Lactation Cookies, Drinks and Galactagogues

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There is NO “magic” food or drink that will increase your supply.  Your breasts make milk based on supply and demand-the more milk removed, the more you make.  Most mothers can and should trust breastfeeding and watch for the cues that baby is getting enough (for more information see this post).  That said, there are mothers that struggle from hormonal issues, PCOS, diabetes, Insufficient Glandular Tissue, and some other issues that can cause low milk supply.  If after you have read the post linked and baby is not gaining weight sufficiently and/or isn’t having 6-8 wet diapers and 3 poopy diapers each day (24 hours) in the first 6 weeks (may have less poopy diapers after 6 weeks possibly) this would be a good time to:

  • Call an IBCLC and have a thorough assessment of baby’s anatomy and your breasts.  Issues can be ruled out and pre-feeding and post-feeding weights can be taken to get a glimpse of how much milk your baby is taking at that particular feeding.  This is just a glimpse and shouldn’t be used to determine absolutely how much milk your baby is removing from your breasts over a full day.  An IBCLC can also check on any possible positioning issues that may be going on-I’ve found with many of my clients very tiny changes can make a huge difference!
  • Pick up Breastfeeding Mother’s Guide to Making More Milk before making any decisions about any extra foods/supplements to take.
  • You may also want to contact your doctor to have prolactin levels checked through some blood work.
  • Finding a cause of the issue is more preferable option because if you’re treating the symptoms rather than the cause you’re just putting a bandage on the problem.

A wise lactation consultant (Christy Jo Hendricks at the GOLD 2016 Lactation Conference) shared a story that really stuck in my mind that I will relay to you now.  We all have that one pair of shoes in our closet.  You know the ones I’m talking about-those ADORABLE pumps that you had to have.  They were a little more than we usually pay for shoes but they were just cute and you had to have them.  You got them home and tried them out for a date or an evening out.  OUCH!  Those adorable pumps aren’t as comfy as you thought there were in the store.  You get home that night and find a blister.  They’re so cute though and a little expensive so you put a bandage on and wear them again the next day to work.  You realize they’re a little too small and they really just don’t feel great on.  Every time you wear them you know you need to wear a bandage.

Closeup of a woman's heel with a blister plaster on

Ultimately, the problem is the fit of the shoes.  Instead of tossing them out and getting a different pair you put a bandage on and keep going though.  Galactagogues work much the same often.

Some mothers do find that certain foods or drinks have boosted their supply.  Some of these work because they’re acting on some type of discrepancy or some mechanism in your body that may need a little extra boost or they’re just helping mama limp along a little (like a bandage).  These are all very individual-Breastfeeding Mother’s Guide to Making More Milk AND working with a knowledgeable IBCLC can help you figure out the possible problem together.  Taking the wrong supplement can actually reduce your supply or cause some serious medical issues (remember that herbs are medicines and just like taking the wrong prescription they can cause some major problems or possibly interfere with medications you are already taking).

A few “lactation boosters” that I have seen throw out a lot online:

  • Blue Gatorade (MUST be blue for some reason)-my guess is that this helps if mom is slightly dehydrated or has imbalanced electrolytes.  Oddly enough, I had issues as a child with “fainting spells” and a neurologist said I had issues keeping my electrolytes balanced.  I wonder if this is somewhat common and this is why it may work for some women, especially a new mom that isn’t able to take as good of care of herself as women in other cultures with laying in periods and lots of help from friends and family from their village.  Other options you could try are coconut water or homemade “laborade” drinks that have less sugar and less sodium.

Sports Drink Set Isolated

  • Lactation cookies/bars/smoothies-these often contain oatmeal, flax seed, and can even have some nuts, brewer’s yeast, and fenugreek (from imitation maple syrup).  Some of these ingredients work on the digestive system or just give a calorie boost.  They are often high in sugar though and can really upset a mom’s system with pre-diabetes (many mothers don’t know that they’re pre-diabetic).  Fenugreek also is known to interfere with some medications as well as cause issues with blood sugar.  If you want to eat a cookie-eat a cookie!  It probably isn’t a good idea for many mothers to eat the 3+ cookies each and every day that many cookie makers recommend.  Instead, try eating oatmeal in the morning or try some of the other digestive system aids mentioned in Breastfeeding Mother’s Guide to Making More Milk.

