Winter Newsletter Editorial: Twins- Double your Fun!

Winter Newsletter Editorial: Twins- Double your Fun!

by Stephanie Ondrack

 

Double your pleasure, double your fun! But also sometimes double the feeding challenges, the tears, the health concerns, and the all-nighters. Every aspect of having a new baby is multiplied with twins, from the good to the bad, the exhausting to the exalting. Generally speaking, the learning curve is steeper, and the need for extra hands greater, but there are also joys specific to multiples, such as the unique bond they form with each other. And of course with two babies, those moments of pure parental delight, when your baby first smiles at you, or laughs for the first time, or says something uncanny and hilarious…these heart-swelling moments happen twice as often.

For this issue on twins, it seems appropriate to include doubles: two birth stories, two questions of the quarter, and two articles about living with twins. We hope the birth and baby stories resonate, and that the tips are useful, whether you have one, or two, or even three, babies.

ASK CHILDBEARING: Is it possible to produce enough milk for two babies?

ASK CHILDBEARING: Is it possible to produce enough milk for two babies?

by Jennifer Landels

Q: I have been told I’m likely to have to supplement my breast milk in order to feed twins, but I’d rather breast feed exclusively. Is it possible to produce enough milk for two babies? 

A: Absolutely!

Breast milk production works on a supply and demand basis, so if you provide the demand (two babies rather than one) your breasts will rise to the occasion. Be aware that it will take longer to establish your supply than it would with a single baby, simply because you have to create twice as much milk. We expect a singleton to return to birth weight at around two weeks old; twins, however, will probably take at least three weeks to make it back to their birth weight. As long as they appear healthy, do not continue to lose weight past the first few days, and are gaining weight, even if slowly, there should be no need to supplement. In fact you should avoid supplementing with anything (even expressed milk) if at all possible, since the best stimulation for your milk supply is nursing your babies.

 

It is extremely important as well to nurse on demand, and avoid schedules. Newborn stomachs are tiny, about the size of a chickpea at first, and preterm babies’ stomachs are even smaller, which means they need to refill frequently. This means for the first few weeks you will be doing almost nothing but breastfeeding, as by the time you’ve nursed one baby, the next is ready to feed again. Fortunately, this helps bring your milk in even faster. Eventually you will learn to breastfeed both at once, and your babies will start to synchronize their schedules so that you do get breaks while both are asleep. But for the first while, have someone around to bring you food and entertainment as your hands will be busy full time!

 

If your babies are very small, they could have trouble latching and sucking, and you may need to feed them expressed colostrum with an eyedropper, syringe or supplemental nursing system (SNS). If this is the case it is still worthwhile putting your babies to the breast, even if they’re not accomplishing much. The skin to skin contact and incidental suckling will benefit them and stimulate your breasts to produce more milk. There are a variety of herbal galactogogues such as blessed thistle and borage to help increase milk production. My personal favourite is fenugreek, which not only increases milk supply but also helps soothe colicky babies. It is inexpensive, free of side-effects, and certainly worth a try before resorting to more expensive prescription medication for increasing milk production.

 

If you encounter feeding difficulties, or your babies take more than three weeks to regain their birth weight, don’t delay in seeking help from a lactation consultant. There are many other avenues of breast feeding support in the community as well, including La Leche League and our own postpartum circles and breast feeding clinics. Remember you can also call your prenatal class instructor who is able to offer advice by phone or email, and can sometimes make home visits.

 

Most of all, persevere. Looking after twins is time consuming enough without having to sterilize bottles and prepare formula. Even though it may not be easy at first, exclusive breast feeding will save you hours of time and provide hours of contentment for both you and your babies. There’s nothing quite like the feeling of two little bodies tucked up under your arms and four little eyes staring up at you in rapt pleasure, so enjoy it as long as you can!

 

ASK CHILDBEARING: I’m expecting my third baby and am wondering what it will be like to add a singleton to the mix?

ASK CHILDBEARING: I’m expecting my third baby and am wondering what it will be like to add a singleton to the mix?

by Jennifer Landels

Q: I’m expecting my third baby and am wondering what it will be like to add a singleton to the mix. My twins are such a duo; I’m having a hard time picturing what it will be like for the little one to grow up in the twin shadow.

