…Contemplating the Core Elements of a Modern Breastfeeding Lifestyle
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Nipple Monologues: Part 3: What’s Wrong with This Picture?

I found multiple references that led back to this  photo guide  for proper latching technique.   I will address the accompanying directions in the next post.  

What is wrong with this picture? 

Plenty.  I’ll list a few of the issues.  There are limits to any two-dimensional portrayal of a baby latching onto a breast. You are literally getting only snapshots of an activity which often looks similar to the untrained eye. 

www.breastfeeding.com/helpme/helpme_images_latchon.html

Frame 1

Looks like the baby here in Frame 1 is taking the breast as if it were a bottle.    

  • It should be noted that most people would not point a bottle nipple down into a baby’s mouth as it would cause him/her to gag.  They may go in centered, but immediately aim the artificial nipple toward the palate. 
  • This is one of the most common mistakes made by new mothers initiating breastfeeding.  They aim the breast as if it were a bottle and end up putting their nipple on their baby’s tongue. 

The mother’s posture is unclear throughout this photo essay.  

Frame 1 looks like she is upright and in frames 2-4, it looks like she could be lying on her back or side.  Is it even the same baby in all of these shots?  The first baby looks different from frames 2-4. 

Frame 2

Frame 3

Frame 4

The impression is that the nipple should be centered in the baby’s mouth for latch-on.  

  • If it is done this way the nipple will be captured by the tongue and gums causing pain and trauma. (Frame 2 & 3)
  • The breast should be stabilized during the latch.  Nose, not mouth opposite the mother’s nipple.   Move the baby, not the breast.

The angles of the baby to the mother’s body are all wrong. 

  • The nose is in deeper than the chin. The baby is barely past the nipple. (Frames 2-4)
  • Baby should not be parallel to the  mothers body, but rather at a 10-15 degree angle to the plane of her body.

 A well-positioned baby should be tucked in very close to the mother’s body.

  • The chin should be deeply planted on the cleavage side of the breast around ~7 o’clock; the top lip would be around ~1 o’clock. This deep mouth position would tip the nipple up into the palate and there would be no contact with the tongue.
  • The lips would automatically evert or fan out if these angles were corrected. You cannot see the phlanging of a newborn’s lips if there is a good latch. (Frame 2, 3, & 4)

The saying goes…A picture is worth a thousand words.   However, a latch photo series is never as simple as it looks and much can get lost in translation. 

As a conscious breastfeeding coach, I remind you that it is all about perspective.  Ideally, a breastfeeding latch taught  through the eyes of the mother and evaluated by the sensation of her nipples.

June 22, 2010   1 Comment

The Nipple Monologues: Part 2: Points of View

To spare nipples pain and trauma during breastfeeding, it is essential that we re-examine our view of the latch. We must keep in mind that it is Breastfeeding and not Nipplefeeding!

The human nipple is comprised of responsive, erectile tissue which carries messages to the brain. However, unlike other body parts with such traits, it does not lengthen that dramatically if there is a great latch during breastfeeding.

The nipple should never be the focus of attention. It is just the exit through which the milk fl0ws.

During breastfeeding, it should be the bottom of the breast, rather than the edge of the nipple/areola, which is actually on top of the baby’s tongue. This is described in some circles as a “sandwich” of breast tissue which needs to be deep in the babies mouth.

I am happy to report that there are thousands of breastfeeding pictures now posted on the internet. You would think that they might add some dimension to the teaching toolbox. However, there is a big difference between an artistic shot of breastfeeding such as this, by Marga Serrano,

FOOD TIME!!

and one that is instructional for a new mom with sore nipples!

Many of the photos that I found depicted babies that are clearly older, experienced breastfeeders. It would be fair to assume that sore nipples would no longer be an issue for their mothers.

Those shots that portrayed newborn babies were vague at best. Varying latches were seen from different angles; the details of each latch were unclear. Most of these breastfeeding photos were understandably focused on the baby and gave no clue as to the mother’s experience of the latch.

Unfortunately, the conventional wisdom is that the baby knows what it is doing and that an attachment of any sort is acceptable. Most people, health care workers, family members and the mothers themselves, believe if it looks like breastfeeding, then it is breastfeeding.

I beg to differ. Breastfeeding should be evaluated by how it feels and how well it works, rather than merely upon how it looks.

Please share your points of view.

