- Don’t believe that breastfeeding is supposed to hurt and that sore nipples are what is to be expected. If the baby is latched on to the breast properly breastfeeding should not hurt!
- Do teach your baby to latch onto the breast, not the nipple! When most women that come into my office are letting the baby latch onto the nipple and not the breast itself. (Remember it is called ‘breastfeeding’ and not ‘nipple feeding’).
- Don’t worry about getting your whole areola into the baby’s mouth. Most women are taught to get the whole areola into the baby’s mouth but all women have different size areolas so this is really not the judge of a good latch. With a good latch there usually is some areola showing, and often times lots of areola is showing.
- Do hold your breast steady and compress it into a pointy shape with your hand, (A pointy breast can fit deeper into a baby’s mouth). Be sure to bring the baby to you deeply (not trying to stuff your nipple into the baby’s mouth). Your goal is to get your breast deeply into the baby’s mouth with the nipple touching the S spot (between the baby’s hard and soft palate). Your nipple actually needs to point back into the baby’s throat.
- Don’t get discouraged. If your latch hurts try again. If you allow the baby to nurse in a way that hurts you, your baby will not get the message that he needs to nurse deeper. When a mom and her baby share the experience of being on the breast deeply, with practice, mom will be able to nurse pain free.
- Do get help from a professional lactation consultant if you are in pain, not getting enough soiled diapers, or feel unsure or discouraged. Birth hurts—breastfeeding is not supposed to!
So, you feel it is time to wean your baby and you are wondering what the best way to approach weaning is. A lot depends on the age of your child; babies under the age of six months will usually transition quite easily to the bottle, while older babies will tend to protest. As a babies age, they begin to realize that their relationship with the breast is more than just nutritive; this is when things become a little tricky. Babies are smart, and if they are gaining weight and feeling satisfied, they will most likely protest when their mother tries to offer them a bottle; especially if they see their mom standing there with breasts filled with milk. Before we go into a few methods of weaning, let’s review a few things first.
A baby can nurse from a mother successfully up until four years of age—I understand that this is not the ‘norm’ in our modern society, but the woman’s body will produce healthful milk filled with vitamins and nutrients until the baby is age four. If you decide to wean early, it is important to ask yourself a few questions:
- “Is this what I feel is intuitively correct, or are others influencing me?”
- “Has my baby stopped gaining the weight that she was gaining before?”
- “Am I taking a medication my doctors has told me I cannot continue breastfeeding with?”
(Dr. Thomas Hale has a book that discusses which medications are safe while you are breastfeeding and unfortunately most doctors do not know this information).
Let’s also discuss some of the common reasons that women rely on when they wean prematurely and unnecessarily:
- You are going back to work– If you are going back to work you do not need to wean. In this case, the first mistaken thought is that the breast-pump must replace the breast if mom is going to be free for the work-place. And since many women are not successful with pumping milk from their breasts, they feel that if they are going back to work full-time, they have to quit nursing altogether. [It is important to note that one reason why women do not pump well, even though they often have an ample supply of breast milk, is because there are only a few flange sizes available for breast pumps, and often women cannot find the proper flange size that fits their particular shaped breasts.] However, if a woman has established her breastfeeding properly, and the baby is thriving on the breast; she does not have to quit nursing if she cannot pump successfully for work, or at work. When it is time to go back to work, you can still continue breastfeeding in the mornings before work, when you come home from work, and during the night. Even if you do not pump during your working hours, your body will still produce enough milk during the time you have provided for nursing your baby. And if you want to, you can nurse exclusively on the weekends, because the breast does not ‘store’ milk from feed to feed, rather it is made immediately as the baby compresses the breast. Fresh milk is produced as the baby is suckling, so you can still produce milk on your days off.
