All posts in weaning

Are Breastfeeding Recommendations Unrealistic?

This week I posted a link to an article that suggested mothers are feeling too much pressure to breastfeed. The author referenced a study in which mothers seemed “stressed” and felt their doctor focused on six months of breastfeeding at the exclusion of the overall health of the family.

We know there are a few moms that are physically unable to breastfeed. That must be a truly frustrating ordeal and I have nothing but respect for mothers in that situation. However, the majority of mothers and babies are physically able to breastfeed. So why are only 14.8% of babies are exclusively breastfed for six months? A few social factors that are associated with shorter duration include smoking during pregnancy (10%), Caesarean birth (32% of births), a baby going to NICU and mom returning to work before 6 months of infant’s age (55%).

The majority of research shows that many moms are also undermined in their goals for a strong milk supply and suitable latching baby by early supplementation, pacifiers and inappropriate birth interventions. The guilt that so many mothers feel about their unsuccessful breastfeeding attempts can make the recommendations of exclusive breastfeeding for six months feel unfair. I understand the frustration, but it should not be directed at the recommendations for exclusive breastfeeding, but the raod blocks that created the difficulties to a fulfilling breastfeeding experience.

Several articles have discussed this study and the suggestion to soften up the 6 month recommendation. The rationale is that if we just took the pressure off mothers they would be happier and more confident in their mothering ability. This theory is based on lowering the bar to make everyone feel like they accomplished something reminds me of giving every kid a trophy so no one feels bad. Except the kid/trophy scenario is a somewhat arbitrary contest, unlike breastfeeding.

With a new baby, life changes forever and completely. One physician observed many families attempt to regain control during the chaotic early months by changing the feeding method in hopes baby sleeps longer and relieves stress on the family. What new parent hasn’t wished for a magic, baby-whisperer trick to get their baby to sleep faster and for hours at a time?

So the choice is framed, family harmony or exclusive breastfeeding. Hmmm- I wonder which will prevail?

Baby Led Weaning – a perfect partner to breastfeeding

The concept (and video) are known as Baby Led Weaning. The practice is very common in Europe, and I discovered the video at an International Lactation Consultant Conference – I knew I had to spread the word to every parent looking for a better way to introduce solids. The title is a bit misleading – the video is not a how-to-wean from the breast. Instead it challenges the idea of introducing solid food that is not solid by any means and food most of us would not eat under any circumstances.

This is a great strategy, and pairs seamlessly with breastfeeding. For all of us that enjoy traveling light, it makes perfect sense to share your food with your baby. Instead of carrying around jars, spoons and asking the waitress to ,”Please warm this up”, you simply use your baby’s tendency to put everything in her mouth to introduce new flavors and textures, allowing her to choose what she likes and moving seamlessly to a varied diet. Often times we do this at mealtime without realizing it. As parents we instinctively share appropriate foods at mealtimes. Baby Led Weaning gives specific strategies to make a variety of foods easier for your baby to handle.

I had the incorrect perception that infants would choke on harder foods and should only be offered soft options like pasta and ripe pears. From around 6 months of age, babies will not even get food to the back of the mouth to swallow – that explains why most offerings end up on your baby or on the floor! I like the phrasing of the narrator “There will be a mess, but it will be less of a problem if you prepare for it.” As with anytime your baby is eating, she should sitting upright and supervised at all times.

The video gives some tips for cutting the food you offer into shapes that are the right size and shape for her to pick up. For example-toast cut into sticks is much easier for your baby to grab and hold onto than bread. See toast stick picture (right)

To simplify mealtimes, cut all of the veggies you serve into 3 inch stick shapes. Slightly cook the veggies for only a few minutes. You want them only softened, not mushy, or baby will have a hard time holding them. Since babies shouldn’t have salt, leave all seasonings off and let family members add them when they plate their vegetable serving. Here is a screenshot of veggie sticks cooking (left)

Parents can offer babies the entire apple or pear (leaving the skin on to make it less slippery and easier to hold). (apple shot) The infants can nibble off what they can, experience new textures tastes and practice self- control with their food choices.

