Stacie Bingham: Birth Support in Kern, Tulare & Kings Counties
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Questions Parents Ask: I Didn't Breastfeed My First Baby -- Can I Breastfeed My Second?

7/22/2020

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Early as a La Leche League Leader, I learned from Linda J. Smith the lactating body works like an ice machine: When you remove ice from your ice maker, there is a sensor in your freezer that tells the freezer to make more ice. Its goal is to replace the ice. When you remove milk from your breasts, there is a trigger in your your body that tells the body to make more milk. Its goal is to replace the milk.

If you do not use the ice, the freezer does not continue to make more. If you do not remove the milk, the body does not continue to make more.

The baby and body expect milk to be removed 12-24 times in the first 24 hours of life. This ensures the baby gets enough. This ensures the body gets the message to start making milk.

Once you get past the first 24 hours, it is normal for babies to eat 8-12 times in 24 hours, and more than that can be normal, too. Milk effectively removed at this frequency is often enough to build a robust milk supply.
Keys for the first few days include:​
  • Avoid bottles (in the case of a baby with weight gain issues or who is unable to latch; remember there are many other ways to offer breastmilk to a baby who needs supplementation)
  • Avoid pacifiers. All baby's sucking should be done at the breast. Pacifiers do not remove ice from the freezer -- they do not help you make more milk. Pacifier use actually releases a hormone in a baby's body that causes "satiety, sedation and sleepiness" -- essentially it tells them their tummy is full and they are sleepy. So again, when a baby would be hungry, cold, lonely, upset and would benefit from breastfeeding (which would also help their parent make more milk), a pacifier offers a temporary halt to the biological nurturing and milk-making that comes in that process. 
​Because the body makes milk by wanting to replace the milk that was used, we know cookies, special drinks, supplements, etc., don't improve supply alone. You can't eat lactation cookies and drink Starbucks' Pink Drink and expect more milk if you aren't feeding your baby (or pulling milk out via a pump) 8-12 (or more!) times in 24 hours.

