When
I had my daughters 14 and 11 yrs ago, I was taught to feed from one
side only-putting baby back on same side after burping to give her rich
hind milk, but all the magazines I read now that I'm expecting my third
child say to nurse from both sides each feed. I live in country Australia
and don't have access to nursing experts like I did all those years
ago! I also am interested in finding the best pump so my family can
take turns to feed bubs-never used one before as both the girls were
fully breast fed and wouldn't touch a bottle. Seeing as I have you here,
is there a good way to reduce the chance of mastitis as I had it six
times with my first and 8 times with my second child. I lived on antibiotics
and ultrasound and would obviously like to avoid that this time. Nothing
I tried worked, and as you know, the pain is excruciating. Thanks heaps
and I look forward to any advice you can give.
Answer:
You
have discovered the "downside" of trying to educate yourself about breastfeeding.
When you are nursing your baby, there are no hard and fast rules to
follow. Women managed to successfully nurse their babies for millions
of years before they ever had books, lactation consultants, and breastfeeding
classes. Nowadays everything has become complicated, and conflicting
advice abounds. The actual process of breastfeeding hasn't changed,
but now there is tons of information available, and it can become very
confusing for mothers who want to nurse, but don't know whose advice
to believe.
As
far as the advice about nursing on one breast versus two at a feeding,
both opinions are valid. Depending on variables like the mother's milk
supply and breast storage capacity and the baby's size and sucking ability,
your baby may take both breasts at a feeding or he may take one. He
may take both at one feeding, and be satisfied with one at the next.
Babies are really good at regulating their own milk intake, and for
the most part, will let you know whether they need to feed on one breast
or two at a feeding. It's a good idea to offer both breasts when your
baby is a newborn, because you need lots of stimulation in order to
build a good milk supply. If your baby won't take the second breast,
and is gaining weight appropriately, then don't worry about it. If your
baby isn't gaining weight well, then you need to make sure he finishes
one breast, and use techniques to wake him up and stimulate him to take
the other side. Many mothers find that their newborn baby will nurse
on both breasts at a feeding, then as they gets older, will start taking
only one. I suggest that you start out by offering both and then see
how it goes after hat.
There
are lots of options regarding breast pumps, and no one pump that is
right for every mother. A lot depends on how often you pump. If you're
home with your baby and pumping only occasionally, then you might do
fine with a manual or small electric pump. On the other hand, if you
are working outside the home regularly or plan to leave your baby with
caregivers often, then you might find it worthwhile to rent or buy a
good double pump. For more details about the different types of pumps
that are available and the pros and cons of each type, see my article
" Collecting and Storing
Breastmilk."
I
hate that you had so many problems with mastitis when you were nursing
your first two babies. There is something very wrong anytime that you
experience recurrent mastitis. Nobody should have to go through that!
If you do develop mastitis with this new baby (and hopefully you won't),
then you need to find out why this is happening and treat the cause
of the infection effectively, once and for all. I don't know exactly
what treatment you have received for the other infections, but obviously
they didn't take care of the problem. In many cases, the infection reoccurs
after treatment with antibiotics because the original infection wasn't
ever completely cleared up in the first place. This can happen when
you don't take the complete course of medication (you feel better after
a few days and stop taking the drug - it usually takes at least 10 days
of antibiotic treatment in order for it to be effective), or when the
wrong antibiotic was prescribed for the particular strain of bacteria
causing the infection.
Recurrent
yeast can be caused by other, less common reasons as well: chronic bacterial
infection, cyst or tumor in the breast, maternal anemia (this causes
a lower resistance to infection), and a secondary fungal infection.
Dr. Ruth Lawrence (Breastfeeding: A Guide for the Medical Profession)
suggests that after the first recurrence of mastitis, mothers should
have their milk cultured (be sure to get a "clean catch" - midstream,
into a sterile container). The baby's mouth and throat should be cultured
at the same time. That is the only way to know for sure what is really
going on. If the infection reoccurs, then you will need to find a "breastfeeding
friendly" doctor who has both the willingness to work with you on this,
as well as the expertise and the capacity to perform the tests that
are indicated (not all doctor's offices or labs are set up to perform
the necessary cultures, and even if your OB's office is, he may not
we willing or able to culture the baby as well as the milk).It is possible
that you had a secondary fungal infection, also called "fungal" or "candidal"
mastitis. If that was the case, then simply taking antibiotics might
not clear up the infection completely, unless antifungal treatment to
address the underlying problem with yeast was administered at the same
time. For suggestions on how to prevent and treat mastitis, see the
article "Breast
Infections and Plugged Ducts."
Best
of luck with nursing this time around. I hope everything goes smoothly
for you. You have two built in babysitters, so that's a plus!
