Lactation Consultant, Hannah Croft shares her top 14 Breastfeeding Tips…
Firstly, Hannah explains the difference between an IBCLC, Breastfeeding Peer Supporter, and Breastfeeding Counsellor.
IBCLC (International Board Certified Lactation Consultant) is the highest level of qualification to show level of breastfeeding support, and is certified by an international exam board, so everyone around the world site the same exam and it is recognised all around the world.
So what is the difference between a Breastfeeding Counsellor, a Peer Supporter, and an IBCLC?
Ok, it is important for families to be able to recognise the different levels of support. So a Peer supporter is generally a mum that has breastfed, they volunteer some time to help other breastfeeding families, often because they have received support themselves, and they want to be able to give something back they know how challenging it can be. A pre-requisite to becoming a Peer Supporter is that they have breastfed themselves, and they then under go a couple of hrs of training per week for around 6-8 weeks, usually on the basic but useful stuff – maybe attachment, information around starting solids, going back to work, emotional support, that sort of thing.
Next level up is breastfeeding counsellor. They are generally trained by breastfeeding charities in the UK, and are usually mums who have breastfed. Each organisation has a slightly different ethos, and different training programme – but they do several more hours training, it can take a few months or a year or so to qualify.
So IBCLC is the next level up, and to sit the exam to be a lactation consultant you have to have studied some science qualifications, 1000 clinical hrs of practical support, so it’s in-depth as a specialism in its own right. So you would talk to a IBCLC about more complex medical situations often, but also sometimes it can be useful to speak to a specialist about some of the more basic things as well, antenatally, getting prepared for breastfeeding your baby, or if things have got off to a tricky start, things have become difficult and you are dealing with things like, maybe low supply, issues with latch, they can all be useful to get that support with.
When it comes to supply issues, sometimes women have perceived low supply, and sometimes it’s real low supply, especially if breastfeeding has got off to a tricky start, it can have an effect on your supply later on, so it is something that lots of women do have to contend with.
Q1 - Have you got any tips for helping with supply?
So we know that the only true thing that is going to help supply is effective and frequent milk removal – there are anecdotal things that people say they are eating, or supplements that they are taking - but there is no real research behind any of those things to say for sure whether they really work or not. So, get the baby on the boob, feed feed feed – make sure they are drinking and swallowing, it’s not just enough to have baby there, they need to be taking milk, but yes, keep the demand there basically. Some people say they have porridge every morning – which is fine, its not going to do any harm. The anecdotal things probably won’t do any harm – so some people say that they are having porridge for breakfast every morning, because they think oats help there milk supply- and while it might not have a direct effect, it’s certainly not going to do any harm!
Q2 – Do you have any tips on how to manage fast flow for someone who doesn’t want to express?
So sometimes this can happen if there is a lot of milk waiting to get out, so sometimes nursing more frequently can take the pressure away, but also feeding them in upright positions, so where you have their head above their bottom. Or diagonally across your body, or even sat upright so that they are coming at your breast from underneath, that can help as well, and they can bob their head back and away easily if they need to so that they are not overwhelmed by the flow. The Koala bear hold one is a really helpful one.
Q3 - Is it normal for baby to reduce feeds once you start weaning onto solids?
“2 weeks into the weaning process, baby has reduced feeds, so doesn’t seem to be coming to the boob as much, and is now sometimes only feeding for around 2 mins each time”
This is something that can happen a lot particularly when baby takes to weaning onto solids very enthusiastically. But it is worth bearing in mind that breastmilk is still going to be the main part of babies diet until they are 1. So although you starting introducing solids and they become important with regards to nutrients for your baby, your breastmilk is still the most important bit. So if you think about the calories and nutrition that a baby, is going to get from solid food, compared to what they are likely to get from breastmilk, it is really important that you prioritise the breastmilk. But something that some mums find that really helps with this, is to give the ‘breastmilk sandwich’ – so what you do is you give the baby boob first, and then offer them some solids, and then finish with a breastmilk feed. That is a really useful way to make sure that they are getting lots and lots of opportunity to be at the breast and having breastmilk.
It can however be normal for baby to start to reduce their feeds once they are taking solids well, but also what is really important is that you are giving them lots of opportunity for them to be at the breast, as it still remains the most important part.
Re: the ‘breastmilk sandwich’ you can just breastfeed them, then feed them food, then you can put them back on the boob if the baby is happy to do that, no need to worry about timings in between each stage etc.
Q4 – Does how much water you drink have an effect on breastmilk supply?
