Feeding With Nipple Shields

Nipple Shields can be a breastfeeding and nipple life saver! They are used in a difficult breastfeeding/latching situation.

They are used commonly used with premature infants, with flat or inverted nipples, for infant anatomical variations (like a high palate), sore nipples or weaning back to the breast with bottle use.

Generally nipples shields are reached for when there is a underlying issue that needs further investigating by a lactation consultant.

When using a shield it is important that the size is correct but even more important that milk transfer is effective. Milk supply can sometimes take a little longer to flow from the breast thus feeding can take a little longer- Even with a shield sometimes latching can still be uncomfortable which warrants further investigation.

Using a shield?  Get some further support to make sure it is working well for you and your baby book here:

https://app.milknotes.com/calendar/?id=1530

Mastitis

Unfortunately Mastitis is common in breastfeeding woman- and no mumma to be wants to know that.

But being aware of what it is, what causes it and how to treat it promptly is important in decreasing its severity and early cessation of your breastfeeding journey.

So what is Mastitis?  It is an inflammation of the breast tissue which may or may not be associated with a bacterial infection.  It can be non-infective inflammation or infective inflammation associated with most commonly staph. aureus bacteria.

It generally occurs in the first 6 weeks of lactation though it can happen any time during the breastfeeding journey.

What you might see and feel?

A redness, pain, and heat may all be present when an area of the breast is engorged

-Red, hot, swollen and painful lump or wedge-shaped area on your breast.
– Breast skin may appear shiny and tight with red streaks, discoloured skin, bruising,  tenderness, a temperature and feeling of tiredness.

How it occurs?

-Most commonly from poor attachment leading to nipple damage, blocked ducts and poor milk drainage/transfer.

-Not feeding enough, missing feeds, or scheduled feeds or limiting timing of feeds on a breast.

-Issues with over supply

-Pressure on your breast- wrong flange size, ill fitting bra and even a seat belt!

 

What can you do if it happens?

-Seek help from a IBCLC if you feel you are having symptoms and keep draining your breast!

-Moist heat and massage are your breast friend.

-Go bra less- reduce any clothing restriction.

-Course of management will depend what the cause of mastitis is- plugged ducts, re occurring plugged ducts, mastitis and reoccurring mastitis.

-Remember the first 12-24hrs it is non infective mastitis so removing the duct or draining the breast frequently can prevent it turning into infective mastitis and potential need for antibiotic use.

-SEEK HELP!

 

What is Breast Feeding Aversion or Agitation (BAA)?

BAA or ‘aversion’ is a phenomenon that some breastfeeding mothers experience, which includes having particular negative feelings, often coupled with intrusive thoughts when an infant is latched and suckling at the breast (Yate, 2017).
It is actually a phenomenon!
It is when the feeding parent is latched on and feeding and experiences negative physical and emotional sensations like:
  • Anger
  • Agitation
  • Disgust/Self-Disgust
  • Irritability
  • Rage
  • Skin itching/crawling
  • Shame & Guilt (usually afterwards)
When the feeding ends, so do the uncomfortable feelings.
Intrusive thoughts can also occur like:
  • Wanting to ‘run away’ so as to not be feeding
  • Overwhelming urge to stop breastfeeding
  • ‘Feeling trapped’ or a like a prisoner
  • Wanting to ‘pinch’ the infant or child so they stop suckling
  • Thoughts and feelings about being ‘touched out’

When the feed ends and the baby is no longer latched these feelings disappear.

Who Experiences It?
There is not much research on Breastfeeding Aversion so it is not greatly understood,  but it is known that  feeding parents can experience it at some point during their breastfeeding experience.
The above study found that breastfeeding aversion seems to happen more often with older nurslings than with small infants and during pregnancy, especially if newly pregnant and still feeding a toddler or with tandem feeding post birth.
It also found it can be linked to hormonal changes like pre ovulation, or pre menstrual timelines.
What Does It Feel Like?
Although it presents in varying degrees, durations and onset and duration is unpredictable the descriptions used are very similar:
Physical:
 -A skin-crawling sensation, repulsion, or the feeling of nails on a chalkboard when their child nurses.
-An itching or smothering feeling.
-Desire to remove their baby from the breast/chest and to get away.
Emotional:
flashes of irritation, anger, or rage when breastfeeding
There is also the  emotions of feeling– guilt, shame, and sadness about having the breastfeeding aversion. Mum’s want to continue to feed their child but the issue of these feelings arsing can be  confusing, painful, and worrying.
How can a lactation consultant help?
If you feel this way please reach out! Many other professionals are not aware of BAA, so you need empathy and a cheer leader on your side! Being able to express how and what you are experiencing, being validated and that you will feel better is essential to understanding and continuing your breastfeeding journey.