If you place an assortment of foods on a high-chair tray, allowing the baby to choose what she prefers, while dropping much of it on the floor and into her lap – you are allowing your baby to determine her level of adventure in eating. The narrator suggests that babies that are allowed to choose their own food adventure are less likely to become picky eaters. This may be true to some extent, however, research has shown a portion of strong food preferences is genetic and a baby introduced to solids using this strategy may still have strong food likes and dislikes.

When Breastfeeding Doesn’t Work (from Healthy Moms, Happy Babies)

love those happy babies

Healthy Babies, Happy Moms is wonderful group of Lactation Consultants in Rhode Island that support families through every stage of parenthood. I subscribe to their newsletter and I thought this month’s topic was especially important to share.

“This month’s article addresses an important issue – when breastfeeding just plain doesn’t work. A lot of factors must come together for successful breastfeeding. Sometimes there are issues with the mother, sometimes issues with the baby and sometimes issues with the mother’s and baby’s support system. Many times we can address these issues and resolve them, yet there are still occasions when despite our best efforts, breastfeeding doesn’t work.

One of the hardest situations for me to be in is the one where breastfeeding just doesn’t work out as planned for a mother and her baby. And if it is hard for me, it is obviously infinitely more difficult for the family that is experiencing it. But sometimes, despite the best intentions, it comes to an end much sooner than anyone wants. My role in that situation is often one of a realist. I am in the home, I know the history, and I see everything the mother is experiencing, in addition to a hungry newborn. Many times, I am just confirming what a family already knows, but needs to hear from a professional who they feel can see the whole picture objectively…

But can a lactation consultant be objective? Aren’t I supposed to encourage exclusive breastfeeding and do everything I can to facilitate that? I like to think I can do both – be objective and encourage breastfeeding at the same time. It is probably my neonatal ICU background that often reminds me that the most important thing is that the baby is fed. Hopefully, it is breastfed or fed breast milk. Ideally, I want to educate women and give them reasonable options, so that the choice is theirs, according to their experience and desires, not mine. I want them to be able to achieve their goals with regards to breastfeeding, whatever they may be and however different they may be from another woman’s. When I have the privilege of being invited into other people’s homes, I always try to remember that people are having me there to receive an honest assessment and opinion of their unique situation. And with that, I believe I owe them a customized, reasonable and realistic plan.

So, why doesn’t it work sometimes? Most often, I think it is because help arrived too late. I think if women knew how important the first few days are in establishing a good milk supply, they wouldn’t wait to seek advice. But what if you have had an unexpected C-section and have a toddler at home, and a house full of helpers/guests? Sometimes, a woman can only do so much, especially if she has had major surgery herself. Some women have all that happen and more but still have an abundant supply, yet don’t want to nurse, and call me to help them stop. Life is not balanced sometimes.

Milk production actually starts around the 14th week of pregnancy when hormones cause the ducts and lobes to proliferate (think bigger, tender breasts). This continues until the 28th week when the second phase of milk production causes colostrum to be produced. This production only continues if the breast is adequately stimulated after the delivery of the placenta, and colostrum will be gradually replaced by transitional milk. Production of mature milk usually begins around 10 days after delivery and by about 4 weeks, if all is going well, a mother’s milk supply is well-established.

If the baby is not nursing frequently, is causing damage to the mother, or is losing weight, a board certified lactation consultant should be contacted immediately. While none of those situations are ideal, they can be fixed. There are options other than suffering through it (which may lead to failure in establishing milk supply). The most important thing is getting that supply established early on. We can almost always get the baby to nurse well if the milk is there. But once the supply begins to decrease, and you experience the subsequent drop in hormones, it is a process that is very hard to reverse.

In the end, breastfeeding is an extremely private decision for a family, and a unique experience between a mother and baby. Each case is different because the desires of and situations surrounding every mother and baby is different. It’s what keeps my job so interesting and enjoyable. But if your goal is to breastfeed and you’re concerned that things aren’t getting off to a good start, contact a professional quickly. Those first few days can truly make all the difference.

There are many reasons that breastfeeding can be unsuccessful or end earlier than planned. But we hope the message you take away after reading this article, is to contact a professional at the first sign of any difficulty. Getting to the issues early on can keep you on a successful track with breastfeeding.

For more information on our products and services, you can always contact us at ”