American style oatmeal rising cookies

  • Lactation Teas-often contain some or all of the following: fenugreek, marshmallow root, nettle leaf, alfalfa leaf, fennel seed, red raspberry leaf, milk thistle, anise seed, or others.  Most of these are considered safe for breastfeeding depending on the source (it’s a good idea to use trusted brands if you chose to use herbal supplements or teas) according to Nursing Mother’s Herbal.  Many of these aren’t in sufficient quantities to really make a difference though or some are contraindicated long term (more than a few weeks)

Some of these may give you a little boost to help you get through a growth spurt along with nursing frequently and following baby’s cues.  They may also help if you need a little extra boost on occasion when you’re pumping if you notice a little supply dip.  They aren’t necessary though, and are just an extra expense that most mother’s can avoid.  Ultimately though, the best way to increase milk supply is to remove milk more frequently.  If you want to eat a cookie or drink a smoothie go for it!  It’s probably not a good idea to have some of these every day without finding a cause for low supply though.  If you genuinely have low supply issues, working with an IBCLC is the first and best thing to do.  If you don’t find the answers you’re seeking, just like with a doctor or other professional you can always seek out a second opinion.

What “lactation boosters” have you heard about or tried?

 

Surviving Growth Spurts

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Growth spurts happen a lot with your baby.  I get a lot of questions about growth spurts and what to expect or symptoms that baby is showing that are very common with growth spurts.  Often, breastfeeding professionals and mother-to-mother support group leaders will refer to these times as “frequency days” or sometimes even “fussy days.”

While a growth spurt can occur at any time they typically occur at about 7-10 days, 2-3 weeks, 4 weeks, 6 weeks, 3 months, 4 months, 6 months, 9 months, and really any other time.  They continue to happen about every 2-3 months through toddlerhood and periodically through to teenage years.  Your baby’s only way to communicate is through crying and baby will often communicate that something is wrong.  Growth spurts can be painful for baby (breast milk has pain relieving properties for babies and the oxytocin released when you breastfeed helps calm you both).  They can just be a confusing time or a time that baby’s brain is growing and not necessarily their body as much.  One nice thing about a growth spurt is if baby is having a fussy day and you’d rather stay home and relax together you can always blame a growth spurt!

Quite often mom will recognize something is different about baby but not quite pin point it to being a growth spurt.  Here are some signs that baby may be having a growth spurt:

  • Baby is nursing more frequently than usual (Do note though that it’s common to have a growth spurt at around 4-6 weeks and this is around the time that mothers will notice their breasts feeling much less full.  This is usually not an indicator that you’re not producing enough milk but this is a concern many mothers have).
  • Baby is fussy even after nursing.
  • Baby seems inconsolable.

While all of these can be signs of other issues, if your baby is gaining weight and has plenty of wet and poopy diapers it is very often a growth spurt.  Another possibility is over-stimulation if the crankiness is happening after being around a lot of new people or things, in the evening, or after being outside for a while.  If baby is about 3-4 months or older it could be teething causing these issues.  More on this in a later post.

Please also remember that your breast milk is usually enough.  If you have any doubts about your supply please be sure to check out this post.  Baby will start nursing more frequently on these days because baby is putting in an order for more milk later.  Imagine that it’s a Friday night and you know you want to have a pizza delivered at 6 PM.  Friday nights are really busy at the pizza delivery restaurant.  If you wait until 5:30 to order they might not be able to deliver or even have a pizza ready for you to pick up until 7 or 8!  Since you’ve probably had that experience before you know that you need to call in earlier so your food arrives when you’re ready for it (and hungry!).  When baby starts nursing more frequently they are phoning in their order for more milk later.

