I had a breastfeeding class after work yesterday at Kaiser, so I took the opportunity to do my lab tests at the same time. The results are already back — I am a bit anemic, which my OB already told me I would be because apparently all pregnant women are. He already instructed me to take iron supplements (I’m taking the non-binding liquid vegan iron supplement “Floradix.” Just 10ml a day. Yummy), and it would only be a source of concern if I’m extremely anemic and need more intervention. I’m not drastic, I came out close to where I was on my last iron test in April, when I wasn’t supplementing. I’m also NOT diabetic. Yay! I don’t know why I was actually worried about that. I guess cuz it would force me to change so many things. I don’t eat a lot of sweets, so if I had gestational diabetes, I’d have to cut out what little sweets I do eat — fruit, the occasional bread item, yogurt, juice. That would suck. But according to results, I tested better now than I did on my gestational diabetes test in April.

Now, the breastfeeding class. I want to write this stuff down cuz the 2.5 hours turned out to be SO much more informative and beneficial than I’d expected, and I don’t want to forget stuff. Mr. W and I know next to nothing about breastfeeding, since his kids’ mom didn’t do it (I don’t think she had the patience or the information), my mom didn’t do it, his mom didn’t do it, and neither of us have sisters we could’ve learned from. He thought it was an important class for me and encouraged me to take it, altho he expected to be bored out of his mind there. “I’ll probably be the only guy in the class,” he griped.
I perked him up with, “Think of all the boobies you’re gonna see in the presentation!” It was a full class and just about everyone, with the exception of maybe 2 women, came with their male partners. Some of the male partners had more questions and concerns than their female counterparts.

We learned (and practiced with infant dolls) three holding positions: cradle hold, cross-cradle hold, and football hold. Baby should be turned on its side, stomach facing our stomach, with baby’s top ear, shoulder and hip in alignment. Baby should be nose-to-nipple, so that it has to tilt its head back to suckle, which encourages better drinking positioning. If the chin is closer to the chest, it causes dribbling and poor latching. (Poor latching apparently hurts.) On the cradle-style holds, if the baby’s nose is pressed too far into the breast, we can wrap baby’s legs around our waist which tilts the baby’s upper body so that the face is away from the breast and it can breathe properly.

Proper latching is, surprisingly to me, a very wide mouth covering much of the areola. Some areola may be visible above the baby’s upper lip. I always thought babies latched onto the nipple, but not so. The nipple should be well deep inside baby’s mouth in the curve of the roof of the mouth, and breastfeeding doesn’t hurt or crack the nipples. If it cracks and hurts, the baby’s been latching too shallowly (at the nipple instead of at the breast). A proper latch will have the baby’s nose tip and chin making contact with the breast. Baby’s lips should be out and not pulled in. If a poor latch is established, we break the suction by gently inserting a clean finger at the breast and sliding it into baby’s mouth, and relatching baby. Oh, and don’t latch baby until its mouth is wide open, which can be encouraged by touching the nipple to its upper lip. When the mouth opens wide, pull baby onto breast quickly and fully for a proper latch.

We were shown how to recognize signs that the baby’s hungry BEFORE the baby’s a crying hysterical mess. We’re told to feed on the baby’s hunger schedule and not by timing a clock. If baby starts sucking on its fists, or starts “rooting” (turning toward your body and appearing to look for a breast with its face), or does an open-mouthed sucking expression with the tongue slightly out, feed it. The baby cries as a last resort when it’s hungry and frustrated that it can’t find food. When the baby’s in the hysterical crying fit, it often is so worked up it doesn’t even realize when it’s got food in its mouth and will refuse to feed, so we’re told to calm the baby down first (skin-to-skin contact, maybe putting the tip of our finger in its mouth), and THEN feed it.

Once every 24 hours, probably in the wee hours of the night (when the baby is used to being awake in utero), the baby will likely go thru a “cluster feeding.” This freaks out a lot of new moms cuz they don’t understand why the baby is being so fussy — it wants to feed, and when done, it’s still clingy, then it wants to feed again, and you can’t take it off you, and it keeps doing this marathon feeding thing. Supposedly this is normal, and the consolation is that after a cluster feeding, the baby takes a long satisfied nap.

No pacifiers or bottles for at least the first month of establishing proper breastfeeding. The human breast is designed to nurse the baby until the baby is satisfied. The rate at which milk is delivered is identical to the needs of the baby to get the “full” signal from its stomach to its brain. Baby learns that to get the milk started, it needs a few shallow tugs, then when the milk starts, it does its deep pulls. Bottles don’t do this, and deliver milk way too fast, so the baby ends up full before it realizes it and will overdrink, then associate the overfull feeling with normalcy, which studies have shown may cause them to gorge themselves later on in childhood/life, too. Pacifiers train babies to make shallow short sucks, which is not how you want them to learn to take milk, which is wide open-mouthed deep sucks. So giving them pacifiers at the same time you’re trying to get them on proper latching technique works against some babies.