Is HypnoBirthing For Me?

Despite being a midwife, when I was pregnant I wanted a childbirth program that would give me and my birth team (hubby, other midwives and yes my ob) the practical information, education and tools that meant the birth of our baby would be as calm as possible, and a positive birth experience.

I wanted to be able to trust in my body and my instinct so that “fear” took a back set in my preparation process. Pain wasn’t really something I was concerned about, but if I could avoid using any pharmaceutical medication I knew that it would be better in my recovery and that of our baby in the first few hours and days post birth.

So I research HypnoBirthing Childbirth Education Classes with HypnoBirthing International!

I learnt the practical information  about what my body does in labour, what my baby does in labour and what my partner can do to support me though labour.

I learnt how to use these tools to give me the opportunity and confidence to be accountable and in control of my birth outcome.

I learnt how to be confident in my choices for my birth.

I found the HypnoBirthing Program has the right balance of science/medicine/common sense and a huge sprinkle of wisdom!

Does my baby have a tongue tie?

What is a Tongue Tie or Ankyloglossia?

Click here for Queensland Health’s Information Fact sheet.

If you suspect your baby might have a tongue-tie or a provider you have seen suggests a diagnosis, you and your baby deserve actionable, realistic guidance & support that will help you discover, action and prepare for treatment and recovery.

Tongue ties develop around 9 weeks in utero.

Signs of a tongue tie in a baby can be visual and functional in nature- you can see the short frenulum, baby can not elevate the tongue when crying, or baby suffers from excess gas, white coating on the tongue, heart shaped/ sting ray look of the tongue.

Signs of a tongue tie in a mum can be physical (painful shallow latch, damaged/misshapen nipples), clicking (snap back or baby losing suction), frustration when feeding, mastitis.

Identification of a tie, painful breastfeeding experiences and stress and concern about treatment are very stressful, overwhelming and often frustrating for many parent’s, as often sign’s and symptoms have been misdiagnosed and even dismissed.

Clarity, guidance and non- judgmental help is what I offer.

Each baby needs accurate individual assessment, planning and support when it comes to feeding.

Whether a frenectomy is indicated there is a formula to follow which includes assessment, establishment of milk supply, body work preparation and IBCLC support before and after release. This sets you and your baby up for “best practice” release and recovery.

Book here for a oral assessment today: https://app.milknotes.com/calendar?id=1530

 

What are the 3 most common breastfeeding problems?

Many new breastfeeding families are faced with common breastfeeding problems. It is really important to touch base with a IBCLC to ask for help as soon as possible to prevent a bigger issue from occurring.

In IBCLC world we know that as long as the issue has been about is as long as it takes to fix with most common breastfeeding problems.

The most common issues are:

  • Sore or cracked nipples- normally to do with position- breastfeeding is not meant to be painful. So if your toes are curling, your shoulders are up around your ears and your baby is damaging your nipples in a nipple cripple then time to seek help.

 

  • Not enough milk- most mums are worried their baby is not getting enough milk. Knowing how many wet and dirty nappies are day your baby should have can give you early confidence that your milk supply is enough. Hearing your baby swallow, Skin to skin, baby wearing all nurture milk supply.

 

  • Breast engorgement- this is when your breasts are full and swollen and painful. It can occur in the days following birth as your breasts swell with milk. The skin will feel tight and shiny- like your forehead. It can also mean your baby is not latching and draining the milk competently when feeding. If it does not settle down as your supply adjusts to your baby feeding its time to seek health. A swollen breast will make the nipple and areola area flatter- this means your baby may have a shallow latch, leading to smaller milk transfer.

If you would like further support please book a consult through this link: https://app.milknotes.com/calendar?id=1530

 

 

Nipple Shield Sizing- how to get the best fit

Did you know that the wrong pump flange size or nipple shield size can lesson or even decrease the amount of milk you pump or transfer?

It is so important to get the correct fit so that you are comfortable and you maximise each pumping or feeding session.

Most pumps come with a 24mm and 22mm size flange.. which often is simply to large.

As a IBCLC I find the majority of my clients are using the wrong size!

Did you know that a nipple can be a different size?- Yes sometimes you do need diiferent size for each breast.

Did you know you measure your nipple size after a pumping session?

Did you know pressing the flange to hard into your breasts can block a milk duct?

If the flange is to big your areola will be drawn  up inside and pain…. OUCH!

Here is a FREE Nipple Measure Chart from Pumpables

OR to book a flange sizing/pump consult click here

credit pic- medula.

Tongue Ties in baby’s- YES they do exist! (and upper lip ties)

Tongue Ties are a whole body systemic dysfunction and need a team approach “Dream Team” support for you and your baby.