So how do you survive when baby can’t seem to get enough?  Here are some ideas to try:

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A little more about the “nest.”  I help mothers that attend my breastfeeding classes prepare what I call their “nest” before baby arrives so that they can have everything easily at hand whenever baby wants to nurse.  Many mothers find that having everything close at hand (and having a little box or container to carry everything room to room as needed) helps to be able to sit down and nurse comfortably whenever baby shows early cues rather than going through the house to hurry and grab a snack, the remote, water bottle, etc.  By the time all of those items are gathered baby may be crying and harder to get to latch well and begin nursing.

Something else that you may find helpful is to have a good breastfeeding book.  I really love the Womanly Art of Breastfeeding and Breastfeeding Made Simple.  A lot of parents also enjoy The Wonder Weeks because it helps predict when baby may be going through a growth spurt or another developmental leap.  Remember that babies haven’t read the instruction manuals so not every baby follows the books exactly as they’re written but they can be reassuring even still.

One last thing I want to note is on dinner and snacks.  It’s so important to take care of YOU during a growth spurt.  Having easy snacks and maybe an easy meal that you can eat one handed while nursing can be very helpful.  It’s very common for babies to be crankier at night during growth spurts so having dinner taken care of is helpful.  You can always call in a favor to a friend that offered help, have some freezer meals on hand that just need to be heated up or baked, or have some crockpot meals on hand that you just need to throw in the crock pot the day of.  We really enjoyed having a couple of whole chickens in the freezer so we could throw one in our crock pot all day with some baby carrots and some other veggies we had on hand with salt and pepper, garlic powder, onion powder, and whatever other seasonings we had on hand that we like.  It would take me about 5 minutes to throw it all in and I didn’t have to worry about dinner.

I offer breastfeeding and babywearing consultations and classes in Oklahoma City, Yukon, and Mustang.  If you’re interested in learning more, you can visit my website, or contact me.

What do you do to survive growth spurts?

Watch the Baby, Not the Clock

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After my last post, you may wonder if it’s better to watch baby or the clock.  A sleeping baby usually only needs to be woken up if there is special circumstances once they have gained back to birth weight.  Breastfeeding is so very intuitive.  We are very procedural and scientific as a society and we are very concerned about numbers.  This is helpful in some ways, especially to make sure that baby is thriving and not having breastfeeding struggles.  In other ways it sometimes gets in the way of what is normal and natural about the ART that is breastfeeding.

Healthy, full-term babies can tell YOU when they’re hungry.

You should expect that baby will continue to want to nurse 8-12 times per day approximately in the first six months.  Unlike with formula, baby will continue to get approximately the same amount of milk at the breast until baby begins eating solid food.

Feedings will eventually become shorter but still work on supply and demand.  Many mechanisms in our bodies work in cycles.  Breastfeeding is no different.  It’s very normal for milk supply to be higher in the morning and lower in the evenings.  It’s very normal for baby to want to nurse more frequently in the evenings and even to be fussy (more on this in a later post).

Scheduled feedings based on a certain time came because someone took the average of 8-12 feedings per day and decided to break that up on a clock.  Because our bodies (baby’s as well as mom’s) don’t work on a strict schedule but more of a routine, this can cause breastfeeding issues when you limit feedings based on certain times.  Certain baby programs meant to train and discipline babies highly discourage feeding more often than a set amount of time (usually more often than every 2 or 4 hours) and also discourage feedings longer than a specified amount of time (usually 15 or 20 minutes).  All babies are different in their efficiency, breasts are different in how often let-downs occur (where baby gets the majority of the milk in a feeding), and some babies have a stronger sucking need than others.  All people are different.  We all have different appetites.  We all expect meals at a certain time to some degree but if we get hungry most people will have a snack when they start to feel hungry.  If you wake up thirsty during the night you will get up and drink some water rather than say “Only 2 more hours until I’m allowed another sip of water.”  Babies are the same in that regard.  Babies will fall in to a routine eventually and following baby’s cues helps keep breastfeeding going in the most optimal way.