You can actually over hydrate when it comes to making milk, so there is no need to force yourself to drink gallons and gallons of fluid every day. Just drinking to thirst is a really effective way to make sure you are staying hydrated and having fluids to make milk effectively. It’s a good idea, to every time you sit down to breastfeed, have a drink next to you and have a drink of water then because that a good way to remember to drink enough.
Q5- Are there anything I need to consider when it comes to breastfeeding and exercise?
There is some limited evidence to say that exercise can affect the taste of your milk – but it is often a case of trial an error and seeing how your baby responds. We want breastfeeding to just be a part of normal life for mums, we don’t want them to feel like they are restricted, or having to do things differently than they usually would before they were pregnant. So it’s just something to bear in mind.
I guess the more important thing would be to make sure you have a well-fitting sports bra. A wrong fitting one could potentially cause you have blocked ducts, and that could lead to mastitis, so you need to make sure that if you are wearing a bra with an underwire in it, you need to make sure the underwire is really clear of your breast tissue, and its not going to press in and damage them. I supported a mum who couldn’t work out why she kept getting recurring block ducts, with some dectective work, we worked out that it was from the sports bra that she was wearing, having gone back to the gym a few times a wekk. She was wearing a bra that she had bought pre-pregnancy, her breast shape had changed, and therefore that bra was damaging her boobs. So the advice is to get a proper nursing sports bra, and it helps to get fitted for one to make sure you are wearing the right size. Our boobs are doing an amazing job so it makes sense to look after them.
Q6 – I recently froze some breastmilk, and when I defrosted it, it tasted/smelt funny – did I do it right?
So some people have high lipase, which is an enzyme that is there to digest fat – so sometimes if they express and then store the milk, it can make it smell or taste quite unpleasant. It is not a problem in itself, and some babies will drink it happily. There is some limited evidence that scalding the milk before you store it can reduce the lipase. But yes it’s not a problem in itself, if the baby doesn’t mind drinking it like that then it is fine.
Q7 – What are your best tips for mums who want to prepare themselves for breastfeeding before they have their baby?
So I think we aren’t very good as a culture or as a society at preparing families for the reality of having a newborn baby, whether they are breastfeeding or not. I think we put a lot of emphasis on the pregnancy and birth, and rightly so, but we don’t think about what is going to happen after that. So I always really recommend that families seek out antenatal information sessions, if you are able to go to a session just about breastfeeding try and do that, and read some books, try and talk to other mums that have breastfed because it is a skill, and it is something you have to learn and practise – it isn’t something that will necessarily come straight away. But with practise and the knowledge behind you of how breastfeeding works, it can be really helpful to know what you are doing and what you are dealing with.
Books I would recommend are:
1) ‘The Womanly Art of Breastfeeding’ is a really lovely book by Le Leche League (LLL) – it is unusual because it is a book solely about breastfeeding, and it’s a really lovely read, whether you are pregnant or breastfeeding - whatever stage you’re at, it is a really helpful guide.
2) “You’ve Got it in You” by Emma Pickett is a smaller book about breastfeeding, and that could be a really good read.
3) The Mindful Breastfeeding book by Anna Le Grange is a really, really lovely book to read as well if you are pregnant. While you are pregnant, the breathing techniques that you learn can be really helpful when you are breastfeeding, and taking those opportunities to really breathe, and remember what you are doing, and not feeling overwhelmed by the situation. Stress can also make it harder for your milk to let down, and feeling overwhelmed and anxious in a situation isn’t good for anything. So if you are able to create opportunities to be more calm, and present it helps in every kind of situation.
Q8 – What would you say to someone who is really reluctant to get help?
You are doing amazing, and if it wasn’t common to experience breastfeeding issues, or if it was easy, IBCLC’s wouldn’t exist – and they do, worldwide! Being a lactation consultant is a specialism in itself. If you are in the UK, you can go to the LCGB website, which is Lactation Consultant of Great Britain website, and you can put in your postcode, and it will come up with where your nearest IBCLC is, and then you can contact them from there.
Q9 – What are the most common issues that you see when you are visiting families?
Painful breastfeeding, so if it is painful to begin with we work on the latch and try and work out what’s going on that it’s not comfortable for the mum. Maybe, if breastfeeding has been difficult, and the family have been supplementing with formula, we can talk about getting off supplements. Or even increasing supply, if mum as true low supply then we can work towards her building that up.
Q10 - What if I am worried about dehydration?
One of the best ways to test for this is to look at the colour of your wee, because the darker your wee is, the more dehydrated you are, you want it to be quite light in colour. It is normal to feel thirsty though, remember to drink to thirst.
Q11 – Nutrition during breastfeeding – is there anything I need to cut out whilst breastfeeding?
