To feed or not to feed the baby, and with what? while also trying to support breastfeeding?

I believe there are 4 vitally important rules to follow in regards to breastfeeding an infant

specifically in the first month after delivery!

~I believe in a balanced approach to breastfeeding. The approach needs to make sense for the mother and her family at that particular time in their lives. I will always do my best to support a mother in her breastfeeding goals; however, I feel obligated to remind her of the different dynamic she must be willing to work with. For example; a young 25 year old Mother with a 3 year old, 14 month old twins and a newborn...all in diapers, with little family support, and very limited support from father of this new baby (who has to return to work shortly after baby is delivered) This mom has little time or energy to sit for hours with a newborn, working on breastfeeding....she is chasing, feeding, helping, cleaning and protecting 3 other small children!

~I believe that breastfeeding should be an enjoyable experience for BOTH mom and baby! Although breastfeeding is definitely not easy, especially in the first 2 weeks, if mom feels resentment or a feels like she is not enjoying the baby, then she is not experiencing the "goal" of breastfeeding. Feeling stressed and angst with every feeding does not serve the mother, nor her infant. This may be a case for exclusive pumping and bottle feeding, or to just move to formula feeding if it feels right to the mother. I support her decision either way, and I know that her worth as a woman and mother have absolutely nothing to do with how she feeds her baby!

~I believe that there are times when we really need to feed a baby due to a medical issue such as low blood sugar levels. Be open to using whatever is the best option you have available at the time; Expressed colostrum or breast milk, spoon feeding, in a tube and syringe via finger feeding, or at the breast. The feeding may even need to be given in a bottle. Donated pasteurized human milk (PHM), again in the above mentioned mechanisms, or even formula, in the above described ways. (Keep in mind that spoon feeding, finger feeding, should be considered a short term solution to the breastfeeding difficulties.) Late preterm, preterm, large for gestational age, small for gestational age, mother of a gestational or type I diabetic... any of these conditions may lead to hypoglycemia or low blood sugar levels.

~I believed that if mother fails to #2 protect her milk supply by pumping after any supplementation can cause this exact "tailspin" scenario graphic shown below (credit to www.bostonbreastfeeding.com) can happen if a mother supplements with formula, but her breast milk is left in her breasts. This sends the mother's body a message "Don't worry about making more milk, I don't need it." Ultimately supplementing without protecting your milk supply by pumping after every supplementation will eventually lead to low milk production. It may also lead the baby to expect and to prefer the easier flow of passive feeding on a bottle, rather than the effort it takes to actively feed from his mother's breast.

I must admit, I feel frustration when the RN reports that a mother who although was previously breastfeeding well, sent baby to the nursery to be bottle fed all night. Now she wants the LC to come in and help the baby go back to breastfeeding...and sometimes infants really do it! It is important to understand that there is a significant differences between bottle milk flow and breast milk flow. In most cases, I see babies who have developed "flow preference" rather than "nipple confusion"

#3 rule is to Seek the RIGHT help. If you are seeking help from an IBCLC, and you go away from the appointment not knowing what you are going to do, or feeling like it was not helpful at all, then you need to find a more experienced IBCLC. Not all lactation consultants are created equally! Some have more education and experience with conditions like "tethered oral tissues" (tongue tie, lip tie, etc.) or physical restrictions that require more than just the IBCLC alone. There are many private mother's groups on Facebook based in your area, that can help guide you to the RIGHT help! Get the RIGHT help sooner rather than later! The reality is that in the hospital (as excellent as their IBCLC's can be) they usually don't have the time to spend or the right knowledge that both mother and consultant need or want to be able to give.

#4 rule is to seek balance and keep trying. Give yourself realistic goals to work toward. Be patient, be compassionate with yourself first and foremost! If you need a break from trying to latch a newborn who is actively resisting the latch, then take it! Pump instead of latching with a good breast pump to keep your supply going. As long as you have fed the baby well (by whatever means, and protected your milk supply, you will still have time and options!)

Remember! You are NOT a bad mom if you feel that your baby is not getting enough, and you choose give a bottle of expressed colostrum, PHM, or formula. Or if he/she has a medical indication that requires extra supplementation. At the same time, if your mother's intuition that says, "the baby is feeding well." Listen...If a medical professional is encouraging you to supplement, always ask why? Weight loss? Hyperbilirubinemia? Low blood glucose levels? Other risk factors discussed above?

So to review the Three Golden Breastfeeding Rules:

#1 Feed the Baby!

#2 Protect your milk supply!

#3 Seek the RIGHT help...early and often!

#4 Seek balance, and Keep working with the baby.

You will find the names of private practice IBCLC's HERE