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LACTNET Home

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LACTNET  October 2000, Week 1

LACTNET October 2000, Week 1

Subject:

Mothers making BF decisions prenatally (long)

From:

Judy Ritchie <[log in to unmask]>

Reply-To:

Lactation Information and Discussion <[log in to unmask]>

Date:

Tue, 3 Oct 2000 09:48:24 -0700

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (84 lines)

While selling drop cup nursing bras to pregnant moms to be, I tested
for flat or inverted nipples on all our customers.  I would ask if
their doctor or midwife checked them for flat/inverted nipples.

I explained it was more common in large breasted women and since we
sold DDD/F to J cups, it was important to know for sure.

Most said their doctor *eyeballed* their anatomy and said "You have
nipples, you're fine."  When I asked if they showed them how to squeeze
their aereola, they all said their nipples were not touched.  I would
excuse myself and say "I'll go wash my hands and show you how to check."
Coming back I'd show them how to squeeze and how the baby's mouth would
encompass a portion of the pigmented aereola in addtion to the nipple.

In most very large breasted women the nipple becomes flat on squeezing
as they near term.  But it is still sequeezable.  We sell them the $10
nursing shells to wear for a few weeks, for longer and longer times,
until they deliver.  Many moms came back to say their doctors were
really impressed they had the shells and glad they had the benefit of
wearing this inexpensive device with their anatomy.

I told them that as their breast skin stretched with pregnancy growth,
the nipple would flatten, much like blowing up a balloon.  The more
air, the more the tip shortens.  I have told them that the baby needs
to practice as much as he/she can on the soft breast, because in some
women (not all) when the milk first comes in the breast firms up and
some call it engorgement.  I've never called it *latch* but told them
the more the baby can practice, the faster the milk comes in.

I would explaint it is unfair to ask a baby to not work at sucking
(such as with a bottle where the fluid fairly runs out) and then
expect the baby to do the different mouth action at the breast where
he/she is actually *milking* the breast, and has to work at it.

If they think their baby will starve to death while waiting for milk
to come in, I used the illustration of the babies rescued in the
Mexico earthquake after nine days.

I explained that orders from their pediatrician should be on file in
the hospital so that their baby will get no pacifier or bottle.  If
the doctor mentions the breast shell in the order that verifies the
mother's need for compliance with the request.  It would be good to
find a ped (either male or female) that is adamant about BF.

They are surprised to learn there is such as thing as "imprinting"
on the first mouth action in some babies which results in nipple
confusion if an artificial nipple is introduced.  I told them their
baby should practice on them, smell their own mom's smell as they
can identify them by day 4.  I would quotes Doris Haire as to how
the baby must try as quickly after birth as possible, preferably
within the first 4 hours in case of complication such as C-section.

I believe when they come to see us, unless they've been attending
LLL meetings, we're the first place to hear all the input they
personally can have to make the breastfeeding happen and work.

All the moms I've given this little talk to then understand that it is
an exclusive scenerio.  Mixing the two is difficult on the little one
and could be difficult on their breasts.  I've told them that some
nurses want life easy or think they're doing the mom a favor by giving
a pacifier or bottle.  When the baby is away from them for any length
of time for whatever reason, they don't know what goes in their baby's
mouth.  I did not get into finger sucking as it was not so common as
now.

I always say that they can go from breast to bottle at a future time
if and when they need to.  Going from bottle to breast is a heck of
a lot of work, though relactation can be done.  I gave them the card
of an LC friend so that they can get help after discharge help and
then information on scheduling pumping, storing and feedings once
they must go back to work.

I always hope they have an option to stay home and continue, but that
has been *pie in the sky.* these days.  This mini course was at
initial point of sale.  I always hoped I helped them to succeed.

Judy Ritchie

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January 2003, Week 5
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February 2002, Week 4
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January 2002, Week 5
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