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How to Successfully Breastfeed

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Hello everyone, this is Liz Harvey coming to you from our razorcast™ studios in New York City where we are dedicated to bringing you cutting edge interviews from many of the leading industry professionals across the United States.

In today’s episode, we are speaking with Stephanie Heintzeler. Stephanie is a German educated midwife, a U.S. educated doula, an acupuncturist and she is a certified lactation counselor (CLC). She is known as The New York Doula.

Stephanie has delivered over 1200 babies and has experience with twins, triplets, breech babies and water births. She also works with newborn parents in their postpartum stage and holds classes and seminars for moms and dads to be.

With a wealth of experience and knowledge in her field, Stephanie Heintzeler is widely considered to be one of the top doulas in the country. She is also a contributing member of our national network of industry professionals.

Today we are going to talk about a very important topic: How to Successfully Breastfeed

RC: Hi Stephanie how are you today?

Stephanie Heintzeler: I’m good, thank you.

RC: Well thanks for joining us.

Stephanie Heintzeler: Thanks for having me.

Question 1: What are the biggest factors that mothers have to take into account when deciding whether or not to breastfeed their baby?

RC: So what are the biggest factors that mothers have to take into account when deciding whether or not to breastfeed their baby?

Stephanie Heintzeler: So that’s an amazing question because often I’m asked what you can do when you want to breastfeed but there’s so much you need to think ahead of when you’re planning on breastfeeding. One thing is you need to look at your birth plan – like what kind of birth are you planning for. Not that it’s always going to happen but in the end the more medication you’re planning for and the more medication you’re going to have during labor, the more sleepy your baby will be, the more problems that will arise after birth. So that’s the first thing to know. And if you’re planning on having a medicated birth, then get help. You know (really) have a doula in place, have someone who can help you after birth – feed your baby so that you have someone who can wake baby up and give you a little bit more tips when breastfeeding your baby and planning on that.

The other thing is do I have enough time to breastfeed my baby. Some moms say, “Yes I want to breastfeed, I want to fully breastfeed. But then, they’re like, “Okay, I’m going back to work a week after the birth.” How is that going to work because in the end when you breastfeed, it does take time. It’s not going to take time forever because after a month, you usually have sort of a schedule and your baby drinks faster but in the beginning, babies might be on the breast for an hour you know and then you need to feed every three hours. So how are you going to do that if you do go back to work? You can pump but then the question is, Do you have enough time to pump? Do you have enough time to then store everything? Go back home, feed your baby, breastfeed your baby in the middle of the night and if not, then we need to really honestly look at what’s possible.

Sometimes it’s better to plan ahead and really feed maybe the first week and then start pumping. Not even breastfeed but only pump when mother goes back to work or she decides to go back to work later and really spend that time with her baby. So it’s those two things: what kind of birth do I want and (okay) timewise do I not go back to work right after birth.

Question 2: How does a mother know if she is breastfeeding correctly? What are the signs to look for?

RC: Okay and how does a mother know if she is breastfeeding correctly? What are the signs to look for?

Stephanie Heintzeler: The signs are mainly that breastfeeding shouldn’t hurt. The mother really needs to be in a good and comfortable position. First of all, she should feel comfortable and the baby should be comfortable. Meaning that baby should not have five layers on but usually the best will be skin to skin and belly to belly so the baby is actually coming towards the mother. Not the mom like throwing herself on the baby and then she’s not comfortable. With that, most of the time the mother is really comfortable and it doesn’t hurt and the other thing is that she notices the different latches.

So in the beginning, I really teach mothers how to notice whether the baby latched on correctly or not. And a good latch is actually a so-called asymmetric latch. So everyone thinks the nipple goes straight into the baby’s mouth. But that’s actually not true. The nipple needs to face up and it needs to face towards the roof of the mouth of the baby and you need a certain angle to latch the baby on and once you have that, you notice a difference. You latch on and then when the baby’s not correctly latched on, you latch off again and you try again. That way, again you notice it doesn’t hurt and you can feed your baby. And once baby is latched on correctly, you hear your baby swallow. That’s important because when they’re not latched on correctly, they might not be suckling and you don’t hear a swallow.