Because we don’t have graduations like a bottle on our breasts and can’t see how much milk baby is actually getting in there are some good indicators to help you know that baby is getting enough.  The most important keys to watch for to be sure that baby is nursing frequently enough and getting enough milk are:

  • Watch for early feeding cues: rooting, smacking/sucking noises, bringing hand to mouth, and in the early days just waking up.  Don’t wait for baby to cry-it will be harder for baby  to latch on and baby may become so tired that they may not nurse as effectively.
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Early feeding cues include bringing hands to mouth and making smacking noises.  This is my daughter when she was just a couple of weeks old.

  • Diaper counts: by the end of the first week expect to see at least 6-8 wet diapers and 3 poopy diapers.  At about 6 weeks baby may have less stools and this is normal.  Some babies may go less than once a day at about 6 weeks and may go as infrequently as once a week or up to 2 weeks and be healthy.  If you have concerns, talk to your baby’s doctor and see a breastfeeding professional.
  • Weight gain: Baby should gain at least 5-7 oz per week after getting back to birth weight.  Baby should be back to birth weight by 10 days, 2 weeks at the latest.
  • When baby finishes a feeding (baby should usually be allowed to finish the feeding by coming off when he/she is finished) his/her hands and body will be more relaxed.  Babies often have fists at the beginning of the feeding and relax as their stomachs are filled.

If you have supply concerns some helpful ideas are to:

  • Check latch-if it’s painful an assessment by an IBCLC is important.
  • Let baby finish a breast, burp, then offer the other breast.  Following babies cues is important as is getting enough breast stimulation so that you continue having a good supply.
  • Nurse baby on cue as long as baby wishes.
  • Take away pacifiers and extra bottles, if baby needs a supplement consider an at-breast supplementer or work on paced bottle feeding to simulate how your breast delivers milk.  If you have supply concerns, all suckling should be at the breast.
  • Skin-to-skin contact as long and as much as possible during the day.
  • RELAX!  Stress can inhibit your let-down and make you not feel the best.
  • And above all, get professional help and support.  Mother-to-mother support groups and volunteers can be extremely helpful as well.
  • A very helpful book is Breastfeeding Mother’s Guide to Making More Milk.

 

For further reading see:

What cues does your baby give to let you know that he/she is hungry?

I offer breastfeeding and babywearing classes and consultations in Oklahoma City, Yukon, and Mustang.  If you would like more information please contact me or visit my website.

What to Expect in the Early Days of Breastfeeding

earlydays

To learn more about getting breastfeeding off to a good start and know what to expect in the first two hours postpartum please see my earlier post in this What to Expect series.  You can also learn more about what to expect that first night home from the hospital (regardless of the timing of that due to a normal vaginal birth, surgical birth, or bringing a preemie home) here.  To learn more about days 2-7 postpartum please see this post.

Now that you’re home from the hospital, your milk has transitioned and is changing to more mature milk, and you’re starting to get to know your baby more you may start to feel a little bit of a groove and your baby may be starting to get more of a routine (or not!).  Your husband or partner may be back to work or may have a little more time off.  You no longer have the call button that you had at the hospital and now is the time to call in those favors that everyone left (“If you need anything let me know.”).  Postpartum is the best time to learn to ask for those favors because taking care of you and your baby are the top priorities, even over dinner. I recommend during pregnancy creating a list of duties, chores, errands, and meal preparation so that when someone is visiting you can encourage them to do a task before getting to see baby.  In many other cultures outside of the United States women have some type of a “laying in” period that other women come and take care of the household chores so mother can feed baby frequently and work on recovering.  A wise midwife, who “caught” my third baby (Lisa Lehrer in Corvallis, Oregon), encouraged me to stay down as much as I was able in the first 2-4 weeks postpartum and promised me that if I did I would feel much better at 6 months postpartum than if I had been running errands, doing chores, etc.  She was absolutely correct.  I felt MUCH better with her at six months postpartum than I did with my first two children.

