Breast refusal

Perhaps, breast refusal and low milk supply are two of the most acute and difficult topics for a nursing mother.

Refusal affects the mum's emotional state very much. It is very difficult to receive such a rejection from the beloved and long-awaited baby. And mum becomes afraid to receive it again, afraid to latch baby on the breast, may begin to think that the baby rejects her, or that she can not cope and thereforeis a "bad mum".

It's not like that! Your baby loves you and you are a wonderful mum. Breast refusal just happens and has its reasons. Baby really needs your help and patience.

All this gives you uncertainty and leads to confusion. It is good to have someone who will tell you what to do and will give you emotional support and hope that this is a stage and it will pass, that there is a way out. The support of family and dads at this time is invaluable.

Breast refusal can happen immediately after birth due to various factors, such as medication, breast swelling, severe breast engorgement, or suddenly after successful breastfeeding period.

Until an age of one year, the baby does not refuse the breast for no reason. There is a reason. Not always the reason is immediately obvious. Let me remind you that in the first year of life, breast milk is the main source of nutrition, and in case of refusal, help should be sought.

In the case of breast refusal and difficulty in latching immediately after delivery, there are a number of techniques to help with swelling, overfilled breasts during engorgement. There are tips on how to help those with large breasts, what to do in case of flat or inverted nipples. There are ways to promote lactation and feed your baby by alternative methods that do not further affect the success of breastfeeding. You can always contact a lactation consultant both before and after labour.

Sudden refusal can also be due to a number of reasons. For example, a cold, illness or teething. The most important thing in this case is to support lactation, feed the baby in another way that will not affect breastfeeding and find the reason.

Breastfeeding refusal is difficult period. Both mentally and physically requires a lot of resources. But as the wise man said: "All things pass, and this will pass."" It will!

If you need help, I am always ready to help. Write!

Author of the article: Aleksandra Ņekrasova

© 2024 Aleksandra Nekrasova. All Rights Reserved.

A woman's recovery after childbirth: the 5-5-5 rule

The first 6-8 weeks after childbirth are a time for the woman's body to recover. In order for this stage to go more calmly and smoothly, helpers are needed to feed, clean the house, walk the dog, listen and support.

For a smoother recovery, the 5-5-5 postpartum rule can be helpful.

• That is 5 days in bed. Mum mostly rests and feeds the baby on demand.
• 5 days in bed. All activity takes place on the bed so mum can lie, sit and sleep more.
• The next 5 days are around the bed. Mum gets more involved in activities, but still rests from time to time.

Of course, in the first weeks after childbirth, a woman will not only have to recover her body, but also rebuild both physiologically and psychologically. Such adaptation will be easier with the support of loved ones and a team of specialists (pediatrician, gynecologist, breastfeeding consultant, midwife, postpartum doula), whom you can contact if necessary.

For yourself or your relatives and friends who are expecting a baby, online support from a lactation consultant can be a valuable gift. A counsellor will be on hand to answer all your questions. Together you can lay a more successful foundation for breastfeeding and motherhood. See you at the counselling!

Author of the article: Aleksandra Ņekrasova

© 2024 Aleksandra Nekrasova. All Rights Reserved.

Fourth trimester of pregnancy

The fourth trimester of pregnancy is the first 3 months of the baby's life.

It is a period of adaptation for both parents and infant.  It is a kind of bridge for the baby between life in the womb and life in the world. Inside the mother's belly the right temperature was maintained, the baby received food and oxygen through the umbilical cord. When he is born, he needs to breathe on his own, he needs to eat on his own. He has so much to master and so much to learn about the world around him. The new and slightly frightening world is more relaxing to explore with someone he already knows so well, with his safety guarantor - his mum.

The baby usually sleeps a lot, often latch on to the breast, wants to be close to his mother, to be on her arms, in close contact with his parents. He is not yet so interested in the world around him. He still needs to get used to bright and loud, to the fact that there is day and night. There's still so much he can't do on his own. And he has a lot to learn.

For parents, this is a stage of restructuring their lives. Lactation is also just being set up and the skills of breastfeeding are being laid.

Time will pass, and the baby will start to roll over, become more interested in the world, and get distracted during feedings. The mother will establish lactation and the breast will begin to produce milk as much as needed, without excess. The mother will begin to better understand the baby's crying. She will be able to distinguish when he cries from fatigue, when he wants to eat, when a wet diaper bothers him. But for now, mastering this skill is ahead. And the main place of comfort for the baby in the first three months of life - it's mum's breast and parents' hands.

