Breastfeeding questions

fergus51 · Feb 16, 2005

Deegale, there are cases where it isn't best. I have worked with women with certain health challenges whose meds preclude breastfeeding (not to mention those who take illegal substances on their own!). Breast milk is ideal, but it isn't always possible to exclusively breastfeed.

deegale · Feb 16, 2005

that maybe true today, but god created breastfeeding long before man created drugs or formula

t2000JC · Feb 16, 2005

I know you can't refreeze milk, but can you put it back in the fridge(24 hrs)?

prmenrs, RN · Feb 16, 2005

I have "gifted" a couple of pregos of my acquaintance with a book called, Breastfeeding for Dummies. One of them has not had her twins yet, it's my cousin's daughter. The other had her baby last July, and she loved it. She had it on the coffee table for months! She might still be breastfeeding. She was able to read it the month before the baby was born-I call that doing your homework-and was very prepared. He started nursing @ delivery, and never quit. These women are not in the medical field, so I am thrilled to help them.

fergus51 · Feb 16, 2005

that maybe true today, but god created breastfeeding long before man created drugs or formula

:chuckle You got me there:), but since we live today I just think it's important to acknowledge that some women won't be able to breastfeed through no fault of their own.

allnurses Guide · Feb 16, 2005

:chuckle You got me there:), but since we live today I just think it's important to acknowledge that some women won't be able to breastfeed through no fault of their own.

And some women shouldn't breastfeed by their own actions. We have a high degree of moms on meth here . . I discourage b/fing if they are going to continue that habit - and it is very tough to quit. Any use of illegal substances that continue after having a baby should be a huge stop sign to breastfeeding.

steph

LilPeanut, MSN, RN, NP · Feb 16, 2005

http://www.askdrsears.com/html/2/T022400.asp This is a great page explaning nipple confusion, in a much more clear way than I was

And sadly there are women who definitely should not be BFing, if they are taking any sort of illegal drugs, they cannot be exposing their baby to that Sad that it even is an issue

Mimi2RN, ASN, RN · Feb 16, 2005

I have sucsessfully breast fed two children and am now breastfeeding my third. Breastmilk is what nature intended and is in every case the best food for your baby. Humans are the only species of animal that feeds it's young milk from another animal (a elephant does'nt feed its young girraff's milk).

deegale, humans may feed milk from another animal, but baby animals that don't nipple will die. Rejected baby animals are taken to a zoo nursery to be fed from a bottle. In the wild they turn into somebody's dinner.

Neither of my breastfed boys took a paci, but my eldest sucked his thumb for years. Both my breastfed grandbabies suck thumb or fingers.

We are all different. The more stress that a nursing mother gets about breastfeeding, the higher chance she has of having problems.

I love the hispanic moms.... "No leche" but they will breast feed when they go home.

FutureNrse · Feb 16, 2005

As a mom of 4, I've had a lot of experience with this topic. One thing that I truly believe though is that there is no hard and fast science to breastfeeding and a lot of factors make it different from one person to the next. I'd like to help you out by answering from my own experiences.

1. What are your thoughts on nipple confusion?

I think it's certainly a valid issue sometimes, but more often than not it's overdramatized. In most situations, as long as mom and baby set a solid foundation of breastfeeding (could be a couple days, could be a couple weeks) then introducing a bottle shouldn't pose a problem. But of course, common sense is needed here. If you introduce a bottle, then use it exclusively for a large number of feedings, it will be difficult to get baby back to the breast and it interferes with milk production, unless mom is expressing her milk. I made the mistake of waiting too long to introduce a bottle with my third child, 2 months, and she never EVER took a bottle. But you know, she's the healthiest child I have, never been on an antibiotic or had more than a minor sniffle.

2. Is there a corellation between breast milk and jaundice really?

This is from my own experience as well. My first child had jaundice, and I was told not to breastfeed until the problem was resolved. On the fourth day, things were improving and I was told I could resume breastfeeding. We ended up back in the hospital within 24 hours. It happened again a few days later, and finally we all agreed to cease breastfeeding for good, and only then did things improve and stay that way.

3. How do you thaw and/do you refridge refreeze milk?

I was taught to thaw breastmilk in cool tapwater, then heat to the desired temp in hot tapwater. You use what you've thawed in one setting and throw away any leftovers. Never refreeze, or rerefidgerate.

4. using a pacifier?

I never gave them to my kids because I had a fear of them becoming to hooked. I hate seeing toddlers, and god forbid even older kids walking around with a pacifier. But, I do think they have a place in a hospital setting as a comfort measure.

