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    Home ›› Breastfeeding Q&A with Doula Mandy Major
    Home ›› Breastfeeding Q&A with Doula Mandy Major

    Breastfeeding Q&A with Doula Mandy Major

     

    6 min. read

     

    Mandy Major here to answer your questions about lactation! As a mama and certified postpartum doula, I’m so excited to connect with you and support you on this amazing, wild journey of new motherhood.

     

    I became a doula because of my experience as a first-time mom. After months of prepping for my birth—which totally did not go according to plan, by the way!—I came home with my daughter and realized: What now? I felt so unprepared, especially when it came to breastfeeding.

     

    It’s my mission to make sure you don’t have that same experience. That’s why I’ve partnered up with Philips Avent to talk all things breastfeeding, bottle feeding, and pumping, and do it in an honest way. Because when #MomsGetReal, we all benefit.

     

    In this article, I’m going to tackle the 5 things I wish I knew about lactation when I had my daughter—which also happen to be the most common questions I get as a professional doula.

    1. How Do I Know if I Have a Good Latch?

    The holy grail of questions! And it’s a great one because we don’t spend much time learning this before birth, and everyone’s breast size and nipple shape is different, which can impact your feeding experience. Before we dive into latch, let’s get you set up for success:
     

    • Sit down in a comfortable spot; booty all the way back and spine tall.
    • Use a breastfeeding pillow that feels good for your body. (You may need to try several to find the right one.)
    • Make sure your elbows are supported.
    • Hold your baby parallel to your body facing your breast—we want to avoid Baby’s body being face up and their head turned to your breast.


    There are several nursing positions to choose from, but these are my two favorites to ensure a good latch:
     

    • The cross-cradle hold: This gives you a direct view of Baby’s position and you can feel more in control to re-position as your hand supports their head.
    • The football hold: This is great for really getting Baby’s mouth placement in the right spot, and it works particularly well for twin moms, heavier mamas, and those with a belly birth scar that’s still healing.


    Now that you’re in a good position, here’s what we want to see for a good latch:
     

    • A wide mouth with flanged lips. No puckered, pursed lips—that’s a sign of a shallow latch, which isn’t efficient and will cause pain and damage to your nipple.
    • Your nipple is fully in their mouth with some areola showing (this is true for most bodies; very elongated nipples may need to be accommodated differently).
    • An audible little “gulp,” spaced a second or two apart, as Baby kneads the breast with their tongue and swallows the milk.


    If nursing is making you wince with pain or it feels unbearable, I recommend calling in some support in the form of a lactation professional including a CLE (certified lactation educator), CLC (certified lactation counselor) or IBCLC (international board-certified lactation consultant).

    2. The Pump You Choose is Personal and Important

    Here’s what I wished someone had told me: Not all pumps are the same. I took the one given to me and figured that was that. I didn’t realize how much choice I had, and why that choice mattered so much.
     

    My pump was heavy (I commuted daily on public transportation and my pump bag hurt my shoulder); not very efficient (I was pumping four times a day and was concerned about dwindling output); and loud (so stressful on days I had to multitask and take meetings while pumping!). If I had a time machine, I’d go back and have the Philips Avent Double Electric Breast Pump, Advanced. Here’s why: It’s light, quiet, and the suction is seriously on-point. I also appreciate the soft cushioned silicone flanges—a far cry from the standard hard plastic ones which leave a lot to be desired.
     

    You and your pump are going to spend hours every day together. Make sure it’s the right fit for your needs—figuratively and literally. Ask yourself:
     

    • Is it comfortable?
    • Is it easy to use?
    • Is it convenient?
    • Is it powerful enough for you?
    • Do the flanges fit correctly on your breasts? (How to tell? Ask me in the comments and I’ll fill you in!)
    • Does it suit your lifestyle and where you pump most often?


    When I breastfed, I was pumping outside my home daily and found it so frustrating that I had to sit chained next to a wall outlet. Sometimes that meant sitting on the floor! Not OK. Thankfully, pumps have come a long way in a short time, and the Philips Avent Double Electric Breast Pump, Advanced is totally portable with a comfy belt to hold the pump, giving you the ability to move around and (with a pumping bra) be totally hands-free. Yas! Freedom!
     

    As you consider your options, talk with other mamas and read reviews, but always keep in mind how their situation is the same or different from yours.

    3. Is Baby Feeding Enough or Too Much?


    Since this adorable tiny human can’t talk yet, it’s natural to wonder how it’s going, especially during those first few weeks as you learn Baby’s cues and rhythms. While every baby is different, here are a few signs to guide you:
     

    • Does Baby have balled up fists? Hungry!
    • Does Baby turn their head toward you when you brush your finger on their cheek? Hungry!
    • Is Baby rooting, sucking or smacking their lips? Hungry!
       

    (Note: Those signs are for a full-term newborn; preemies will need to be on a timed feeding schedule, under the direction of your pediatrician and/or lactation professional, and may not exhibit all of the same cues.)
     

