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Dale Hansson
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What happens at a lactation consultation?
We will need to ask some questions about feeding, birth and medical history, look at your baby, including the mouth, watch a breastfeed and identify if there are strategies that can improve any problems you may be having. The advantage of working within a medical centre is the proximity of skilled medical support.
Even though our practice is seen as a place to treat tongue and lip-tie this is really just part of a wholistic approach to managing feeding concerns.
Being able to identify if a frenulum is impacting feeding and if there is an identifiable outcome that can be achieved by treatment, cannot be separated from the consultation, the mother-infant relationship is the most important consideration.
What about if I am bottle feeding?
We welcome all families with feeding difficulties at Premier Health, we know that having a challenging breastfeeding experience is not always solved by bottle feeding and issues with comfortable relaxed feeding continue after weaning from the breast. We hope you will find a safe and welcoming place to help you with feeding your baby, no matter the feeding method.
If there has been concern expressed about your milk supply
Breastfeeding is very important for immune protection, keep breastfeeding, this is not a time to wean!
Have you been given the correct information about breastfeeding?
The NHMRC Infant feeding Guidelines for health Workers recommends:
- unrestricted access to the breast
- around 8 to 12 feeds in 24 hours - do not obsess about intervals
- night feeds are very important important
- bottles interfere with establishing and maintaining breastfeeding
The NHMRC states this about growth:
- breastfed babies growth should be avereraged over 4 weeks
- growth charts are screening tools only
- concern about a single measurement is a reason to explore, not give supplements!
The World Health Organization(WHO) had conducted extensive research into infant growth and developed Growth charts and their studies and charts can be found easily on their website.
Key messages to families from this research are:
- Breastfed babies grow is spurts
- This cannot be measured accurately by measuring the weight weekly
- Length and head circumference determine wellbeing
- Brain and skeletal growth is much more valuable that a random measurement of weight
- Growth measurements should be sequentional using the same equipment
- Neurological milestones are also important indicators or wellbeing
If you are worried about growth/milk supply:
- Feed more often
- Feed for comfort
- Change sides when baby pauses or fusses
- Encourage the let-down reflex (Milk Ejection Reflex) - deep breathing, dropping your shoulders, thinking happy thoughts etc
Managment strategies that will harm your supply
- Restricted times
- Using weekly weights without checking overall well-being, output and feeding behaviour
- Being told you baby is asleep and "tired" from feeding - babies will pause as you do when eating, even with their eyes closed and are often waiting for you to have another milk release (let-down), then they will suck and swallow again. Babies are clever and know not to waste their energy feeding, they are NOT lazy, babies having trouble feeding, are shallow or causing pain pain pause longer and take longer to feed this is sensible, don't restrict them!
- Interval recommendations - for example - being told to feed every so many hours
- Being told to "drain" your breast - this is not possible, breasts are never empty and milk will be sitting in the other breast waiting to be removed and when it isn't, the body thinks you don't need it! This is very harmful advice - be flexible the baby can finish on either side
- Foremilk and hindmilk is not a thing! Your milk is always mixed, fat ratio is related to fullness and emptiness of the breast, time of day, how far into the feed you are, it is NEVER separated into foremilk and hindmilk (unless you express and let it separate on the bench) so trying to do this is a wild goose chase!
Relactation
Relactation and return to full breastfeeding is possible, see this information sheet from breastfeeding Advocacy Australia.
We support the following policy and offer a Lactation Consultant to support your informed decision to breastfeed.
RACGP Breastfeeding Policy
Breastfeeding should be promoted as the most appropriate method for feeding infants and one that offers protection against infection and some chronic diseases. General practitioners should encourage and support exclusive breastfeeding in the first 6 months, then the introduction of complementary foods and continued breastfeeding thereafter. It is recommended that breastfeeding continue until 12 months of age and thereafter as long as mutually desired.
Mothers have the right to breastfeed wherever and whenever their baby has the need.
Breastfeeding mothers in the paid work force should be supported to continue breastfeeding.
Royal Australian College of General Practitioners (RACGP)
Breastfeeding should be promoted as the most appropriate method for feeding infants and one that offers protection against infection and some chronic diseases. General practitioners should encourage and support exclusive breastfeeding in the first 6 months, then the introduction of complementary foods and continued breastfeeding thereafter. It is recommended that breastfeeding continue until 12 months of age and thereafter as long as mutually desired.
Mothers have the right to breastfeed wherever and whenever their baby has the need.
Breastfeeding mothers in the paid work force should be supported to continue breastfeeding.
Royal Australian College of General Practitioners (RACGP)