Breastfeeding questions

Specialties NICU

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Just wondering what your thoughts are on this..

I know that especially in our culture today breastfeeding is the absolute it thing to do, but sometimes it is not best for the baby, or not done correctly (ex. outside admissions for hyperbili, baby is dehydarated and tada..exclusively breastfeed; we give them the first bottle and they chug it down!). My questions are:

1. What are your thoughts on nipple confusion?

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

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

4. using a pacifier?

Of course, in the NICU it's a little different because we have to put the baby's health first, and once it's explained (in an ideal world you could breastfeed your child, but he/she is in the NICU, this is not ideal!) parents are usually better about it. I have noticed that if a baby will BF he will, and if he won't, he needs a little more support, regardless of the bottle feeding.

We thaw out frozen milk, but we put the rest in the fridge.

We do give children pacifiers if they are not eating and need a soothing mechanism.Thoughts? t.

I'd also like to add that when it is doable we absolutely try to help both mom and baby with the process, including setting them up with a lactation consultant. The benefits of breastfeeding cannot be denied, and it's wonderful when it works.

again, thank you all so much for these and future responses. even today i had a baby whose mother wanted to exclusively breastfeed, and it was good that I had reviewed some of these thoughts already...I was able to support her but also answer her questions more effectively. t.

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Gompers and Mimi - thanks for your informative and knowledgeable posts.

Good reading in the middle of the night when I can't sleep. :)

My 3 year old was jaundiced and had a few bottles as well as breastfed . . no nipple confusion there and he just recently stopped nursing at 3 1/2.

Mimi - you are right, we are all different. One size fits all doesn't work.

steph

Please dont take this the wrong way.......But, why would you want to breast feed a child up to 3 1/2 yrs old? The idea of breast or formula feeding is to nourish the infant until they can nourish themselves with solid food and alternative fluids. Was it for comforting reasons? I just cant get that picture out of my head... I have a 3 year old, and he plays soccer, on a TEAM, I cant IMAGINE actually breastfeeding him still......Please dont take offense to my dismay, I just cant figure out why.......:uhoh21:

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Specializes in NICU/Neonatal transport.

Breastfeeding continues to provide immunological, emotional and physical benefits, well past a year. The average and normal age for human weaning is between 2 and 4 years. It also continues to provide benefits to mom, including lowering her risk of breast cancer.

http://www.lalecheleague.org/NB/NBextended.html this has a lot of good information about extended breastfeeding and why it is beneficial to continue it beyond a year.

Plus, keep in mind that nursing a child that age isn't at all like nursing a newborn, it's typically before/after naps/bed, depending on the child, and occasionally needed if the child is injured in some manner. But it's not their sole source of nutrition by far.

If only by looking at our teeth, it's clear we are supposed to be nursing for much longer than we do; we keep our milk teeth for quite some time. The reason we have stopped nursing so long in this country is because of our unnatural hangups about sex and breasts.

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

Once breast milk is thawed it is good refrigerated for 24 hours. It should be warmed by a warm water bath only. If it is poured into a bottle for a feeding, but not all is consumed, the remainder should be discarded, not re-refrigerated.

"If in doubt, pour it out."

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Please dont take this the wrong way.......But, why would you want to breast feed a child up to 3 1/2 yrs old? The idea of breast or formula feeding is to nourish the infant until they can nourish themselves with solid food and alternative fluids. Was it for comforting reasons? I just cant get that picture out of my head... I have a 3 year old, and he plays soccer, on a TEAM, I cant IMAGINE actually breastfeeding him still......Please dont take offense to my dismay, I just cant figure out why.......:uhoh21:

There are a bunch of threads about extended breastfeeding and there are alot of us out there.

As LilPeanut said, I didn't breastfeed my kids like I breastfed them when they were infants and only relying on breastmilk. It became a first thing in the morning time for us, before naps or bedtime and yes, when they fell and got an owie or were just having a fatigue-related meltdown. It was comforting. Breastmilk also continues to have health benefits for my child and for me. As mentioned, a decrease in the risk of breast cancer.

My son doesn't play on a soccer team at 3 - I can't imagine him even doing anything that organized. He is bright, surprises people by how advanced his vocabulary is, rides his tricycle, takes walks with me, sings the ABC song, "reads" his books from memory (Green Eggs and Ham is one he has memorized), puts together track on his Thomas the Tank Engine track, puts puzzles together, just the typical pre-school stuff. I've coached soccer before with 8-10 year olds and they were NOT organized - basically played bunch ball. :roll

Fergus - Dr. Thomas Hale's book, Medications and Mother's Milk is very comprehensive. I had a mom who had already successfully breastfed 3 older children and then had a child 10 years later. She was on metformin and zoloft and her OB doc told her she could not breastfeed. She was at risk for depression and she called me and then her husband called me about their wish to breastfeed their child - she was very upset. I faxed Dr. Hale with the medications, her history and asked if she could breastfeed. He actually called me at work!! I was so surprised. He sent me two studies, one about metformin. He said she could successfully breastfeed without any problem. I had to go through her OB doc and let him have the info, diplomatically . . . .he agreed. I called her back and she was so happy.

