Breastfeeding A Baby With Special Needs

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Melissa Portunato MPH, IBCLC, RLC

All babies benefit from the nutritive properties of breast milk but the benefits are even more significant for babies with special needs. For instance, premature babies or babies with congenital disorders like Down Syndrome, are at a higher risk for upper respiratory infections and health problems early in life. Many studies show these babies do better when they receive mama’s milk. As a matter of fact, breast milk is so important for babies with special needs that it is quite likely they will receive donor breast milk at birth if mom cannot provide her own breast milk. Breastmilk can never be duplicated and can enhance the health, growth and development of fragile babies.

Here are 5 Tips For Breastfeeding A Baby With Special Needs:

If Baby Can Latch 

There are some cases where the baby will not medically be able to nurse directly but often a baby will be encouraged to suckle at their mother’s breast. Positioning can be critical for a baby with a congenital disorder like Pierre Robin’s Syndrome or Down Syndrome. If baby is able to practice at the breast, try a nursing position like the “dancer hand” that supports the chin and jaw. Babies with congenital disorders can often have low muscle tone making it difficult to nutritively suckle at the breast. Providing chin and jaw support by using the “dancer hand” position can help keep baby feeding at the breast for longer and more effectively during nursing sessions. Allowing the baby to come to the mother’s breast can help milk production, increase bonding and promote the overall well being for both mommy and baby. It’s not only about nutrition but about the bond as well. 

Try an Alternate Feeding Method or Tool 

A supplemental nursing system can be used to supplement the baby while suckling at the breast. A soft medicine cup or spoon can also be used to feed a baby allowing the baby to continue to practice at the breast. A nipple shield can be used as a temporary tool to encourage more nursing directly at the breast. If bottles need to be used, try the Paced Bottle Feeding Techniquewhich can allow the baby to control the flow of the bottle. Paced bottle feeding prevents overfeeding which can lead to the discomfort associated with colic, gas and reflux.

Maintaining Milk Supply 

It’s recommended to pump a minimum of 8-12 times per day with a hospital strength breast pump to ensure healthy milk production. Learn more about finding the perfect Spectra Baby USA hospital strength breast pump here. If you are separated from baby watching videos or seeing pictures of your baby while pumping can stimulate more effective letdowns. 

Finding the right size flange is an important part of the pumping process.  A flange that doesn’t fit properly could leave you with nipple pain, redness, and full breasts. Pumping shouldn’t hurt! If you are experiencing any of these symptoms measure your nipples using our breastshield guide for the correct flange sizing. Spectra baby USA offers free sizing via virtual consults and email IBCLC@spectrababyusa.com. We’re here to help!

Skin to Skin 

Skin to skin is an important way to sustain your breastfeeding hormones and continue bonding with your baby. Mama’s chest is a newborn baby’s natural environment. It promotes healing and encourages transitioning back to the breast if that’s your goal. Skin to skin should be done on your bare chest and with baby only in a diaper. Try to do skin to skin any chance you can get. You can even do it while pumping for quicker and easier letdowns! Combining skin to skin with pumping can increase milk volume, increase weight gain, stabilize the baby’s heartbeat, and is even linked to premature babies going home sooner!  If your special needs baby can’t be brought skin to skin, pumping crib side can keep your milk flowing while staying close to your little one. 

Set realistic expectations with the right support 

Breastfeeding a baby with special needs directly at the breast may come with challenges but you can still provide breast milk for your baby even if baby is not latching directly to the breast. Breastmilk can help babies recover sooner from surgery and lower the risk of infection. Working closely with a medical team including a lactation specialist like an IBCLC (International Board Certified Lactation Consultant), Pediatrician, and Neonatologist will help in providing the support and education parents need to be successful. Finding a local support group can help special needs parents connect with their community and find emotional support when they need it most. 

Are you pumping for a baby with special needs? Share your story with us! We’d love to hear more about your journey! Email us at IBCLC@spectrababyusa.com. 

Sources

Seddon PC, Khan Y. Respiratory problems in children with neurological impairment. Arch Dis Child. 2003;88(1):75-78.