There isn’t anything that routinely needs to be cut out, generally just a healthy balanced diet is the best thing you can possibly do – again, we don’t want mums to feel restricted whilst breastfeeding and it is different to pregnancy where there are things you can’t eat – but during breastfeeding, what you would normally eat is fine. Some babies do react to things, like onions, garlic etc, but each mum will know her baby, but there is no blanket information of avoiding those things.
Q12 – Can you speak to us about drinking and breastfeeding?
So alcohol is going to be in your breastmilk in the same way as it is in your blood, and leaves your milk at the same rate too. There is some evidence that a babys liver responds to alcohol differently in the first 10 days, so you need to be a little bit cautious then during those first 10 days of life, but after that, we know that because it is going to be in such tiny amounts, its very unlikely to have an affect on the baby, one or two glasses of wine. Obviously we aren’t talking about getting drunk, but again, we want breastfeeding to be part of mums life, we don’t want her to feel that I can’t do that because I’m breastfeeding, and we know that having a glass of wine or two when you sit down to have Sunday lunch, or when you sit down on an evening is part of how mums relax, so actually, if you breastfeed while you are drinking your wine for etc, then by the time baby is ready for their next breastfeed, most of that alcohol is going to have left your blood, and therefore left your milk, and you can breastfeed again.
There is a really good article by Jack Newman, he is a paediatrician in Canada, and has done a lot of research into breastfeeding and supporting breastfeeding mums, and he has a really thorough explanation of how little alcohol gets into your breastmilk – with the comparison of a shot glass in a bath full of water, so it is a teeny, tiny amount. Basically, if you are sober enough to hold your baby, you are sober enough to feed them!
Q13 – Is there any need to pump and dump?
There is not really any need to - you don’t want to give your baby breastmilk if you are really inebriated, so if you are concerned that you are going to be away from your baby whilst drinking you need to make alternative arrangements for feeding. But there is no need to routinely pump and dump, because we know that the amount of alcohol in the milk is going to be so small. So if you know that you are going to be drinking a lot and getting quite drunk, then find alternative arrangements for those feeds – but if you are just having one or two drinks, then you don’t need to pump and dump. As soon as the alcohol has left your blood, it has left your milk.
Q14 – What advice would you give to mums who are coming to the end of maternity leave, going back to work, and are still breastfeeding?
So, in the UK, we are very fortunate that we get quite a lot of maternity leave in comparison to other countries, so if you are going back to work when baby is 9 or 10 months old, it probably may well be the case that because they are going to be fairly established on solids, that they can cope with your absence and just make up for the feeds they have missed when they are back together. Women’s bodies are astounding because they seem to be able to get into the routine of which you are with your baby, and which days you aren’t. So your body will make milk to compensate. Also, it might be the first couple of times that mum is away from baby that she needs to pump just to relieve any discomfort, rather than to make milk for the baby, because, what can happen by the time that baby gets to 9 or 10 months they aren’t interested in taking mums milk from a bottle or a cup . So there isn’t necessarily any need to pump for your absence because they can just have food and water during the day. At 9/10 months, they can usually go a reasonable working day without milk, as long as they are having meals, snacks and water throughout the day.
Also you can talk to your nursery about ways that they can support you breastfeeding whilst going back to work – such as not giving baby any food in the half an hr before you pick them up, to ensure that they are keen to feed when you pick them up.
We know that breastfed babies get ill less and recover quicker. So there is a real invested interest in breastfeeding mums continuing that breastfeeding relationship, particularly once they start nursesry and is exposed to all of those bugs – it really can boost their immune system to have that mums milk still going into their system multiple times a day. So it is really important that you talk to your employer, and also the nursery about ways they can support you breastfeeding.
We know that as soon as we go into an environment, our body senses any bugs/bacteria that it is being exposed to, and makes the antibodies for it. And we know that very quickly those antibodies are put into your milk, within minutes, ready for the next feed. So, also, when mums go back to work and baby goes into nursery, it can be really helpful for mum to breastfeed the baby as soon as she picks them up from nursery – maybe even at the nursery – because then she gets the opportunity to be exposed to the same bugs that baby has been exposed to all day, and will then make the antibodies to respond to those.
I always say to mums it is really good to say to the employer that it is in their interest to keep you breastfeeding because you will likely have less time off ill looking after baby if they are ill.
The employer has to make reasonable allowance to support you breastfeeding, so you shouldn’t have to pump milk on your lunch hour etc. Just remember to remind the employer what is in it for them, it is a really helpful way to sell it to them.
I really hope you have found this useful! For more tips on breastfeeding or to book a session with Hannah, visit https://www.hannahcroft-ibclc.co.uk