In searching for a optimal outcome families of tongue tie baby’s often navigate between many different providers/medical professionals/social media platforms in the effort to find answers to the symptoms that they are experiencing. Many many families are dismissed and told its nothing to be concerned about unfortunately.

If you have been told that there is not much research on baby tongue tie’s unfortunately that is not the case. There are many many many research papers available.

https://www.bfmed.org/assets/Anklyloglossia%20position%20statement%202021.pdf

50 in the above link alone!!

Here is a clinical consensus paper: https://journals.sagepub.com/doi/full/10.1177/0194599820915457

Here is a link to the Queensland Health fact sheet for bubs with tongue ties.

https://www.childrens.health.qld.gov.au/fact-sheet-tongue-tie-in-babies/

 

(shared with permission of parents).

 

 

 

Online Breast Feeding Consultation

Virtual Lactation Consultations are a great way to access expert breastfeeding support if you have limited access to a face to face visit.

They can assist in providing immediate assistance, care and support with your breastfeeding journey.

This is a 60-75 min online breastfeeding consultation for you and your baby. It also includes follow up support via phone/email for 1 week is included.

Book Here:

Breastfeeding issues I can help you with include:

-Antenatal Breastfeeding Consultations- Colostrum Harvesting.

-Correcting positioning and attachment

-Engorgement

-Low weight gain

-Prevention and healing of thrush, mastitis or plugged ducts.

-Management and plans for lip/tongue tie identification/feeding and revision plans or questions.

-Post tongue/lip tie release rehabilitation.

-Hand Expressing.

-Top Ups.

-Bottle Feeding.

-Help or questions with using a Breast Pump/ Flange Sizing.

-Oversupply.

-Sore/damaged nipples.

-Feeding/weaning off a nipple shield

-Building milk supply.

-IGT/Thyroid/PCO

-Premmie baby- in hospital/at home.

-Twins.

-Preparing for a return to work/ expressing plans

-Gentle weaning plans.

 

Before our consultation

-You will need to complete your profile set up, consent forms and breastfeeding assessment form via my lactation platform MilkNotes.

-Your baby has had a recent weight if you are concerned that this is potentially a issue.

-I will ask you to send through specific photos and video’s of your baby before, during and after a feed, which will allow me to  provide information to assist with latch and also creating a treatment/breastfeeding plan.

-If you are experiencing and nipple damage, redness then please send them as well.

-I assess for both mum breastfeeding issues and baby latching issues.

Examples of pictures (shared with client permission):

 

Online

 

 

 

-During the consultation

-What you need is a well lit, comfortable space with good wifi connection.

-The aim is for me to see a feed if possible, so it is often beneficial to have a spare pair of hands to film your current situation if required.

-I want to see the feed from all angles- so sometimes having a video taken in different positions can also be very helpful in me assisting you.

BOOK HERE

 

 

 

When should I contact a IBCLC Lactation Consultant?

Its EASY!  ANYTIME you are unsure about your breastfeeding journey! There is no right, nor wrong, just about you and your baby.

So many families whether first time parents or experienced parents receive SO much conflicting advice and/or discouraging advice on feeding their baby.

What they are really after is expert up- to- date information and non- judgmental support.

 

These few simple points below are great reasons to seek some additional support to ensure your breastfeeding journey starts smoothly and continues after birth and beyond for you and your baby.

-cries “a lot”

-spits up “a lot”

-feeds “all the time”

-is fussy “all the time”

These 4 “a lot and all the time” descriptions may indicate a latch or transference issue for your baby and most of the time is not “something” they just grow out of. Babies are incredible “compensators” and that is different to be “competent” at their job at hand which is to feed.

Why a IBCLC and not a Lactation Consultant?

IBCLCs are:

  • Recognized the world over as possessing the only standardized, board-certified lactation credential available
  • Knowledgeable about up-to-date evidence-based practices in lactation as demonstrated through a rigorous exam process and re-certification every five years.
  • Experienced in a wide variety of complex breastfeeding situations
  • Competent to assist mothers with establishing and sustaining breastfeeding, even in the midst of difficulties and high-risk situations that can arise
  • Sensitive to the needs of both mothers and children as they work to help mothers meet their breastfeeding goals
  • Ethical in their practice, abiding by Standards of Practice and a Code of Ethics and working within a defined Scope of Practice.

 

So please let me help you if you:

-feeling stressed around feeds

-think your supply is low (most of the time it is not)

-think your supply is to high

-fast or slow let down

-flat inverted nipples

-sore nipples

-breast implants

-returning to work.

 

IBCLC- stands for International Board Certified Lactation Consultant.