By
tanya ⋅ May 16, 2013
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We’re very pleased to share an abridged excerpt from the new book, The Virtual Breastfeeding Culture: Mother-to-Mother Support in the Digital Age, by Lara Audelo.
Have you benefited from the power of online mom-to-mom breastfeeding support? Tamara’s story below is a testament to this power in making breastfeeding work.
Tamara’s Story
Somehow through a mix of my own upbringing and arbitrary standards forced on women to be “better” or “best,” I went into motherhood with expectations that reality slowly crushed, sending me into a chasm of self-doubt. Then people — strangers — reached through the Internet and pulled me out.
It took us seven months to get pregnant for the first time, and after two active, healthy trimesters I experienced preterm labor at 27 weeks. I was rushed to the prenatal intensive care unit and given fluids and medication to stop my contractions. My husband watched the monitor with a stoic face, almost willing the contractions to stop. I remember asking him how big a baby is at 27 weeks, and his answer was, “Not big enough.”
That was the first time my heart swelled with the enormity that is motherhood. I think for most people, it happens the moment their baby is born. For me, that day was my introduction. It was heavy and scary, and I felt like my body was failing to do something that seemed effortless for other women. That prayerful day turned into ten weeks of strict bed rest and tocolysis. The days were long and fear-filled. With nothing but time on my hands, I paged through the bibles of natural birth and breastfeeding. I dog-eared pages on latch and positioning, practiced Kegel exercises, and tried not to focus on my weakening body and spirit.
Early in the morning just past 37 weeks gestation, my water broke. I leaked fluid from ruptured membranes for 12 hours without a single contraction, and as the intravenous Pitocin began to drip, my granola dreams for an un-medicated birth slipped away. I held on tight, almost to a fault, as induced back labor worked against my body, which was so weak after being confined to a hospital bed for the last 10 weeks. I got an epidural and delivered a healthy baby boy, who was placed on my chest smelling of tears and musky clay. Looking back on that moment, it was not joy that I felt; it was relief. His safe arrival was my biggest accomplishment to date.
Within minutes of his birth, I had nurses with blue gloves manipulating my breast into my son’s tiny mouth. I felt clumsy and awkward as he refused to suckle. Over the next two days doctors, nurses, and lactation consultants bustled in and out of our room watching him cry, monitoring his climbing bilirubin, and commenting on his rapid weight loss. I remember one nurse rolling in a hospital-grade breast pump. She hooked me up to two small cups and told me to pump so that I could feed my baby colostrum. I turned up the pump and sat crying over those empty cups until I had abrasions on my areolae. I was given nipple shields, a supplemental nursing system and breast shells. My feelings of failure culminated with my husband finger-feeding our hungry baby formula, doctor’s orders. I had been a mother for less than 48 hours, and already I felt like I had failed him. People were examining me as if I was auditioning to be a mother: watching me struggle with nursing, with sleeping, with balance. I remember once we had our son home, I was trying to bring him to the breast before supplementing with pumped milk, and my mother said, “none of my babies ever cried like that.”…
I felt like both my pregnancy and birth expectations had slipped away, and I refused to give up on nursing. After a particularly frustrating day of trying to get my son to latch followed by finger feeding him milk and pumping every two hours, I posted a Facebook status about how hard it all was. A friend I hadn’t talked to since high school messaged me with her story and offered me help and support. Then another message came in, this time from a college friend, again commiserating with how consuming it all is at first, but encouraging me nonetheless. People I hadn’t talked to in years, even blog comments from people I had never even met–all cheering me on. These women were sharing their stories and encouraging me to nurse my baby.
I found a local La Leche League meeting, and was so embarrassed to attend with a baby who screamed at the breast. I sat through the meeting with my tiny infant in a room full of strangers telling their stories. I was amazed as they shared so many of the same feelings that had kept me so isolated. Meeting after meeting, I watched and shared, and learned not only to breastfeed but to be a mother. I found a weekly Twitter chat on Thursday nights called #bfcafe. Women used this hashtag all week to ask questions and share anecdotal stories and pictures of their breastfeeding journey. The women behind the hashtag–they lifted me up too.
