Breastfeeding tips

During first few days when milk doesn’t come in yet

-skin-to-skin as much as possible, more time with baby means more time to try latching and more chance of success

-avoid using nipple shield unless really necessary (nipple shield may create nipple confusion and hinders milk transfer)

-hand express breast milk (study shows hand express in first few weeks to empty breasts increase production down the line)

-track weight daily to avoid drastic weight loss (if weight drop more than 10%, suggest starting formula supplementation of 15-30cc per feeding)

-no bottle feeding (may create nipple confusion), please use Medela Supplemental Nursing System to keep baby at breasts

-mum only nurses and rests, no other housework

-get hospital grade pump with battery/car charger

After breast milk comes in

-use both hand express and breast pump after feeding to increase production

-set clock to empty breasts regularly (even one time of delayed emptying may cause clogged ducts and mastitis)

-to prevent mastitis, wash nipples with warm water  and clean pump tubing every day

-if any breast pain/redness/fever, start taking antibiotics and once feels fluctuation/pus formed, get needle aspiration as soon as possible to avoid I&D

-if clogged duct, warm compression every 2-3 hrs right before pumping/electronic tooth brush and cold compression in between; lethicin?; if not relieved in 24-48hrs, be more aggressive and be careful of mastitis

 

 

 

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How I ended up with a 4cm hole in my breast one month after delivery…

The title says it all.

I am in a dark mood now but I plan to write about my experiences of how mastitis turned my life upside down for the past week.

Among all the outcomes of lactational mastitis, having a 4cm by 1.5cm hole in the breast is not the worst outcome but does stand on the ‘bad’ end of the spectrum of all possible outcomes. From a very quick recovery and resuming breastfeeding, to a series of needle aspiration and eventual recovery without scars, to an emergent incision and drainage with a gaping wound on the breast. But anyway, I didn’t develop bacteremia/septic shock/death and still alive so thank goddess for that.

But this is the true reality of healthcare. A mixture of bad luck, rapidly progressing disease and subsequent clinical decision making behind the disease progression curve, you will find yourself end up in some place you never imagine would be.

Even now, I am still waiting to see where it goes since the wound is not healed.

I think it started on last Saturday when I found some area near my right nipple painful and bulging – thought it was some milk pouch since it was clogged duct there with hardened clots and it was difficult to see the redness as it was near areola. But I kept pumping – the next day pumping was so painful I even went to the hospital to borrow another hospital grade pump and the lactation consultant pointed out to me – isn’t that more red than usual?

Actually no, I think it all started when I was still staying in the hospital and son didn’t learn how to properly latch. Because he did not learn how to properly latch so I had to pump and nurse at the same time to increase my milk production (which never exceeded 3-5oz per day), and I had developed lots of clogged ducts which never went away and eventually developed into mastitis?

Chain of events.

My journey of breastfeeding (1)

Young parents usually underestimate the work needed for feeding their newborn.

First night

Our son was born around evening time, and on that specific night, I was so tired from the 12-hour long laboring and really wanted to sleep through the night, but when the nurse asked if I would like to have some room-in time with my son to try breastfeeding, I said yes. As you know, we’d better take advantage of newborn’s suction instincts, the earlier we try to let them latch on, the better. If you put them on your breasts for the first hour of their life, they actually start seeking out your nipple just by instinct. But trust me, when you are so tired, you forget all things learned from breastfeeding class took weeks ago (early room-in, early hand expression of colostrum, etc).

So, when I tried and failed my attempt for breastfeeding for that night (there was no lactation consultant  to help you at night) and overwhelmed by the desire to sleep, I tried to send him back to nursery (during the tour of the labor & delivery ward, they told us we can leave the newborn in the nursery overnight). It turned out I am too naive about this.

After I sent him back and started to fall asleep, my door was knocked and a nurse assistant wheeled him in. Instantly I knew what was wrong, the nursery staff didn’t want to deal with a crying baby! With the very last strength in me, I picked him up and held him on my breast and he calmed down a bit.

He slept on my breasts for a few hours and started to cry again. I noticed he has a poopy diaper so I tried to send him back to nursery again to change his diaper. This time I even walked him to the nursery myself with the hope that he won’t be sent back to my room again. I was totally wrong – in 15 minutes, the nanny wheeled him back to my room again saying he was hungry and he needed to eat. I was so tired thinking – “I tried, there was no milk yet…” and almost argued with her about this practice of bringing him to my room every one hour just because he was smacking his lips…

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Looking backward, there were a few things we could have done better to kick-start our breastfeeding journey.

  1. Put the baby to your breast right away after delivery – I felt very weak after the labor and initially didn’t even want to have a screaming baby on my chest but once he was there I felt a flush of love and joy for this little guy.
  2. It is not a crime to give some formula to a baby if you felt too tired to feed him the first night, but you need to discuss this with your nurse.
  3. You can hand express some milk and feed to him if the baby still hasn’t got the hang of latching yet. Check out “hand expression Stanford hospital” for the video.

Continue reading “My journey of breastfeeding (1)”