Laid-back Breastfeeding

Laid-back breastfeeding, also called Biological Nurturing, is a method of baby led breastfeeding that starts with the mother first being in a comfortable reclined position. The keys to this position are:

-tummy to tummy on top of mummy

-baby is given time to seek the breast

-baby is free to explore the mother’s body with hands and head

-the nipple is still (mom is not holding the breast as a bottle)

Here’s a video of how this position is achieved on our YouTube channel: https://www.youtube.com/watch?v=PKoEnqrSkvs

Laid-back nursing is ideal for babies who have latch on difficulties from a high palate,  bubble palate, tongue tie, lip tie, recessed chin, or birth trauma. Most healthy full term babies can achieve this position from birth.

Laid-back breastfeeding increases skin-to-skin which helps babies coordinate better for feeding and improves mom’s milk production. This position also adds gentle pressure to the abdomen to help babies release gas more easily.

Laid-back breastfeeding is the original tummy time, leading to the other label “biological nurturing.” Babies nursed frequently in this position may avoid flat spots on the head and enjoy on or above target physical development because they are engaging in developmental appropriate baby “exercise.”

Tummy down feeding stimulates baby’s inborn feeding reflexes. This position helps the jaw rock forward, the neck and head lift, and the arms work the full range of motion. You may find your baby making motions very similar to swimming in this position. These movements will later translate into skills for rolling, sitting up, pulling to standing, and crawling.

 

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10 Questions with a Homebirth Midwife

1) Moms planning a home birth are planning for a low intervention birth. Is the same true for their breastfeeding goals? Do women delivering at home plan to exclusively breastfeed and avoid formula intervention?

Yes. Most women who are planning natural birth also plan to exclusively breastfeed. However, there are situations where a mom chooses not to breastfeed. She may be a victim of sexual abuse or was unable to breastfeed a previous child. We ultimately want women to make the decisions they are most comfortable with after having been provided with as much education and support as possible.

2) What kind of support can a homebirth midwife provide to breastfeeding mothers that is different than a midwife in a hospital or birth center setting?

We offer a lending library that includes breastfeeding books. We offer a one hour prenatal visit so the mother has ample time to discuss her questions, goals, and fears about breastfeeding.

3) What role do you take in prenatal breastfeeding education?

In addition to the support and information provided prenatally, we also suggest the utilization of outside resources like breastfeeding classes, lactation consultants, and La Leche League meetings.

4) What aspects of homebirth uniquely facilitate breastfeeding initiation and establishment?

We are adamant about the necessity of skin to skin contact between mom and baby, with as minimal interruption as humanly possible.  Every aspect of the postpartum experience works better when you just leave them alone. Moms heal faster and babies want to nurse when they are not being poked, prodded, and taken away from mom for reasons that could, in most instances, wait.

5) Describe your breastfeeding-specific training. Does it differ from the training hospital midwives have?

I am not familiar enough to speak on the training of hospital midwives. My experience has grown through living and learning. I nursed all four of my babies at various lengths, based on my education and abilities at the time. I am learning all the time through my clients’ experiences ranging from no intervention to the necessity of an IBCLC or pediatric ENT. I also continue to learn through the support of my peers.

6) Describe the well baby care homebirth midwives give in the first 48 hours. How does this care screen for breastfeeding obstacles?

We usually stay with the mother after birth until baby has latched and is nursing well. If this doesn’t happen for some reason, we are in constant contact until it does. We listen to what moms are describing and make the call for further help based on what they are reporting. We may make another trip back to the house, or, if it seems like an issue that is out of our scope of knowledge, we will refer first to an in-home lactation consultant who is willing to assess mom and baby while maintaining the need for skin to skin contact in their own environment.

7) Do women with gestational diabetes, PCOS, or other endocrine disorders birth at home? What special feeding support do these dyads receive from a midwife?

Yes, and we don’t tend to do anything special unless we are finding it to be an issue. The premise is that it is normal and natural unless it’s not. We aren’t in the business of fixing things that aren’t broken. If we need to refer out for these things, we will.

8) Do Homebirth midwives facilitate informal milk sharing between clients? Why or why not?

Yes. However, not all moms are comfortable with that and we support that, too.