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Check out my FREE printable helping list!

At this point your baby may begin sleeping up to a 4 hour stretch during the day or night (maybe, it’s totally normal not to have a stretch for a while though).  If baby is gaining well and having enough diapers letting baby sleep is usually ok.  You may need to wake up a sleepy baby though if your baby is not up to birth weight by 10 days or has lost more than 10% of their birth weight, is jaundiced, or was premature or has special circumstances.  If you need to wake baby up, and baby is difficult to arouse, here are some ideas to help:

Ideas to help wake baby up

One other note that is important in the first two weeks.  Babies lose weight after birth.  It should be 7% of their birth weight or less.  It can be up to a 10% weight loss.  More than this and it’s very important to get immediate help from an IBCLC and your doctor to figure out if there is an issue with breastfeeding (even if you aren’t having any pain).  If you received IV fluids during labor baby may lose more weight than if no IV fluids were given.  Baby should be back up to birth weight by 10 days, 2 weeks at the latest.  If baby is not back up to birth weight by 2 weeks it’s important to see an IBCLC right away to assess for any breastfeeding issues.

Who was the biggest help to you postpartum?

If you live in the Oklahoma City, Mustang, or Yukon area and need breastfeeding help or would like to attend breastfeeding classes please see my website for more information.  You may also contact me here.

Breastfeeding Support in Oklahoma City

breastfeedingsupportokc

Why YOU Need Breastfeeding Support

Free Breastfeeding Support Groups in the OKC Metro Area (including Mustang, Yukon, and other surrounding areas)

Local Online Breastfeeding Support

For Other Professional Breastfeeding Help

If you have information that you would like added to the list or any updates for your group’s information please email Ashley Barrett.

Where do you like to go for breastfeeding support?

What to Expect When Your Baby is 2-7 Days Old

2to7days

Whether you are breastfeeding or not your breasts will begin to transition from colostrum to mature milk at about 2-5 days postpartum.  This post is geared toward breastfeeding mothers.  If you choose to feed artificial breast milk (formula) it’s a good idea to manage the swelling in your breasts with expressing your milk to comfort for the first few days and slowly expressing less milk each day after the first couple of days to prevent mastitis (a painful breast infection which can cause you to be very sick).

To learn more about getting breastfeeding off to a good start and know what to expect in the first two hours postpartum please see my earlier post in this What to Expect series.  You can also learn more about what to expect that first night home from the hospital (regardless of the timing of that due to a normal vaginal birth, surgical birth, or bringing a preemie home) here.

In the first 24 hours after birth, your baby is receiving colostrum which is a thick breast milk that is extremely high in antibodies and vitamins because baby has such a small tummy.  The average a baby receives is about 0.35-3.68 oz in the first 24 hours (based on a 7 lb 8 oz baby) (Source: Counseling the Nursing Mother, Fifth Edition).  Your body begins producing this liquid gold breast milk during pregnancy and it protects baby against bacteria and helps jump start baby’s immune system and GI system to living in the world outside of the womb.

Beb mamando

Sometime in the first 2-5 days your body will begin producing more milk as it begins transitioning to mature milk.  I don’t like to use the phrase “milk coming in” because colostrum is also breast milk.  It’s all important and vital to baby’s survival and optimal growth and development.

You may notice some engorgement in your breasts at this time.  Not all mothers experience this and those who do notice varying degrees of this engorgement and time that it lasts.  It typically resolves in about 2 days but it may take about 7 days after milk transitions for it to resolve but it will get better each day.  Not all of this fluid in your breasts is breast milk.  Much of it is lymphatic fluid and blood from which milk is synthesized.  Like if you have an injury, ice packs can be very helpful after a feeding to help take this engorgement down.  The very best way to resolve this is by putting your baby to your breast frequently-a minimum of 8-12 times per day, many babies like to nurse more frequently.

ping pong ball.jpg

Your baby’s stomach has increased to the size of a ping pong ball (like in the picture above).  Baby will take an average of 14-19 oz per day of breast milk.  Your milk will slowly transition over the first two weeks postpartum but the components quickly resemble those in mature milk.

