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Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA

International Board Certified Lactation Consultant

www.virginiathorley.com

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Emergency situations - another year

Posted on October 3, 2015 at 2:02 AM Comments comments (2)
With the bushfire season and the stormy season already started in different parts of Australia, it is time for a reminder that the disaster channel for up-to-date information in emergency situations in Australia is ABC Local Radio. Do remember to have spare batteries for a portable radio.

If accessing crucial information from a mobile device, it is useful to know that, if the power goes off, the device can be recharged from a car battery. (Just check - now - that you have the right connection to do this.) 

If your baby is breastfed and you are considering weaning you might want to delay this till after an emergency.  Continuing to breastfeed means food security for your baby and no worries about interruptions to water supply or power, or unsafe water. Did you know you can boost the milk supply by increasing breastfeeds for the duration of the emergency? If you need support to do this or are worried about your milk supply, contact the Australian Breastfeeding Association for 24/7 advice by telephone or email, or go to the website for links, at www.breastfeeding.asn.au . You may want to telephone your lactation consultant (IBCLC) if you are already in touch with one.

If you are not breastfeeding, now is the time  - before any emergency situation arises - to put together an emergency kit with your baby's food and the utensils needed to mix and give the feed. If in doubt, contact your local Child Health Nurse for detailed information.

Be prepared! We always hope that natural disasters won't happen anywhere near us, but unfortunately they do, as the last few summers have taught us. 

How much fluid does a breastfeeding mother need?

Posted on September 26, 2015 at 2:02 AM Comments comments (8)
Water:
It is good to see more people are carrying refillable water bottles - computers on the train, school kids, breastfeeding Mums, fitness fans, busy Mums on the go, bike riders. It is one of those positive practices that has sprung up, to maintain hydration conveniently - without having to look for a drinking fountain or a shop. It's also good for the environment. So it is win/win.
Keeping the water bottle hygienic I guess means one user - not sharing it - and regular washing and draining it to dry it. On days that I use a water bottle I wash it in really hot water at the end of the day, before refilling it. When I have time I try to remember to let it drain on the sink, not every day, before refilling it. What do others do?

Other fluids:
Earlier in this blog I mentioned soup as a way of drinking enough fluid. I'd love to have your comments about your favourite soup - chicken soup, pumpkin soup, congee, or other soups. While I enjoy many soups, I particularly enjoy the pumpkin and sweet potato or pumpkin and lentil soup in a cafe on campus.  It's my occasional treat.
Do YOU have a favourite soup recipe you want to share, or a story about why you enjoy it?

Favourite memories of breastfeeding

Posted on May 8, 2015 at 9:20 PM Comments comments (4)
Mothers often look back over the time when they were breastfeeding and mention special memories. A baby's little hand patting the mother's face, the sounds babies make during breastfeeding....  If you are a breastfeeding mother, or if you breastfed in the past - even a long time ago - you are welcome to share these special memories here.

How much liquid should I drink as a breastfeeding mother?

Posted on May 2, 2015 at 12:56 AM Comments comments (8)
So often busy mothers with new babies wonder if they are drinking enough fluid, particularly if they hear conflicting ideas, often involving a number.

A set number doesn't account for changes in the weather or your activity. For instance, in hot weather you will of course need to drink more fluid, especially water. The same applies if you start more intense physical activity, such as going to the gym or playing a sport.

A quick guide is a) to drink according to thirst and b) increase intake or water or other fluid if your urine looks darker than usual. You will probably find you are thirsty and need to drink more while you are making milk for your baby.  Many mothers now carry a water bottle so that they can take a drink anywhere, any time, to make sure they drink enough. This is a good idea as it is so easy to forget one's own needs when caring for a baby.

Drinking an excessive amount of water to try to meet a goal that doesn't suit your needs can make you feel uncomfortable, and may even hamper the milk-ejection reflex, if taken to extremes. As mentioned, the amount you need may vary according to the weather and your level of physical activity.

Besides water, don't forget that soup and other drinks, and the cow's milk added to breakfast cereal, also count as fluid intake.