FutureNrse · Feb 16, 2005

I want to qualify slightly what I said. I think the term nipple "confusion" isn't really the problem.
With a bottle, a child must move their tongue up to regulate the flow of milk to keep from being overwhelmed with the liquid, it comes out really whether the child sucks actively or not. In breastfeeding, the child must actively work, plus keep their tongue down and forward. If you put your own thumb in your mouth, you normally revert to the correct nursing position for the tongue. Then they have to move their tongue in a wave motion to get the sinuses to eject milk and all in all, especially prior to let-down, it's a lot more work for a baby who is being breastfed (which is actually one of the benefits and why it promotes proper mouth and jaw development)
My son was "nipple confused", in that he had a few bottles and got used to the milk pouring down his throat. He liked that, it involved no work on his part, he just got all the milk easily. So, he would be put to the breast and scream, because here was a nipple and there wasn't milk pouring out. Or he'd fall asleep, again for the same reason.
Sometimes they forget how to get the coordinated motion for ejecting the milk, which is why fingerfeeding can help, retraining them to suck the "right" way. Or having the mom pump until she lets down and then putting the baby to breast then.
I do wish more moms would be taught fingerfeeding or cup feeding, because I know with both my kids (34w and 35w) they couldn't afford to skip any meals. So if they had a bad nursing session, or a questionable one, I would make sure they got enough milk. Too many moms aren't taught what successful nursing looks like and how to watch output to make sure input is adequate.

Great post. You're so right about the amount of work involved for a baby to BF. It's obvious that you've been through the experience. I do think most moms need more education, it would help the ones that truly want to BF. What I have a problem with is when new moms use "nipple confusion" to cover the fact that they've just given up. Breastfeeding is serious work for the first couple of weeks, for baby and for mom. Moms should be educated about the work involved well before the baby is born. I think many moms go into it with good intentions, but as soon they have blisters, or have spent a few nights feeding hourly, they stop. Or they create true nipple confusion by introducing a bottle on day 3 when the first blister appears and keep using until day 6 when the blister is healed and by then baby has gotten a little lazy.

I wish I'd known about finger feeding back when I was breastfeeding. I agree that these things should be taught, and long before baby is born, it's a serious subject that requires more than can be easily taught during the average 24 hour stay.

Mimi2RN, ASN, RN · Feb 16, 2005

Years ago, moms who did not want to breastfeed (for all kinds of reasons) used wetnurses. Moms who had a baby close in age, maybe had lost their own child. The other feeding choices were very poor, gruel, sugar titties, cow or goat's milk if available.There was a high mortality rate.

I lost track of this thread.

For the most part, I don't believe in "nipple confusion". We have many moms who come in to feed their babies after discharge, the rest of the time they take a bottle. As long as they are fed, the babes don't seem to mind. We have premies who are tube, then bottle fed. They usually go to breast before they go home. Some moms just want to pump, and bottle feed, even at home. We don't cup or finger feed in our level II. The neonatologist doesn't feel it's appropriate. If a baby won't eat on pp, they have to cup feed (lactation gets upset if they don't, or document why not...."mom asked for a bottle") Why doesn't the baby want to suck? If I don't feel good, I don't want to eat, so why assume a baby will?

I wish that meth babies didn't go home with their moms. Too many of them do, and God knows what kind of life they have. If mom is high, who will feed them?

And then we have methadone babies. Of course they can breast feed, if mom so chooses. After all, most of the babies have to come of it cold turkey. Some of them are so bad that they have to be started on methadone, and weaned off before they can go home with mommy.

The joys of feeding babies.

I don't do much of that right now, I take care of ones who are too sick to eat, or have just started gavage feeds. I do like a nice chubby nine pounder, though, who's feeling good enough to eat, and then socialize and snuggle.

Gompers, BSN, RN · Feb 16, 2005

Breastmilk is what nature intended and is in every case the best food for your baby.

In a perfect world, maybe. But it's not a perfect world. I'm not just talking about moms who take medications (legal ones or not). I've worked with plenty of NICU babies (mostly former gastroschesis/omphalaceles or short-gut NEC survivors) who couldn't even tolerate breastmilk and had to be on special formulas (usually Neocate). It was either formula or TPN, and while some of their mothers were upset (many had 6+ months worth of pumped milk in their deep freezers), they understood that it was either agree to the formula...or watch their babies die of liver failure from long-term TPN.

Breastmilk is great, WE GET IT. But "in every case" it's not the best.

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Also wanted to add that my NICU doesn't do cup, spoon, or finger feedings. It's breast, bottle, NG, or nothing. In six years, 100% of the hyperbili re-admit babies I've seen have been exclusively breastfed. Either they're sleeping at the breast, or sucking like crazy and mom is producing only drops. Yes, colostrum is very nutritious, but we're talking hydration here, and many of the moms just don't understand that. When they do accept the fact that the baby needs fluids, many of the moms say they'd rather have an NG placed down their baby for feeds or poked for an IV for hydration. I just don't get this!!! Is the threat of nipple confusion or the horror of man-made formula so bad that they'd rather have their baby go through NG or IV placement than get a couple of bottles? It just hurts me to do this!!!

If the baby is on full IV fluids, then we'll allow breastfeeding if the bili is on its way down. If no IV, then only pumped milk is allowed so that we can keep track of fluids. In severe cases, we give formula instead of breastmilk because the docs say that breastmilk has bilirubin in it??? Overall, we try to keep SOME feedings going on since of course it only helps clear out that liver. Once the bili is low enough for the lights to be off, formula and IVs are DC'ed and exclusive breastfeeding can resume. Bili is checked a few more times before discharge.

Okay, said my bit. Tried to stay quiet, but I finally blew!!! JMHO, as always.