And then after the feeding, the baby is happy. That’s another thing, right? So that’s how we know that the baby was latched on correctly – they are happy. They’re kind of in a ‘milk coma’ as we say and after their feeding they usually have a wet diaper. So in the twenty-four hour period, we want to see about ten wet diapers and quite a few diapers with stool and all these things together – they prove that the mother is breastfeeding correctly.

Question 3: How often does a mother need to breastfeed a newborn during the day and at night?

RC: Okay so how often does a mother need to breastfeed a newborn during the day and at night? I know you mentioned just now every three hours but really if she wants to plan ahead how often should she be breastfeeding?

Stephanie Heintzeler: In the beginning, usually the first month, it is in fact every three hours. Meaning that the mother breastfeeds from the beginning to the next beginning and there are three hours in between. So in fact with her baby sleeping or resting, it’s sometimes only two hours because the baby breastfed for about an hour. And that’s the minimum and the reason is because the body, hormone wise, needs this constant information that the milk is still needed. So if a mother would suddenly sleep for six hours… I’ve certainly had a mother call one day and she’s like, “Oh two nights ago, I slept six hours – I really needed to, it was really important for me but now I have trouble breastfeeding. Well, no surprise because the body got the information that the milk is not needed.

In the end if you stop breastfeeding like if you wean your baby. Right, that’s how we wean. That’s how we show the body that the milk is not needed by just kind of stretching it out a little bit so the milk is taken back. But in the beginning, the body needs this constant reassurance that the milk is needed. So it is every three hours. The baby needs to be woken up but after about a month, usually babies find their own schedule. Because first of all, the breast kind of sinks in. Everything loosens up, there’s more space in the breast to hold the milk. And then second, baby drinks more in a shorter amount of time so they usually feed only in maybe fifteen minutes. And then third, is really that the baby is bigger, it’s older and he might be able to have a little snack here and there, drink more often in the evening but then sleep a little longer during the night. That’s actually what we welcome. Most babies do have cluster feeding at night, even in the first month. They drink a lot because the mother has a lot of fat content in her milk and in the morning the milk has more water. So in the evening, the baby usually has a lot of snacks which is kind of nice because you know it’s in the evening when the mother is still up and drinks ten minutes here, ten minutes there, a half an hour here, five minutes there over the course of three hours but after, they usually have a longer sleep. And that’s the idea, something that I work on, that we see the baby gets all this food so that overnight they hopefully sleep a little longer.

In the end that’s it, it’s really after a month. The first month is the part where you really have to be on with the timing. But after one month, I look at the schedule with the mothers I work with and we see what’s happening – what’s doable and what’s not. Where do you want to be in terms of the feeding and from the moment on, the baby could sleep maybe five hours a night. That’s certainly possible. Not all do obviously but it’s a goal.

RC: That would be amazing.

Question 4: Is there a special diet mothers should follow while breastfeeding?

RC: Now is there a special diet mothers should follow while breastfeeding? Anything to avoid or something to add to your diet?

Stephanie Heintzeler: Yeah. Thank goodness there’s not so much that the mom shouldn’t eat or have. We did have all these old beliefs that sage tea is not good or peppermint tea is not good or certain foods are not great. What is a fact is that there’s a few foods that can cause gassiness in a baby. Something like onions, garlic, beans – even certain kinds of beans, cauliflower. But that’s like a trial and error. There’s certainly cultures especially in New York where the mother eats everything or she eats what European mothers would never eat and the babies are just fine.

What’s a fact is that the flavors change. So let’s say a mother eats something with a lot of garlic, the milk changes, the flavor changes. Otherwise babies are usually just fine. What a mother should avoid is certain medications of course. So mainly everything that you would take maybe regularly even when you’re not pregnant, you need to ask your healthcare provider because most medications do go in the breastmilk. And you can’t take anything. The other thing is alcohol. Although we know now that alcohol is actually okay when you’re breastfeeding. You should of course not have a lot but if you have a glass of wine, it’s fine because the baby won’t drink the milk. He might be on the breast a little bit and drink a little bit but he won’t like the flavor because it does go into the milk and so he will drink less, of course complain, and then drink again. So it’s not ideal to do that but now we do know. Before we did this pump and dump thing. That’s not recommended anymore. So if you only have a glass of wine, that’s totally fine.