9) What signs or symptoms of feeding challenges do you refer out to an LC?

Baby not gaining weight, latch that just isn’t getting better despite our suggestions of different feeding positions,  mom in extreme pain with cracked, blistered, and bleeding nipples.

10) If a client chooses not to breastfeed, what alternative feeding do you recommend and why?

I usually don’t do much recommending of formula, but I suppose an organic formula of some type if they must. It is extremely rare that a client of ours comes to their six week postpartum visit and is not still exclusively breastfeeding. If they are supplementing with formula, they have already been working with a lactation specialist and have made those decisions together.

Bonus question 11) Share your favorite nursing memory.

I remember a moment nursing my last baby. I nursed all four, but I think I was in a hurry for a lot of that time. Hurry up and quit nursing. Hurry up and walk. Hurry up and potty train. With number four, I knew she was my last and I was thankfully in a place in my life where I didn’t want to hurry anymore. I wanted everything to slow down. I am grateful that I was able to have the awareness to enjoy every single stage with her. I squeezed every last drop. Nursing her one afternoon, she was holding my finger and resting her hand on my chest, while staring into my eyes. I felt in the depths of my being, at that very moment, what an amazing gift to be given the ability to nurse my baby, and I wasn’t going to hurry.

 

Rachel Hart I am a traditional midwife and CPM. I moved to Atlanta from Las Vegas with my husband and four children in 2008. I am a graduate of the University of Nevada, Las Vegas with a Bachelor’s degree in English. I began my midwifery journey through an apprenticeship training program in 2005 and began my own practice in 2007.  All four of my children were born at home, the last birth unassisted. I joined Beth at Birthing Way in 2010.

Helping women realize their true power and potential as a woman and mother through the birthing process has been a privilege. I have really enjoyed attending births with the lovely families here in Georgia. I also support the birth community as Secretary of the Georgia Midwifery Association and as Membership Director of the Georgia Birth Network.

 

www.birthingway.com
rachel@birthingway.com
770-597-4478

10 Questions with a HypnoBabies instructor

1) What is labor hypnosis?

Hypnosis for birth is a very effective way to prepare for a birth with fewer interventions and greater comfort. Many women report that their births were completely comfortable without any pain medications. Using hypnosis during labor is a great alternative to an epidural. Basically, you will have harnessed to power of your own mind to change how the sensations of labor and birth are perceived. 

2) Why is labor hypnosis a useful tool?

No matter what kind of birth you are planning, hypnosis is going to equip you with tools that will allow you to remain calm and clear headed, even when plans change. This makes it much easier to enjoy the process of giving birth. Hypnosis has been used in the medical field for quite some time, and is a very successful option for those that have severe reactions or life threatening responses to anesthetics. Birth hypnosis by Hypnobabies has been carefully crafted to address the specific needs of this normal bodily function in the modern world.

3) How does labor hypnosis impact initiation of breastfeeding at birth?

 

When hypnosis is used during birth it prohibits the release of adrenaline. This is a tremendous help in allowing the uterine muscles to work without tension and conflict. When the uterus is functioning optimally during birth it can eliminate the fear, tension, pain syndrome. That elimination means that birth can progress more quickly and more efficiently. Many times there is no need for epidural or narcotic use for pain management. When babies are not exposed to these interventions they are more alert and responsive after birth. This allows us to maximize that ‘Golden Hour’ after birth and early initiation of breastfeeding. Also, the newborns are much less likely to experience side effects such as low respiratory response and therefore are less likely to be separated from their Mom right after birth. 

4) What barriers to breastfeeding does labor hypnosis help reduce or eliminate?

 

Babies that are not removed immediately from their Mom are able to benefit from immediate skin to skin. This facilitates bonding, regulation and familiarity. The biggest barrier to this aspect of breastfeeding might be the Cesarean section. Using hypnosis for birth can certainly greatly reduce the risk for a Cesarean, mostly by eliminating or reducing the use of interventions that can lead to more interventions that may ultimately lead to a surgical birth.

5) Do these hypnosis techniques come in handy after birth?