I used to think that direct breastfeeding would be too rough on my body, so I didn’t have a problem conceptually just pumping and delivering the breastmilk (full of nutrition and antibodies) via bottle. However, I learned last nite that a properly latched baby has so little contact with the nipple, which only serves to deliver the milk and is not the point of interaction, that it shouldn’t cause any discomfort or soreness. And, the Montgomery’s glands at the areolas keep everything antibacterial and moisturized. (For sanition, therefore, only gentle cleansing once a day with mild soap and water is necessary.) If there is some soreness for some reason, no ointment is really necessary; some of your own breastmilk can be rubbed onto the area and allowed to air dry for the best moisturizer and anti-bacterial treatment properties.

Yes, you can and should breastfeed even if you’re sick (assuming you’re not on meds that doctors tell you not take while breastfeeding), because the baby gets your immune defense immediately. This makes the baby even less susceptible to getting the bug that you currently have. However, if you have some alcohol, it’s best to pump and dump, cuz that gets infused into breastmilk. Even tho you can return to some of the food you had pre-pregnancy like sushi while breastfeeding, you should still avoid the high-mercury fish because mercury also goes into breastmilk.

Apparently for the first 1-2 days after birth, the baby’s stomach is the size of a marble. Therefore, your breasts produce quality over quantity. A thick concentrated breastmilk called colostrum, dense with nutrition and antibodies, is made during that time to feed the baby. At 3+ days, the baby’s stomach is slightly bigger, and your body is simultaneously making transition milk. It’s a blend of more liquified mature milk with colostrum. After that (which I think is around the 2-week point), your baby’s stomach is the size of chicken egg, and can take mature milk. The milk breasts make is now plentiful and very fluid to match baby’s needs. (This is so amazing.) Apparently each breast makes enough milk to properly feed a baby, so 1 baby + 2 breasts means more than enough milk. You can encourage the milk flow by pumping in between feedings. A baby will feed 8-12 times a day, so we’re told to make sure to switch breasts and empty out the breasts to encourage proper milk production (supply vs demand). I guess a lot of new moms don’t realize that they’re not gonna make mature milk immediately, so they think they aren’t making enough milk and just give up. Or they don’t want to pump to keep supply up, or find it too inconvenient to breastfeed 8-12 times a day, so they start supplementing with formula. After that, because demand on the breasts drops, the supply drops off correspondingly.

We’re also taught how to check for signs that the baby’s getting enough to drink. (Breastmilk exclusively for the first 6 months of life, no water or other foods until after, for proper GI behavior.) The first day, baby should make at least one poopy diaper and 1 wet diaper. Day 2, 2 wet and 2 poopy diapers. Day 3, 3/3. Day 4, 4/4. Day 5, 5/5. Then it will even out about that time. The first couple of days’ poopy diaper mess is going to be black and tar-like; that’s the bilirubin and amniotic fluid stuff the baby has in its system from the womb that it needs to expel to prevent jaundice and other complications. Next couple of days, poopy diaper is now greenish, as the last of the bilirubin stuff comes out. After that, poopy diaper is now mustard-colored, the proper color of processed breast milk. If the baby is making less than that, especially by beginning guidelines, we’re told to bring them in to the hospital to see if the problem is with lactation, or with feeding, or with baby. (Yes, we were shown photos.) We were also taught how to chart/track these diapers to make sure baby’s on the right track. Just for the first few weeks.

Apparently, dairy products make the baby gassy or colicky. If you’re giving the baby exclusively breastmilk and the baby’s having these problems, cut your own dairy intake cuz cow’s milk stuff is getting into your breastmilk and affecting baby’s sensitive GI tract. We’re also taught about burping the baby, and told that breastfed babies may not have gas (no air in breasts to transfer), so if we’re patting for 5-10 mins and nothing happens, we can assume the baby doesn’t have an air bubble.

We’re also told how to manage sleepy babies. Some babies are so drugged up when they’re born due to the epidurals and other stuff administered to mom during delivery, that they aren’t as responsive and sleep the day away. This is not good, because they need to eat. We’re taught how to wake them up, establish bonding, how to burp them in a way that doesn’t put them to sleep, how to encourage sleepy babies to feed.

And apparently, some women leak and some women don’t. The instructor told us not to buy a ton of breast pads unless we know we’re the leaky women. (Did not know that.)

Also interesting, babies are not designed to be away from mom. They’ll go into complaint mode and cry for mom, then if they don’t get mom, they go into despair, and then they eventually shut down and metabolism drops, vitals drop, etc. This is nature’s way of protecting them; baby will cry for mom to let mom know it’s lost or abandoned, and mom’s supposed to find the baby. If mom and baby aren’t reunited soon, baby goes on shut-down to keep it alive as long as it could until mom can find it. Babies are supposed to be with mom at all times until they can survive longer periods of time without mom (we see this in animals all the time), so Kaiser doesn’t put them in nurserys away from mom anymore; if mom so desires, the baby is in the room with her until discharge. That way bonding can be encouraged between mom and child, and mom can start learning her baby’s body language for hunger or loneliness or sleepiness, etc.

They really put things into perspective by saying that babies only need 3 things: to feel its presence is acknowledged, to be fed, to be secure. All the other stuff out there is just marketing.