My firstborn latched after 11 weeks and went on to nurse for 25 months, when he self-weaned. Those online messages, La Leche League meetings, Twitter chats, and blog posts got me through eight months of biting, chronic milk blisters, growth spurts, and multiple nursing strikes. At the same time, these strangers, friends, and strangers-turned-friends celebrated a love for nursing. They modeled parenting at the breast and helped me to revel in a motherly confidence that grew with each feeding.
We suffered a miscarriage when my son was a little older than a year, but became pregnant for a third time last Fall. My firstborn weaned half way through my second trimester on his own terms. With this pregnancy, a lot of fear came flooding back surrounding my miscarriage, preterm labor, birth trauma, and nursing difficulties. I read through forums on the La Leche League website, reached out to friends who had a second child, and prepared myself and my body, for birth and breastfeeding. I found a doula, talked to lactation consultants, and shared my fears online. I reached far and wide, and got back nothing but love and support in return.
I birthed my second son naturally in three hours and with only three pushes, in a hospital with the help of my husband and our doula. My body successfully carried a baby to 39 weeks, and I bravely and confidently gave birth to him on my own terms. They say you don’t get a medal for birthing naturally, but you actually get more. I have never felt more powerful, confident, or feminine than I did on that day. I put him to my breast and he nursed without hesitation from his very first feeding. My firstborn made me a mother, and my second child made me an even stronger one. Each time I nurse, I am hit with an instant wave of motherly love and vulnerability that comes with seeing your children grow. In succeeding at this primitive task, I have gained not only two secure and healthy boys, but also a mothering self-efficacy that can never be taken away.
Anyone who knows me knows that I am passionate about being a mother and about nursing my children. I have reached out to friends and strangers. I started sharing my journey through my writing. I shared my struggles, my triumphs, and my love for breastfeeding with the World Wide Web. I gave personal and intimate details of my postpartum anxiety, my birth stories, my miscarriage, and our weaning ceremony. I shared it all unapologetically, not because I am an expert on motherhood, but because I discovered that reading other women’s stories is a vital piece to navigating the journey. I wanted to give back a small portion of what was given to me. I’ve supported, without judgment, women who nursed for six days and women who nursed for six years. I have shared my breastfeeding story over and over until that pain went away, and then I did everything in my power to help other mothers never have to feel the way that I did because I wasn’t alone–and I never failed. I am so grateful to the women who reached out to me, and if I have helped one person nurse one baby during one moment of weakness, I’ve done enough.
We don’t live in an age where upon giving birth, we can be swept underneath a red tent by our elders to learn by example how to nurse, love, and care for our children, but we do live in a time where honest, supportive, and knowledgeable women can be found at any moment of the day or night with just the click of a mouse. Just log onto Twitter while you are feeding an infant, bleary-eyed at 3 a.m.; someone else across the country is staring at her phone doing the exact same thing. The two of you are instantly connected. Reach out and share the journey.
By
tanya ⋅ May 10, 2013
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Not sure how to take Motherlove products* to increase your milk supply? Here are our answers to some common questions:
How much of my Motherlove product should I take?
Liquid Extracts
Under 175 lbs: 1 ml – 4 times per day
Over 175 lbs: 2 mls – 3 times per day
Capsules
Under 175 lbs: 1 capsule 4 times per day
Over 175 lbs: 2 capsules 3 times per day
How should I take this product?
These products can be taken with a small amount (1-2 oz.) of liquid. For maximum effectiveness, avoid drinking liquids 15 minutes before or after each dosage. Drinking more liquids than specified with each use may dilute the herbs in your system.
How long will my Motherlove product last at the suggested amounts?
This depends on dose and body weight. Here is the approximate time each product size will last:
60 caps 10 days – 2 weeks
120 caps 20 days – 4 weeks
2 oz. 10 days – 2 weeks
4 oz. 20 days – 4 weeks
8 oz. 40 days – 8 weeks
How long should I use Motherlove liquid extracts or vegetarian capsules?