The hypnosis tools learned in Hypnobabies certainly will continue to be beneficial well after birth. One technique in particular is an instant cue for comfort and healing. This can be so useful for immediate postpartum discomforts such as perineal repair, uterine involution, and any nipple pain while finding a resolution to whatever issue is causing 

6) What do you think are the 3 biggest factors in a birth that impact breastfeeding?

Interventions such as routine IV administration and epidural/narcotics for pain relief 
Cesarean births, in particular those that could have been prevented
Separation of mother and infant

7) How can moms find a labor hypnosis friendly care provider? 

 

Ask! I hear so often that a student or client informed their care provider about using Hypnobabies and they were thrilled. Also, many of my students have been told to seek out birth hypnosis if they desire a low intervention birth. 

8) How can moms find a labor hypnosis educator in their area?

Of course you could search online or try www.Hypnobabies.com 
Word of mouth is a great resource, as well. I get a lot of referrals from local mom’s groups.

9) What skills in Hypnobabies apply to long term breastfeeding success?

 

Hypnobabies focuses on informed consent and we encourage families to continue asking those questions throughout their parenting adventures. Finding support and evidence based guidance is key. Hypnobabies provides that guidance and applicable national and local resources for a successful breastfeeding relationship.

10) What skills in Hypnobabies improve partner support of the breastfeeding relationship? 

Having the partner attend the weekly classes allows the couple to create an even deeper bond with each other and their baby in utero. This bonding helps to foster a union that has impressed me more times than I can count. These partners understand the importance of breastfeeding for both mother and baby and are willing to go the extra mile to help facilitate that. 

Bonus Question! 11) Share your favorite nursing moment?

I’m not sure if it’s my favorite, but it is the most memorable… my son and I weaned from breastfeeding much earlier than I anticipated, unfortunately. About a month later, he got pretty sick with a fever and all the other usual crud that can bring a baby down. He was very snuggly (not his typical nature) and somehow he wound up latched on and nursing for comfort. I was nearly in tears and I relished that short time and knew that it was the last. I don’t know many people that know the exact last nursing session.
Nicole DiBella HCHI, CD
Hypnobabies Instructor, Birth and Postpartum Doula

follow me @NaturalBirthATL

Bonus Question! 11) Share your favorite nursing moment?

I’m not sure if it’s my favorite, but it is the most memorable… my son and I weaned from breastfeeding much earlier than I anticipated, unfortunately. About a month later, he got pretty sick with a fever and all the other usual crud that can bring a baby down. He was very snuggly (not his typical nature) and somehow he wound up latched on and nursing for comfort. I was nearly in tears and I relished that short time and knew that it was the last. I don’t know many people that know the exact last nursing session.

10 Questions with a Doula

1) What is a doula?
         A doula, also known as a birth companion, is a nonmedical person who is trained to assist women before, during, and/or after childbirth as well as her spouse and/or family, by   providing physical assistance and emotional support.
2) Why hire a doula?
        There have been numerous studies that show the benefits of hiring a doula include a decrease in the chance of C-section, decrease in the amount of time a woman spends in labor, decrease in the use of interventions like forceps and vacuum, decrease in the use of epidurals or need for pain medication, decrease the chance of postpartum depression, and increase the satisfaction a woman feels about her birth experience.
 
