The Breastfeeding Basics Series wrapped up with a discussion led by Katie Halverstadt, RN, International Board Certified Lactation Consultant and Chair of the Colorado Breastfeeding Coalition, on the common issues that occur during breastfeeding and ways to address them.
The most common issue that mothers experience during breastfeeding is low milk production, which can hinder efforts to breastfeed for longer than six months. To address this, mothers should start breastfeeding almost as soon as baby is born and should feed on demand, including through the night. The more the mother breastfeeds, the more milk her body will produce.
To see if enough milk is being produced and baby is latching correctly, it is important to keep track of how much weight baby is gaining. Normally, babies will lose 7% of their weight at birth, and should return to that weight ten to fourteen days after birth. Counting diapers is another great method for tracking milk production and identifying latching issues. As milk matures, changing from colostrum to transitional milk, parents will notice a change in the color and consistency of stools. It is recommended to consult baby’s primary care provider if baby is not eating at least eight times in a 24-hour period, has yellow eyes or skin discoloration, experiences sudden changes to stool patterns, or needs to be awakened to be fed.
Understanding breast care is a crucial part of breastfeeding, including massaging the breast to prevent engorgement and using an ice pack to reduce swelling. If breastmilk is not being expressed properly after 48-hours, a specialist should be consulted. Breast care also encompasses nipple care, which includes refraining from harsh soaps, changing wet breast pads as often as needed, using herbal creams or gel pads, and checking for scabs (a sign that baby is not latching properly). A healthcare provider should be consulted if breast engorgement continues after 24-hours, there is no milk production after four days, or there are signs of mastitis (a hard, red tender area on breast accompanied by flu-like symptoms).
Breast care can also become more complicated when a mother returns to work. Women in the United States breastfeed exclusively for only six weeks, as opposed to the average two-and-a-half years worldwide. This figure coincides with when maternity leave ends and women are expected to go back to work. For some women, they may return to work much earlier. It is thus important for a mother to know her rights concerning breastfeeding when returning to work. Taking time off, working part-time, pumping, or choosing a breastfeeding-friendly daycare are all encouraged, especially if barriers do not exist that would prevent them from accessing those resources and creating a schedule that suits their and their baby’s needs.
As breastfeeding becomes more normalized, resources are becoming more available. Mothers can talk to their healthcare provider about pumps and supplies that are best for them, and how to store breastmilk and for how long. Other resources include partner support (such as cleaning the pump!), support groups, postpartum doulas, healthcare providers, and milk banks, of which Colorado has the largest in the country.
As most new mothers have very little education and resources on the topic of breastfeeding, the series’ goal was to impart knowledge to RVU students that will help them become more compassionate physicians and knowledgeable support for future patients who are breastfeeding or contemplating breastfeeding. Students were also engaged throughout the series, such as asking questions about how insurance could affect their patient’s access to lactation consultants, pump supplies, and much more. Their interest was not just in the medicine itself, but also in the circumstances of their future patients.
Additional resources discussed during the lecture include: