As a lactation consultant, I like to spend some time with mothers asking them questions that are directly related to the breastfeeding challenges that they are presenting with. After about 30 minutes of specific questions, here is what I learned.
Leslie lost enough blood after her birth that she needed a transfusion. Leslie and Sadie came home at 5 days postpartum. Sadie had lost 10 oz in her first two days of life and needed to be supplemented. Her feeding routine was to breastfeed first and drink milk from a bottle afterwards. This worked great as Sadie seemed happy and satisfied after feedings, had the appropriate amount of diaper count and was sleeping well. Stephanie slowly began to wean baby from the bottle until baby was receiving no supplements by the time she attended her first pediatric appointment. This appointment was actually when baby was 10 days old, rather than the initial thought of 2 week appointment. I would agree with her pediatrician that given her initial weight loss, a 5 oz weight gain between discharge and appointment was appropriate. At this point, Sadie was 5 oz less than birthweight but not yet two weeks old.
I surmised that Sadie was probably weight appropriate at that appointment because of her supplements. In talking further with Leslie, she states never having felt full in her breast tissue, but she attributed this to her baby feeding so frequently and so long each time that she never had enough time to really “fill up.”
It is common for new mothers who have never breastfed, to not necessarily know what a baby with a good latch looks like when they are nutritively sucking, as well as what it should feel like. Stephanie made an assumption that since breastfeeding did not hurt her, that the latch was good and baby was getting enough milk per feeding.
spent time showing pictures and videos of a well latched baby who is actually drinking milk from the breast. I talked about what a good latch should look and feel like and with Sadie at her breast, demonstrated to Stephanie how to help her come onto the breast with an excellent latch. Stephanie now understands that her baby was doing very little suckling ( milk removal) at breast and that the feather like sucks did not cause her nipple pain.
It was helpful for Stephanie to learn that when mothers have severe blood loss that requires a transfusion, this can cause a delay in their milk volume increasing. Stephanie was given appropriate advise to supplement her baby and this is why Sadie looked and behaved normally at her 10 day appointment.
Now that you have been given a window into what Stephanies breastfeeding history has been, please check in tomorrow to read the conclusion and find out how Stephanie turned her situation around and reached a happy place of a great milk supply and exclusive breastfeeding in a relatively short period of time.
Please note again: While this is a true story, certain parts of the information has been changed to assure anonymity.