But the main thing of course is nicotine. So smoking cigarettes, that’s really dangerous. One thing of course is it can cause problems with breathing for babies but the other thing is that really the whole nicotine, all the chemicals, they do go into the breastmilk and may cause harm in a baby.

Generally for a mother who breastfeeds, I do recommend that you eat regularly of course and more warm foods. We really notice that mothers who eat warm, soothing foods like pumpkin or sweet potato, mashed potato, pumpkin soup, chicken soup. Everything that’s warm, sort of winter foods. That’s really helpful for breastfeeding. It helps to create more milk. The mom feels better. She has less digestive problems which often times arise after birth versus the summer babies. Summer moms eat yogurt and everything is cold and ice and often times we have more issues with milk production. So once they switch and just have all the pumpkin stuff in the summer, it makes a huge difference. So in the end, we see that it needs to be something warm, warming foods, food that gives you energy versus cold foods, they usually take energy. They give it later but the moment you take it, your body takes a lot of energy to actually warm it up and that’s what can stress it out and reduces the milk production.

Question 5: Is it helpful to take a Breastfeeding Class before you have the baby? And what topics are covered?

RC: Interesting. Okay so is it helpful to take a breastfeeding class before you have the baby? And what topics are covered? And what topics are covered in a breastfeeding class?

Stephanie Heintzeler: I like breastfeeding classes unless someone does have a doula or lactation counselor. If a mother hires me for like ten home visits after the birth, I’m there and so she doesn’t need to get crazy with all this information and read up too much. I do give information like what’s important and how often to feed and to latch so that she really knows what it’s about but then I’m there to watch. But if people don’t have help and just go, which most do, they’re just like, “Oh we’ll just see how it goes. But then they come from this place of fear. I have so many moms on the phone, they’re like, “Oh I’m really worried about breastfeeding, I just hope it’s going to work.” But then I’m like, “Well, what are you doing to make it happen?” And then I hear silence, you know.

It doesn’t work just like that, the baby won’t jump on the breast. Yes, the baby has a reflex and the mom sort of knows but you’re a team. And together it’s tricky and the mom needs to know what to do. The mom needs to teach the baby how to latch on and how often and what to do and just really teach baby and if she doesn’t know because she didn’t take a class and she didn’t use a little bit of time and look into it then she will come from a place of fear when she starts breastfeeding and then it just won’t go well because then she’s tense which means your baby’s going to be tense and baby is going to be screaming at the breast which won’t work at all and then we have problems of course.

So when she knows what she’s doing because she took a class, she will be calm, her baby will be calm and chances are 99% that it’s going to be fine plus her partner will know. If partner is in the room and takes a class, they just know this is what we need to watch out for. The latch needs to be good and the baby should face you and make sure you’re comfortable – let me get you another pillow. So that way, it’s more of a team effort and it can help tremendously.

The main thing is really the fear aspect. That she feels prepared and therefore the baby is calm and then it just works. The topics are mainly things like what to look out for, what are the baby’s signs, what are the signs that your baby is hungry. Because years ago, we thought the baby is hungry when he’s crying, right? So that’s like okay hungry – crying. But now we know, it’s too late. So when a baby is crying, she won’t go on the breast, right? I’m sure you know, they just don’t latch on. So there’s different signs before that. When the baby has fits that means baby’s hungry or when the baby’s just moving like just moving the mouth a little bit or we see the tongue. Or the baby’s like when they’re half asleep and the eyes are moving behind the lid. All those are signs of hunger and then we latch on baby so we don’t have a franticly crying baby and then they latch on. These things are really important and that’s what you learn in the class.

RC: Great. Well this has been fantastic advice thank you so much Stephanie.

Stephanie Heintzeler: You’re welcome.

RC: And we know you’re really busy so thanks so much for being here and for our listeners across the country, if you are interested in speaking with Stephanie Heintzeler, you can either go online to www.thenewyorkdoula.com or call (917) 399-2031 to schedule an appointment.

On behalf of our entire team at razorcast™, we want to thank you for listening and we look forward to bringing you more top quality content from our country’s leading industry professionals.