- Pregnancy– You do not have to wean if you become pregnant. Most woman can breastfeed after they become pregnant. If your body is still producing milk, you can nurse all the way through your pregnancy. Your body can safely produce milk for the baby and also leave enough nutrients for the growing fetus. While some women’s first sign of pregnancy is either decreased milk supply or intense nipple pain—that is not caused by yeast infection, if you do not have either one of these challenges, then you can continue breastfeeding without complications. However, I do suggest that women stop breastfeeding by the seventh month of the pregnancy, in order to give the older infant a chance to find other comforts, and to avoid jealousy with the new baby. In general, I personally do not think that tandem nursing is the best choice. I feel that the dynamic and intimate relationship you have with a baby is a special time that helps the child develop properly and builds self-confidence. In contrast, I have found in my practice that the older infant tends to use the breastfeeding manipulatively and uses the breast as a way of getting attention from the mother, which allows for increased jealousy toward the new baby!
- Baby has teeth-If your baby has teeth you do not have to wean. Most babies will learn very quickly how to nurse with their new teeth, without hurting their mothers. If your baby is biting you and using you as a teething ring, the best way to handle this problem is to look into your baby’s eyes, when she bites you, and say firmly, ”No biting”. Next, put your baby down safely—on a blanket on the floor, or in a baby seat—and walk out of the room for a moment. Then walk back into the room, pick up the baby and while looking into the baby’s eyes state that biting hurts you; then continue nursing the baby. Babies are very smart and will learn quickly that biting you while nursing is not part of your relationship. Unfortunately, the usual pattern of events and reactions are: when baby bites mom, mom screams in pain, which draws a shocked look on a baby’s face—a look of confusion, which mother attempts to sooth with a kiss. However, mom’s loving approach only reinforces the bad behavior, rather than shut it down. Consider too that a mom’s scream can be accompanied by a funny or oddly contorted face, which often makes a baby laugh, and which now establishes the pattern of: yell, funny face, laugh and kiss—which baby looks forward to repeating! Therefore, the best way to stop the biting from becoming a habit is to stop the behavior quickly after the first bite. And know that kissing your baby after a bite is inappropriate, and only reinforces the wrong message.
Given the possibilities for continued breastfeeding, it is important to speak with a qualified lactation consultant, to help find other potential solutions to your problem; besides the weaning option. But if you really feel you must wean, let’s go over a few rules, because you will need to cut down slowly, since you are producing more milk than you think.
- Cut down to two feeds a day.
- When you are down to two feeds a day, use ice and cabbage to reduce the swelling in your breasts.
- Ice your breasts six times a day for ten minutes intervals.
- Wear cabbage in your bra throughout the day. Using green cabbage, crunch and break the leaves in your hand, and place them against your skin, inside of your bra. Wear the leaves until the smell of cabbage gets to you.
- Don’t just take away breastfeeding suddenly. Change is difficult for most people, including your baby. Make sure to speak with your infant, no matter how old the baby is, explaining the process that you and she are going through. All of us would like clear explanations of the changes in our lives.
- After you have reduced the nursing to one feed a day, put an herb or oil on the nipple area that changes the taste of the milk, preferably to one that the baby will not like. This is not cruel. In this way, the child makes a decision, on her own, to stop that final daily nursing session. If a child is well loved and taken care of, then it is best for the child to make that final choice, rather than have mom take it away from her. This is a universal method that is employed in many cultures.
- Some suggested nipple applications are olive oil with a little black pepper or aloe vera.
Weaning your baby is often difficult for both the mother and the baby. Sometimes weaning is the best choice for the mother, sometimes it is the best choice for the baby. Just make sure you are weaning for the right reason; instead of weaning from misinformation.
If you give birth to a premature baby you can breastfeed, even if your baby spent time in the NICU and was given bottles. It may take some time for you and your baby to master the skill of breastfeeding but with some patience and, most importantly, proper guidance you can be successful. In fact, the prevailing thought is that breast-milk is even more important for premature babies than it is for full-term babies, because the nutrients in breast-milk will help the internal organs, which did not have as much time to form without the full nine months of gestation, develop to their fullest potential. The other vital component, that is just as important as nutrients are for the baby, is the act of the mother touching and caressing her child. Breastfeeding moms, who normally nurse their babies at least eight times a day, end up touching their babies more often than formula feed babies are touched. It is not that bottle-feeding mothers do not want to touch their babies; however, once the breastfeeding baby is properly latched onto the breast, these moms tend to stroke their babies throughout the nursing event. This motherly nurturing in turn helps stimulate proper growth.