Each mother’s needs are different. Some women are able to use these products for a short time to increase their breast milk supply. Other women, once their supply increases to the desired level, are able to decrease the amount or number of doses per day to maintain the desired supply of breast milk. Many women are able to stop taking the product altogether as their bodies are able to maintain an adequate milk supply. Some women may need to use Motherlove’s lactation products the entire time they are nursing to maintain their milk supply. We encourage women to use the amount that best meets their baby’s needs.
When should I expect to see an increase in milk supply?
Most women see an increase in breast milk supply with the More Milk Plus products within 1-2 days. It does take longer – usually 2-3 weeks - to see an effect when taking Goat’s Rue to support mammary tissue development.
What should I do if it is not working?
Be sure you are taking the correct amount for your body weight according to the suggested use on the label, as well as our recommendations above on water consumption. There are certain herbs (including sage, parsley, and peppermint) and medications (such as over-the-counter decongestants) that can lower milk supply. Try to avoid these while breastfeeding. Some lactation consultants also warn that some forms of hormonal birth control may lower breast milk supply. It’s also possible that you would benefit more from a different Motherlove product. As there can be many causes of low milk supply, we recommend working with a lactation consultant to help you with your particular breastfeeding situation.
*Not sure which Motherlove product is right for you? Check out our guide to choosing the right Motherlove product for your needs.
We’re very pleased to share a new podcast interview with Alyssa Schnell, author of Breastfeeding Without Birthing.
Alyssa talked with Tanya about what it’ s like to breastfeed an adopted baby or a baby born via surrogacy. They discussed inducing lactation, latching and attaching, and even the baby’s need to grieve the loss of their birth mother. Alyssa shared her own experience nursing her adopted daughter.
You can listen to this interview using the player below, with Quicktime, or download it from our free iTunes store!
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By
tanya ⋅ April 26, 2013
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Ever heard of power pumping? Some moms swear by it for increasing milk supply.
Power pumping (also called cluster pumping) is pumping in a series of ten minute sessions – ten minutes pumping, ten minutes off – over the course of an hour, one session each day. It’s typically used when mothers experience a temporary dip in supply, not as a means of establishing a new milk supply.
The theory is that power pumping simulates a baby’s behavior during a growth spurt, when they feed more frequently and often in a cluster-like manner. Alone or in combination with other measures to increase supply (more frequent and effective feeding at the breast, use of galactagogues, skin-to-skin, etc.) it may increase milk supply over time. Mothers may find that initially they collect little milk during these sessions, but over time their milk supply will catch up with the increased demand. Moms report that it can take as long as one week to see an increase in supply.
Moms who have low milk supplies are often advised to pump after each feeding for the same purpose, but many find the routine of feed-pump-feed-pump around the clock to be unworkable. One nice thing about power pumping is that it can be done at any time – including when the baby is sleeping. So some moms power pump during naps, and some (whose babies are going to bed earlier than they do) pump in the evening after the baby is asleep. Some mothers also power pump several times a day over weekends (described by some as Power Pumping Boot Camp), when care of the baby is shared with a partner.
Pumping is not the most entertaining way to spend an hour, so some moms have gotten creative. This mom described how she synchronized her pumping with a TV show, pumping during commercials and resting during the show. She would also rent a movie and pump during one scene and rest during the next. And here’s a radio strategy: pump during one song, rest during the next!
While there is no research specifically on this practice, some moms report significant increases in milk supply.
By
tanya ⋅ April 2, 2013
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Have you heard the term “food desert?” It means a place where people have poor access to stores selling healthy food. As a result, residents of these communities are hard pressed to eat in a way that supports their health.
Now let’s think about how that term applies to the first food, breastmilk. In order for babies to have access to this all important food, their mothers need access to support for breastfeeding – everything from breastfeeding help to employer support to supportive attitudes about nursing in public.
