ROS'S TOOLBOX

There are various useful tips that can help with many common problems, therefore see this section as your toolbook of helpful solutions.

Breast Compressions

This technique has been well documented by Dr Jack Newman (2014). A useful technique to learn to increase the amount of milk a baby receives while they are actively ‘drinking’ at the breast. This can have a twofold benefit, your milk supply will increase, your babies milk intake will increase and this should then lead to your baby becoming satisfied quicker.

Uses:

Slow or poor weight gain
Fussing at the breast
Often unlatches
Pulling off breast due to slow let down (can often happen where there is a growth spurt and the milk output needs increasing to their demands)
Short frequent feeds or never ending feeds
Relieve persistent blocked ducts or mastitis
Stimulate a sleepy baby to continue to feed

Technique:

Support your breast with your thumb above and fingers below, or if you find it easier with a flat hand then compressing by bringing the fingers towards your palm (see the video clip below). You should place your hand close to the chest wall rather than near the areola, to prevent baby’s loss of latch.
Assess when your baby is actively drinking; there should be a rhythm of WIDE OPEN MOUTH/DEEP DROP IN JAW – PAUSE- CLOSE MOUTH This will be different from when the baby is merely suckling to stimulate let down, here the jaw doesn’t drop so low and the mouth isn’t as wide open.
When your baby starts to suckle but is not drinking yet COMPRESS THE BREAST. The compression should be firm but must not hurt you.
The baby will then start to drink WIDE OPEN MOUTH/DEEP DROP IN JAW – PAUSE – CLOSE MOUTH. Keep the compression going through this stage too.
Release when the baby stops drinking.
The baby starts to suckle again REPEAT.

At some point the baby may not suckle for some time, so a gently massage of the breast may stimulate a let-down. If you feel your baby has finished feeding on this side switch to the second breast and continue to feed to their satisfaction. Baby’s require differing amounts of milk throughout the day and night and can vary due to their temperature, their health, their growth.

The Flipple

The "Flipple" for a deeper latch:

A method of "flipping" the "Nipple" (hence Flipple) deep into the back of your baby's mouth, to ensure a good latch.

Whichever direction your baby comes onto the nipple press your finger on the opposite side of the areola. This causes the nipple to direct away from your baby's mouth. The baby actually starts to take in the breast before the nipple. Then just at the point they have their widest gape and are about to latch, let go and bring baby to the breast, simultaneously. As your baby sucks in your breast, because the nipple is attached, it is taken deep into their mouth.

The Breast Sandwich

Think about when you eat a really deep sandwich or filled roll, you squash it to fit your mouth, this technique helps squash the breast to fit your baby’s mouth. It can be used in conjunction with the previous Flipple Technique. Have the thumb in position, as with the Flipple, just behind the areola and the supporting fingers under the breast but not too close to the lower jaw and post the “sandwich” into the baby’s mouth.

Natural Breastfeeding Program

This program was developed by two esteemed American experts; Dr Theresa Nesbitt, MD and Nancy Mohrbacher, IBCLC, FILCA. The following is an exert from their introduction to their Programme:

"Wouldn't it be nice to feel confident that breastfeeding will be as easy as 1, 2, 3? Well, have no fear. When mothers draw upon their babies' natural inborn responses, the whole process becomes simpler. No more worries about nipple pain, milk production, and correct latching.

The biggest hurdle to Natural Breastfeeding isn't the technique, that really is as easy as 1, 2, 3: adjust your body, adjust your baby, adjust your breast. The biggest obstacle facing most new mothers-and often lactation consultants-is to let go of their preconceived notions of needlessly complicated breastfeeding holds and their pursuit of a proper latch. It's no wonder that many new mothers get overwhelmed. All those complications can make nursing a baby seem like it requires a nursing degree!"

https://www.naturalbreastfeeding.com/

The Dancer Hold

The "Dancer Hold" to support a mouth with low tone or recessed chin.
This technique helps stabilise the baby’s jaw and aid weak masseter (chewing) muscles (Riordan & Wambach, 2010).

Cup your breast.
Slide forward your Thumb and and index finger, leaving 3 fingers supporting your breast.
With your thumb and forefinger in a “U” shape support your baby’s head, either side of the jaw and gently squeezing their cheeks.
An alternative version can be to support the chin only. Extend the index finger to apply pressure just behind the chin bone to support the tongue while baby feeds.

Biological Nurturing

A method of positioning that works with the baby’s instinctive “Primitive Neonatal Reflexes” (Colson, 2008) that stimulate reflex responses; to root, suck and swallow and behaviours that illicit breastfeeding. It is wonderful for your baby to start its life in this position, to enable them to self-latch, but it is useful at all times to stimulate breastfeeding behaviours, or simply to calm and respond to your baby, especially beneficial in skin to skin contact. Babies feel secure in this position, where gravity holds them against your body and you have very little to do to hold and support them to feed.

Lay back from your hips, either by slouching back in a chair or laying back on the pillows of your bed, or reclining your hospital bed.
Ensure you are comfortable and your back is supported. If you have just had a Ceaserean delivery, support your wound with your flat hand as you recline.
Lay your baby onto your body (this can be any angle as long as they are comfortable) ensuring their head and body are in line.
Allow your baby to seek the breast, they may start to manoeuvre towards one side, you can help them by using your arms as boundaries. If you need to move them, do so by holding under each armpit.
Allow your baby to bob their head to find the nipple and self-latch. If they have come up too far just move them back to ensure they get an asymmetrical latch with the nipple going into the roof of the mouth. A good visual guide is there is more areola seen at the top. Although we are made differently so this may not be such a clear mark if you have a small area of arealo. Babies will often readjust themselves however, if they are not quite on properly.

Skin to Skin time

Anytime to stimulate bonding and feeding instincts or just for comfort.

Dangle Feed

This can be a helpful method to unblock a plugged or blocked milk duct. By leaning over you baby and allowing them to lie on their backs, using gravity to dislodge the plug.

Re-Birthing Bath

There are various situations where your baby may not want to latch at the breast, or have never fed at the breast, because things didn’t get off to the best start.

This technique is a lovely relaxing way to encourage your baby back to the breast, using the stimulation of skin to skin contact to trigger natural reflexes present at birth, to crawl up the mother’s abdomen and self-latch (Birth Crawl).

Run a bath that is the temperature you would bath your baby, have the lighting low if possible or perhaps candlelight (ensure this is safe to do so and the candle is well away from the bath). Hold your baby under the arms gently swimming them in the water, between your legs, ensuring their head is well clear of the water. Then place them between your breasts as if they had just been born and allow your baby to lay there and explore if they wish.

They may or may not latch but this is ok. Just allow this time together to enable your baby to regard being near the breasts in this manner as a positive calming experience. This should not be done when baby is wanting a feed.

Whatever floats your boat

To stimulate Prolactin and Oxytocin, the hormones that produce and let down breast milk you need to be in your "happy place" and whatever that is; "floats your boat" to be in that place will help. This could be:

a cuddle with your, baby, partner or anyone you love.
music.
aromatherapy, scented candles.
a nice relaxing bath.
a good film or your favourite soap/

..............whatever floats your boat

Ros's Toolbox