Proesmans M. Respiratory illness in children with disability: a serious problem?. Breathe. 2016;12(4):e97.

Zeisel SA, Roberts JE. Otitis media in young children with disabilities. Infants Young Child. 2003;16(2):106-119.

Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care. Geneva: World Health Organization; 2009. Session 10, INFANTS WITH SPECIAL NEEDS. Available from: INFANTS WITH SPECIAL NEEDS – Baby-Friendly Hospital Initiative

Newborn and Infant Sleep – What Is Normal?

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By Jacque Ordner BSN, RN, IBCLC, RLC 

One of the biggest concerns and struggles of parenting young children is SLEEP!  Sleep deprived parents of newborns and infants have undoubtedly been asked, “Is she sleeping through the night yet?”  Many of us have received advice from well-meaning friends and family regarding how much our babies “should” be sleeping and how to get them to do so.  But what does research tell us?  What is developmentally normal for babies?  What about the countless methods and internet-based courses focused on getting babies to sleep? Read on for some important truths about newborn and infant sleep. 

First things first, it is completely normal for your breastfed newborn to wake and eat every few hours around the clock.  Babies’ stomachs are small, and they need to feed frequently in order to consume adequate calories and nutrition.  For most breast milk fed babies, this translates to 8-12 feedings in 24 hours. It’s true that most newborns spend 15-18 hours sleeping each day, but that sleep comes in small chunks spread across 24 hours.  Frequent waking is also a protective mechanism that is designed to reduce the risk of SIDS! Check this link out for additional info https://www.ncbi.nlm.nih.gov/pubmed/9346985 .   

Scheduling or restricting feeds can be dangerous! Any sleep training method, sleep course, sleep product, or sleep coach that that advises limiting feeds, scheduling feeds, or only feeding during certain “windows” for babies is NOT BREASTFEEDING FRIENDLY despite any claims to the contrary. Babies should be breastfed on demand rather than on a schedule or within specific windows. Our IBCLCs are aware of several cases where scheduling and restricting feeds has led to poor infant weight gain and significant milk supply issues. Feeding on demand is the best way to ensure your baby is getting enough milk and to encourage your own milk production. In fact, studies show that babies can take as much as 20% of their nutrition requirements during nighttime feeds.  

It is a myth that babies regularly sleep through the night at just a few months old.  In fact, most babies do not sleep through the night until closer to age one or beyond! Sleep is a developmental skill.  Babies cannot learn to fall asleep on their own until they are developmentally ready to do so, and they aren’t all ready at the same age. It’s important to let go of unrealistic expectations regarding sleep.  Though unicorn babies, who sleep all night at 4 weeks old, do exist, they are the exception, not the norm.  

We can encourage healthy sleep behavior in our babies. Though sleep is developmental, we can still create an environment that fosters healthy habits related to sleep.  Babies are often tired, but need help falling asleep. Learning your baby’s sleep cues is a first step to helping him get off to dreamland before becoming overtired and cranky.  Common sleep cues include rubbing the eyes, yawning, drooping eyelids, redness around the eyes, smiling less, vocalizing less, exhibiting a weaker than normal suck, and turning away from toys or people. Picking up on these cues and responding in a way that helps our babies go to sleep is key!  Experts also tell us that encouraging adequate daytime naps positively contributes to more consistent night–time sleep. Breastfeeding to sleep is normal, and absolutely ok!  Your baby sees you and breastfeeding as their greatest source of comfort and safety, so it is only natural that they would desire that comfort and safety when trying to fall asleep.  Many breastfeeding mothers follow the Safe Sleep Seven to help their babies feel safe and secure all night long. Your child will eventually be developmentally ready to learn to fall asleep all on their own even if they need your help right now.  As your baby gets older, you can start to transition to more independent sleep behavior slowly.   