 

A: Twins do seem to garner more than their fair share of attention, whether it’s

from passersby who seem magnetically drawn to doubles, grandparents who are delighted to each have a baby to hold, or parents who feel they’re twice as busy as all their peers attending to the needs of multiples.

But remember almost all attention twins receive is divided in half. Your singleton, on the other hand will have so many benefits. You are now an experienced mother: you’ve had not one, but two older guinea pigs on whom to practise trial-and-error parenting. If we’re to feel sorry for anyone it’s for all those first-born singletons out there who have had to bear the brunt of our early tries at the parenting gig. Breast feeding a single baby will be a breeze in comparison, and you’ll be able to gaze as long as you like into those newborn eyes without feeling you have to keep switching your focus from one baby to the next. You’ll be able to practise baby-wearing full time – something you can only do with twins when your partner is home too – and you’ll be able to sit on the floor playing with your toddlers while nursing your baby in one arm.

Just imagine what a fabulous hothouse of love and sensory stimulation this new baby will be born into. Don’t worry too much about your twins either. Most older children feel some normal resentment and displacement at the birth of a new sibling, but for twins this road is so much easier to travel. They have been used to sharing your attention since birth, and going from half to a third is not nearly as hard as going from all to half. Plus, they always have each other, which is no small thing. There will of course be quandaries that come up when you have three children, only two hands, and only two parents. You will always feel you are balancing and juggling who sits where, who holds whose hand, and so on. But these are issues for any family with more than two children, regardless of birth order. Enjoy the one-baby time you’ll have with your singleton while her siblings play with each other. Just beware of periods of unusual peace and quiet in your household, perhaps punctuated by distant giggles. It usually means your twins have decided to redecorate the bathroom with wads of wet toilet paper while your attention was elsewhere!

Wouldn’t Change a Thing

By Jessica Lin

On October 10th, I went into my obstetrician’s office at 12:00pm for a membrane sweep (I was 37 weeks and 4 days and my obstetrician wanted to induce by 38 weeks). When my obstetrician did the cervical check, I was already 4cm dilated but I didn’t feel any contractions. She did the membrane sweep and said I would likely see her at the hospital that night! Later that afternoon, I started feeling mild cramps but I wasn’t sure what it was so I called the Assessment line at BC Women’s at 7:00pm and they suggested that I come to the hospital to get checked out.

 

My husband and I arrived at the hospital at 8:00pm and my cramps were getting stronger. My obstetrician came to see me at 8:30pm for a cervical check and I was already 6cm dilated when she broke my water. After that, we went to the delivery room and waited for the anesthesiologist for the epidural. In the meantime, my husband did hand massages for me, which was a great distraction from the contractions.

 

The anesthesiologist did the epidural at 10:45pm and my obstetrician came in for another cervical check at 11:50pm and I was 10cm dilated. We started doing some practice pushes. The first epidural didn’t work since I could still feel everything, so another epidural was redone at 12:15am.

 

Hi, my name is Jessica and I’m from Vancouver. My husband and I were enrolled in the summer prenatal class in June 2017. Since then, we’ve had our two fraternal twin boys in October. They are now five weeks old and we are adjusting to life as new parents to these two amazing babies. We have been busy but enjoying the snuggles!

At 2:05am, I started pushing, but I couldn’t feel any contractions so I just pushed

when I was advised to. After an hour of pushing, Baby A didn’t descend and was face up. The doctors tried manually turning his head twice but weren’t able to. At 3:30am, my obstetrician said that they could either try to use rotational forceps for the delivery of Baby A or a c-section. We decided to go ahead with the c-section because it was the most predictable and safest option for us. Within the hour, Baby A and Baby B were both delivered and I was able to stay awake and do skin-to-skin with them. Although it was not what we expected, we wouldn’t change our experience, and are very happy to have two healthy baby boys.

 

Advice for new parents of twins: Breastfeeding can be a challenge, try to get an appointment with the lactation consultation at the hospital. Don’t be afraid to ask and accept help. Take lots of photos and enjoy your time with your newborns, they change so quickly every day!