Things to Watch For:

  • Baby should be on the breast 8-12 times per 24 hours (or more frequently).  Feedings may last 7 minutes up to an hour or possibly longer.  Expect to spend lots of time feeding your baby and recovering from birth.  Your baby will get more efficient at nursing over time.
  • You should notice your milk increasing in volume and transitioning between day 2-5.  If by day 5 you do not notice your milk increasing in volume or baby has lost more than 10% of birth weight (7% is the number where we really start watching babies closely but if you received IV fluids during labor your baby may lose more) contact your doctor and your baby’s doctor right away and seek help right away from an IBCLC. 
  • Follow the care instructions from the hospital regarding cord care, body temperature for you and baby, and other discharge directions.
  • If you have any breastfeeding questions contact a breastfeeding professional right away.
  • Baby’s stools should become more green in this timeframe as your milk transitions.  Baby should have at least 1 wet diaper in the first 24 hours, 2 the second day, 3 the third day, and so on until baby is having at least 6-8 wet diapers and 3 yellow seedy poopy diapers by the end of the first week. Baby’s stool should be the consistency and color of French’s mustard with sesame seeds in it (the seeds are the curding milk from digestion).
  • Skin-to-skin contact helps babies to breastfeed better.  Many issues can be resolved by making the breast a happy place to be even if baby isn’t latching.  Getting help from a breastfeeding professional is also very important in this process.  If you don’t feel the care plan that you and your professional work out together is working you can always seek extra help or seek a second opinion.  Like doctors, breastfeeding professionals all have different areas of expertise and unfortunately not all are on the same page with evidence-based information because we are continually learning more and more about breastfeeding.

 

What did you find most helpful in the first 7 days postpartum?

If you have breastfeeding questions in the Oklahoma City, Mustang, or Yukon areas I am happy to help.  I offer breastfeeding classes and consultations.  You can find out more on my website or contact me here.

August Breastfeeding Classes

Happy August!  Here are my class dates for my August breastfeeding classes.  Registration is available on my website here.  More information about what is taught in the classes here.

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Tuesday, August 9: 7-8:30 PM at Babies R Us in Oklahoma City

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Tuesday, August 23: 7-8:30 PM at Babies R Us in Oklahoma City

and a FREE mother-to-mother breastfeeding support group on Friday, August 19th at 4 PM.  This is a meeting for mothers and babies not comfortable being away from mom, nursing babies are always welcome.  You may want to bring toys to help keep your older children entertained while we chat.  Lending library available at the meeting.

NBBC August

Synchronized Latch On in Oklahoma City

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The Big Latch On has strict rules about where an event can be hosted (Babies R Us isn’t allowed) so we decided that we will be doing a synchronized latch celebration during our Nurturing Bonds Breastfeeding Circle meeting.  Join us at 12:00 PM on Saturday for our meeting.  At 12:15 sharp whoever brought a nursing baby will be latching their babies on at the same time as a way to celebrate breastfeeding.

Happy World Breastfeeding Week Oklahoma!

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I will be hosting a World Breastfeeding Week celebration with Babies R Us in Oklahoma City on Saturday!  More details are available on my website (including a link to the Facebook event).  I will be posting about different events that will be going on throughout the main event over the next few days.  Help us celebrate and educate about breastfeeding in Oklahoma.