The baby's second week

Posted on April 18, 2015 at 1:39 AM Comments comments (6)
Parents, especially mothers, often worry when their baby wants to feed-feed-feed at the breast in the second week. Does it mean there's no milk? Is your baby the only baby in the world doing this? Are you creating a bad habit?

Be assured that this is normal behaviour. When your baby was born, he had a very tiny stomach, which was just right for the small amounts of colostrum (the first milk) he was getting at the start. By the end of the first week and into the second week, his stomach capacity has grown - a lot. To fill up this larger stomach he needs more milk, and the way to make MORE milk is to stimulate the milk-making system by feeding very frequently.  at this age, your baby has one job to do - take lots of breastfeeds to stimulate  your breasts to make more milk. This is his WORK. Your clever little baby knows innately that if he keeps feeding his needs will be met. He doesn't have to think about this - he just does it. He is doing his JOB. Meeting his needs at this age won't create a bad habit, but will help him grow and feel satisfied.

Many mothers across Australia and across the world are also breastfeeding their new babies very frequent and some, like you, will worry whether they are doing the right thing. You are not the only one. You are doing the right thing. If in doubt, you can contact an IBCLC (lactation consultant) - see the Contact Ss page on this website or, for someone near you, visit www.lcanz.org and go to "Find a lactation consultant". Or you may want to contact the 24/7 helpline of the Australian Breastfeeding Association (see the Links page of this website).

Fussy babies at about 6 weeks

Posted on May 8, 2014 at 7:07 PM Comments comments (7)
It is common for babies to be fussy and to want to go to the breast more often at somewhere around this age.  A number of ideas and "names" for this stage have been suggested, none of them based on evidence - terms such as "appetite increase", "wonder week".  The most relevant question is: What has been happening in the last few days?
 
The consistent factor that I have found is that this is when mothers and their babies have several appointments.  These are their 6-week check-ups with the paediatrician and the obstetrician, and they may have an appointment with the Child Health clinic also. These appointments often involve finding parking and then waiting round.  While out for the day, they may stop off to get a load of much-needed groceries on the way home.
 
Consequently, a feed or two is delayed or missed.  The baby KNOWS what to do to make up for this reduction in intake, and wants to feed more often. More frequent feeding stimulates the breasts to make more milk (as the more milk taken out, the more that will be made).  In a short time, if the baby is given unrestricted access to the breast, the slight reduction in supply is fixed.  Easily fixed.  The baby becomes content again. 
 

Hand expressing - with or without pumping

Posted on April 2, 2014 at 8:16 PM Comments comments (7)
Best Practice for expressing milk long-term – “hands on pumping”
 
-          Have a photo of your baby, so that you can focus on your little one, instead of the machine
-          Massage the breast or apply a warm pack
-          Hand express to start the flow [See YouTube videos – links below]
-          If using a machine pump, apply the well-fitting pump flange, making sure to centre your nipple so it won’t rub against the side. (A mirror can help.)
-          When the flow slows or stops, switch sides. You can switch back and forth if your supply is really low
-          When no more milk is coming, or 15-20 minutes is up, whichever  comes first, stop pumping
-          Use your hands to express your breasts for a little bit more
-          If you keep the pump set up on the table, you can do a short pumping session anytime you walk by it. That’s called “power pumping” – great stmulation!
 
REMEMBER
 
- If you have no electric power or your manual pump breaks, you can skip the pumping stages – and just express by hand. With practice you will improve.  In many parts of the word pumping machines aren’t marketed as local women can’t afford them  and they become good at hand expression.
 
- You can hand express anywhere, with no need for a power socket.  It is a skill worth learning and practising. Practice makes perfect.
 
Search Results for “hand expression”RECOMMENDED:
1.                             Hand Expression Tutorial - YouTube
 
 
2.                             Hand Expression of Breastmilk - Newborn Nursery at LPCH ...
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But there are many benefits of knowing how to express milk from the breast ... In this video, Dr. Jane Morton demonstrates how easily hand expression can be  ...
 