Researcher Dr. Schanberg, from Duke University, found in his extensive research with animals that, “when mother rats licked their babies, the action produced a cascade of much needed compounds, in fact, the growth hormones that produce normal body development. Remove the mother—(but keep giving the rats the needed nutrients), remove the touch of her tongue, and the baby rats became stunted beings.” Furthermore, he states that this need for touch also transfers to humans, especially premature babies, and that encouraging the mother to touch and hold her baby, “led to better health and shorter hospital stays.” Ashley Montagu writes in his book called Touching, The Human Significance of the Skin that, “gestation in the human being continues for as long outside the womb as it does inside the womb and places the end of gestation at the age at child a child begins to crawl on all fours, about nine months old”. He also states “that touching and coddling a baby is needed all the time to help build the child’s immune system and their emotional health”.
Not to understate the importance of nursing a premature baby, below are some guidelines and suggestions for breastfeeding premature (premie) babies:
- Premies have smaller mouths so it is imperative that you latch your baby onto your breast as deeply as possible. If the premie is not on the breast deeply enough, it is impossible for the baby‘s tongue to reach the mother’s milk cavities that are located deep within the breast.
- Almost all of the premies that I have treated required breast compression in order to keep up the proper nursing rhythm on the breast.
- Although I am a fan of nursing on only one breast during a feed with a term-baby, I encourage moms to use both breasts during a single feed with premies.
- Often premies do best when a mother uses a nipple shield, (even if the mother has protruding nipples). It appears that these small critters like to experience a firm shape in their mouths.
- Some premies who are having endurance problems—an inability to stay awake on the breast, will require the use of an SNS (supplemental nursing system) in order to breastfeed.
- If your child has nipple confusion as a result of feeding from bottles in the NICU, finger-feeding for a few days will teach the baby how to eat with a flat tongue, which will allow transfer back onto the breast.
- If your baby is taking the breast, but is not putting on enough weight, the recommended procedure is to nurse the baby for 20 minutes, followed by 20 minutes of finger feeding.
- Premature babies can fall asleep very easily on the breast, so it is important to watch carefully and listen for swallowing during nursing. If the baby appears to be drifting off, take the baby off the breast before the sleep becomes too deep and reawakening becomes increasingly difficult.
- Although all babies are different, I have recognized two distinct nursing patterns used by premies. The first pattern is employed by those babies who need to eat uninterrupted for twenty minutes with lots of breast compressions. Secondly the ones who need to eat for 5-7 minutes, need to be burped, then again for 5-7 minutes burped and again a third time.
- Most moms are not warned about the ‘premie-grunt,’ it is a grunting nose that is not a sign of danger but a sound these children make in between their times of nursing. It is a deep guttural sound that leaves as the child grow.
- If you feel frustrated with your new “little-package” get help from a lactation consultant, from my experience, these little guys become great nursers when given the proper guidance.
Most women can provide enough milk for their baby, so the concept of “low milk supply” is often a misunderstanding of what is really going on. When women come into my office complaining of low milk supply, they usually are not managing their breastfeeding properly, latching incorrectly or have a baby with a suckling disorder. I would venture to say, that, if the breastfeeding is being managed correctly (meaning, not putting the baby on a schedule), and the woman still feels she does not have enough milk; it is usually the baby is that is having an issue and not the mother. Women who have babies with suckling disorders are often confused—feeling that they are doing everything correctly. They ‘feel’ that the baby is latched on properly, and they ‘believe’ the baby is taking in milk, but they are shocked when the baby is weighed before and after nursing, and the digital scale which can tell how much the baby is taking in, barely moves. If the problem is with the baby’s latch or the baby’s suckle, most proficient lactation consultants can teach the woman how to fix these problems.
In rare cases, when it truly is the mother with the problem, it would tend to be from one of the following conditions:
- Insufficient glandular tissue
- Retained placenta
- Thyroid problems
- Hashimoto’s thyroid inflammation
- Sheehan syndrome
I will now briefly discuss the above conditions to clarify what they mean.