Will cutting out nighttime breastfeeds help my toddler sleep? It’s important to note that babies often require night–time feedings well beyond the newborn stage.  It’s also important to note that cutting out night-time breastfeeds for older babies and toddlers needs to be approached on a very individual basis with special consideration to the child’s overall intake.  It is not uncommon for older babies and toddlers to reduce night-time feedings if their daytime caloric intake simultaneously increases.  Many parents find that night-time weaning is often easier when their child is closer to 18 months of age because they are capable of communicating and understanding the negotiation surrounding the weaning process. There is evidence that reducing night-time feeds contributes to less night-time waking for toddlers.  Keep in mind that hunger is not the only reason that babies and toddlers wake at night!  When made to feel safe, secure, and comforted older babies and toddlers can learn to get themselves back to sleep without parental intervention.  

Infant sleep problems are a common concern among parents, but knowing what is normal can help put your mind at ease! 

Our team of International Board Certified Lactation Consultants is happy to discuss newborn, infant, and toddler sleep as it relates to breastfeeding and pumping.  Click here to schedule a consultation.  

Sources: 

Burnham, M., Goodlin-Jones, B., Gaylor, E., & Anders, T. (2002, September). Nighttime sleep-wake patterns and self-soothing from birth to one year of age: A longitudinal intervention study. Retrieved May 18, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201415/ 

 McKenna, J., & McDade, T. (2005, June). Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding. Retrieved May 18, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/15911459 

 Kent, J., Mitoulas, L., Cregan, M., Ramsay, D., Doherty, D., & Hartmann, P. (2006, March). Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Retrieved May 18, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/16510619 

 Middlemiss, W., Granger, D., Goldberg, W., & Nathans, L. (2012, April). Asynchrony of mother-infant hypothalamic-pituitary-adrenal axis activity following extinction of infant crying responses induced during the transition to sleep. Retrieved May 18, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/21945361 

Breastfeeding Twins

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By Jacque Ordner BSN, RN, IBCLC

Many moms feel a bit of anxiety at the thought of breastfeeding as a first time mom.  That anxiety is often amplified for moms who are expecting multiples!  It’s true that breastfeeding is natural, but that doesn’t mean it’s always easy. We’ve got six tips to help you get prepared for breastfeeding twins.

 

#1  Know that it’s possible! Yes, moms can make enough milk for multiples!  Frequent milk removal and stimulation are the keys to building and maintaining milk supply.  Feeding your babies on demand is the best way to encourage an adequate supply. Skin to skin is also vital to incorporate as much as possible.  If nursing isn’t possible,frequent pumping is essential. Because multiples are at higher risk for being born prematurely, make a plan for how to pump if your babies are in the NICU or aren’t able to nurse. Communicate your desire to provide breastmilk for your babies to your healthcare team. 

 

#2 Learn as much as you can BEFORE your babies are born! This tip can apply whether you’re expecting one, two, or more babies.  It’s so important to take a breastfeeding class and to connect with an IBCLC before you’re overwhelmed with all that comes with the early days postpartum. Connect with an IBCLC who is experienced in supporting moms of multiples and consider joining a support group (in person or online) for moms of multiples as well.

 

#3 Enlist help! Newborns need us for EVERYTHING!  Multiply that by two (or more) and it’s a recipe for exhausted and even exasperated parents.  Identify friends and family members who are willing to help out with things like laundry, running errands, cooking, and even sitting with the babies so you can get some much needed rest.  It is not weak or selfish to ask for help!  Mamas, you are amazing, but that doesn’t mean you can’t ask for help sometimes!  Make a plan, before the babies arrive, for who can help with what. 

 

# 4 Supplementing doesn’t mean failure!  It’s important to know that breastfeeding doesn’t have to be “all or nothing”.  If your babies require a supplement of donor breastmilk or formula, that doesn’t mean you have failed! Breastfeeding multiples often comes with unique challenges, and many multiples require supplementation in the early weeks.  Often, this supplementation is temporary. 

 

# 5 Positioning is key!  It is beneficial to practice positioning even during pregnancy.  Try different holds with two teddy bears or two dolls. Practicing can lead to greater confidence in positioning once your babies are born. Investing in a breastfeeding pillow that is specifically designed for twins can be a game changer!