 

 

Keeping Twin Birth Normal

by Jennifer Landels

 

I didn’t find out I was having twins until thirty-six weeks into my pregnancy. How on earth could I not know until then?

 

Well, it was my second pregnancy, so the extra tiredness and nausea I put down to the work of keeping up with a three-year-old. I measured bang-on normal size for dates right up through 30cm fundal height at 30 weeks. The fact I’d always measured slightly small with my first baby didn’t clue me in either: after all, second babies often measure larger. And what about the ultrasound? Well, I didn’t bother with that. I’m not a big fan of screening tests in general, and since I was healthy and everything about my pregnancy was normal, I saw no reason to subject myself to unnecessary tests.

 

That simple omission was probably the biggest factor in keeping my pregnancy and birth normal. If I’d found out about the twins at the usual 18 week ultrasound my pregnancy would have been much different. My care would have been transferred to an obstetrician, and I would have had the rest of the pregnancy to worry about the birth and postpartum. And I certainly wouldn’t have taken the holiday in London and Rome that I did at five months pregnant. As it was, I was completely relaxed and unconcerned for most of the pregnancy, and my blood pressure reflected that.

 

At 32 weeks the midwives and I became a bit concerned when my fundal height shot up to 36cm: four centimetres larger than expected. A bit of palpation turned up a head at the fundus and we figured the singular “baby‟ had turned breech, popping herself out of the pelvis where she’d previously been nestled head down. In fact, it was simply the two babies rotating around each other so Isabel, my breech baby, was in front, preventing us from being able to feel Eleanor, who was still snugged down in the pelvis. But it took some time to figure that out, so I spent the next two weeks between visits doing breech tilts and every other trick in the book to turn “the baby‟ head down.

 

During the next month the mystery continued: Eleanor and Isabel swapped places again, giving the appearance of a head-down baby, but the fundal height continued to grow. Worries about polyhydramnios (excess amniotic fluid) and an anencephalic (small-headed) baby were dismissed by fluid thrill tests and internal exams, and the search for more than one heartbeat only turned up an identical heart rate that sounded more like an echo than a second baby. Finally, at 36 weeks we decided on an ultrasound to solve the puzzle.

 

The tears I shed on the ultrasound table, and over the next weeks, were not just caused by anxiety over the impact twins would have on my life. I was in mourning for the home birth I would never have. Now I had to see an obstetrician, give birth in a hospital, and fight to avoid the interventions so common in twin births. My blood pressure shot up ten points on both scales and stayed that way for the rest of the pregnancy. I considered refusing to go to the hospital. I know my midwives would have attended my labour at home if I’d refused to move, but I didn’t want to put them in a position of contravening their scope of practice. I thought about hiring a private birth attendant, who would have done a home birth; but at 36 weeks, I was already considered term, and could go into labour at any moment. I had a great relationship with my current midwives, and didn’t feel I had time to develop a rapport with a new one. I decided to pick my battles, and see what I could do to make a hospital twin birth as natural as possible.

 

Fortunately, because the twins were discovered so late in my pregnancy, my wonderful midwives, Lee Saxell and Linda Knox, were able to continue as primary caregivers with the obstetrician brought in on a consulting basis. They found me a doctor who would work with me and honour my birth plan. Both Linda and Lee attended my birth at St Paul’s. They took fabulous care, both physical and emotional, of us afterward, and I was fortunate beyond deserving to have had them at my side throughout the whole time.

 

With an understanding and flexible obstetrician I was able to labour and give birth drug-free. After five short hours of labour I caught Eleanor myself with Linda’s help, and held her on my chest while Dr Bagdan pulled Isabel out feet first. I left hospital later that day with two beautiful, healthy baby girls weighing 8lb 10oz and 8lb 9oz, born at 40 weeks plus 2 days gestation.

 

Is there anything I would change? Of course.