Insufficient glandular tissue is a condition in which the straw-like tubes in the breast that carry the milk, called ducts, never grew properly during adolescence. This means that the breasts were never properly formed, and even with the use of herbs and supplements, excess pumping, or in the event that it were possible to place the baby on the breast 24/7, this woman will never produce more milk—this is a true breast condition. And here are a few very clear signs to help identify insufficient glandular tissue: the breasts are asymmetrical—although all women have slightly different shaped breasts, here one breast is noticeably larger or different than the other in shape and size; the breasts are situated so widely apart on the body, that the woman does not have a cleavage; and occasionally the breasts can be triangular in shape and pointing downward, or tubular in shape; the breasts do not grow or change shape very much during pregnancy, as would be expected, and they do not appear to fill up with milk on the third day post-partum. With this condition the quality of the breastmilk is fine; it is the quantity that is missing. In general, my clients with this breast condition, who choose to breastfeed their babies, will supplement with formula till the child is past one year old, but each case will be different and will require supervision by a professional to make sure that the infant is gaining enough weight.
Retained placenta– Retained placenta means that part of the placenta or fragments of the membranes are left behind in the uterus after delivery. If small fragments of placenta or membrane are retained, the body’s signal to trigger the release of hormones necessary to produce milk will not be properly activated often causing low milk supply. A woman with this condition will usually begin to suddenly bleed very profusely after her bleeding has slowed down. Woman usually get very frightened by this sudden gush of blood, but the good news is that after the body has removed the left over fragments the woman usually will feel a her breasts filling up with milk. Sometimes women with this condition will require a DNC to clean out her uterus.
C-sections– Often a woman after a C-section will not have her milk ‘come-in’ till day five unlike woman with vaginal births who’s milk comes in by day three. I wish women would be informed of this in the hospital after they birth by cesarean section so they can feed their babies in alternative ways (i.e. finger-feeding, spoon or cup feeding) as they are waiting for their milk to ‘come-in.’ Another problem for mom’s who had a C-section is that often these babies spend more time in the nursery and are given a lot of bottles and then suffer from nipple confusion and are not willing or even able to take the breast properly even after the milk has come in.
Low thyroid-Many woman with low thyroid levels will struggle with milk production. Testing for low thyroid levels are controversial because sometimes women’s blood work appears to be within normal range, but when they begin to be treated for hypothyroidism they feel an increase in their breastmilk production. Women who are already taking synthroid during their pregnancies must get their levels checked right after birth because their need for more of less of the medication may change post-partum. If your blood levels appear fine and your baby has been checked by a lactation consultant and the baby is nursing properly and you are still not producing enough milk another way to check your thyroid function is with a basel thermometer. This method of testing is done by taking your Take your temperature every morning when you first wake up, preferably before you move. If your temperature is lower than 98.0 chances are your milk may increase with some thyroid boosting supplements.
Hashimato disease– is an autoimmune disease that affects the thyroid. With this condition the immune system makes antibodies that damage thyroid cells and interfere with their ability to make thyroid hormone. Often for postpartum woman this is a temporary state. Hashimoto’s disease can be hard to diagnose during pregnancy because a normal pregnancy and hashimato often have the same symptoms: weight gain, and fatigue. If you test positive for this condition medications such as levothyroxine work well and often can help the woman begin to produce breastmilk. For more information on this condition you can contact womenshealth.gov.
Sheehan syndrome- happens after the woman has lost a lot of blood after the birth of her baby. Blood loss that exceeds the normal range for vaginal birth (up to 500 cc) or cesarean birth (up to 1,000 cc) can place a mother at risk for low milk supply. This condition is rare, but often overlooked by the medical profession. This amount of blood lose can stop her pituitary gland to stop functioning normally. It’s the pituitary job to secrete the milk making hormones. Often this is only a temporary condition and with this condition it is important to set up a pumping schedule, eating a lot of healthy foods and vegetables and working with a professional. Other signs of Sheehan syndrome besides low milk supply often are: low blood pressure, hypoglycemia, weakness and dizziness, hoarse voice, joint pain, abdominal pain and Constipation.
