This is the first installment of our new Blog Spotlights . Every few weeks we will be featuring a blog written by one of our maternity experts from the Philadelphia Maternity Network. These blogs will discuss a wide range of topics and will help parents learn about the services available to them from local professionals. Enjoy!
About the Author: As a professional postpartum doula Joanne Galloway is specifically trained in every aspect of postpartum care. Often referred to as the “Baby Whisperer”, Joanne loves serving, empowering, and teaching her clients so that their experience of new parenthood is as joyful as it was meant to be. Areas of special expertise: breastfeeding support, infant digestive issues, soothing techniques, sleep training, and identifying/supporting issues related to postpartum depression.
Breastfeeding within the first 48-hours after birth
by Joanne Galloway
When people I meet hear me introduce myself as a Professional Postpartum Doula specializing in overnights, one of the most frequently asked questions is, why can’t the parents just get up and check on the baby? This obviously misses the point. New moms are themselves going through recovery. Even with vaginal deliveries there are issues such as exhaustion, healing physically and emotionally, wacky hormones, baby blues, and let’s not forget the brain fog that comes from the overwhelming experience of bringing a new baby in the world! Plus, often there are less-than-ideal deliveries.
First, I recommend having a conversation early in pregnancy with your doctor or midwife about your wishes concerning breastfeeding. You may have firm wishes, or questions about what would work best for you. This is an important conversation to have early on, before delivery, so that decisions can be made.
Also, no matter where your doctor delivers, do some research and pick the best delivery hospital that is also breastfeeding-friendly. It may not be the closest one to where you live, you may have to change your doctor/midwife, but it is so important because many hospitals are focusing more and more resources on developing state-of-the-art birthing facilities. A consultation with a Doula will offer more information on hospitals that have gotten great grades from our lactation consultants. (and clients!)
My practice focuses on seven main areas: Healing for mom, Sleep for mom (and dad), household setup and management, soothing techniques, sleep training, identifying and supporting issues related to postpartum depression, and breastfeeding coaching and support. When my clients request day work I also provide sibling care and meal preparation.
Many decisions are made concerning breastfeeding within the first 48 hours, after delivery and before the mom and baby come home from the hospital, when the Postpartum Doula would then be on the scene. I have heard too many accounts of the mom’s wishes concerning breastfeeding not being taken into consideration at the hospital, and so then my work by necessity focuses on turning the ship around so that there is a better chance of the mom meeting her breastfeeding goals. This blog will focus on best practices for breastfeeding success. Here is what the first 48-hours of a breastfeeding mom should look like:
Breastfeeding should ideally start soon after your baby is born. A breastfeeding-friendly hospital encourages breastfeeding immediately after the birth since the baby is usually alert and will spontaneously seek the breast within an hour or so if left undisturbed on their mother’s abdomen. This may need to occur before the baby is weighed, bathed and dressed, since skin-to-skin contact with their mother’s body is best for baby. Breastfeeding within the first hour or so after birth is important because it increases the mother’s confidence that she can actually breastfeed! The bond between mother and baby is enhanced, and important immunity is transferred through the colostrum (the first breastmilk which provides protection against infection and disease). Interestingly, indications have been presented that the baby’s sucking difficulties may be avoided if the baby feeds properly at this stage.
When the above is not possible for any variety of reasons, skin-to-skin contact between mother and baby that allows “getting-to-know-you” time can occur later, prior to breastfeeds. In the case of a caesarean section, this first breastfeed may occur either in the operating room while mom is being stitched up, or when this is not possible, in the recovery room as soon as possible after delivery.
Let your doctor know ahead of time that you will want to meet with a lactation consultant as soon as possible after the birth. Breastfeeding may be “natural”, but that does not mean it is “easy”! If your baby will not latch on, and the lactation consultant has not visited yet, try expressing the colostrum directly into your baby’s mouth or give it by teaspoon or cup. This may stimulate your baby to seek the breast. Continue with lots of skin-to-skin contact, and even stroke your baby gently on the abdomen and legs to help wake your baby to seek the breast. Your baby may be very sleepy for the next 24 hours, this is normal. Keep waking your baby at least every 3-4 hours for a feeding using the above strategy (skin-to-skin, stroking). Avoid bottles in the early days until baby’s latch is established. This will promote strong sucking, which is essential for milk production. (In the future I will be blogging about tips to help ensure a good latch is established).
Consult with your lactation consultant about offering pacifiers before latch is established. It is generally considered wise to wait until baby’s latch is established, to avoid “nipple confusion”; however, I have worked with lactation consultants who instead refer to “flow confusion” as the problem. Babies need to suck so if you are not able or willing to have your baby suckle at your breast for comfort another nipple may need to be introduced. Another option that moms or dads can do is to offer a clean finger, nail side down against the tongue. Make sure the pad of the finger is resting on the roof of baby’s mouth as this will deliver the comfort baby is seeking. You will know you are doing it right if your baby becomes soothed.
It has been reported that only one in three women reach their breastfeeding goals. The number one reason for failure is lack of proper support. As an expectant mom there are many variables, and many women are confused about how much support they will need. A Postpartum Doula can consult with you about what support, and how much support, may be optimal. I recommend scheduling more coverage than you think you will need, and then deleting what you find is not necessary as time goes on.
Finally, enjoy this precious time of your life! There is nothing quite like having a baby, and infancy only lasts for a short time, so trust your instincts, forgive yourself, relax and call the Doula!
To contact Joanne and learn more about the services she offers call: 215-704-9966. Free consultations are available, and recommended at least 90 days before birth.