 

I would have refused the saline lock put in my hand at second stage. It was unnecessary and was the first true pain I felt during labour. I would have given birth on my hands and knees. This would likely have prevented Isabel from turning sideways after Eleanor was born and allowed me to birth her as a frank breech, rather than having the doctor perform an internal version. The internal version, in which the obstetrician reaches inside the uterus to pull the baby out feet first, was the most excruciating two minutes of my life. But at least it was only two minutes. I would have insisted that Isabel’s cord not be clamped immediately, and that she be given oxygen with a bag and mask rather than at the incubator, which wasn’t working anyway.

 

These are minor complaints in the grand scheme of things, especially when I consider what might have happened if I had not had the support of my midwives; if I had been transferred to obstetrical care early in pregnancy; if this had been my first pregnancy; if I had not been so stubborn. I would have had monthly ultrasounds to check foetal growth (ironically, studies have shown more than five ultrasounds during pregnancy is related to decreased foetal growth). My blood pressure would have no doubt been high for the entire duration of the pregnancy instead of just the last four weeks. I would have been encouraged to gain more weight than I did; as it was, I only put on one pound more than I did with my singleton, despite the fact she weighed just under 8lbs and the twins weighed over 17lbs combined. I would have been pressured to have labour induced at 36 weeks. I would have been pressured to have an epidural during labour ‘just in case’, which likely would have prevented me being able to push Eleanor out on my own. I would have had to spend at least a night in hospital recovering, interfering with my ability to establish breastfeeding in the narrow confines of a hospital bed.

 

One woman’s story is only anecdotal evidence. My experience is not the same as the vast majority of twin mothers’ experiences, and it would be absurd to expect it to be.

However, what I hope others can gain from my experience is the sense that twin pregnancy and birth is not an abnormal condition but, like breech birth, a variation of normal. I can’t suggest you follow the same path I did, as most of it involved serendipity and unusual circumstances, but there are a few general tips at my disposal:

 

Talk, talk, talk. Talk to your caregivers about everything they expect will happen during pregnancy and birth and everything they will recommend. Find out why they expect these things, and why they make these recommendations.

Don’t forget your BRA: there are Benefits, Risks, and Alternatives to everything.

Jennifer Landels is a writer, editor, doula, childbirth educator, and is the author of the fantasy novel Allaigna’s Song: Overture from Pulp Literature Press. When she is not doing any of the above she can be found swordfighting with her partner or horseback riding along the Richmond dykes with her three daughters.

Research. Do your own research. If I’d had more time I would have learned about giving birth on hands and knees to prevent the second baby turning transverse.

Make a birth plan. Usually I suggest a one page birth plan, but having multiples warrants one page per baby. Include contingencies. “If X should happen, then I prefer Y”. Discuss your birth plan with your caregiver to find out if there are nonnegotiable points between the two of you. If you and your caregiver can’t find common ground you may want to consider changing caregivers, so write your birth plan early. You can always amend it later if your situation changes.

Be stubborn. If something is truly important to you, explain why. Trust your gut feelings. Be flexible. This is not a contradiction to the above. Again, your instinct will tell you when to hang on and when to go with the flow.

 

Above all, trust your body and your babies. Your babies know when to be born and your body knows how to birth them. All the medical technology and expertise is just back up for a normal yet miraculous process.

 

 

It Gets Better

It Gets Better

By Jennifer Landels

 

When I found out, at 36 weeks of pregnancy, that I was having twins, I burst into tears.

 

They were not tears of joy. Not only did I have to throw my carefully planned homebirth out the window, I was gripped by fear. I already had a three-year-old, and knew how much work one newborn was. How on earth was I going to cope with two?

Nonetheless, I survived. Granted, the first eighteen months were pretty much a blur, but some way, somehow, I’ve ended up with two beautiful, clever, and for the most part, happy teenagers, so I guess you could say it all worked out eventually.

 

There is something wonderfully resilient about multiples. They’ve had to compete for parental resources since conception, and they’re born knowing more about sharing than some people learn in a lifetime. They can fight like Tasmanian devils one minute, then turn around and play happily together for hours afterward. Over the years I have worried far less about my twins than I have about my eldest daughter because I know the twins will always look out for each other.