 
3.                             Maximizing Milk Production with Hands On Pumping - Newborn ...
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Maximizing Milk Production with Hands On Pumping... This video demonstrates some ways that pumping mothers can increase production without medication.
 
 
 

Heatwaves and emergencies

Posted on February 22, 2014 at 1:00 AM Comments comments (4)
Emergency information:
 
This message was prepared for people in Australia in areas of the southern states suffering serious bushfires, but it applies in other emergencies. Please be aware that ABC Local Radio is your emergency channel with regular updates specific to your location.  If you are a health professional, you will want to remind the families you work with about this.
 
Hot weather:
 
While other adults and children need extra fluid in the heat, breastfeeding mothers need to remember to drink plenty of water, too. A good guide in hot weather is to drink enough to keep urine clear (not dark).
For mothers:  A healthy breastfed baby, given unrestricted access to the breast, will obtain enough fluid to avoid dehydration, but make sure your baby doesn't become overheated, especially if a newborn. Unless you have air-conditioning, that means:
- undressing your baby to just a nappy (diaper),
- sponging her/him with cool water as often as necessary
- your baby's biggest feeds may be in the early morning and evening, with short, frequent feeds through the heat of the day to quench thirst
- if you  baby is too listless to feed or you are concerned about her/his condition, seek medical attention
 
It's worth repeating that
- the coolest spots in the home are away from windows and external walls, such as in an internal passageway
- pools and beaches are a no-no in the daytime, because there is reflected heat as well as direct heat. This can be overheat a baby, as well as damage delicate skins
- glare means heat.  So keep the curtains drawn to block the glare
 
 

Baby's hands and how they use them - helping the milk to flow

Posted on February 8, 2014 at 8:28 AM Comments comments (4)
Almost twenty years ago a mother, whose baby had just head-butted her breast, asked my why he was doing that. I had been around farm animals and so I knew that calves and goat kids head-butted their mothers to make the milk "let down"; that is, to stimulate the milk ejection reflex (MER).  Cows and nanny goats have leathery udders and so only a vigorous action would be felt. This isn't the usual way that human babies do it - and so I started observing babies at the breast, to see what they did.
 
Very soon, I realised that babies have their own way.  They use their hands. What they usually do is to place a little hand on the breast and gently push. Mothers feel the pressure and look down at the cute little hand - and there is a surge of oxytocin, the hormone that works the MER. The milk is released and the baby starts drinking again.
 
This seems to work even when mothers know what is happening.  In fact, when the MER needs a little help I sometimes ask a mother's permission to place her baby's little hand on her breast. I get her to focus on his hand, talking about how it looks, the dimples on the knuckles, and so on. Its seems magical when he starts drinking again.
 
This natural process is messed up if a baby's hands are restricted, in the belief that they need to be controlled. So frustrating for babies!
 
For years I have shared this information with one mother at a time, about how babies use their hands. When I mentioned it to a group of other health professionals a few years ago, it was a "lightbulb" moment for them!  They had seen babies do this, but had never made the connection about WHY. Whether you are a mother, a family member, or a health professional, you may find this information useful.
 
This is the second of three topics about the importance of babies' hands in breastfeeding.

Baby's hands and how they use them - "I've finished my feed".

Posted on February 8, 2014 at 4:53 AM Comments comments (3)
Caring for a new baby is a learning process for first-time mothers, especially as many mothers haven't held a newborn baby before. A common question is - "How do I know when my baby has finished a breastfeed?"
 
Of course, as you get to know your baby and gain more confidence, it is easier to know when the feed has finished. 
 
Unfortunately, people ofter tell mothers that a baby will always go to sleep or come off the breast by herself.  This isn't the reality with a lot of babies. They like staying there.
 
At the beginning of a feed, most babies have closed fists.  What I find is a good guide if you think the baby has finished is to see if your baby's fingers have opened out and if her hand is floppy.  This has been a useful guide for a lot of mothers.  As with any guide,  the occasional baby may act differently - but most will do this. If you use this as a rough guide, remember to watch your baby to know what is usual for her.

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