Season 1 / Episode 08 / Feeding

Feeding: Breast

This is the story of what it was like to exclusively breastfeed, how long we did it for, the challenges and connections that will forever be in our memory.

Two parts, one conversation

Part 1 The Moms

Feeding: Breast, with the moms

paula’s story

Breastfeeding is such a loaded topic! Between deciding to breastfeed, learning how to breastfeed and dealing with all the stigmas around breastfeeding, it’s fair to say it has become almost as debated as a political election. I remember being pregnant with Maya, thinking, I’m going to breastfeed because “breast is best,” and it's going to go just fine; she will know what to do, and no problems will be had because I’m the exception to the rule; or so I thought. When I gave birth to her, she was plopped on my chest for some skin-to-skin action, and after that, she was ready to have her first meal. I thought she would open her mouth and do what she needed, but no, it had to be a joint effort. No class in the world could have prepared me for actually doing it myself. Thank god the nurses were there to assist me, and after two days of being at the hospital, I didn't want to leave! I remember pressing that call button repeatedly, asking the nurse to come and place her properly to check my technique or make sure I was doing it right and that she was actually drinking. What did it feel like the first time? Just as you would think, someone is sucking on your nipple, but for feeding purposes, not for pleasure, so a little more tug than you would expect.

Once we brought her home, I thought we would keep calm, carry on, and pick up right where we left off. We did pretty well for the first couple of weeks or so; it felt like riding a bike, until one day, her feeding pattern changed out of nowhere, and she just kept latching, unlatching, and crying...it was awful. I didn't know what was happening, and I still don't know to this day what happened. You hear all these words like cluster feeding and football pose, but I didn't remember any of them from the one class I took or from the nurses showing me! Youtube to my rescue! When that didn't help, I called my CLSC nurse. Tamara was her name; even during full-on COVID, she came over, ensured my technique was adequate, and helped me navigate what I was doing wrong. The way she showed me how to open her mouth and place her on my breast stayed in my mind forever, and when I had Maddie, I remembered to do precisely that because it was explained to me in a way that stuck.

katherine’s story

Katherine, a mom of two, begins by sharing that her breastfeeding journey was challenging for both girls. Starting with her firstborn, she felt something was off right away. Although she was in a very breastfeeding-driven hospital, as soon as she was discharged, she felt uncomfortable, unconfident and in pain. Once home, alone, expected to get “this right” by herself, Katherine thought of what they had told her at the hospital, how the discomfort was expected and how it was like breaking into a shoe; it was new for her, it was new for her baby, and it was new for her breast.

“i would dread each feed…”

At this stage, Katherine was feeding her newborn on demand, about every two hours and between the pain, the tears and the fatigue, she knew that this shoe would need some extra support. Katherine reached out to a lactation consultant and was lucky enough to find one that came to her home during the pandemic to check on her technique and the mechanics of her breastfeeding. Unfortunately, those visits amounted to nothing because, as it turned out, the mechanics were never the issue. Her kids always followed their weight curve and were feeding a reasonable amount, but it was Katherine who was in agonizing pain, blistering, and not sleeping. Finally, she decided to consult a medical doctor who was also a lactation specialist and diagnosed her with overactive letdown. What did that mean for her and her baby? From what she was told, it meant that her supply and flow were too abundant for her baby to take in comfortably. This resulted in constant unlatching and excruciating pain, and she was told that this would all subside at about the three-month mark when her milk would regulate.

“everything went to hell at that point…”

Having seen all sorts of professionals, from doctors to osteopaths, giving her all kinds of diagnoses, from tongue ties to tight jaws, Katherine’s takeaway is sticking to her gut. She trusted her motherly instinct, ignored the recommendations she felt were unsuitable for her and her child, and finally discovered the real issue. She stayed the course, waited it out, and learned how to dance the dance with her baby.

She goes on to mention that the day before coming to do this podcast, she saw two women nursing their newborns on a bench in a park, having a conversation, and she remembers thinking that was never her experience. The bonding between her and her babies was there, but breastfeeding was never this easy, flowing, natural experience.

“when you’re in week three, it’s really hard to get to month four…”

Having a toddler in the mix the second time around, Katherine remembers the insanity of it all and knowing that she just had to wait it out until month four, as breastfeeding was something that she wanted to do. Still, it came at a cost to her and her family, and she highlights that she feels that she may not have been able to persevere had it not been for her husband and his unconditional support.

