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Breastfeeding: What's Normal, What Isn't, and When To Seek Help

2/17/2017

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Read this before scheduling please!

As a new mom, it's important to know when things are going well with breastfeeding because when you know what is healthy and normal, you're able to better understand when it's time to seek help .

If you're pregnant, the best way to prepare and gain knowledge of what is normal about breastfeeding is to attend a good breastfeeding class in order to learn the basics. In addition to taking a breastfeeding class, reading as much as you can on recommended website and books will be helpful. If you're on Facebook, one of the best ways to seek recommendations on helpful breastfeeding resources is by asking in reputable "mommy-groups" where breastfeeding is embraced.

Whether you're expecting, are just just getting started with breastfeeding or have been nursing for a while, yet aren't sure what is normal and what isn't, the lists below will help you understand what is normal for your breasts, and for your baby, and when to know it's time to ask for help.

What IS normal for breasts:

It's normal for breasts to feel "empty" the first few days after birth
It's normal to feel some discomfort (not full-on pain) when you first start latching your baby
It's normal for nipple discomfort not to get worse and to be gone within a week
It's normal for only a glisten of colostrum to be seen by you
It is normal for your breast to feel full-ish or heavier by day 3-5
It is normal for your breast to feel very, very, very full by 2-9
It's normal for some breast to feel so full they hurt
It's normal for moms to feel a painless pull and tug when baby is nursing
It's normal to feel tingling after a few days/weeks/months when your milk is letting down
It's normal not to ever feel tingling after a few days/weeks/months when your milk is letting down
It's normal for your breasts to leak, especially during the first few weeks
It's normal for your breast to feel less full after a few weeks even if you are exclusively breastfeeding .

What ISN'T normal for breasts:
If you have doubts about your milk supply, your baby's weight or baby's pees/poops, consult your baby's doctor, your midwife or your lactation consultant immediately.

It's not normal for nipples to be overly sore, bruised, cracked, or scabbing, during any season of breastfeeding
It's not normal for even mildly sore nipples to feel worse not feel better by a week after delivery
It's not normal for breasts to feel full meanwhile no milk is being removed by your baby or your pump
It's not normal for breasts to appear red, feel hot or for you to run a fever while you feel these symptoms
It's not normal for you not to feel or see a difference in your breasts from pre-pregnancy to after 7 days after after you baby is born
It's not normal for your nipples to burn, itch or hurt between feedings or pumping sessions.

What IS normal for your baby:

It's normal for a baby to feed every 1-3 hours the first few days and week
It's normal for a baby to tug your breast while nursing
It's normal for you to see and hear your baby swallowing
It's normal for babies to be happier being held the first weeks and months of life
It's normal for your baby to only want to soothe on your breast
It's normal for your babies poop to be yellow and watery after day 4
It's normal for your baby to poop several times per day during the first few weeks
It's normal for your baby to pee 5 or more times per day after their 4th day of life
It's normal for a baby to lose a few ounces after birth
It's normal for your baby to start gaining weight again after a week
It's normal for your baby to spit up every now and then

What ISN'T normal for your baby:
If you have doubts about your milk supply, your baby's weight or baby's pees/poops, consult your baby's doctor, your midwife or your lactation consultant immediately.

It isn't normal for a baby to chew, clamp or pull on your nipple without an easily explainable reason (teething, loud noise scared baby, etc.)
It isn't normal for a baby not to meet their pee and poop goals
It isn't normal for your baby's poop to still be black or dark after 4 days
It isn't normal for your baby to appear progressively yellow after the first days home from the hospital
It isn't normal for your baby to not start gaining back their birthweight by day 7, or not be fully back to birthweight by day 14
It isn't normal for your baby to cry for long stretches of time
It isn't normal for your baby's face or neck to seem asymmetrical (twisted, or misaligned) for more than a few days
It isn't normal for a breastfed baby to sleep more than 4 hours consistently during the first few weeks
It isn't normal for baby's to have dry lips, tongues, eyes or sunken soft-spots on the top of their head
It isn't normal for baby to have thick white anything that you can't wipe off on their tongue or cheeks
It isn't normal for your baby to seem uncomfortable during all or most of his feeds
It isn't normal for a baby to projectile-vomit after all of their feeds, even if they're happy after spitting up
It isn't normal for babies to appear in pain after all feeds
It isn't normal for your baby to not wake up to feed at least every 2-4 hours during their first weeks of life.

And, if you are pregnant, you might want to see a lactation consultant prenatally if any of these sound familiar to your situation:

If you have very flat or inverted nipples to which baby will not latch
If you have history of breast surgery or scarring (reductions, augmentations, nipple piercings, etc.)
Markedly asymmetrical breasts; when one breast is significantly larger or differently shaped than the other (almost every woman has differences in her breast size; this refers to very obvious differences)
If a mom has a history of hormonal imbalance/endocrine issues
If mom is or plans on taking a medication whose compatibility with breastfeeding is unknown

Imperfect breastfeeding IS more common than it's made to seem by many. "Bumpy" breastfeeding can be smoothed out by reaching out for support as soon as you know you're having issues.