Kimberly Seals Allers, award winning journalist and author, set out to investigate places where breastfeeding rates are low and infant mortality is high, to see if these places are in fact “first food deserts,” where the support necessary to make breastfeeding possible is lacking.
The result is a project called “Be First Food Friendly.“ Tanya Lieberman spoke with Kimberly about her research and the advocacy work that has resulted from it.
You can listen to this interview with the player below, listen with Quicktime, or download it at our free iTunes store!
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By
tanya ⋅ March 4, 2013
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We know that many of you have had challenging breastfeeding experiences with your first babies. And when it comes time to consider breastfeeding again, it can be a daunting prospect.
That’s why we think you’ll enjoy this podcast with the author of Breastfeeding Take Two: Successful Breastfeeding the Second Time Around. Tanya talked with Stephanie Casemore about the complex emotional experience surrounding breastfeeding after a challenging prior experience.
The author, Stephanie Casemore, also answered some questions on this topic for a post on our blog. It was a popular topic!
You can listen with the player below, with Quicktime, or download it at our free iTunes store!
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By
tanya ⋅ February 25, 2013
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Note: If you’re an African American nursing mom living anywhere in the country and interested in donating breastmilk for this research, please contact Beth Punska at (413) 545-0813, or email her at epunska@vasci.umass.edu. More information is also at the study website.
If you’re not nursing, please consider joining the Love/Avon Army of Women, and select “breast milk study” when asked how you heard about it!
You’ve heard it many times before: breastfeeding and breastmilk gives your baby important nutritional and immunological support.
But could breastmilk hold the keys to preventing and treating breast cancer? And could African American moms’ breastmilk be especially important?
It’s clear that African American women have a different pattern of breast cancer than other women. The U.S. Office on Women’s Health reports, “Research has shown that African-American women are more likely to get a form of breast cancer that spreads more quickly.”
In spite of this difference, black women are also underrepresented in some important research which could get to the bottom of breast cancer risk, prevention, and treatment.
What is this research? It’s being done by Dr. Kathleen Arcaro at the University of Massachusetts, and it uses breastmilk to assess breast cancer risk. We’ll explain.
Breast cells are key in breast cancer research, but they’re really hard to get. You can get a limited number through biopsy or extracting nipple aspirate (ouch!), but neither of these methods sound like much fun to most women. They also have limitations: breast biopsies only yield cells in a very small area of a breast, and nipple aspirate produces very few cells for analysis.
Enter breastmilk. It’s been clear for some time that ductal breast cells naturally slough off into breastmilk. The cells in breastmilk of course come from all ductal areas of the breast, and they’re plentiful – an average of 30,000 per milliliter.
Until very recently the presence of these cells in milk was only an interesting footnote in the literature. But with the advent of DNA analysis, scientists can now extract DNA from these cells and look for patterns of “methylation” – methyl groups that attach to key parts of our DNA which are thought to regulate its functioning in important ways.
For example, if a methyl group attaches to your tumor suppressor genes, it can essentially turn them off – kind of like you would a light switch. This leaves us more vulnerable to the growth of tumors. In a cancer-prone area of our bodies like the breast, their function is critical.
Knowing this, Dr. Arcaro began looking for breastmilk donations about ten years ago. Spreading the word through lactation consultants and others (and occasionally stopping a mother on the street), she found many mothers enthusiastic to donate their milk in the name of breast cancer research. Many viewed their milk donation as a way of fighting the disease which had taken the health and sometimes lives of friends and family members.
Dr. Arcaro’s research has already yielded some important results. She has found that certain patterns of methylation are correlated with a higher risk of breast cancer. These findings may pave the way for a personalized breast cancer risk profile for each woman. It also may lead to new treatments to reverse methylation and prevent breast cancer. Amazingly, some of the first generation chemotherapy drugs are in fact “anti-methylating” agents – drugs which can actually remove methyl groups from your DNA, allowing your DNA to function properly in the fight against cancer.
But Dr. Arcaro has a problem: the vast majority of her samples have come from white women. Her goal is to uncover findings that apply to all women. To ensure her findings applicable to women of all races – and because the differences in breast cancer between races needs to be investigated in its own right – she has been working to recruit African American women to donate breastmilk samples.