Like every chapter in motherhood, such as in life, everything must come to an end, and Katherine’s breastfeeding journey ended when her first baby was about fourteen months. How did she make that decision? You may notice that Katherine is someone who likes to read, research and follow guidelines. Since the AAP (American Academy of Pediatrics) and the WHO (World Health Organization) suggested breastfeeding until at least the age of two, she went as close as she could.

“you spend about 1800 hours breastfeeding in one year…more than a full-time job…”

Spending all that time with your baby, bonding, giving them food and nurturing them, once that is over, Katherine remembers that she felt a huge void and that this time around, with her second, she is going to cry up a storm or breastfeed her until she is seven, either or. All jokes aside, in breastfeeding, like in all jobs, there was a learning curve for her and her baby. Whether or not she chose to stay the course was entirely up to her.

Moral of the story: trust your gut and decide upon instict.

Part 2 The Specialist Responds

Feeding: Breast, with Naomi Berkowicz

Naomi Berkowicz

Naomi Berkowicz, RD, IBCLC

Registered Dietitian, International Board Certified Lactation Consultant

In this podcast, lactation consultant Naomi describes a typical breastfeeding journey as well as responds to Katherine’s struggle with overactive letdown, a less common issue. She shares management techniques, tools that can facilitate breastfeeding, things to consider, and support that can be provided should concerns arise.

Challenges of Lactation Support in the Hospital

In the hospital, Naomi explains that the main focus is on ensuring the health and safety of both the mother and baby, with little time for in-depth lactation support. Red flags to look out for include issues with elimination, weight loss, and pain experienced by the mother during breastfeeding. However, due to limited time and resources, it may be challenging to address these concerns fully during the short hospital stay.

Naomi stresses the importance of postpartum care and the nurse's role in supporting new mothers. She mentions that in Quebec, a CLSC nurse visits within 2-4 days after giving birth, providing more time for assistance. The nurse may have more training in breastfeeding than hospital staff and can refer to specialized breastfeeding clinics if necessary. After the first week, new mothers may seek further lactation support if needed.

The Art of Proper Breastfeeding

Naomi takes time to explain and show proper breastfeeding techniques and the importance of positioning and latching. The baby's body should be straight from head to bum, with no twisting. The nipple is the clock's center, allowing the baby to latch on easily. If challenges persist, a lactation expert can guide and troubleshoot any concern.

Keeping a baby straight while feeding is crucial, as it ensures a proper latch and comfortable position for the baby. The emphasis is on coming from under the chin during the latch process rather than a direct approach, as this helps the baby breathe and avoid a shallow latch. There are different positions and approaches, but the fundamental principle remains consistent.

To summarize, it's recommended to place the baby's mouth close to the nipple and touch from the nose to the chin to stimulate the gape reflex and ensure the baby opens their mouth wide enough for successful breastfeeding. This method avoids potential confusion or discomfort for the baby and provides better access to the nipple. She also addresses the average amount of pain or discomfort associated with this technique, stating that it is normal for there to be a feeling of tugging. Still, it should not escalate into pulling and pain.

Addressing Breastfeeding Pain

Pain is a common factor when it comes to breastfeeding issues, with 80% of cases involving discomfort. The first step to address it is to check the latch and position of the baby. Many people lack proper education on breastfeeding, with the knowledge not being passed down through generations. Techniques have evolved over the past 100 years, and ensuring a comfortable and happy experience for both the mother and baby is essential. If the latch and position are still causing pain, healthcare professionals look for underlying problems, such as nipple damage, and work to heal it.

Pain during breastfeeding can be caused by various factors such as poor latch, positioning, skin conditions, or issues with milk supply. A detailed examination of both the mother's and baby's symptoms and behaviour is necessary to determine the cause and find an appropriate solution. Factors to consider include latch issues, milk supply, baby's behaviour, and potential dietary issues for the mother.

There can be challenges breastfeeding mothers face and the various factors affecting milk supply. Naomi highlights the importance of proper latch techniques, addressing baby issues, and understanding the natural progression of milk production. However, it acknowledges that a perfect breastfeeding journey is not always possible due to the many variables involved.