Doula Training: Breastfeeding & Postpartum - Doulas of the Diaspora PDF

Doula Training & Mentorship Class 4: Breastfeeding & Postpartum Processes of Breastfeeding Milk Production Made by the mammary glands Hormone prolactin triggers production Production begins in third trimester Foremilk is milk that sits on the surface and is watery Hindmilk is m...

Doula Training & Mentorship Class 4: Breastfeeding & Postpartum Processes of Breastfeeding Milk Production Made by the mammary glands Hormone prolactin triggers production Production begins in third trimester Foremilk is milk that sits on the surface and is watery Hindmilk is milk that is stored further back and is fattier Main production factors are nutrition/hydration, stimulation and rest! Milk Contents Breastmilk is over 80% water! Less than 2% of what mother consumes gets to the breastmilk Contains macronutrients, carbohydrates, protein, fat Stages of Breastmilk Maturity Colostrum Transitional Milk Mature Milk Produced through Produced from day Week 2 through end 3 days postpartum 3-14 of breastfeeding journey Dark yellow/gold in Yellow in color color Whiter, creamier Milk-like Contains clear Thick in consistency foremilk and hindmilk consistency Easier to pump Ever-changing Difficult to pump Nutritionally depending on baby’s High in antibodies: balanced for age, health and immunoglobulin, newborn stage nutritional needs lactoferrin, leukocytes, epidural growth factor The First Latch Should happen during the first hour of life (the golden hour) Is ideally initiated by mother and/or baby Mother may experience some discomfort, but should not hurt Can take several attempts to successfully latch Is not an indicator of long term issues – practice makes perfect! Latching Positions Let’s discuss! Supply & Demand First 6 weeks First 12 weeks After 6 months The body will make Regulation occurs Essentially the amount that it Production will still impossible to is told to make fluctuate based on increase supply Adding in pump baby’s growth Baby’s consumption sessions in between Milk will contain has plateaued nursing sessions carbohydrates to Many experience dip can increase supply keep up with growth in supply upon spurts introducing solids Will produce more Milk will typically milk during growth contain more fat spurts Feeding Schedule Assessing for Success Measure the number of wet diapers (not poopy). Assessing for Success (Continued) Weighing Bottle Weight Gain (Longterm) Weigh the baby Offer the baby a Follow the before and after the bottle with a specific percentile charts for feed to determine amount of milk weight gain based how much was on baby’s gender consumed Otherwise, bottles and age should not be introduced for at least 6 weeks Processes of Breastfeeding Physiological Emotional/Hormonal Breasts will be hard after a Prolactin triggers production few days (engorgement) Oxytocin triggers milk to eject May experience tingling Can experience warm/fuzzy session upon a letdown feeling upon letdown Can feel relaxed/sleepy (common to fall asleep while feeding!) DEBUNK THESE MYTHS! “Breastmilk “comes in”” “Formula is just as good” “Breastfeeding hurts” “You cannot drink alcohol while breastfeeding” “You cannot take medicine while breastfeeding” “Breastfeeding will make your breasts sag” “It’s normal to have a freezer full of milk” “Pumping isn’t breastfeeding” Breastfeeding Complications Milk gland dysfunction due to surgery Inverted nipples Hormonal issues with production Cracked nipples/painful feeds Dysphoric Milk Ejection Reflex (D-MER) Breastfeeding aversion (hormonal or trauma-based) Mastitis The issues should be escalated to a lactation consultant. You should advise your clients to stay away from all herbs or supplements that are promoted to increase supply until being assessed by a higher-level professional. Pumping People typically pump for a number of reasons Because baby is having difficulty latching To store milk for later use Because they will be away from baby for a feed or longer Types of breast pumps Passive (haakaa) Manual (handheld) Electric (powered machine) Wearable (rechargeable) Breastmilk Shelf Life Room Temp Fridge Freezer Up to 4 hours Up to 72 hours Up to 6 months in a regular freezer Up to 12 months in a deep freezer Stigma WHO recommends that babies be breastfed for at least 2 years CDC recommends babies be exclusively breastfed for 6 months Many people opt not to breastfeed due to stigma or fear Some employers are still not breastfeeding-friendly What are some reasons that people may not breastfeed? Benefits of Breastfeeding Increased bonding with baby Protects baby from infections (mother’s body will produce antibodies) Helps develop strong immune system Lower risk of asthma, obesity, type 1 diabetes and SIDS Lowers the maternal risk of developing breast cancer May help mother lose weight (not always!) May prevent periods from returning (not always!) Let’s discuss! Newborn Care Pediatric Care Choose a pediatrician by 36 weeks gestation Pediatric care schedule 3 days, 1 week, 2 weeks, 1 month, 2 months, 4 months, 6 months, 9 months, 12 months, 18 months, 2 years, yearly Pediatricians may be strict about following vaccine schedule May be difficult if anti-vax Hepatitis B first dose is usually administered at birth Normal to lose weight first week Pediatrician may have baby return for an extra visit if weight gain is a concern  Common Newborn Considerations Circumcision – commonly done in first 48 hours Jaundice – high bilirubin levels, cured by sunlight and breastmilk Constipation – GI adjustments Colic – extreme fussiness, gassiness, crying Umbilical cord – can become infected Tongue ties/lip ties – may need correction Sleep Schedule Wake windows Don’t sleep when they sleep Circadian rhythm Sleep specialist/postpartum doula Immediate Postpartum: Social Support Newborn haze for first two weeks For every baby that is born we need three adults One to care for baby: baby’s needs and wellbeing One to care for mama: healing, physical/mental wellbeing One to care for the house and other family members Want to make sure there is a plan for Food House supplies Adjusting to new family dynamic Introducing pets Still at risk for complications for the first 6 weeks (preeclampsia)! The Postpartum Stage This entire stage lasts SEVEN YEARS! Hormonal adjustments Physical/bodily adjustments Need ongoing therapies and intentional, consistent follow-up care Mood and anxiety disorders can develop at any point within the first year postpartum (and sometimes later) Not recommended to get pregnant again for two years Let’s discuss! Until Next Class… Things to think about Things to do What are some important Look up the tongue tie and lip resources for you to share tie release procedures with your clients to prepare Familiarize yourself with types them for the postpartum of breast pumps and how period? they function Research high lipase breastmilk