33: “What if My Baby Doesn’t Latch at the Hospital?”

Here’s the deal. There’s no reason to expect breastfeeding to go anyway but fabulously. Those oh so common “what if” scenarios like to have us anxious and spinning for what may very well not even happen. That being said- it does sometimes happen that a baby doesn’t latch and breastfeed smoothly right off the bat even with in-hospital support. So instead of spinning and worrying, it’s helpful to have your backup action plan settled.

During the very sensitive window the first handful of days after birth, a lot is happening. For one thing, you and your baby are resting from the birth experience and acclimating to life out of the womb. Second, your newborn baby is learning to eat (remember that babies have helpful reflexes and nursing is biologically normal, but feeding is still a learned skill). And third, your body is going through a significant hormonal shifts and receiving the information that will dictate your milk supply. That means that, if your baby isn’t nursing frequently and effectively, your body is getting the message that less milk is required resulting in a low milk supply. The longer this goes on, the harder and more work it may take to recover.

So let’s think about how this snowballs for a new first time mom, and let’s call her Judy. Judy plans to breastfeed. She’s told the staff, her husband knows to slap any formula out of the nurse’s hand, and she has read a couple of popular books that give her “schedules'' (which I am putting in air quotes because frankly many of them do not follow infant cues but instead outline an easy on paper schedule. Which by the way, your newborn baby has not read.). 

Back to Judy. For some reason, let’s say some muscle tightness leftover from the position in the womb or the birth, her baby just can’t seem to get a nice wide latch and sustain breastfeeding. She tries and she tries but it’s just not happening. The lactation consultant in the hospital says maybe it’s xyz, baby gets some donor breast milk, Judy gets a nipple shield, and they are sent home with some random formula samples to sustain baby’s needs until things magically click or until Judy gives up her feeding goals. Basically, Judy gets a pat on the back and an “It’s okay, just keep trying and good luck!”.

Well naturally Judy is exhausted, overwhelmed, trying not to feel defeated, and goes home with her baby and the formula.

Now let’s fast forward about 10 days. Breastfeeding is not better despite the continued attempts, Judy is not pumping enough to stop giving her baby the formula, and she finally calls for help after she’s been trying to get her feet under her with this unexpected postpartum experience.

Here’s what I wish Judy knew prior to day ten postpartum:

I wish someone had told Judy that she needed to be pumping at least 8 times a day if her baby wasn’t nursing effectively. 9-10 times within 24 hours is probably better since newborns nurse upwards of 12 times a day when we follow their cues. You see, you can’t reduce the frequency and just pump for super long sessions to make up the minutes. It’s the high frequency feeding (or pumping) especially in the early days that is key to communicating supply needs early on.

I wish someone had told Judy, that one of those pumping sessions ideally would be between 2:00-4:00 a.m. which is when prolactin levels are high.

I wish someone had told Judy to offer her baby a truly slow flow bottle rather than one marketed as a newborn bottle. Because her baby came home on a hospital “slow flow” nipple but was gulping and having to chug the formula with every feed.

I wish someone had told Judy that her colostrum was enough for her baby in those early days. That they were better about helping her protect her milk supply and her feeding goals.

And I wish someone had given Judy the name and direct number of a well experienced lactation consultant to call the day she got home. Because the longer an underlying issue goes unaddressed, and the longer her body was under pumping, the harder and more stressful trying to get back on track was going to be.

Additionally, things like nipple shields, triple feeding, and many other strategies are a TON of work and a very heavy mental load. Which means they should be used with a bigger picture in mind and frequent check-ins. New moms and newborns are changing at a pace that requires adjustments once something is stable and working but also if something is not working.

If you are planning to breastfeed. First take a deep breath and know that it’s very likely things will go well. Next remember that if for any reason it doesn’t, and you still want to breastfeed or provide breastmilk to your baby, you must mimic the high frequency feeding with a pump to send the “make the milk” messages to your body. That means a minimum pumping of 8x/day and don’t forget that pumping session somewhere between 2 and 4 a.m. (give or take). This is also a good time to remind you that the flange should fit, suction level be the right balance, and you shouldn’t need to be damaging your nipples to pump successfully. (I know, it’s a lot, but you gotta know the deal). 

And last but definitely not least, know who you are calling before things go array. You can ask for a little screening chat to see if they are the right fit, get a referral from a like minded mom friend, or seek someone with great reviews. However you do it, do it. Maybe you won’t need to make the call, but nothing is worse than being in a pickle and having to figure out who to call. 

If you have questions related to this episode, can relate to this story, or have a topic you’d like me to cover I’d love to hear from you! Shoot me an email at Barbara@feedingbyjanuary.com, I always respond:) And if you aren’t driving, please consider rating the show. As you probably know, it’s how a show grows. See you next week!