Concerns

Was that a diagnosis I heard?!

I’ve heard a few people getting quite hot under the collar because individuals are “diagnosing” conditions in mothers and babies who are just not qualified to do so.  But I can’t help wondering – are those people really making a diagnosis or are they just talking openly to parents about a variety of situations and conditions before suggesting that they visit a GP or other medical professional to get a diagnosis?

Imagine you are a stressed/tired/anxious (all of the above) parent of a baby and things are just not going well.  You visit your well-child provider, peer supporter, LLL group, breastfeeding counsellor, a n other person, and talk about what’s going on.  They listen well, they encourage you to explore how you are feeling, what’s happening now, what happened prior to the current situation, they show empathy and understanding of how you are feeling, they discuss things that could be going on with you and/or your baby, and suggest you go to your GP/other medical professional to find out one way or the other if a particular condition exists.

So, you go away feeling relieved that it’s not all in your head or because you are doing something wrong.  You visit your GP/medical professional and they say “oh yes, that thing you discussed with that person – yes, that’s what’s happening, we can fix that”.

Yay!  Someone who listened suggested a couple of things to you and that enabled you to have a discussion with a medical professional about the situation, who then pinpointed the problem and helped you fix it.  Thank goodness that lovely person who helped you first could tell you what was wrong… thank goodness they were able to diagnose the colic/reflux/thrush/vasospasm/tongue tie/lip tie/food intolerance etc….

But they didn’t actually diagnose anything.  They listened, they discussed options, they gave you some space to air your concerns and talked about the things that can sometimes happen.

I don’t know how many times I’ve heard a parent say “but they told me I have to do xxx, and it’s not working” or “she said that my baby should be sleeping xx hours/feeding xx times/putting on xx grams…”

We humans sometimes hear things in a way that wasn’t intended when it was said.  Sometimes that’s due to poor communication skills and sometimes because different words mean different things to different people.  Most people try to clarify understanding when they are working with parents, but even then there can still be misunderstanding.

Next time you hear or think someone diagnosed something when they shouldn’t have done – maybe they didn’t.  If, like me, you are working with mothers, remember that what you say isn’t always what is heard… and accept that sometimes you can’t do anything about that, but be aware and just keep trying… I try to remind myself often, but I bet I often get it wrong too 🙂

This is a fabulous article written by Diane Wiessinger in 1996.  It’s all about the language used in relation to breastfeeding – Watch Your Language

 

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Is my baby getting enough milk?

This is a question that many mothers ask themselves at some point during the time they are breastfeeding their baby.

Often the frequency of a baby’s feeding habits can be a surprise for new parents and without the right support and information it’s easy for a mother to feel she hasn’t got enough milk for her young baby’s growing needs.  Many women I speak to worry about not having enough milk, and I often hear that well-meaning friends and relatives have commented on how the baby should be made to wait for 3 hours, or sometimes longer, or to top up with a bottle of milk after a breastfeed.  Unfortunately this advice, if followed, actually has the opposite effect on the mother’s milk supply, and therefore the baby’s growth too.

On average, a baby born at around 40 weeks of pregnancy can only fit around 5mls (a teaspoon) of milk into his or her tummy in the first 24 hours of life.  This increases to around 25/30ml by about day 3, and 60/80ml by about day 10.  Even though a baby only drinks small quantities of milk, it can still take them 20 minutes or more to finish feeding.  Just like adults, each baby is unique and some eat more quickly than others, so it’s important to let the baby decide when he or she has finished; that way babies will drink until they are full, ensuring they get enough calories to grow well, and stimulate the mother’s milk supply adequately.

Every time milk is removed from the breast, more is made.  However, if milk is left in the breast then a protein called FIL (Feedback Inhibitor of Lactation) increases, which slows milk production.  Therefore, the more often a baby feeds at the breast, the more milk a mother is able to make.  Most people are not symmetrical and this applies to breasts too.  A lot of women have breasts that vary slightly in size, this is quite normal.  The size of a woman’s breasts bears no relation to the quantity of milk she will make.  Large breasts may contain a small amount of glandular tissue and vice versa.  It is not possible to tell!  By allowing a baby to feed as often, and for as long, as he or she needs to, most women’s breasts will make enough milk for their baby.  If you think of the breast as a glass, it doesn’t matter how big the glass is – you can still drink lots of water in a day from a small glass, you just need to drink more often.

So even if you feed your baby for as long and as often as he or she wants, how do you know it’s all working?  Weight gain and growth is something that can be measured, and certainly in the first couple of weeks your baby will be checked to ensure that by around day 10 your baby is at least still at birth weight.  Many babies lose a little weight in the first few days and this is completely normal.  If the mother has had IV fluids during labour then the baby’s weight can be slightly inflated at birth and this can mean the baby loses a little more weight than otherwise as they lose the excess fluids taken on during birth.  On average, a baby will gain anything between around 110g-220g a week in the first four months.  As you can see there is a wide range of “average” and at different times babies put on different amounts of weight.  It can be important not to weigh a baby too often as some weeks babies won’t put on much weight which can cause unnecessary worry.  It’s better to look at the overall pattern of growth, taking into account growth in head circumference and body length as well as weight gain, and to ensure that the overall trend is upwards on the growth chart, and that the baby is staying more or less on their percentile line on the chart.

However, in between your baby being weighed you’ll want to feel confident that things are going well.  One of the easiest ways to do this is to check what’s coming out the other end 🙂  If milk is going in at the top, then something will be coming out the other end.  It’s amazing how important the contents of your baby’s nappy becomes!  When your baby is born his bowel contains meconium.  This is the first poo you baby will pass and breastmilk helps your baby’s digestive system start to work; the colostrum works a little like a laxative helping your baby pass meconium – a sticky, black/dark green bowel motion.  In the first 2 days your baby should produce one or more poos a day, and two or more wees a day.  On days 3 and 4, your baby will produce three or more poos a day, which will become more green coloured and possibly a little softer, and three or more wees a day.  On days 5 and 6, your baby will produce three or more soft yellow poos.  The poos change to yellow as all the meconium has been passed and your baby starts to drink and digest more milk.  By now you will notice that you are producing more milk.  From day 7 onwards, your baby will produce at least two soft yellow poos, possibly a lot more, which is quite normal.  They may also look a little “seedy”, which is fine.  Your baby should also be producing six or more heavy wet nappies a day.

It can be hard to feel confident of something that we haven’t done before, and having a baby that seems unsettled or unhappy is enough to make any mother concerned.  If you are worried about your baby’s behaviour, development, or health then you should always seek advice.  A mother’s instincts are often right and sometimes it can take a while to get to the root of the issue, so keep asking and talking to people who have been well trained and have good experience until you are satisfied.

You can find some great information here about how milk production works, and on this page for what to expect in the early days of breastfeeding.  If you are worried about how often your baby is feeding, you might feel reassured after reading the information on this page.

Please feel free to comment on this post, or ask questions.  You can also contact me directly vie email:  bfc.denise@gmail.com