3) How does having a doula impact initiation of breastfeeding at birth?
        All doulas should be equipped to assist moms with the initiation of breastfeeding after birth. Often times in a hospital setting, nurses might have to leave to attend to another patient leaving the new mom to figure it out on her own. Some hospitals do not have on-site lactation consultants on call around the clock. Having a doula ensures that a knowledgeable person will be there to help if/when needed. 
4) What barriers to breastfeeding does a doula help reduce or eliminate?
    1. Educational barriers: misinformation about breastfeeding, milk production/supply
        2. Emotional barriers: lack of confidence in ability to breastfeed, embarrassment of feeding in public. A doula provides support if the mom is lacking support from family/friends.
        3. Physical barriers: learning how to prepare for breastfeeding, postioning mom and baby for comfortable and sufficient nursing/bonding time.
        4. Medical barriers: Breastfeeding while recovering from c-section, helping to identify potential medical issues such as tongue ties and lip ties and refer to specialists
5) Does a doula come in handy after birth?
        Yes. Doulas routinely remain in close proximity to moms immediately after the birth of their baby. This is to help facilitate the mother’s wishes for skin-to-skin care, breastfeeding initiation as soon as possible, and to answer any questions about newborn care and postpartum care. Many moms also benefit from the services of postpartum doulas. Postpartum doulas contract with the mother and her family for a specified amount of time (hours/weeks) once the family is settled at home after the birth. Postpartum doulas assist with baby care, sibling care, light household chores, and meal prep to help parents acclimate to having a new baby in the home. It can be a great help to have someone onsite those first days/weeks after birth to help with breastfeeding issues among other things, when needed.
6) What do you think are the 3 biggest factors in a birth that impact breastfeeding?
        1. Medications administered during labor and their effects on the mother and the newborn.
        2. Type of birth. If mom has interventions such as forceps, vacuum, or caesarean and baby has a medical issue due to this and they must be separated for an extended amount of time after birth.
        3. The length of the birth. A mom who has a lengthy labor may be extremely fatigued and unable to breastfeed right away.
7) How can moms find a doula friendly care provider?
        1. Moms can ask their care providers how they feel about having a doula in attendance at the birth. Most providers will have a definite opinion one way or the other.
        2. ICAN of Atlanta has a provider review section on their website. Anyone can join ICAN. You do not have to have experienced a c-section. The forums provide excellent information for all expectant moms.
        3. Word of mouth. Ask your friends,  who have used a doula, who their provider was and what the experience was like. If you have already hired a doula, most can tell you of the more popular doula-friendly practices in the area.
8) How can moms find a doula in their area?
        Resources for finding a doula in your area include www.doulamatch.net, www.gabirthnetwork.com, (or local birth networks) asking your provider if they have a list of doulas that they work with, websites of doula certifying organizations such as DONA, CAPPA, and ProDoula, and again referrals from friends/family/mom’s group members who have used a doula’s services before.
9) What skills does a doula have to help with long term breastfeeding success?
       Many doulas have taken breastfeeding classes to assist their clients in the early stages of breastfeeding. For long term breastfeeding success, doulas assist moms through emotional support and encouragement. Many moms give up just because they do not have the support needed to continue. Doulas provide practical information and solutions to assist with challenges associated with breastfeeding. We are knowledgeable about common problems like engorgement, symptoms of clogged milk ducts, mastitis and can refer you back to your care provider or a lactation consultant for added assistance.
10) Do moms need a doula for birth center or home births?
         I believe all moms could benefit from the support of a doula no matter where they choose to give birth. Birth is a very beautiful, but physically and emotionally draining experience. Having a person who has walked the journey before can make it easier by helping to reduce or eliminate the obstacles of fear, anxiety, lack of information, and more because they are a trusted, trained and experienced individual who is there just for the mom.
Bonus Question! 11) Share your favorite nursing moment?

My favorite nursing moment was probably the first time my daughter latched properly. I was unable to successfully breastfeed my older son due to lack of education and support. I became engorged and had painful, cracked, and bleeding nipples. After 3 days of crying (both of us) I gave up. After I had my daughter, I was able to get help from the buses at the hospital. They explained what a good latch looked like and should feel like. They gave me tips for sore nipples, too. So once at home, when she latched with little help from me and with no pain to me, I was very excited. I went on to breastfeed her for 14 months.

Elysia Douglas is a wife, mother of 4, and a professional, certified birth doula in the Metro Atlanta area. In her first 3 years as a doula, she has assisted over 50 families as they prepared for and welcomed their little ones into the world.  She offers attentive, nurturing, and compassionate support during pregnancy, labor, birth, and beyond. Elysia is passionate about equipping, encouraging, and empowering women to achieve their birth goals by providing unbiased, evidence-based information, emotional, and physical support throughout their pregnancy journey. She fully believes in your right to know your options and make decisions that are best for you and your baby. When Elysia is not at prenatal visits, facilitating a childbirth education class, or attending a birth, she enjoys sewing, painting, volunteering in children’s ministry at her church, and spending time with her family and friends.

www.mother2motherlaborsupport.com
http://doulamatch.net/profile/6020/elysia-douglas
www.facebook.com/mother2motherlss
www.instagram.com/mother2motherdoula

What is a Normal Feeding Routine? How Does it Change with Age?