African American moms can play an important part by donating your own milk for this effort. It’s easy, quick, and makes a big difference! Dr. Arcaro’s lab sends moms a kit, a questionnaire and consent form, and moms send it back with their milk. They’ll send participants $25 in thanks for their time and effort.
For African American who are not nursing, Dr. Arcaro still needs help! She’s urging participation in the Love/Avon Army of Women – a project aiming to recruit one million women to sign up to participate in breast cancer research (if they choose to do so). Having African American women well represented in the breast cancer research is key, for her research and many others.’ So Dr. Arcaro hopes women will sign up for the Army of Women (and be sure to select “breast milk study” in the drop down menu to help track the impact).
Dr. Arcaro’s lab is one of the few in the world which is consistently investigating the secrets breastmilk holds for our understanding of breast cancer. You can learn more about Dr. Arcaro’s work, and see if you or mothers you know might qualify for one of her studies, at the website of the UMass Breastmilk Lab, and follow the lab on Facebook, Twitter, and Pinterest.
By
tanya ⋅ December 31, 2012
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Breastfeeding made the news quite a bit in 2012. And this year also saw a number of advances in support for breastfeeding moms. Here is our round up of the year’s highlights!
Federal pumping law upheld. The Affordable Health Care Act contained some important advances for nursing moms, and these were in jeopardy due to court challenges to the law. The Supreme Court upheld the law this summer, letting stand the requirements that many employers accommodate nursing moms wishing to pump at work. The law was also the basis of the mandate that insurance companies cover, at no charge, breastfeeding support and pump rentals, starting in August of this year.
Time Magazine features a 3-year-old breastfeeding on its cover. Setting off a furious debate, Time Magazine featured a photo of California mom Jamie Lynne Grumet nursing her 3-year-old son Aram as part of its story on attachment parenting. For more on extended (or “long term,” or “full term”) breastfeeding, see our podcast interview with the author of Breastfeeding Older Children.
American Academy of Pediatrics (AAP) adopts stronger breastfeeding policy. Calling it a matter of public health, not a lifestyle choice, the AAP published its revised breastfeeding policy. Among the highlights: exclusive breastfeeding is recommended for 6 months (not 4-6 months as previously written), the Ten Steps to Successful Breastfeeding (the foundation of the Baby Friendly Hospital Initiative) are endorsed, and the WHO growth charts are promoted.
Photos soldiers breastfeeding in uniform highlight challenges of military moms. While photos of two mothers nursing in Air Force uniforms was deemed inappropriate conduct by the military, they succeeded in raising awareness of military mothers’ breastfeeding challenges. One of the mothers explained: “I’m proud to be wearing a uniform while breastfeeding. I’m proud of the photo and I hope it encourages other women to know they can breastfeed whether they’re active duty, guard or civilian.” For more on this topic, see our podcast interview with the author of Breastfeeding in Combat Boots!
Breastfeeding rates have largest jump in a decade. The CDC reported this year that rates of breastfeeding initiation and breastfeeding at 6 and 12 months rose by about 2 percent. Breastfeeding initiation increased from 74.6% in 2008 to 76.9% in 2009 births, representing the largest annual increase over the previous decade.
Beyonce breastfeeds baby Blue, and breastfeeding has its first celebrity event. Beyonce won the hearts of nursing mothers everywhere when she breastfed in public and encouraged other moms to do it. Breastfeeding had its first celebrity event promoting breastfeeding and toxin-free living this spring, with hosts Kelly Preston, Laila Ali, and Jenna Elfman. See our 2012 celebrity round-up for more!
Baby Friendly hospitals on the rise. According to the CDC, the number of Baby Friendly Hospitals in the U.S. tripled, and thanks to a CDC grant program, and many other initiatives ranging from Mayor Bloomberg’s in New York City to Kaiser Permanente’s in California, there are many, many hospitals in the Baby Friendly queue.