Babies don’t need to eat solids until they have from four to eight teeth, or until they can sit up and support themselves in a high chair, and manage to get more food into their mouths, by themselves, than they do in their hair or on the floor. The precise age for this varies greatly from family to family. But don’t confuse the need for oral discovery, with hunger. Babies become very orally excited from between five to nine months. Perhaps as an extension of an innate and basic survival mechanism, all humans in their first year of life discover the world with their mouths. Infants, when they begin to wiggle, creep and crawl along, sweeping the floors clean with their bodies, begin to taste EVERYTHING. For a baby, a dust bunny is a delight, a piece of newspaper a delicacy, and sticky leftover food droppings a hidden treasure. It is not that they need to fill their tummies with solids or liquids, rather it’s really more about the oral sensation. If a baby is breastfeeding well, not getting sick and is happy, then think of food as a science project. Let your infant explore the world of taste and texture by letting her smell, play and mush all kinds of foods. Give her different colors and textures to play with. Rather than push quantities of food into their little tummies that most babies don’t require, allow their inquisitive scientific minds develop. Breast milk changes as the child grows, keeping up with the nutritional needs of the baby, so why the rush into solid foods? Your breast milk is as nutritious for a ten month old as it was for a two week old.
- Don’t rush the introduction of solid foods. Babies don’t need to eat solids until they have from four to eight teeth, or until they can sit up and support themselves in a high chair, and manage to get more food into their mouths, by themselves, than they do in their hair or on the floor
- Don’t confuse the need for oral discovery, with hunger. Babies become very orally excited from between five to nine months.
- Do let your infant explore the world of taste and texture by letting her smell, play and mush all kinds of foods. Give her different colors and textures to play with. Rather than push quantities of food into their little tummies that most babies don’t require, allow their inquisitive scientific minds develop.
Do be aware that breast milk changes as the child grows, keeping up with the nutritional needs of the baby, so why the rush into solid foods? Your breast milk is as nutritious for a ten month old as it was for a two week old.
Here is a question my clients often ask:
Do nursing babies need to drink the same amount at each feed just like formula babies do?
When a baby is nursing, rather than being bottle-fed, the baby will take in a different amount of liquid at each feed. In a twenty-four hour period, a baby needs to take in a certain amount of total ounces and a certain amount of total calories in order to thrive, but a nursing baby will take in a different amount of milk at each individual feed, depending on the infant’s hunger and mood. When an infant is bottle fed, the caregiver will pour the exact amount of formula into a bottle at each feed and expect the baby to drink the entire poured amount. Even if the child turns his head a way, the caregiver will do her best to try to “force” the child to eat the amount in the bottle. With nursing, the mother’s body does not display “ounces”; so the typical, healthy baby is allowed to take in whatever amount he wants and needs. (Babies that are premature or have a suckling disorder will need to have a different protocol to insure that they receive enough milk at each feed.)
So for example, a six week old baby might take in 2.4 ounces at one feed, 3 ounces at the next feed and only 1.8 ounces during the following feed.
So, how do we know if this baby has taken in that ‘certain amount of total ounces and a certain amount of total calories in order to thrive’, that was mentioned earlier? As a general rule, the thing to remember is, “what goes in must come out”; therefore, looking for a content baby and by counting the amount of soiled diapers her baby is producing, a nursing mother can gage how their nursing is going. As long as the baby is producing six to eight wet and dirty diapers in a twenty-four hour period, the nursing mother can stop worrying about “how much the baby is getting” and, with confidence, focus instead on her baby’s happiness (be sure to occasionally monitor periodic growth on a competent digital scale).
Sara Chana Silverstein is a mother of 7 and lives and works in Brooklyn. She is a board certified lactation consultant, classical homeopath, and herbalist. She has helped over 5,000 babies breastfeed and treats chronic ear infections, and other childhood ailments.
Spring and summer are wonderful times of the year, so be happy. You waited months for the change of season, and the nicer weather that it would bring. But that joy can be ruined very quickly if you or your child is smitten with painful and swollen bug bites! Ouch! Bug bites can ruin a fun day at the park, or make us grumpy if we are up all night scratching and itching! Although we are bitten mostly when we are outdoors, those pesky critters somehow make their way into our bedrooms as well. And yet hope in enjoying the finer months of the year is not lost. There are natural bug repellents you can employ, and a wonderful green powder you can use if, unfortunately, you have already been bitten.
Essential oils are great bug repellents when used properly, and my favorite defense against that terrible itch from a bug bite is simple French green clay. The oils are safe for use with children.