 

Some multiples are born with incredible uphill health challenges, but premature twins seem to thrive and gain weight faster than singletons born at the same gestational age and weight. Maybe it’s because they’re never alone. Ask a twin what it’s like to be twin, and she’ll shrug. For them, having a twin sibling is as normal as being a singleton is for most of us. And yet, what a marvelous secure feeling it must be to know, deep down, that someone’s always got your back. That, I think, is the payoff for those who have experienced the stress of a multiple pregnancy, and the sometimes overwhelming task of caring for more than one baby at once. Believe me, not only does it get better, it gets great.

 

 

 

 

Bringing Home Twins!

By Katy Thomson

Coming home from the hospital is a big moment for all of you. For your babies, it is the start of their relationship with a place and people that will become increasingly theirs to explore, enjoy and bond with. For you, it is the start of your independent life as a family together, away from the rules and routines of hospital life.

 

You may not be coming home all together which can be very emotional and tricky to navigate feeling needed in two places at once. As a twin parent you become exceptionally good at dividing and conquering so to speak.

 

Some say it can be easier to start caring for one baby at a time, and if home with one baby you can work together to provide your milk for baby still in the NICU, by pumping while nursing or immediately after feeding. Do not be surprised if you find yourself on an emotional rollercoaster, changing daily as situations change, celebrating as one baby improves and feeling guilty as another multiple is not doing as well.

 

It is common for parents to feel more attached to a baby who is home and in their care sooner. The sicker baby is not avoiding interaction, that baby simply does not have the energy to interact. Touch, talk, and hold this baby as much as possible, an equally unique and beautiful bond will still form but perhaps at a more gradual pace

 

Each time a baby is discharged the household routine-no matter how tentative- is disrupted again. Having a meal train set up for you (I highly recommend this) can help ease this transition. Ask for meals to be portioned or for some to prepare healthy snacks. This will make for easy meals to bring to the hospital each day or for quick lunches and snacks once all are home and the busyness of life with multiples sets in.

 

The next few weeks will be incredibly busy. Friends and family may offer to help out. Not only should you accept these offers, but try to make sure they are helping with real chores (laundry, shopping, cooking, cleaning etc) so that you can have as much time as possible to rest, enjoy and care for your babies and share moments with your partner. Some find it helpful to have a list of supportive things to do up on the fridge to save you time explaining and is not as awkward to ask.

 

Do make sure you don’t end up looking after the helper, though. If someone pops over to see the babies, they will certainly be able to make their own cup of tea, and one for you while they’re at it.

 

If family and friends are not available or supportive you may want to consider hiring a postpartum doula who is experienced with twins offering nonbiased support for breastfeeding, newborn care and many do night shifts as well.

 

You will learn to sleep like a baby again, in short bursts and it takes more organization and packing to leave the house, but the fog of the first few months will gradually diminish. When you’re living it, it’s difficult to imagine a time when you will sleep again. It will happen! Until then, remember that this stage is only temporary. The moment you adjust to your babies’ habits and patterns, they transition into something new. The change is constant, surprising, and extraordinary.

 

Watching the bond grow between siblings especially twins is awe inspiring; as they make each other laugh, seek comfort in one another, and make up games and languages that we can never fully understand. It is worth every minute of the busyness and lost sleep.

 

Katy Thomson has been involved with the wondrous world of birth for over fifteen years. She has worked, lived and volunteered with many families and organizations while travelling around the world before settling in beautiful Vancouver to further establish her career as a Doula and Childbirth Educator. Being away from her own family Katy really got to see and feel the importance of family and learn how other cultures support a new mother during the childbearing year. Drawing her closer to her doula nature, Katy has been privileged to witness and participate in births within different cultures, giving her a wealth of information on pregnancy and the birthing process. Katy is a mum of three, a Breastfeeding Counselor, Childbirth Educator, as well as a certified Birth and Postpartum Doula, who is always continuing her education and working towards a lactation consultant certification.