And the lactation crisis of three months, familiar to many, will come. But this is a story for another article.

If you wish to consult about breastfeeding during pregnancy and get advice on how to establish successful lactation, let me know!

Author of the article: Aleksandra Ņekrasova

© 2024 Aleksandra Nekrasova. All Rights Reserved.

When to take medication for a nursing mother during breastfeeding?

Medicines are excreted from the body at different rates. Their ability to pass into breast milk also varies. Some medicines have side effects not only on the mother but also on the baby. This is why it is worth considering each medication individually.

I recommend that you always consult your doctor and pharmacist about the compatibility of the medicine with lactation. A breastfeeding counsellor can also tell you whether the medicine passes into breast milk and what recommendations exist for its use during lactation, after analysing the available information, studies and recommendations.

Once the breastfeeding mum has established that the chosen medicine is approved by her doctor and is compatible with breastfeeding:

1. General recommendations may include the use of the medicine by a nursing mother immediately after a breastfeeding session or after pumping, if the mother is pumping.

2. In cases of drugs with a long half-life and drugs taken once a day, the mother is recommended to take the medicine immediately after feeding before the baby's longest sleep.

3. In some cases, milk expression may be necessary: in advance, to form a milk stash for the baby, and while taking the medicine, to reduce the risk of clogged milk ducts.

Allergies of a nursing mother and breastfeeding

Allergy is a common chronic disease and the most common chronic disease in Europe (EAACI, 2016). Globally, the World Health Organisation estimates that between 10% and 40% of the total population suffer from allergies (Pawankar, R., 2013). If this condition is so prevalent, there is a high probability that a breastfeeding mother may be faced with the dilemma of how to treat her allergy symptoms and combine breastfeeding of the baby. If it is easy to give up a particular food product, what about seasonal allergies to pollen or insect stings? In this case, allergy symptoms are worth treating, because most allergy medications are compatible with lactation. But not all!

We can divide allergy medications into the forms in which they are used.

Nasal sprays and eye drops are a good choice because they act locally and do not pass into breast milk. You can also try nasal rinsing with physiological saline solution for allergic rhinitis.

I will highlight two medications used for allergic reactions that reduce milk production. They should be avoided if possible during breastfeeding.

This is pseudoephedrine, which is found under other brand names, so I recommend reading the ingredients of medicines. Pseudoephedrine is also sold in combination with other medicines, such as in cold powders. For breastfeeding mums, especially those with problems or risks of decreased milk production and in the late stages of lactation, should be careful when using pseudoephedrine and use safer alternatives if possible. And there are alternatives. Also, pseudoephedrine can adversely affect a baby's sleep and feeding patterns, which can lead to weight loss or worse weight gain. In general, pseudoephedrine falls into the L3 category. These are drugs that are moderately safe/probably compatible with lactation and should only be prescribed if the potential benefit justifies the potential risk (Hale, T. W., 2021).

The next antihistamine to avoid is diphenhydramine, also known as Benadryl. It may decrease milk supply. There is not enough research on this at the moment. Benadryl is also a sedative, causing drowsiness in both mother and baby. Therefore, it is recommended to either use it for a short time only or use safer alternatives. It is categorized as L2, which means that this drug may be compatible with breastfeeding without increasing side effects in the baby, but there is not enough research and the evidence is limited (Hale, T. W., 2021).

I would like to remind you that the information in this article is for general informational purposes only and does not replace consultation with a doctor! You should always consult your doctor or pharmacist to choose the right medicine for you!

If you want to know about the effects of a particular medicine on breastfeeding and your baby, you can ask for help from a lactation consultant. Lactation consultant cannot treat or prescribe a medication, but the specialist will inform you about the available information, studies and recommendations. After such counselling, it will be easier for you to work with your doctor or pharmacist to choose the right treatment for you and, if necessary, to find an alternative that is compatible with breastfeeding. 

Do you have any questions? I will be happy to answer them. Write!

Sources:

Pawankar, R., 2013: World Allergy Organisation (WAO) White Book on Allergy: Update 2013

EAACI, 2016: The European Academy of Allergy and Clinical Immunology (EAACI) Advocacy Manifesto, 2016

Hale, T. W., 2021: Thomas W. Hale. ‘Hale's Medications & Mother's Milk.’ 2021. 19th Edition.