Facebook continues to ban breastfeeding photos. The latest issue in the long standing problem of Facebook deleting breastfeeding pictures belonged to The Feminist Breeder, whose account was suspended when she posted a picture of her daughter taking a break from nursing and swiping a piece of bacon from her plate. It violated no Facebook standards, and her account was later reinstated, but it highlighted this problem once again. For more on this issue see our podcast interview on Facebook vs. The Leaky Boob!
Joint Commission to hold large hospitals accountable for exclusive breastfeeding rates. Here’s a late breaking piece of good news: the Joint Commission will soon be requiring large hospitals to report on their exclusive breastfeeding rates. Not sure why that’s a big deal? Check out this post!
California passes first breastfeeding employment discrimination law. In September, Governor Jerry Brown signed AB 2386 (Allen) which prohibits discrimination in employment and housing on the basis of breastfeeding or conditions related to it (pumping at work, for example). For more on this complex subject see our podcast interview on the topic!
By
tanya ⋅ December 12, 2012
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If you’ve had shoulder, wrist, back or other muscle pain while breastfeeding, you’re probably not alone.
Breastfeeding (as well as bottle feeding) requires that we log lots of hours in one or more position, and if those positions set us up for pain we’re sure to feel it!
We asked, Debbie Roberts, an occupational therapist and author of “Preventing Musculoskeletal Pain in Mothers,” in a recent edition of Clinical Lactation, to describe some of the more common positions which cause nursing moms pain, and what they can do about it.*
What are the most common areas where nursing moms may end up with musculoskeletal pain?
Nursing moms may be predisposed to develop musculoskeletal pain in their neck, shoulders, forearms, wrist and low back. Pregnancy and the postpartum period place unique strains on a woman’s body. Some of these stressors are related to physiologic changes and others are related to new child care demands. Picture how pregnancy changes a woman’s posture: abdominal and pelvic floor muscles tend to get overstretched and weak, while anterior shoulder muscles, lumbar paraspinals and hip flexors tend to get short and tight. As a result, a postpartum woman may have a tendency to sit, walk or nurse in a slightly kyphotic posture ( picture her neck, upper back and shoulders flexed forward, or rounded). A kyphotic [hunched upper back] posture can lead to neck, shoulder and low back pain. Postpartum women may also be predisposed to joint pain due to ligament laxity (ligaments that surround and support joints may be overstretched and weak). Sleep deprivation and pre-existing medical conditions can also pre-dispose nursing moms towards having musculoskeletal pain. For example, hypothyroidism may predispose a postpartum woman towards developing carpal tunnel syndrome.
What are some ergonomic principles nursing moms should know?
Ergonomics is a big topic but a few important ideas can be summarized as follows:
First: neutral positioning for spine and joints refers to a balanced, comfortable position that avoids musculoskeletal strain. This may vary slightly between individuals.
Second – conserve your energy and rest before you get too tired. Standing uses more energy than sitting. A neutral spine position may feel more restful.
Third – protect your joints – avoid bending or using your wrist in awkward positions (especially when carrying something heavy or for an extended period of time); protect your low back – avoid bending at the waist with straight legs. If you must carry something heavy, keep the object close to your body and keep your forearms/wrist straight.
Picture the amount of joint stress that a mom would experience if she tried to carry a gallon of milk and a heavy grocery bag with one hand and an infant strapped in a carrier with the other hand. Ouch! This would really strain her wrists, forearms, fingers, shoulders and back. To protect the joints in her hands, Mom should make multiple trips and should take the baby out of the heavy carrier. Now picture Mom, leaning forward to nurse. She’s likely in a slightly kyphotic position, with the baby’s heavy head resting in the web space of her hand. This position puts stress on the mom’s neck, back, shoulders, forearms, wrist and fingers. In contrast, imagine how mom’s posture changes if she’s sitting in a semi-reclined position and brings the baby up to her breast or if she brings the baby up to her breast. When semi-reclined or lying on her side, a nursing mom is more likely to have her spine, forearms and wrist in a relaxed, neutral position.