We are a culture steeped in instant gratification. We can get things next-day from Amazon. We can get fast food 24 hours a day. We don't have to wait long in many cases to get what we want. Milk supply doesn't work like this. There is an element of work that comes with having an adequate supply, and that is feeding or pumping 8-12 times in 24 hours.
To get the most optimal start, it isn't that difficult:
  • Reach out to your local IBCLC, La Leche League, Breastfeeding USA, Baby Cafe or other breastfeeding support organization while you are pregnant and ask about in-person, virtual, or other meeting options. Discover what they recommend for successful feeding and how to get help if you need it later.
  • Once your baby is born, ensure you and baby have your Golden Hour time. Keep baby on your bare chest with nothing between you. Your nurse will cover you with blankets so you both stay warm. Dr. Kerstin Uvnäs-Moberg, author of Oxytocin: The Biological Guide to Motherhood, shares how babies are born with two kinds of hunger -- the first is skin hunger, when they expect to be placed on their parent's skin; the second is stomach hunger, when they expect to latch to the breast. They are both important, and just because your baby isn't quickly trying to feed, this doesn't mean anything is wrong.
  • Let baby try to self-latch -- babies are programmed to do this. Place baby on your chest and allow them to decide what to do. Gravity safely holds baby to your body, and baby can feel secure while using their arms, legs, neck, head and mouth to get to where they want to be. Babies are born with nearly 20 reflex responses that help them get to the breast, latch to the breast, and pull milk from the breast. 
  • Ask every nurse for help, and ask for a visit from the lactation consultant. Most nurses have extensive experience in helping babies feed. While it can be handy when someone latches your baby for you, it is like getting your hair cut and styled -- you look amazing! Now, can you replicate that at home? The best IBCLC I have ever known could sit on her hands and talk a parent through latching. While this helps a parent actually learn, it isn't the fastest, and in hospitals we often get what is fastest. Don't be afraid to ask to try and repeat what a helper just did. Don't be afraid to also ask that they put their hands on your hands to help guide your practice.
  • Skip pacifiers. Many experts agree babies should not have a pacifier or bottle for 6 weeks, or until the milk supply shows it is robust enough to handle less stimulation. Remember: Babies don't get satisfied sucking on a pacifier, and it doesn't tell the parent's body to make more milk. A pacifier is like working really hard for something, and then not getting the reward. In a baby's case, sucking on a pacifier burns calories but does not provide a way to replace that lost energy.
  • Plan to spend the first days skin-to-skin with your baby. Feed your baby every time they wake up. Feed, feed, feed. The heavy feeding in the first days helps to bring your mature milk in, and it helps to tell your body, we need to make enough milk!​
Some people respond more to negative messages, so for fun, let me share ways to make breastfeeding hard:
  • Let other people hold and feed the baby for you, so you can get a full night's rest. Night nursings actually help us make more milk, as we have higher levels of the milk-making hormone prolactin when it is dark. Studies have shown babies consume up to 30% of their daily milk intake at night -- both important reasons not to skip night feedings. There is a growing body of evidence that suggests babies aren't ready to differentiate their days and nights until they hit two-ish months -- and even this varies from baby to baby.
  • Offer pacifier when baby is fussy so you don't feed them too often. Many experts agree breastfed babies cannot be overfed. Did you know a cobra can decide whether to inject venom into the animal it has bitten, or it can just bite without venom? Babies can do something similar -- they can suck to pull out milk, and they can suck for comfort -- both are natural, wanted behaviors for newborns.
  • Schedule your baby's feeds by watching the clock, even if baby seems upset like they want to eat. Let's be honest, babies don’t have a whole lot going on. If you are a baby, your main goals are eat, sleep, pee/poop, stay awake for a while, and repeat. It is perfectly okay to feed your baby when they exhibit any sign of disturbance or upset -- this is a programmed mammalian response for this age. 
  • Doubt your body's ability to make milk. If you are pregnant right now, your body knows to grow your baby because of the location of your placenta. It knows the baby is inside because the placenta releases hormones that say, "Baby is inside, let's grow this thing!" Once your baby is born and the placenta is removed, the drastic drop of hormones tells the body, "Baby is outside now, let's get those milk factories going!" Doctors check the placenta to make sure it looks like it is all there, because even a small piece of placenta can send hormonal signals out that confuse the body: Is baby inside? Or is baby outside? And this can stop the body from making the full hormonal switch needed to make milk. Just as your body grew your baby on the inside, it is prepared to grow your baby on the outside through feeding baby at the breast.

The biggest success factor for breastfeeding is time for you and your baby to be together. Your baby is programmed to be with you, to want to be close, to want to feed freely. Babies don't come out and say, "Hey, we've been a little too close for a little too long -- please put me in my own room, in my own crib." In actuality, babies do not know where they end and their parent begins. They have been rocked, held snugly, been kept warm, heard all the sounds of your body and your voice, and they have not been hungry -- think about that! They were fed through their blood. So suddenly, it's bright, they're cold, they have no control over their arms or legs, and where's that person!? My person? It is a lot to adjust to. And can you guess what answers all those questions of discomfort? Being at the breast.

There is an amazing author out that by the name of Kimberly Seals Aller. I heard her say this at a conference once: The first time you had consensual sex, it probably wasn't the greatest. You may have wondered, How do people do this? Why do people make it seem so easy? I'm pretty sure I did that all wrong. Did you walk away and say, "Well, that didn't work, so I'm never going to do that again." Generally not. We stick with it. We figure things out. It takes time and practice.

While breastfeeding is not sexual, the idea that, if it doesn't work the first few times it isn't going to, often causes many of us to quit before we have even had a chance to practice and figure things out better. Repeat this to yourself: Just because it isn't working right now doesn't mean it won't work. Seek help, because it is out there. We should not be expected to figure things out on our own. Heck, if you can't find help, reach out to me! I may be far away from your location, and I can try to help you find support appropriate for your situation.

Let me close with Linda Smith's "Coach's Rules":
1. Feed the baby
2. The parent is right
3. It's the parent's baby
​4. Nobody knows everything
5. There's another way


You can do this! And with support, you don't have to do it alone! 