Article author: Aleksandra Ņekrasova

© 2024 Aleksandra Nekrasova. All Rights Reserved.

Colds and breastfeeding

Autumn is the time of colds, acute respiratory infections. A lot of people get sick. Including breastfeeding mums. Colds and breastfeeding are compatible, provided that you check medicines for compatibility with breastfeeding. Remember that many medications are compatible with lactation. Breastfeeding is not a reason to endure pain and other unpleasant symptoms of illness.

Here are a few more tips:

1. Remember to empty your breasts.
2. Drink enough fluids.
3. Don't tolerate pain. It reduces milk production. There are painkillers and antipyretics compatible with lactation.
4. Warning! Pseudoephedrine reduces milk production. It is used in the treatment of colds, for example, in powders or tablets with other components. Therefore, double-check the composition of medicines.
5. Herbal teas and herbal medicines are NOT EQUALLY compatible with lactation. They also should be checked for compatibility with breastfeeding. Not all herbal remedies are research-proven.
6. Get as much rest as possible. It's time to call someone for help. Mum's illness is a reason for dad or relatives to take a day off or come home early from work and help out, reducing the strain on mum as much as possible. Ideally, it is a few days for mum to only feed the baby on demand and rest.
7. Breast milk will protect your baby from acute respiratory infections, through the antibodies produced in your body, as well as the increase in white blood cells in the milk.
8. If your baby gets infected, it will be quicker and easier to cope with an infectious disease if he or she is breastfed.

Consult your doctor and/or pharmacist about taking medicines!

© 2024 Aleksandra Nekrasova. All Rights Reserved.

Breastfeeding and heart health

September 29th was World Heart Day. Can breastfeeding promote heart health?  As it turns out, yes. A number of studies have found that breastfeeding has long-term health effects for both the baby and the mother.

For a nursing mother:

• the risk of heart attacks and strokes during her lifetime is reduced, as well as the risk of cardiovascular disease.
• Breastfeeding reduces the risk of high blood pressure and the development of hypertension. 
• In addition, lactation has a beneficial effect on the level of cholesterol and triglycerides in the blood of the breastfeeding mother.

The beneficial effects of breastfeeding on heart health are provided by at least some period of lactation. Breastfeeding for 12 months and longer has greater beneficial effects.

For babies:

• breastfeeding contributes to lower systolic blood pressure and cholesterol in adulthood.
• Also, in the case of breastfeeding, babies with congenital heart disease grow better.

Take care of your heart health! Breastfeeding can give you a healthier foundation for health, but whether you lead a healthy lifestyle and check your health is up to you!

And if you have any questions about maintaining breastfeeding, I am always ready to answer your questions. Write me!

© 2024 Aleksandra Nekrasova. All Rights Reserved.

When to contact a lactation consultant?

Who is a lactation consultant?

A breastfeeding counsellor or lactation consultant or breastfeeding specialist is a professional who has the knowledge and skills to help a nursing mother throughout the breastfeeding period. 

Many breastfeeding counsellors have knowledge of mixed feeding and artificial feeding. Medical professionals often tend to focus on treatments and diseases. Also the limited time is available at the doctor's visits, so usually there is not enough time to go over the basic, yet very important points about infant feeding and development. Lactation consultants become invaluable sources of knowledge that parents lack. However, breastfeeding consultant provides not only practical support, but also emotional and psychological support, increasing the mother's confidence and faith in her abilities, supporting and encouraging in the most crisis moments and during the period of adaptation to the new life as parents. Breastfeeding consultation can dispel parents' fears, worries and anxieties.

This is a relatively new profession that appeared about 40 years ago as a need to help breastfeeding mothers. Due to many factors, such as living in mono nuclear families away from mothers, grandmothers and other relatives who could tell and show how to breastfeed. In addition the increase in artificial feeding in the 20th century did not facilitate the transfer of knowledge. Even if the grandmothers were nearby, they often could not teach anything since they themselves did not breastfeed. It is because of the break in the transfer of knowledge and the appearance of lots of women who wanted to feed their children with their own breast milk, a new specialty appeared - a breastfeeding consultant. This was facilitated by the development of science confirming the value of breastfeeding.

A breastfeeding specialist has interdisciplinary knowledge in the field of lactation physiology, anatomy, psychology, pharmacology, nutrition, and child development in the first years of life. 