If you are in San Antonio, Texas, Laura Gruber, IBCLC is happy to help!

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What a visit from a lactation consultant is really like...

2/17/2017

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What exactly happens during a lactation consultation?

Well, if your lactation consultation is with moi (or w:someone like moi) this is more or less what you can expect:

Before we meet, you'll schedule your appointment online. You'll receive a text from me confirming our appointment, then an email asking you to fill out forms. We may chat on the phone if you have time, then I'll usually see you same or next-day.

On my way to you, I'll usually send you a "Headed to you...see you soon!" text...or you'll come over to my cozy office and send me something similar. If either one of us is running behind, we check in with each other because, well...babies!

But wait. A few things to know about me before you have me as a guest in your home:

I don't care what your house looks or smells like
I will immediately wash my hands when I enter
I wear shoes I can take off and will always ask your preference about this before entering your home
I carry changes of clothes in my car in case anyone pees or pukes on me, so don't stress it
Hablo español, por si tu mamá, suegra o tía quiere ser incluida en nuestra consulta (I speak Spanish, in case your mom, mother-in-law or aunt would like to be included in the consult)

And then it all begins...

If your sweet baby isn't super hungry when I arrive at your home, or you arrive at my office, we'll chat a while I wash my hands, get my lactation scale ready, etc.
If we're at your house, you'll show me the areas where you nurse, or want to nurse, and tell me about your support system, if they aren't at the consult (dad, grandma, best friend, etc.).
The stage will be yours, this is where I kick in to listening mode
You may or may not show me what's going on with your breasts/nipples right way (I will see this, too, when nursing starts). I may respectfully ask to touch your breasts in order to feel what you are feeling (if lumps, plugs or breast infections are present).
I'll ask to touch/hold/examine your baby, and then assess the baby's posture, state and, with gloves on I'll assess your baby's mouth/lips/tongue via digital exam.
We'll weigh your baby before the feed.
If I observe anything pressing, we'll talk about it, and if its something urgent (rarely happens during consults), this is usually where I will buzz your doctor. If it isn't urgent, but needs to be run by another provider, I will buzz them after the feeding
If all is well, I'll observe a feed and I'll do my best to verbally walk you through improvements to positioning and latch
I'll listen to you tell me what is going on with the feed, and I'll talk you through what I see baby doing, pointing out what is normal and what we can improve.
I may ask to to touch your breasts if needed to help position your nipple for latching, and I may hold your baby simultaneously in order to gain understanding of how your baby moves during positioning and latch (which can give me clues to certain breastfeeding issues)
With your permission, and on your phone or camera, we may record short parts of the consult for you to have as a reference of my latch-teaching.
We'll weigh sweetpea again to see exactly how breastmilk was transferred
If you pump, we will use your pump together so that I may teach you how to determine your flange size, how to use your pump more efficiently, etc.
If you're a mom who plans on bottle-feeding, we may go over bottle-feeding for your particular situation
If you're a working mom, time-permitting, we may go over some back-to-work topics, or we can decide to meet specifically for a Back-to-Work Prep Class or 1:1 appointment dedicated to returning to work.
Based on the general appointment events, your health history, baby's overall big-picture, I will help you create an achievable and specific-to-you plan to help you meet your breastfeeding goals. These will be written out and left with you, or uploaded to my patient-portal immediately after our time together.
Some appointments require a follow-up consult to gauge results of our care plans. We may schedule this before I leave, or we may play things by ear. If it's a housecall, 'll let you know that you can have me back at your home for the follow-up visit, or you can come see me at my office-- whichever works best for you.
If I recommend that you or your baby need to see other providers (your obgyn, pediatrician, etc.) I will write up a consult report for you to give your provider, or will email it to them.
I'll make sure that I have answered all of your questions, and let you know that I am available to call or secure message for future ones related to our consultation.
You'll pay your balance-owed before I leave, and I will give you a claim form to submit to your insurance company for reimbursement.
If you're a hugger, we'll hug good-bye and if you aren't a hugger, we'll peace-out...and stay breast-friends!

Now that you know what to expect from your time with me, I look super forward to supporting you and your sweet baby!

Virtual hugs,
Laura

Read this before scheduling please

Read this before scheduling please!

breastfeeding
lactation consultation
what to expect
breast infection
lactation scale
weighted feed
latch
positioning
pumping
back-to-work

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Comments

Breastfeeding: What's Normal, What Isn't, and When To Seek Help

What a visit from a lactation consultant is really like...

breastfeeding
lactation consultation
what to expect
breast infection
lactation scale
weighted feed
latch
positioning
pumping
back-to-work

Check Previous Blogs!

Categories

Breastfeeding: What's Normal, What Isn't, and When To Seek Help

What a visit from a lactation consultant is really like...

breastfeeding lactation consultation what to expect ​breast infection lactation scale weighted feed latch positioning pumping back-to-work ​

Check Previous Blogs!

Categories

breastfeeding
lactation consultation
what to expect
breast infection
lactation scale
weighted feed
latch
positioning
pumping
back-to-work