The one thing that is certain with babies is they change every day. Knowing what the range of normal is for infant feeding can help parents make better decisions about the family rhythm.

Exclusive Breastfeeding and Human Milk Feeding

0-6 weeks: This is the time when babies nurse constantly. Their tiny tummies want a constant and steady fuel supply, just like they were accustomed to in utero. The placenta nourished the baby so well, hunger is something completely new after being born. It’s easiest to feed babies before they show signs of agitation. Nursing in clusters is common. Nursing every 1-3 hours day and night is normal. Nursing sessions may last 5-35 minutes at a time. Babies frequently fall asleep at the breast and nurse in their sleep. Expect 10-15 nursing sessions per 24 hours. Babies should be fed on cue or on demand. No medical organization endorses scheduled feeds for breastfeeding infants.

6-12 weeks: This period is usually full of what most people call growth spurts. Babies this age are still nursing around the clock. Remember, human milk is digested in about 90 minutes. The tummy is still small, maybe as little as 2 or as many as 5 ounces. Some babies will have a “witching hour” in the early evening where they feed in a cluster of sessions. Babies who have been separated from mom during the day may be particularly interested in a marathon evening nursing session. Nursing and bottle feeding human milk should continue on cue or on demand.

3-6 months: The World Health Organization and the American Academy of Pediatrics recommend that babies continue to receive only human milk at this time. Babies in this age range have a variety of sleep patterns and growth patterns. Teething may begin during this stage which may disrupt feeding or increase night wakings. All of this is normal. The stomach size is 3-5 ounces. Babies in this age range may increase their nursing or cluster feed just as newborns do. On cue feeding should continue at this age.

Breastfeeding with Complimentary Solids

6-9 months: Most babies will have a first tooth appear at this point. Babies who have a tooth, can sit well unsupported, and have lost the tongue thrust reflex are ready to begin solids in compliment to human milk. Human milk is still recommended as a primary source of nutrition. Ideally, the baby is nursed first then solids are offered as “dessert.” You may have heard “food before 1 is just for fun.” Small amounts of complimentary solids are important for iron and other minerals as stores from birth are utilized by this age. Human milk should be offered on cue. Solid foods can be offered at scheduled meal times.

9-12 months: Most babies are interested in self-feeding. They have mastered the pincer grasp and can put bits of food into their own mouths. Human milk is still the bulk of their nutrition. Some babies may not have had a tooth erupt yet. Nursing through the night is very common.

Nursing a Toddler

12- 15 months: The American Academy of Pediatrics feels this is a safe time to replace human milk with other foods including the milks of other mammals. Many mothers continue to nurse their toddlers for nutrition. Toddlers at this age are busy and may have nutritional gaps because they are out exploring the world instead of eating. Their stomachs may only be a few ounces bigger than they were a year ago. Continuing to breastfeed at this age can help a growing toddler meet nutritional needs during a “picky” phase.

15-18 months: Children who are still nursing may continue to do so at night as well. Mothers commonly explore night weaning around this age. Other mothers are glad to nurse through the night to help with the pain and wakings associated with eruption of molars.

18-24 months: By this age, most children are well established on solids interested in eating with the family at more regular times. Self feeding has been mastered. Many children can drink out of a small cup unassisted. Toddlers who are nursing may nurse frequently or only once a day. The range of normal is very wide.

Full Term Nursing

2 years and beyond: The World Health Organization recommends that children breastfeed for a minimum of 2 years with nursing continuing if both mother and child so desire. Children often self-wean some time after the second birthday. Pregnancy or extended separation may motivate a child to wean faster from nursing.

How Do Moms Pump Enough to Return to Work?

Many moms want a safety net of pumped milk in the freezer for their return to work away from their babies. While it’s only necessary to have enough milk saved for the first two days back at work, many moms want to save several days or even weeks worth of feedings during their maternity leave.

Please read What to Expect When Pumping to trouble shoot and get the most out of your pumping experience. This article addresses how to juggle pumping during your maternity leave and during the working day.