When can a breastfeeding consultant help?

Breastfeeding and lactation is a period in a woman's life, which causes a huge number of changes in the organism of a nursing mother at the level of physiology, anatomy, psychics, hormones and emotions. The birth of a child leads to the necessity of adjusting to a new role. For this reason, a large number of questions arise, which can often be answered by a breastfeeding counselor. The specialist will inform you about life with an infant and the development of the baby. 

Such related topics as sleeping, crying, infant care and behavior, indicators of successful development and growth of the baby, introduction of complementary foods are topics of consultations on a par with typical topics such as:

• Proper latching and effective breast latch;
• Problems with effective sucking and latching;
• Questions about the duration and frequency of the infant's naps/sleep and feedings;
• Increasing milk supply, low milk supply, lack of milk;
• Relactation;
• Lactostasis (blocked ducts, plugged ducts), mastitis, breast abscess;
• Oversupply, hyperlactation;
• Fast let-down;
• D-MER reflex (feeling on negative emotions during start of breastfeeding session);
• Engorged breasts;
• Problems with breastfeeding in the first days after delivery;
• Nipple or breast pain;
• Cracked or sore nipples;
• Nipple blister/white spot on nipple;
• Teething;
• Biting;
• Lactation induction;
• Weaning;
• Milk expression, pumping and storage of breast milk;
• Growth spurts and breastfeeding crisis;
• Introduction of complementary foods and breastfeeding;
• Sleep and breastfeeding;
• Crying baby, unsettled baby at the breast, unsatisfied baby after feeding;
• Breast refusal;
• Suspicion of food intolerance or allergy to mother's food in infant;
• Illness of mother or child during breastfeeding;
• Flat and inverted nipples;
• Redness and itching of the breast;
• Contraception and planning pregnancy during breastfeeding;
• Breastfeeding after breast surgery;
• Hypoplasia (lack of breast tissue);
• Breastfeeding after previous negative experience of breastfeeding;
• Breastfeeding twins, triplets;
• Issues on the use of donor milk;
• Pacifier and bottle using when baby breastfed (paced bottle feeding);
• Colic;
• Maintaining lactation and establishing breastfeeding of premature baby/babies;
• Breastfeeding in case of anatomical and physiological characteristics of the baby (chronic diseases, tongue tie, low muscle tone, cleft palate or lip, etc.);
• Cluster feeding (frequent feedings in the evening);
• Slow weight gain or no weight gain of the baby;
• Breastfeeding after caesarean section, traumatic labour, instrumental delivery, induction or stimulation of labour, analgesia with epidural anaesthesia in labour;
  
• Breastfeeding and medications, smoking, alcohol;
• Breastfeeding and diet/nutrition of nursing mother;
• Co-sleeping, safe sleep for babies, night feedings;
• Supplementation with expressed milk, donor milk or infant formula;
• Alternative feeding methods;
• Consideration of individual situations (return to work, hospitalization, chronic illness of the mother or baby, pregnancy, tandem feeding of an older child).

A lactation consultant is a healthcare professional but is not a doctor or medical professional and therefore cannot diagnose, prescribe medications or treat. The area of competence of a breastfeeding specialist is healthy breasts in the period of preparation for lactation and during breastfeeding.

However, the consultant will be able to advise which specialist to contact, tell which galactagogues, nutritional supplements, medications or medical procedures are usually used in certain problem situations associated with lactation, their benefits for lactation and risks. After consulting with both a breastfeeding consultant and a doctor, a nursing mother will be able to more successfully cope with the problem. Also, a lactation consultant can, based on his/her knowledge, competence and availability of scientific information, inform a nursing mother about the passage of certain medications into breast milk and compatibility with breastfeeding. Often, after treatment recommended by a doctor or medication suggested by a pharmacist or doctor, a nursing mother begins to worry about the compatibility of treatment and breastfeeding. Then consultation and support from a breastfeeding specialist is indispensable for overcoming fears, anxiety and maintaining breastfeeding.

In cases of breast surgery, retracted or flat nipples, chronic diseases of the mother, risk of premature birth, risk of hypoglycemia in the baby, expectation of twins, wish to express the colostrum before delivery, wish to prepare and start lactation as successfully as possible, counselling will be helpful before delivery. You can take your time to figure everything out and get ready!

If you want to consult or ask a question, write to me!