This woman was already at risk for Post Partum Depression as she had a hx of psych problems and was diabetic. Not being able to breastfeed was pushing her into a depression. The best thing for her was to get accurate information. Alot of OB docs are not up to speed with this aspect of breastfeeding.

I use Dr. Hale's book and website often.

http://neonatal.ttuhsc.edu/lact/index.html

steph

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Specializes in NICU/Neonatal transport.

I can't imagine my 4.5 year old actually playing soccer either. He can run after a ball of course, but actually understanding the game, no way! I still nurse my 2yo daughter, I nursed my son until he was 21 months, but I was forced to wean due to becoming pg with my daughter and being a very high preterm labor risk. It would seem strange if you haven't nursed your child in a long time, but she is still a baby in so many ways and it has been so gradual, I can't imagine imposing an artificial cutoff just because someone else has decided that she's too old.

It's been especially helpful now that I've gone back to school because I'm having to be gone a lot sometimes and it provides her a reassurance and way to reconnect with me.

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There are a bunch of threads about extended breastfeeding and there are alot of us out there.

As LilPeanut said, I didn't breastfeed my kids like I breastfed them when they were infants and only relying on breastmilk. It became a first thing in the morning time for us, before naps or bedtime and yes, when they fell and got an owie or were just having a fatigue-related meltdown. It was comforting. Breastmilk also continues to have health benefits for my child and for me. As mentioned, a decrease in the risk of breast cancer.

My son doesn't play on a soccer team at 3 - I can't imagine him even doing anything that organized. He is bright, surprises people by how advanced his vocabulary is, rides his tricycle, takes walks with me, sings the ABC song, "reads" his books from memory (Green Eggs and Ham is one he has memorized), puts together track on his Thomas the Tank Engine track, puts puzzles together, just the typical pre-school stuff. I've coached soccer before with 8-10 year olds and they were NOT organized - basically played bunch ball. :roll

steph

Fair enough steph. I just referenced the soccer thing, because, in my view of breastfeeding, ( AND i REALIZE THIS IS MY OWN VIEW) , it isnt the "norm" to breastfeed a child that is old enough to do something like that, organized or not. I realize there are probably forums and threads I could review, but since you mentioned it here I thought i could just ask, and I realize there are lots of "you" out there, as you said. But, mostly the reason moms give for that is they are "not ready to give it up" Just curious what your reasons were.... thanks for sharing!!!! Please, no hard feelings, none intended here......:)
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Yeah Steph, I think lithium is one of the few that is still out. Most diabetic meds are ok as are most anti-anxiety meds I believe.

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Fair enough steph. I just referenced the soccer thing, because, in my view of breastfeeding, ( AND i REALIZE THIS IS MY OWN VIEW) , it isnt the "norm" to breastfeed a child that is old enough to do something like that, organized or not. I realize there are probably forums and threads I could review, but since you mentioned it here I thought i could just ask, and I realize there are lots of "you" out there, as you said. But, mostly the reason moms give for that is they are "not ready to give it up" Just curious what your reasons were.... thanks for sharing!!!! Please, no hard feelings, none intended here......:)

No hard feelings at all. I was surprised that people did this too. Until I had my own children. It just sorta develops naturally . . .

steph

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Yeah Steph, I think lithium is one of the few that is still out. Most diabetic meds are ok as are most anti-anxiety meds I believe.

What was scary for me and what I forgot to mention is the mom was going to go off her meds if she couldn't breastfeed so she could breastfeed. And that was what would have put her at risk.

Funny, I was paged at work and answered the phone and heard "Hi this is Dr. Hale" .. .he has a charming southern accent and I said "Hello, wow, I never expected you to call me" and he said "honey, what did you expect me to do?". He was very nice.

Our Lactation Consultant bought Dr. Hale's book and gave it to each and every OB doc. They really needed updated information.

Of course, they all tease us about being breastfeeding Nazi's . . .

steph

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In the case of NORMAL healthy moms, yes, breast is best. But if a mom is a drug-user or HIV positive, it becomes a question of what is truly "best" for baby. Also, very heavy smokers sometimes can't produce enough nutritious milk to feed adquately. Sometimes, supplementation is essential to infant wellbeing.

So, no, in "every case" breastfeeding is NOT best. It depends on the situation.

You are 100% right. Deegale, however has many of her facts wrong.

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Please dont take this the wrong way.......But, why would you want to breast feed a child up to 3 1/2 yrs old? The idea of breast or formula feeding is to nourish the infant until they can nourish themselves with solid food and alternative fluids. Was it for comforting reasons? I just cant get that picture out of my head... I have a 3 year old, and he plays soccer, on a TEAM, I cant IMAGINE actually breastfeeding him still......Please dont take offense to my dismay, I just cant figure out why.......:uhoh21:

I agree with your feelings on this. I think that 3 and a half is far to old to be breastfeeding. We don't condone giving a child a bottle at that age, or infant formula, so I don't understand continuing to BF so long. I have a 3 year old, who also plays soccer, so I know where you are coming from. He's no longer a baby, he's a little boy now. There is a natural order to things even if there aren't hard and fast rules, and if your child potty trains while still BFing, then you're doing things out of order.

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