 

#6 Consider feeding both babies at the same time! It may take a few days to get accustomed to each baby’s feeding behaviors and preferences.  Once you get the hang of feeding each of them, consider nursing them at the same time.  Many twin moms report that feeding their babies simultaneously results in much more rest. Ultimately, you get to decide what works best for you and your babies!

We know that welcoming twins can feel a bit overwhelming, but we hope these tips help you feel a bit more prepared!  We’re here to help as well.  Schedule a free consultation with one of our IBCLCs here .  Congratulations times two!

Self Care While Social Distancing

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By Melissa Portunato MPH, IBCLC, RLC

Finding time for self care as a new mom can be hard enough. Throw in a global pandemic and life can get pretty intense. While the majority of the country continues to remain with stay at home orders, stress levels are at an all time high for everyone. Maybe the end of your maternity leave now means transitioning to working virtually or maybe you have found yourself home with older siblings and your new baby since most daycares have closed their doors. Self care doesn’t need to be fancy or always involve a spa or nail salon but we know those things can definitely be a sweet treat! Stress from the pandemic and everything else that comes along with being a new mom can start to get taxing mentally, physically and spiritually. If you’re not feeling well, truth is no one at home will. Let’s start with being mindful and kind to our perfectly created bodies. You just birthed a baby and with that a new mother was born too. Let’s nurture her and treat her right. 

 

Read on for 3 tips to practice Self Care while Social Distancing:

 

Get More Zzzzzzz

Sleep? Yes please! The lack of sleep that comes along with having a newborn can be the biggest life transition. No matter if you’re a first time mom or if it’s your 5th baby, you’re never really prepared for the lack of sleep you’re going to experience. Frankly, you will never sleep the same again. Good news is eventually it will get better, but how can you get more sleep during the newborn phase? Here’s how! Research shows moms who bring baby to their beds to nurse get more sleep. Co sleeping can be safe when proper guidelines are followed. And if you are exclusively pumping it’s still important to keep your baby close! The AAP recommends keeping your baby in the same room with you at least until 1 year. You’re able to respond faster to your baby, allowing you both to peacefully nod back into dreamland.

 

Get Moving 

With most public parks remaining closed, more moms are finding a neighborhood walk soothing and relaxing. A breath of fresh air can do wonders for your mood and boost your immune system. Vitamin D, which we mainly get from the sun, is critical in keeping your immune system up and running to help fight off viruses. How much Vitamin D should you be intaking? For nursing moms, the recommendation is to intake 6400 IUs per day in order to have adequate supplementation for both mommy and baby.  Is it impossible to get outside? Try a quick 7 minute workout like these with the 7 minute workouts (app). Quick easy to follow workouts and even some yoga poses you can incorporate. Namaste! 

 

Kick The Sugar 

We’ve piled our pandemic emergency stash with all the essential items cookies, cakes, and chips! But why does everything non perishable seem to always have to be unhealthy? Not true! Some easy non perishables to add to your daily diet that help with sugar cravings are nut butters like almond and cashew, dried fruit or trail mix, coconut flakes or cocoa bits can curb hunger and keep you fuller longer. Add in healthy fats like olive oil and avocados too! Breastfeeding moms gotta eat! You’re burning between 300-500 calories just by making milk. Limit sugar to have more energy to keep up with all the new normals going on. Make sure that you are compensating for those extra calories with real food. 

The life of a new mom revolves around breastfeeding, diaper changes, rinsing and repeating. It’s pretty easy to forget about yourself. But it’s especially important now, more than ever to practice healthy self care habits. Social distancing doesn’t mean social isolation mamas. Be sure to connect with your family and friends during this time. Schedule a virtual happy hour with friends, have family drive by to see the baby through the window, or even host a celebration parade to welcome your new bundle of joy. Always remember your doctor is only a call away. Don’t isolate yourself and confide in a trusted professional. Schedule a virtual consultation with one of our IBCLCs and we can help talk it over. We’re for you mamas and we support you!

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