    Newborns will feed on a 24-hour clock, about every 2 to 3 hours the first month. So if you feel like you’re constantly breastfeeding, guess what? You are. That’s why you actually need more calories when breastfeeding than you do while pregnant.
     

    Let’s be real: This 24-hour life is exhausting. But please know that it won’t always be like this, and day-by-day your baby’s tummy will get a bit bigger and they’ll empty your breasts more efficiently and start going longer stretches between feedings.
     

    As they gain weight and grow, cluster feedings—shorter nursing sessions that happen in quick succession—are totally normally and not a “forever” habit. If Baby is cluster feeding a few days in a row, go with it. They are signaling your body that it’s time to ramp up milk production to meet their needs. This isn’t the time to hold back or try to put Baby on a schedule.
     

    Once your breastfeeding relationship is well established, you may want to consider introducing some pumping, even if you’re exclusively at home. It’s a great way to get your partner involved with feedings, and it’ll give you a few precious moments alone. (It’s OK and normal to want—and take—some space!) You can use a manual pump or something like the Philips Avent Double Electric Breast Pump, Advanced, which I particularly like because it has customizable levels for stimulation and suction.
     

    Overall, the best indicator for how well feeding is going is your baby’s weight. Is Baby gaining weight? Great. Keep it up! Is baby feeding regularly and not gaining weight? You’re still doing great…and now it’s time to get a little support in the form of a lactation expert. More on that below.

    4. Signs It’s Time to Call a Lactation Pro


    First things first: In many countries, it’s standard practice to have lactation support after you leave the hospital or birthing center. I say that because breastfeeding can be very emotional, and we often put a lot of pressure on ourselves to “get it right” and figure everything out alone. That’s a tall order! You have a lot to learn, and you’re healing and adjusting, too.
     

    If things aren’t clicking as fast as you’d like, you may feel sad, disappointed, or even resentful or jealous of other moms who don’t seem to have those same challenges. Those are normal feelings. This is all new, and I hope you can give yourself space to learn about your breasts and your baby, and embrace getting support!
     

    While every situation is unique and needs to be evaluated individually, in general here are some situations that may benefit from the help of a CLE (certified lactation educator), CLC (certified lactation counselor) or IBCLC (international board-certified lactation consultant):
     

    • You have flat or inverted nipples or very elongated nipples (which may impact the success of feedings).
    • Baby is feeding regularly but not gaining weight.
    • You are concerned about a tongue tie.
    • Breastfeeding is physically painful.
    • You’re concerned about under- or over-supply.
    • You are considering supplements to boost supply.
       

    I am still grateful I had an IBCLC who helped me breastfeed. My daughter was a late preterm infant and struggled to gain weight at first. The pressure was on me to figure out why and fix it. Our IBCLC introduced me to nipple shields, outlined a pump schedule to boost my supply, and we successfully did a combination breastfeed-and-bottle approach using the Philips Avent Natural bottle. That’s when I learned we shouldn’t expect ourselves to magically know these things once we birth our babies. It’s why I became a doula, and now it’s my turn to be here for you.

    5. Nipple Care Should Be a Top Priority


    Who knew that having a baby would mean your whole life was going to revolve around your nipples, right? I know. Here’s the most important thing I can share: Bleeding, cracked, painful nipples are not a normal part of breastfeeding and pumping. That’s a sign something is not quite right. Not only are cracked nipples painful, but they can also cause mastitis, which needs medical intervention. Here’s how to keep your nipples in tip-top shape:
     

    • Follow the best practices above for latch. A shallow latch with the baby suckling only the nipple will cause pain and unnecessary damage.
    • Make sure your pump flange is sized correctly. With the Philips Avent Double Electric Breast Pump, Advanced, the soft silicone flanges flex and gently adapt to various nipple shapes and sizes up to 30mm (measuring top-to-bottom of the nipple). If you have a traditional pump with plastic flanges, your pump will come with a set flange size, usually 22mm or 24mm. Flanges range from 17mm to 36mm, and you can purchase them separately. You want to make sure that your nipple is not squished or squeezed too hard against the flange tube, which can cause chaffing and tearing.
    • Air-dry your nipples after a feed or pump. Even 1 minute will do the trick. Moisture is the enemy; it can cause chafing and sometimes yeast, which can be transferred to the baby and become thrush.
    • Use breast pads to absorb excess letdown throughout the day. Change your pads regularly so they don’t get soggy and trap moisture. Philips Avent makes a really nice, soft one with a honeycomb texture to better absorb milk and keep you dry.
    • Olive oil! Way easier than buying creams and lotions and half the cost. Dab a pea-sized amount on each nipple and rub in after a feed or pump to reduce soreness and keep the delicate skin hydrated.
       

    Sending you support and tight swaddles,

    Mandy

    Mandy Major aka Doula Mandy, MA, PCD(DONA), is the founder of Major Care and creator of My Fourth, the first-ever app devoted to mothers and birth parents in the fourth trimester. She holds a MA from Columbia Journalism School and has written for Healthline.com, Motherly, and Prevention among other publications. You can follow her @doulamandy. This post is part of a paid partnership with Philips Avent.

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