When to start building a “stash”

Most women start with over production. The first 10 weeks of breastfeeding are the easiest for milk collection. This is also a critical time for conditioning the body to respond to a pump. Ideally, moms should nurse on cue and spend a great deal of time resting skin to skin with their babies for the first 2 weeks. Once baby has regained birth weight, around day 10-15, it’s time to try pumping.

Milk collection is easiest in the morning hours when the milk making hormones are highest. Beginning at this favorable time will help make pumping a more positive experience. After nursing the baby, pump either one or both sides for 20 minutes each. Even if the milk stops flowing, continue pumping for 20 minutes per side.

Weeks 2-4, pump one time per day in the morning after nursing. Expect to collect 1-2 ounces each day. Remember: 20 ounces is enough milk for about 16 hours of mother-baby separation.

If you wish to increase your daily milk collection, add a second daily pumping session weeks 4-6. Pumping only twice a day will help you collect several days worth of milk before returning to work.

If your baby cues to nurse after pumping, just nurse. The breasts are never truly empty until you wean. The more milk removed, the faster the glands work to produce more milk. No pump is as efficient as a baby who is properly latched. There is no need to feed the baby the pumped milk in place of nursing.

If your maternity leave is longer than 6 weeks, continuing pumping 1-2 times per day as is possible for the duration of your leave. This helps maintain a conditioned response for more efficient pumping in the future.

When to Pump at Work
No two work environments are the same. No two work days are the same. Not every work environment allows for predictable or scheduled pumping sessions. Things to consider:
– aim to pump every 1-3 hours. This is a range. Babies and breasts are flexible.
– don’t feel trapped on a schedule
– if you anticipate a long meeting or event you cannot break out of, consider pumping once an hour for 2-3 hours beforehand and/or afterward
– your body does not require you to pump on a set schedule just as your baby does not feed at set time
– a hands free pumping bra can help you pump during your drive to and from your work location
– hand expression may help moms who have a short break but can’t make it to the pumping room
– taking a lunch break to nurse your baby may be easier than pumping as frequently at work

7 Things You Can Do Right Now with a Fussy Baby

When you have a fussy baby, the minutes feel like hours and it’s easy to panic. Don’t panic! Take control of the situation and help your baby adjust to life outside the womb. Set aside worries about allergies, diet restriction, and milk production. Get the baby calm, help mama get calm, and then call your lactation consultant.

Hop in the Bath
Babies love baths. Mommies often need one too. Co-bathing can calm and focus your baby. Babies who are frustrated at the breast often respond well to nursing in the bath. Bath tub nursing can halt a nursing strike, help a baby with a shallow latch relax and open wide, and help a mom who is having let down trouble. Safety tip: have another adult present to pass the baby in and out of the tub to mom to avoid slip and fall risk.

Magic Baby Hold
It’s magic. Hold the baby like this. Magic Baby Hold with Bill

This is a variation of the common tummy massages like bicycling legs, rubbing the tummy clockwise, or burping. This can help pass gas or ease a baby who seems constipated. Remember: constipation is hard dry stool, not infrequent stool.

Swing and Sway
Not just the baby swing. Babies calm faster in arms. Swing with your baby on your lap on your porch swing or glider. Wrap your baby in a sling or carrier and walk through the house. Babies like to be near a heart beat. Being skin to skin while swaying through the house is extremely soothing.

Nurse in a Carrier
Nursing in a carrier allows the baby to be upright and compressed. This helps with reflux symptoms and gas. Upright feeding can also ease the stress of fast milk flow or over-active let down. Babies with tongue or lip ties can often open wider because of the firm back support carriers provide while the head can move more freely. Sucking also helps relax babies and their GI muscles. More nursing helps them poop.

Play with Temperature
Take some frozen milk out and spoon feed it to your baby or put it in a mesh feeder. The cold is exciting and different for older babies, especially teething babies. Older babies may like to hold a frozen teething toy or a warm teething toy.

Get Outside
Even if the weather is crummy, just standing on the porch may change things. If you’re able to carry your baby for a walk, this is usually better than a stroller. The upright position and being near an adult care giver are more relaxing than a stroller.

Play with Texture
Let your baby touch something interesting and new. A tooth brush or cotton ball or sand or salt. Watch that these things stay away from the mouth. Novel sensory experiences can change your baby’s outlook pretty rapidly.

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