovarian Syndrome, Thyroid disorders
  • You smoke
  • Some medications can effect supply including herbal and over the counter preparations

How to increase your milk supply

There are many ways to increase you milk supply.  This may take some time and it is important that you seek advice and support from an experienced lactation consultant who can guide and encourage you.

Talk to Adelaide Lactation Consultants & Midwifery about strategies to manage feeding and expressing while you are increasing your supply.  Often it can take about 1 hour to feed and express.  Then you and your baby can rest between feeds.  Your partner or support person can settle baby, while you express so you do not feel overwhelmed.

If I could tell a new mum a few simple things to remember.....

  1. You can legally refuse anything. Vaginal exams, induction, c-section. It's your right to refuse, ask for more information, ask for a compromise on your providers care..... negotiate a mutually agreeable solution.  The medical/midwifery team all have one common goal... to ensure a safe birth for you and a well baby.  Simple.
  2.  Birthing while laying on your back narrows the pelvic diameter, it also means you are pushing    uphill making it more difficult and thus lengthening labour.  Most women find this position can be more painful.    Try squatting, standing, onto all fours, kneeling, these positions all have gravity on their side.
  3. Labour is hard..... very hard.  Research has proven that drugs used in labour can slow labour down, increase the need for medical intervention and impact breastfeeding outcomes.  Try to adapt a positive mindset to ensure you can get through labour. Surround yourself with a birthing support network who are all on the same page.  Don't have your friend or sister there if they are going to push you to have an epidural (because they had one),  if you do not want one.  This will erode your willpower and make you second guess your choices/preferences.  Remember.... it is one day..... and it is hard work!
  4. The midwives are there to help you.  They will discuss your birth choices and negotiate with you accordingly.  You are the boss!  But do remember that midwives also work within a medical model of midwifery, where the doctor and hospital protocols are what govern decisions/choices.  If you are well researched and discuss with the medical team your wishes, a mutually agreeable care plan will be negotiated.
  5. Cutting the umbilical cord before it has ceased pulsating means your baby can lose up to 1/3 of their blood volume!  This is routine practice in most delivery suites, however discuss this with your midwife/obstetrician.  It can also be done at C-section.
  6. Skin to Skin following birth for at least one hour is very important.  Ringing/texting people can wait until after this special time.  You never get these precious minutes back again and some babies find their own way to the breast and attach themselves!
  7. Delay weighing and bathing the baby after birth.  The special sticky white vernix over most babies acts as a moisturiser and antibacterial.  Baby is used to smelling this fluid and it is familiar to them.  If baby is placed directly skin to skin following birth, the vernix is around the breast... again offering a familiar scent for baby.  Think Hansel and Grettel and the crumbs!
  8. Doctors, nurses and midwives often get minimal breastfeeding education.  There is very little, if any, in a medical degree.  Some hospitals are BFHI accredited and therefore all staff dealing with babies are to have 20hrs of breastfeeding education.   If you are not getting the answers you need to support you to breastfeed, such as tongue ties, thrush, weight gain, positioning and attachment issues, seek further advice or ask to make an appointment with a Lactation Consultant.    You know your baby and you know what is working and what isn't.  If you are experiencing a concern, always talk to a International Board Certified Lactation Consultant (IBCLC) or breastfeeding counsellor.
  9. If you do need a c-section, it does not mean you cannot have a natural birth next time.  Your obstetrician will discuss with you their recommendations for future pregnancies and what is safest for you.  A healthy mum and healthy baby should be what matters most.