Places to reach out to before baby, for support, or if struggling:
Find an IBCLC
La Leche League 
​Breastfeeding USA
​Baby Cafe

Resources for further reading:
Importance of Responsive Feeding
​Are Pacifiers a Problem for the Breastfed Baby?
Six Ways to Help When Breastfeeding is Hard
Why Doctors Aren't Lactation Consultants

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Questions Parents Ask: Should I Encapsulate My Placenta?

7/21/2020

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There are different ideas about placenta ingestion after birth. While it is true most mammals eat their placenta right after birth, they do so raw, directly after it is expelled. This cleans up a bloody mess (which keeps predators away), and it provides the mother with energy without her needing to leave her vulnerable babies alone to find food.

As humans, we don't do it this way. We process it, and then take it slowly over time. Many lactation experts say this is opposite to how the body works. While pregnant, the placenta sends out hormones that stop us from making milk. This is why, if you pump before birth, you will barely get anything out (and it will be colostrum).
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Once baby is born, the placenta comes out. It is the placenta that is responsible for the hormonal changes which turn on the body's milk-making factory. If a piece of the placenta is accidentally left inside the body, it can stop the body from making milk due to the hormones it carries and releases. It can also prevent the uterus from shrinking back up like it needs to to stop bleeding. It may contribute to uterine infection, as well. This is why we should never tolerate a doctor pulling on the cord to try and yank the placenta out before it releases on its own -- the cord or placenta can be torn, and pieces can be left inside.

Many experts say by putting the placental hormones back into the body, it can confuse the body about what it needs to be doing: growing a baby inside, or making milk outside.

Here is tangent, but stick with me, it applies: Medication like Sudafed can cause a person's milk supply to decrease because of how it works (dries up sinuses). Breastfeeding people are told not to use decongestants because of this. BUT a person who has just had a baby will be less impacted, and maybe not impacted at all, because of how their body is making milk at this point -- it is making milk simply because the body had a baby -- the placenta left the body, causing that chain of hormonal responses which turn the milk-making factory on.

If a person has a breastfeeding 6 month old and takes Sudafed, they have a higher chance of it reducing their supply because their body works in a different way now -- they make milk in direct response to how often and frequently the baby nurses. This is the difference between endocrine control (automatic because of the hormones of birth), and autocrine control (supply and demand).

Another example of how our bodies and hormones differ has to do with the return of our fertility. Some people get their periods back while breastfeeding like normal, 8-10 times a day. Some won't get a period at all until their child has weaned totally and dropped off every single feed, and even then it might take a couple months for their cycle to return. Every body is different. So just be mindful of how things are working for you.


Every person is individual, and what lactation experts are noticing is: Some people have robust, healthy supplies when consuming their processed placenta slowly and over time. And some don't. So guidance to know what to watch out for is imperative. If you choose to have your placenta processed for consumption, be sure your encapsulator is aware of this, and that they can give you guidance on what to expect. Be cautious if they feel this is not true -- enough lactation professionals have experienced this for us to believe it is real and it can happen.

I may sound opposed to the practice of consuming one's placenta. I really am not. I just want more evidence of the benefits -- thus far, I believe the only documented benefit is that people have increased iron levels. I tend to think more about how things are done across the spectrum of all mammals. There is no mammal who has its placenta processed, encapsulated, and then slowly takes it over time. My belief is, if you want to ingest your placenta, do it like other mammals do -- raw and right after birth. 


Placental Encapsulation: Friend or Foe
How Does Milk Production Work?
A Lactation Consultant's Perspective on Placenta Encapsulation
​

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Stacie Bingham, LCCE, CD(DONA), CBS(LER)

Calm, comfortable Lamaze education & experienced support for pregnancy, birth, & breastfeeding serving Bakersfield, Delano, Hanford, Porterville, Tehachapi, Tulare, Visalia + the World

​661.446.4532 stacie.bing@gmail.com
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Photos used under Creative Commons from Renaud Camus, jmayer1129, jmayer1129, Rob Briscoe, jmayer1129, jmayer1129, jmayer1129, operation_janet, CJS*64 "Man with a camera", symphony of love, Aravindan Ganesan
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