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Frequently Asked Questions Regarding Breastfeeding

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Frequently Asked Questions Regarding Breastfeeding Assignment 7 - Part B Frequently Asked Questions regarding Breastfeeding 1. When should I use a hakka or breast shell? Breast shells are used for inverted, sore, or leaky nipples. The shell can help take out the nipple right before you are going to nurse your baby if your nipple is inverted. You do not breastfeed with the breast shell on (this is not the same as a nipple shield). So, you should remove the breast shell right before you breastfeed. You can also use a breast shell if your nipples are very leaky and don't want to wet your clothes when you’re out and about. The breast shell catches all the milk that is leaked out, and when you remove the shell you dump out the milk. Also, if you have sore, dry, cracked nipples, breast shells are amazing for preventing your nipples from chafing against your bra or clothes. This helps heal your nipples quicker. A hakka is a plastic device that you suction onto the breast to also help pull out the nipple through the vacuum technique if you have inverted nipples. But, more importantly, it is a pumping tool that is inexpensive and not electric! Lots of women when breastfeeding their baby will use the hakka on the other breast to pump out milk and store it (as well as even out the breasts and prevent engorgement). This is less irritating on the breast and nipple, unlike electric breast bumps. 2. Is it true that breastfeeding can act as a natural contraceptive? Yes! Frequently breastfeeding will prevent your menstrual cycle from starting again, which means no ovulation. There is a ton of science behind this, but in layman’s terms, this process is called lactational amenorrhea. Lactational amenorrhea is the lack of periods due to breastfeeding. Your menstrual cycle, and ovulation occurs because of the high amounts of estrogen and progesterone throughout your cycle. These two hormones help with ovulation, implantation, and maintaining pregnancy. When your baby is born, progesterone levels decrease drastically (because it doesn’t need to maintain pregnancy anymore), and estrogen also decreases. Then your body knows it’s ready to lactate and breastfeed your baby, so prolactin levels increase. Prolactin is the milk producing hormone. The longer you are breastfeeding, the longer prolactin will be released and make milk. Now, how does progesterone/estrogen, and prolactin tie in together? Basically, if prolactin is being released by a small part in the brain (called the pituitary gland), then progesterone and estrogen are not being released. You can think of prolactin as being released by a tiny tunnel from the pituitary gland, which blocks other Assignment 7 - Part B hormones like progesterone and estrogen from being released too. These two different types of hormones with separate functions, can’t work at the same time. So, what happens when you stop breastfeeding? Prolactin levels decrease, and make space in that tiny tunnel for other hormones to come in and produce estrogen and progesterone. These other hormones are called luteinizing hormone, and follicle stimulating hormone, and they are essential to producing estrogen and progesterone. Then you will start ovulating and getting your period again! How does lactational amenorrhea work? There are three things you must continue and consider for it to be 98% effective as contraception (which has been studied and concluded)! You must: 1) be breastfeeding on demand, around the clock non-stop; 2) be breastfeeding your baby who is 6 months old or younger; and 3) not have a period at all (not even spotting) since childbirth. 3. Can I breastfeed with breast implants? Yes, you definitely can! Do not be discouraged by any fear mongering, or rumour you've heard that breast implants completely take away your chance to breastfeed your baby. It all really depends on a few questions like: where your incision was to place the implants?; do you feel sensation in your nipples?; did you have them done cosmetically, or because medically necessary? There may be some difficulties when it comes to breastfeeding if you have tissue/nerve damage and required surgery. If any milk ducts, or glands were damaged during surgery or previously due to medical reasons, this could affect the way milk is produced and released. If you had breast augmentation due to underdeveloped breasts, there could be a chance your breast tissues and milk ducts did not develop enough or properly, and this could affect breastfeeding. If you were incised for the breast implants on your nipples, there could be damage to the nippes pores, milk ducts, and Montgomery glands which will affect breastfeeding. Usually, the incisions are underneath the breast or at the armpits, and this won’t affect breastfeeding. Sensation of your nipples is a great sign that the nerves are working properly, but even if you don’t, breastfeeding can still be done! Be positive, and focus on methods that help your breastfeeding journey be more successful! Every mother’s journey is different and has their own challenges. Assignment 7 - Part B 4. What are the best positions for my newborn to have the best latch? There are five optimal positions you must try that can easily be found on the internet if you need photos or videos for extra guidance, they are: cradle, cross-cradle, football, laid back, and side lying. The cradle position requires you to basically put your whole arm (let’s say right arm) underneath your baby's ​ head and body for support, with their head on the bend of your elbow. Both of your hands should be near your baby's bum. The cross cradle is similar, but you are holding your baby's head with your hand (and ​ ​ opposite arm, so let's say the left arm) instead of the bend of your elbow. Your entire left arm will be under the baby supporting them. Next is the football hold, where your baby won't apply as much pressure ​ ​ to your belly. Place a comfortable pillow beside and under your breast and lie your baby on top of the pillow (or you can just hold the baby). Your baby’s head should be directly facing your breast, and their body will wrap around your ribs and towards your armpit. Your hand in this position is supporting their back or head. The laid back position is you laying down in a semi-reclined position with your baby ​ ​ tummy to tummy with you. You can guide them to your breast. Finally, the side lying position is when ​ ​ you lie on your side facing your baby with one pillow behind you supporting your back and one underneath your head. Your baby will be on their side facing you, with your nipple aligned to their mouth. Pull their feet and lower body close to yours and you can place a blanket behind her for support as well, or she can be lying down, or you can support her up with your arm/hand. 5. Can medications pass through my breastmilk? Yes, medications can pass through your breastmilk, but it is in extremely tiny quantities. These amounts are not enough to affect your baby, compared to when your baby is in the womb and medications are passed on through the bloodstream. There is a significant difference between drugs being passed through the blood and through breast milk. Most medications are safe to take while breastfeeding, and most of the time it is safe to breastfeed your baby while taking medication. It is important to weigh the risks and benefits of taking a certain medication that would cause you to stop breastfeeding for a few days to weeks. Not breastfeeding for this amount of time can make it difficult for your baby to nurse again. They can have trouble latching on, or start weaning off the breast. So, if there is a medication that prevents you from nursing, ask your doctor if there are alternative medications that allow you to nurse. If a drug is safe to take during pregnancy, it is usually safe to take while breastfeeding as well. This is a good indicator. Also, if the drug can be prescribed to infants, it also works. A few common drugs that you can take while breastfeeding are: ibuprofen, acetaminophen, aspirin, antidepressants, zoloft, and paxil. Remember to always ask your doctor before taking medications that were not prescribed. You can also use the following websites for more evidence-based research on which drugs you can and cannot Assignment 7 - Part B take: https://www.ncbi.nlm.nih.gov/books/NBK501922/, and ​ ​ https://www.infantrisk.com/category/breastfeeding. ​ 6. What do I do if I'm not producing enough milk? Many breastfeeding women don’t realize that breastfeeding is all about supply and demand. The more you breastfeed, the more milk is released, the emptier your milk lobules are, and the more your body begins to produce milk again. If you are constantly feeding your baby on demand, 8-12 times a day (in the first few months), there shouldn’t be a problem with producing milk. Now, if you are only breastfeeding a few times a day, and then supplementing with formula (so you don’t pump and feed your baby pumped milk), this can cause your breasts to engorge, and stop milk production. This is how milk supply decreases. The longer you go without breastfeeding, the more “dried up” your milk supply gets. It is crucial to begin breastfeeding within the first 24 hours after your baby is born. The sooner you get them latched on in those first 24 hours the better! The first few days to a week are crucial for the outcome of your breastfeeding journey and milk production.
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