Breastfeeding: Is it Normal?

We are mammals which means when we birth a baby the female species produces breastmilk by lactating. Therefore, it should be normal to breastfeed. But then, why is it that we have a national goal to increase breastfeeding rates according to the latest Healthy People 2020 report? Healthy People is a national organization that historically has as its goals and objectives to improve the health of the people of the United States. Every ten years a new report is published with its latest findings which is that 75% of new mothers initiate breastfeeding. Although the initiation rates are high, current rates of duration and exclusivity remain low. Providing lactation services impacts the duration and exclusivity rates of the population served by decreasing the number of breastfeeding-related problems and increasing maternal satisfaction with their breastfeeding experience.

Many mothers discontinue breastfeeding before 6 months of age and lack exclusivity because they cannot find the lactation services to assist with breastfeeding-related problems. In the state of Illinois, the initiation rate is 70.2% with continuation rates of 36% at 6 months and 16.4% at 12 months. Rates of exclusivity are 27.9% and 13% at 3 months and 6 months respectively. Indeed, research shows that pediatricians, nurses, and other health care staff do not have the knowledge and skills needed to provide appropriate interventions for managing breastfeeding problems effectively. Common problems such as difficulties with latching technique, sore nipples, and low milk supplies can be effectively managed by lactation services. Consequently, these services can address the national breastfeeding promotion targets of increasing duration rates to 50% at 6 months and 34.1% at 12 months, and exclusivity rates of 40% and 23.7% at 3 and 6 months, respectively.

Common Concerns

Myths surrounding breastfeeding that drive me crazy are that sore nipples must be a part of the experience, and that some mothers cannot make enough milk for their babies. Yes, sore nipples happen so often that it is assumed to be “normal”. Proper latching technique causes no soreness, and this technique can be assessed and fixed immediately at the lactation appointment. Too often I hear mothers tell me that the lactation consultant said the latch looked good, but it hurt. It doesn’t matter what it looks like to me, but if it hurts you, it isn’t right. I cannot see inside your baby’s mouth to distinguish the pain that you are feeling by the shallowness of your latch or the wrong pressure exerted within the oral cavity (mouth). Therefore, when I work with you, I will quickly remove that baby of yours if your response to my inquiry of “how does it feels?” is simply not “it doesn’t hurt at all”. Then, I will assist your latching technique and re-latch your baby so that we achieve the goal of no pain. Sore nipples is a myth about breastfeeding. Call for an appointment if you experience any soreness.

The second myth surrounding breastfeeding is that some mothers cannot make enough milk. In reality, what usually happens is based on research. Dr. Peter Hartmann has done most of the latest lactation-related studies in Australia. He has demonstrated that if colostrum, the initial milk after delivery, is not removed from the breast within 6 hours of delivery, that “delayed lactogenesis” occurs. Whenever moms have a complicated delivery process, such as a cesarean section, or a hard, long labor, there can be a delay in active nutritive-suckling by the newborn at the breast. Nutritive-suckling is defined as at least 6 long jaw excursions in a row, with a pause to breathe and swallow, and then repeated patterns of at least 6 jaw movements. Many new moms do not know this definition of effective suckling for effective removal or extraction of the colostrum within 6 hours of delivery. Consequently, these moms have delayed lactogenesis unless they express or extract the droplets of colostrum with an effective hospital-grade electric breastpump, which I feel is the Medela Symphony pump. According to research findings, less than 1% of women cannot make enough breastmilk for their infants for various reasons such as infertility or hormonal problems.

Lactation Services

The lactation services provided are reimbursed by several insurance companies. The main one is Blue Cross/Blue Shield PPO since the state of Illinois allows me to be a provider and bill for services with my license as an Advanced Practice Nurse (APN) with a specialty as an International Board Certified Lactation Consultant (IBCLC). Once you call to schedule an appointment, the consult includes fixing the latches, which is the main problem seen. The fixed latches causes mom’s nipples to no longer be sore and then we take steps to increase the milk supply if we “temporarily” experience a low supply from the lack of proper stimulation and extraction of breastmilk. Most all breastfeeding-related problems are fixable. The best time to seek help is within the early weeks of breastfeeding. The visit takes about 1 to 1-1/2 hours. There is also a measurement of intake at breast done. Only the BabyWeigh Scale is accurate for measuring intake at breast by calculating a before and after feeding weight in grams. Grams equals number of cc’s or ml’s of breastmilk intake at breast. This resolves the concerns or worries that many mothers have regarding breastfeeding being hard because you don’t know how much your baby is getting at breast. Schedule an appointment with your BCBS card in hand for insurance reimbursement like going to the doctor or to the physical therapist, and this issue can be resolved.

The moms and babies served by Carol Chamblin, RN, APN, IBCLC at Breast ‘N Baby Lactation Services, Inc. exceed the national duration and exclusivity rates of breastfeeding. Most of them report back that they breastfed for at least a year. Call: 630-513-1101.