Autumn Newsletter Editorial: Mama Care

Autumn Newsletter Editorial: Mama Care

Mothering the Mother After Baby Arrives

By Stephanie Ondrack

Many of us spend our entire pregnancy anticipating the upcoming birth of our baby, but somehow our vision fades out there—right after the birth itself. Once we’ve come through this experience, we often find ourselves the shell-shocked guardians of a new baby, one who is with us all day and all night, utterly dependent, and ours to keep. Somehow, we never imagined what this would be like, or what an enormous life change it would be. We may have heard that babies sleep a lot. They do, but rarely for more than half an hour at a time, and almost exclusively in our arms. We may have envisioned the baby cooing peacefully in a basket while we ‘get stuff done’, only to discover that babies never like to be put down…ever. We may have pictured promenades and outings, beaches and restaurants, only to learn that it requires extreme juggling and dexterity to leave the house with a newborn, a feat at which few parents succeed during the first couple weeks. We may have thought this would be the time to paint the house, write a novel, or catch up on thank you cards, only to realize that somehow, these teeny tiny little people we call babies take up all of our time, all of our hands, and all of our energy, day and night, without breaks.

 

But somehow, we do this. We have babies. We look after them. We get through those early months of reeling. We learn to let go of our unrealistic expectations, and to surrender to the much more basic ebb and flow of a new baby’s needs. We stop aspiring to ‘get stuff done’, and aspire instead to enjoying these precious early months with our brand new progeny. Eventually, we may even embrace this ever-shifting new existence, and learn to appreciate this short and passing season in our lives, the “in-arms” phase of early parenthood.

 

 

In this issue, we consider some key postpartum issues, such as early breastfeeding challenges, postpartum doulas, and what to expect during this turbulent time. Becoming a parent is the steepest learning curve we will likely ever face, a maelstrom of a roller coaster with frayed emotions and little sleep. Like all new adventures, new jobs, and new situations, the curve will eventually level off, and the chaos will settle into familiarity and confidence. For now, we encourage you to ignore those dishes, turn off your phone, and surrender to the motion of your postpartum journey. We hope you enjoy the ride. Of course, if you’re right in the middle of this crazy, magical time, you won’t be reading newsletters anyway. You will hopefully be busy settling in and finding your groove with your new baby.

 

Milk Supply

Milk Supply

By Dr Stephanie Peltz, ND

 

Are you interested in breastfeeding? Did you know that learning to breastfeed is a joy for some, but an uphill climb for others? Did you know that it doesn’t come ‘naturally’ for the majority of women? I advise my patients that it can take up to six weeks for a woman and baby to feel confidant breastfeeding. In my personal experience, it took ten weeks. I’m not suggesting that supplementation is automatically necessary in these cases, what I am saying is that the learning curve can be steep. Creating reasonable expectations is one of the best ways to set women up for success. As a naturopathic physician working with pregnancy and paediatrics, I am all about setting families up for success!

 

 

One of the biggest concerns breastfeeding women have is their milk supply. This article will focus on not-enough-milk (the most common supply issue), but there can also be challenges with over-supply. Read on for more information on diagnosing a supply issue, and how to start addressing it from home.

 

 

 

 

 

The numbers:

In general, women produce 90 mL colostrum / 24 hrs for the first two – five days post partum. Milk typically comes in between day three – five, and it is estimated that 500 mL/day are produced. This increases to 750 mL/day for months three – five and then reaches an estimated 800 mL/day at six months and onwards. These are ballpark numbers because every body is unique.

 

Do you actually have a low supply?

A low supply is suspected when babies don’t grow at an expected rate (according to charts, care providers, or the parents themselves), when babies are fussy, feed frequently, fall asleep at the breast, or are unable to stitch together long enough stretches of sleep. Some women worry about their supply if they have small breasts, when pumping does not produce much milk, or their breasts do not feel full. However, there are lots of myths around assessing supply, and I’d like to debunk a few.

 

First, remember that growth rates are guidelines, and that most babies don’t grow on a perfect curve. Growth charts are only one piece of the puzzle on determining how a baby is doing. Did you know that a baby can be anywhere from 3rd-97th percentile and still be in the realm of normal? Breastmilk supply cannot by assessed by a baby’s weight alone.

 

As well, fussiness, feeding frequency, and sleep behaviour can be indications of several issues beyond supply. Breast size is not proportional to breast milk supply, and if your breasts don’t leak it doesn’t mean you have insufficient supply. If you don’t feel engorged, or if you don’t feel a let-down, again it doesn’t automatically indicate a problem. Did you know that some women produce a perfectly fine supply, but their pumped volume remains low? Take home message: be cautious what information you use to judge your supply.