Let’s Talk Sucking Issues (and the IBCLC Credential)

talkaboutties

Let’s talk sucking issues. Let’s especially talk to medical profession and future medical professionals. Palpable ridges along cranial sutures and plugged tear ducts. These were two things that really stood out as weird to me with Brendan, my oldest who is now 8, as a newborn. Brendan couldn’t latch at all when he was born and he had a big bruise from the suction cup from the vacuum extractor. He was also taken away from me immediately. That was extremely traumatic for me-no one heard me when I was shouting “I want my baby! I want to breastfeed!” All of those were signs of major problems and I wish that his tongue-tie, the ridges, the bruising would have been identified as issues. The doctor said he had seen worse ties and *I* must be the problem and I must not have been holding him correctly. Guess what buddy? YOU were wrong. YOU should have been more educated in to breastfeeding issues.

palpableridges

My oldest son had palpable and visual ridges.  We didn’t know this was a unique situation so we didn’t focus on them trying to get good pictures but they are pretty obvious in several pictures.  You can see them on the side of his head in this picture. Taken May 2008 when he was 3 weeks old.

I am currently reading a book called Supporting Sucking Skills. EVERY doctor, midwife, RN, OT, IBCLC, “lactation consultant/nurse” that is around breastfeeding needs to read this book. If you ever have a breastfeeding patient you should read it. Do some self-educating. I get that there isn’t a lot of time in Med school, nursing school, etc to learn about breastfeeding, identify breastfeeding issues, assess mouths and sucking, and diagnose the issues but that’s no excuse to not educate yourself. There are amazing resources out there. Identify your limits. Don’t PRETEND to know what you’re talking about. It can be detrimental to a mother to tell her in any way she isn’t sufficient or to not properly support her in breastfeeding.

Doctors know when to refer to other doctors who are specialists. There are other non-doctor specialists though that everyone needs to be familiar with.

Have you heard of an IBCLC? Most of the general public has not. Many of my friends should have because it’s my passion to be one. An IBCLC is an International Board Certified Lactation Consultant. They’re the boob helpers if you will. Like doctors not all are created equal and there are some crummy ones despite having to complete 14 specific health science courses at the University level, 90 hours of breastfeeding specific education, and depending on pathway chosen up to 1000 hours of hands on clinical breastfeeding support. After all that they must pass a rigorous international exam with an international perspective. They must recertify with a lot of continuing education or resit for the exam every 5 years and for sure sit for the always updated exam every 10 years. They must know how to identify breastfeeding problems. They learn about many diseases that effect neonates and are often a front line to identify possibilities so the doctors can look in to them further. They are experts on poop, newborn and infant sleep, and normal term breastfeeding (hint-if you are not supporting a mother “still” breastfeeding a 2+ year old you need to revisit your perspectives). Many know how to assess for tongue and lip ties and while they can’t diagnose they can refer to specialists that know how to take care of them (although many are bound to refer within the system that employs them even if it isn’t the best option for the mother and baby-one of many reasons why I have chosen to be in private practice). Many recognize sucking issues. Take them seriously when you get a referral or a report from an IBCLC.

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I’ll be the first to admit I didn’t get a very good picture of this tie but you can still see this thick band that was ignored by several providers.  This was my daughter’s class 4 lip tie.  It attached down and around her gum line back in to her palate. (My youngest-taken 1/27/14 when she was 4 weeks old, her revision was in February a week later)

If you don’t know how to properly assess for a tie be honest-remember to first do no harm. Refer to a specialist that actually knows what they are talking about. www.Drghaheri.com has a lot of information about how doctors should be assessing. He has an excellent bedside manner and knows what the heck he’s talking about because he was a father of a baby with sucking issues and he went out of his way to learn how to help his wife, child, and future patients. He teaches other doctors how to revise ties.

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This swollen blistering lip was caused by my daughter’s lip moving in and out (rather than staying stationary) and continually breaking the seal while breastfeeding.  This was taken a week before her revision.

Treat mothers with respect. If a mom has a concern take it seriously. You are not in her home at all hours day and night. If you treat her with dignity and respect and her baby as well you will be well respected. Learn to properly identify sucking issues. They cause a host of problems and are a main reason why mothers give up on breastfeeding. That may not be important to you but it is to her.