Some moms end up with carpal tunnel pain. What would you suggest they do to relieve this pain?
Carpal tunnel pain is due to entrapment of the median nerve in the carpal tunnel. Symptoms of carpal tunnel syndrome may include numbness, pain, sensory changes and loss of grip strength in the hand. First, it’s important for the mom to see her primary care provider. She needs to have a diagnosis and plan of care to accurately treat her symptoms and to ensure that she gets long-term follow-up. Her primary care provider may in turn recommend an occupational therapy or hand therapy consult. Under the care of an MD and therapist, treatment options may include: using NSAIDs (non-steroidal-anti-inflammatoy-drugs) for short-term pain management; use of a custom-made hand splint; home exercise and stretching program; and recommendations for modifying specific activities in the “mom’s” daily routine.
In the meantime, a mom who is experiencing carpal tunnel should avoid prolonged, extreme wrist positions, especially if it involves gripping an object tightly. And get plenty of rest. If a mother finds it too painful to hold her baby with her forearms, laid-back or side-lying positions may provide some relief.
* This post is provided for educational purposes and is not intended as medical advice. If you are are experiencing musculoskeletal pain – especially if it is negatively impacting sleep, daily activities and/or mood – please discuss it with your primary care provider.
By
tanya ⋅ November 26, 2012
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Did you have IV fluids during your labor and birth? Did your baby lose a lot of weight in the early days of breastfeeding? Did your ankles look more like cankles?
A growing body of research is making connections between these things, and it’s important that moms understand these connections for ourselves.
Getting IV fluids during labor is quite common. Why? For epidurals, for labor induction or augmentation, for a cesarean section, and for group b strep antibiotics, even for exhaustion. Many women get fluids for several of these reasons, adding up to a remarkable amount by the time the baby arrives.
What happens next is the subject of a number of recent studies:
- A 2010 study found“intrapartum fluid administration can cause fetal volume expansion and greater fluid loss after birth.”
- A 2011 study found that “timing and amounts of maternal IV fluids appear correlated to neonatal output and newborn weight loss.”
- And a 2012 study found that “maternal average IV ml per hour positively correlated with infant maximum weight loss.”
What these studies have found is something that some providers have suspected for some time: having lots of fluid on board at birth can make a baby look like she’s losing too much weight. In other words, some babies are born with extra fluid because of all of the fluids their mothers have received. Their birth weights are inflated by this fluid, and when they shed it they may appear to be losing too much weight.
When babies’ birth weights are inflated by excess fluid, they are at greater risk of the interventions that come with large weight loss: supplementation, and in some cases low milk supply and eventual early weaning. It’s significant enough that one of the above studies concludes that babies’ birth weights should be considered their weights at 24 hours in order to avoid this inflation and resulting breastfeeding problems.
There are other breastfeeding problems which result from large amounts of IV fluids given in labor: breast edema and delayed milk coming in.
When you’ve had a lot of IV fluids in labor, the fluid can collect in certain areas, including your breasts. This fluid retention is called edema, and while it may be mistaken for engorgement, it’s quite different. It can be very painful, and make it quite difficult for your baby to latch on and remove milk. When milk isn’t removed, over time it can result in milk production problems. Fortunately, there is something you can do to relieve breast edema and make it easier for the baby to latch on: reverse pressure softening.
Having lots of fluid in labor is also a risk factor for your milk coming in late. This can lead to other problems, like your baby becoming very sleepy, jaundice, poor feeding, supplementation, and later low supply. That’s why milk coming in late is associated with early weaning.
What can you do to avoid getting a lot of fluids in labor? Plan for a breastfeeding-friendly birth, with providers who have a good track record of low-intervention births, good labor support, use of non-pharmacological pain relief methods, ability to move around, and other factors associated with low-intervention births. And if you run into any of the above problems, be sure to seek help from a qualified breastfeeding support person.
Did you have IV fluids during your labor and birth? Did your baby lose a lot of weight in the early days of breastfeeding? Did your ankles look more like cankles?