 

So how do we know?

Combining weight, alongside milestones, and baby’s behaviour is wise. When assessing weight, it is important to take into account the size of the biological parents, and to watch how a baby follows the weight percentile curve they are on. As well, watching for typical developmental milestones like smiling, babbling, rolling over, sitting, etc. are important factors. Also look out for numbers of wet and dirty diapers for more clues. Unfortunately, there is not one way, and it is not a perfect science.

 

Why do women have low supply?

The reasons are multifaceted. Maternal health plays a big role (i.e. postpartum haemorrhage and maternal illness both decrease supply). A woman’s hydration level, caloric intake, and stress levels are also factors. Hormone balance influence supply (i.e. elevated oestrogen from birth control pills or deficient thyroid levels). A history of breast surgery / trauma may play a role. And remember: breastmilk production is based on demand, if the breast is not emptied, the supply will be lowered. Did you know that a great many cases of low supply are actually caused by insufficient or too-infrequent emptying of the breasts? If you are supplementing with bottles, distracting baby with a pacifier, trying to lengthen intervals between feedings, sleep training your baby, or doing anything that results in nursing baby less than baby might need/want, you are at risk of decreasing your own milk supply. A lot of mothers are delighted to learn that they’re capable of producing much more milk than they realized, they were just being led astray by faulty advice or information.

 

Solutions:

  1. Address technique (especially latch). An experienced care provider needs to watch a baby nurse to get a good reading on latch and milk transfer.
  2. Breastfeed on your baby’s demand. This is key to all supply issues.
  3. Consider breast compression, offering both sides per feed, and potentially pumping after/between feeds.
  4. Stay hydrated and well fed. I recommend drinking water every time you nurse. Women need 500 kcal extra /day than they required pre pregnancy. A nutrient dense diet with lots of protein and healthy fats will help. Specific foods to increase supply include oats, barley, peas, legumes, walnuts, and almonds, sunflower, sesame, flax seed, pumpkin, and hemp seed. Also, limiting caffeine, pineapple and sage is a good idea.
  5. Get rest and address stress. This is where partners, friends, families, and postpartum doulas come in. Women working on their supply should do little else beyond nurse, rest, and eat.
  6. Consider herbal medicine. There are several herbs out there that act as galactogogues to increase milk supply. They come in tea and tincture form. The list includes fenugreek, blessed thistle, goat’s rue, milk thistle, fennel, hops, and many more. These can be highly effective. I often recommend combining tinctures with teas to cover more bases. Every practitioner has their favourites, so speak with a licensed practitioner to get a specific prescription and dosing regimen.
  7. Consider prescription medication. Domperidone is the most commonly prescribed medication to increase milk supply. It can be highly effective and requires a prescription from an MD or ND.
  8. If you choose to supplement get informed on what you are giving, your delivery system, and how this will impact supply.

According to Dr. Jack Newman “the majority of women are perfectly capable of producing all the milk their babies need”. So if you are at home struggling, try some of the above tips. And please reach out to a friend, family member, lactation consultant, birth educator, postpartum doula, la leche league leader, or naturopathic physician well versed in breastfeeding support. There is no reason to suffer alone, and there are wonderful resources and support out there. And remember: with every steep learning curve comes a stretch of smooth sailing! Happy nursing!!

 

References

Dr. Jack Newman’s Guide to Breastfeeding

KellyMom.com

Diane Bengson’s How Weaning Happens

Kathleen Huggins’ The Nursing Mother’s Guide to Weaning

 

Dr. Stephanie Peltz is a naturopathic doctor practicing in the Yaletown area of Vancouver, BC.  Her area of expertise is working with women through conception, pregnancy, delivery, the postpartum period, breastfeeding, and treating children of all ages.  She uses low invasive natural therapies including lifestyle modification, nutritional advice, the prescription of herbs and nutrients, and more.  As a mother herself, she is passionate about supporting women through the joys and challenges throughout their journey.  She is currently accepting new patients.  Visit www.drpeltz.com for more information.

 

 

 

 

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