There are many essential oils that can be used within the space of children’s bedrooms or sprayed directly on your child’s bedding or clothing, and which can also be used outside where the kids are playing. My favorite bug repellent essential oils are: cedar wood, citronella, eucalyptus, geranium, catnip and lavender. You can combine all of these oils into one jar to make a lovely blend; or you can begin with choosing only two to three oils to begin your blend. You will also need to purchase a diffusor and a spray bottle. The diffusor can be used in your child’s bedroom or outside by where your kids are playing; the spray bottles are used for spraying directly on your child or their clothing. When using a diffusor, make sure it is placed on a high shelf or in an area that your child cannot reach. Place a candle under the diffuser, fill the top with hot water and put between 10-15 drops of the oil into the hot water. The room or area will be filled with bug-repellent smells—pleasant to us humans but repulsive to those nasty insects. To use the spray bottle: fill the bottle with 4oz. (half of a cup) of water and add to it 15-20 drops of the essential oil mixture, shake well and spray on child’s pillowcase, sheets or clothing, or into the child’s hair (avoiding the eyes). In fact, it is a good idea to get into the habit of spraying your children’s clothing during the heavy mosquito outbreaks.
My favorite cure for bug bites is pure French green clay. Often sold as a facial mask, you can purchase green clay at your local health food store or order it on-line. The best way to use pure green clay for bug bites is in the form of a paste; which reduces the inflammation of bug bites and also helps pull the toxic venom out of the skin. To make the paste, put some of the clay into a cup and add a drop or two of water, but don’t add too much water because you want to make a paste that will stick to, and cover over, the bitten area. When you have made the paste into the correct consistency, spread it over the bug bite. When the paste has dried, if the child is still complaining, you can add another layer of the paste over the dried layer. You can continue painting the green clay over the bites, layer upon layer, until your child is no longer bothered by the bite. The green clay will begin to crumble off but don’t worry; it doesn’t stain clothing or bed sheets. Your child may, temporarily, look a little green but this is the best cure I have found for those itchy, painful bug-bites!
Relax and enjoy the summer. Just keep a little bottle of the ‘natural-bug-spray’ with you at all times, when the mosquitos are out, and feel confident that the little buggies won’t bit your precious ones!
I am a classical homeopath having worked with hundreds of children with both typical sore throats and chronic strep throats. There are many natural methods that can bring relief and cure for this problem.
- Take a small spray bottle, fill with filtered water (2oz), add herbs in tincture form (the herb steeped in grain alcohol like: elder berry, cleavers, usnea or echineaca. You can use these herbs in single form, or mix them all together. You can add 25-30 drops of the herb to the water. The child can spray the mixture into their throats 1-4x a day. The child will feel the soothing spray on their sore throat and the herbs will help kill the bacteria or virus that is present.
- Sage honey is another wonderful idea. The plant sage is specific for sore throats. If you want the honey to be more medicinal you can add sage tincture to the honey. Heat honey on stove chill and store in the fridge. Kid’s over age 1 love the taste of honey and kids are more likely to comply if they help you make the honey. Dosage is one tablespoon 2-3x a day.
The homeopathic remedy phytolocca 30c is specific for sore throats. Homeopathy is easy to administer to children. The medicine is given in small pellets that can be dissolved either under the tongue or on-top of the tongue.
Smudging is a wonderful way to help keep bugs away from a barbeque or outside ‘evening activity.’ Smudging is a technique used my people all over the world. Smudging is burning dried herbs and letting the smoke build in the area you want to be in. A smudge stick is a combination of dried herbs that are wrapped together with string. You light the end of it and walk around and let the smoke permeate the area. Bugs and mosquitoes don’t like the smell and stay clear of the area. You can also smudge in your home if mosquitoes have gotten in your house.
Another wonderful tool is to diffuse essential oils in a diffuser in your house or outside. You can also buy a spray bottle and put a half cup of water in the spray bottle and add 30-40 drops of essential oil. You can spray this water mixture on the chairs you are sitting on or directly onto you or your child’s hair or clothing (avoid the eyes). Bugs and mosquitoes are also repelled by the smells of these oils.