June 22, 2010   1 Comment

Nipple Monologues: Part 1: What Sucks is Really Nipplefeeding

There are two things that you absolutely need in order to breastfeed…a baby and breasts. The way in which human milk is dispensed to the baby is through a fine spray that flows through its mother’s nipples. The nipples and areola are visually attractive to babies and, in combination with the scent of milk, they help them to find their way onto their mother’s breasts for feeding.

Therein lies the problem.

1. Nipples come in many shapes and sizes and are not standardized like the rubber and silicone models that can be purchased at your local drug store.

2. Nipples have nerve endings which carry messages from the baby to the mother’s brain causing the release of prolactin and oxytocin which are the hormones that guide milk production and release of milk.

3. Nipples can feel pleasure and pain sensations depending upon what is being done to them.

4. Unfortunately everyone seems to think it’s all about the nipples.

The real truth of the matter is that the nipples are only a means to an end. They are meant to serve as a guide for the mother to draw her baby onto the breast during latch-on and are the exit through which the milk flows. If too much focus is put on the nipples by the baby’s tongue and gums they will become sore and may crack and bleed. Sore nipples are one of the top reasons a mother will stop breastfeeding.

New mothers will often be subjected to an ongoing commentary about their anatomy when they begin breastfeeding; much will be said about the shape or size of their nipples. They never seem to be just right. Many health care workers make faulty assumptions, or have been taught, that the baby will not be able to latch without a prominent nipple. This is absolutely not true.

Can anything be done?

Breast Shells worn during the pregnancy will help soften the tight bands of tissue that cause inverted nipples. They also can be worn in the early days after giving birth if swelling of the breast changes the shape of the breast and makes the nipple appear to be flat or less defined.

Pumping can reshape the nipple and breast tissue temporarily so that the mother can draw the baby on past the nipple. However, this can cause some discomfort as the pump primarily pulls on the nipple.

Proper hand postitions using preferably a C-Hold, or alternately a U-Hold to shape the breast will help the mother to steady the breast during latch-on. She should actively put the baby on the breast rather than the nipple.

Nipples are the guides, not the destination. They should be used as a stationary navigational tool that will help the mother with her visual line up for a great latch. The mother’s nipple should be opposite the baby’s nose rather than in front of its mouth during latch-on. *More on this point in Part 2*

A piece of candy has the juice extracted from it by rubbing it between the tongue and palate. This is one image that comes to mind when we use the verb sucking. Given that definition, the breastfeeding baby would seem to be focusing its attention solely on the nipples. Milk, however, can actually be expressed without any direct manipulation of the nipples; compressing deeply with the hands where the jaws would be situated will produce milk flow.

Babies are really not sucking but using their jaws to compress the breast with a “chewing” action and swallowing as needed. The tongue should be under the breast covering the bottom gum and not manipulating the nipple at all as this will cause injury and pain.

It is all about the depth and angles. Ultimately the baby needs to be guided past the edges of the nipple to a place deep on the breast. It is here that they will access a great flow without hurting their mother. You want them to be oblivious to the fact that a nipple exists. You want them to be breast-centric rather than nipple-centric.

They call it Breastfeeding and not Nipplefeeding for a reason!

June 21, 2010   1 Comment

Starbucks and Breastfeeding Promotion: Building by One “Cup” or Two at a Time

There’s a joke in my family that I should just mainline coffee.  I am surprisingly calm in spite of my allotment of at least two vente coffees per day.  That being said, spending long hours writing in Starbucks has recently made me fantasize about how to make  breastfeeding promotion be as successful as the spread of this ubiquitous brand.

Relationship building is at the heart of the Starbucks Philosophy.   Howard Schultz  was CEO of Starbucks in 1997 when he published his first book ” Pour Your Heart into it:  How Starbucks Built a Company One Cup at a Time”.  According to a review of this book  on Amazon.com,  “An exemplary success story, Starbucks is identified with innovative marketing strategies, employee-ownership programs, and a product that’s become a subculture.” 

To paraphrase the famous line from the movie “Harry Met Sally”, I’ll have some of what he, Howard Schultz, aka Starbucks & co. , is having… so that I can use it to successfully promote breastfeeding.   His secret weapon is a communication style where he is clear about what he stands for, the values he promotes and he consistently makes emotional connections with his audience be they employees or consumers.  On a limited advertising budget, he literally built his brand with a heartfelt passion, one cup at a time.

This realization is most encouraging for me. I am reminded of the long standing ILCA campaign, Reach one, Teach one.  One by one, whether at Starbucks, in my prenatal breastfeeding class or anywhere else I reach and teach using the same powerful communication strategies. 

1. Identify what you are passionate about and convey that message to everyone.

I am passionate about breastfeeding.  I use a holistic approach to shift the experience to a uniformly positive one for the mother and by extension her baby or babies.  This means optimizing the latch connection to ensure ample transfer of milk and pain-free feeding.  There is no need to rely so heavily on external measurements and gadgets.  Doing so only moves us further away from the essence of breastfeeding.

2. Inspire everyone with how the service, product , or cause will improve their world. 

Breastfeeding is a human baby’s biological birthright. It is ecological and economical.  Not breastfeeding adds significantly to pollution and is expensive.  Breastmilk is a custom blended, living superfood that cannot be commercially duplicated. It is truly like liquid gold. Priceless!

3. To lead a revolution leaders tap into the emotions not just the minds of colleagues and consumers.

Storytelling is a technique that I use all the time.  It supplements hands-on and teaching by example.  When moms can relate and see themselves in another mothers story they can connect with a positive vision of successful breastfeeding for themselves.

Starbucks paid attention to both its employee/partners and customers. They created a good experience and a reputation that expanded their brand rapidly by word of mouth.  Breastfeeding advocates can learn much from this innovative marketing ploy. 

Focus on the mother, the thinking partner in a breastfeeding relationship and create for her a pain-free, positive breastfeeding experience.

June 20, 2010   1 Comment

Are You All Pumped Up?

Single-use, high quality electric pumps have been available for consumer purchase since the early 90’s.  During these intervening years, the amount of pumping has increased exponentially in the United States and across the industrialized world.  Pumping is very much part of the popular culture, often being featured in sitcoms and instructional media geared to expectant parents.  There is a not too subtle imperative to own a deluxe pump before the baby is even born.  Doctors, Nurses and Lactation Consultants encourage pumping as a way to both evaluate and to increase a mother’s milk supply. 

Pumping for some women is their idea of Breastfeeding.  Are you all Pumped Up?

Symptoms include, but are not limited to the following: 

  • You Breastfeed and pump after almost all feedings
  • You wake up in the middle of the night to pump
  • Your are pumping weeks worth of extra milk, just in case
  • You “power pump” if you get less milk out than usual in order to increase your supply
  • You pump whenever you feel something is wrong with your breasts
  • You pump to “empty” your breasts

I field inquiries in all my venues about pump management.  Mothers have been sold on the idea that the pump tells the whole story about their Breastfeeding.  They worry when they can’t extract the same amounts as their friends or in volumes that compete with ready-made formula bottles. 

Those women who do obtain copious amounts of milk when they pump will often have issues in their breasts while breastfeeding.  They tend to be out of sync with the baby and often contend with excessive leaking and engorgement.  Some will report having had Mastitis which was the result of inadequate drainage from only pumping or mixing pumping with direct, but inconsistent patterns of Breastfeeding.

Pumping can actually compound any problem brewing in the breasts.  Women who have sore nipples and engorgement are often advised to pump, rather than to correct the latch.  Congestion can build up and if not relieved the mother will spike a temperature leading to a course of antibiotic therapy.  Whenever, the health of the breast has been compromised it is essential to use the baby and not the pump to solve the problem.

Of course there is a time and place for Pumping…

  • Premature Delivery
  • Illness of mother or issues with the baby or babies that require a delay or interruption of direct breastfeeding
  • To obtain human milk if supplements are medically indicated
  • Returning to Work outside the home

Other reasons cited, may include:

  •  Mom needs a break from breastfeeding
  • Dad/partner wants to participate in feedings
  • To know how much the baby is getting at feedings

Since the mother is the only one pumping and Breastfeeding, it is not exactly a vacation.  Pumping will increase her workload and can create additional anxiety as her milk output can vary greatly depending upon when she pumps.  The mother who feels overwhelmed and worried about her milk supply may begin supplementing and make decisions that lead to early weaning. 

If you are pumping or have pumped what has been your experience?  Are you all pumped up?…or more aptly all pumped out?  I invite your comments and concerns related to pumping.

June 30, 2008   2 Comments