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1
WHY WOULD A BREASTFED BABY LOOSE WEIGHT??Kittie Frantz, RN, CPNP-PC
Clinical Instructor in Pediatrics
Keck School of Medicine at
The University of Southern California
2
DISCLOSURE
I own Geddes Productions, LLC – producer of breastfeeding DVDs and a distance learning course called “The Baby’s Perspective”
I was breastfed for 9 months
I breastfed my three children
All of my 7 grandchildren have been breastfed
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I have received copyright permission to show these photos, films, and drawings only to the live conference audience.
Handouts, photos and recordings may not duplicate these images.
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BREASTFEEDING IS NATURALIT HAS BEEN GOING ON FOR TENS OF THOUSANDS OF YEARS……RIGHT?
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SO, IS THE CAUSE OF POOR WEIGHT GAIN…
The Mother? The making
The Baby? The taking
The Opportunity?
The Absorption?
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WHY IS IT ALWAYS “BLAME THE MOTHER”?
“She doesn’t “Have enough milk”
“This is her first baby so she is inexperienced”
If this were true most of the time, all first borns would never survive
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UNDERMINING THE MOTHER’S CONFIDENCE
My bottle baby weighs more than your baby
Maybe she just thinks she is not making enough milk
AP news
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IF SHE BREASTFED HER OTHER BABY WITH GOOD WEIGHT GAIN, THEN….
She has a proven breast
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I AM NOT SAYING THAT IT COULDN’T BE THE MOTHER
Likely possibility is low She does the making
but the other 3 categories involves the baby
The lethal gene theory
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MATERNAL DIAGNOSIS THAT COULD EFFECT A MILK SUPPLY Hyper or Hypothyroid
Pituitary gland problems
Polycystic Ovarian Syndrome
Retained Placenta
Sheehan’s Syndrome
She has lost her pregnancy weight too fast
Gastric bypass that inhibits absorption
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COULD BE MEDICATIONS SHE TAKES
Estrogen containing birth control pill
Progesterone birth control shot, patch or pills before 6 weeks postpartum
Antihistamines
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ANATOMICAL DEFICIENCYLACK OF GLANDULAR TISSUE
Gift from patient
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SURGERYREDUCTION MAMMOPLASTY
Gift from T Fuller
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SUGGESTIONS CAN ALSO: “BLAME THE MOTHER”
Let’s build up your milk supply with
an electric breast pump
© Kittie Frantz
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SUGGESTIONS THAT ALSO CAN… “BLAME THE MOTHER”
Take some herbal tea or capsules to
build up the milk supply
Buy special cookies or oatmeal
Use gut motility drugs
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THIS FEEDS INTO HER FEELINGS OF INADEQUACY
LAC+USC Midwives
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BUT…WHAT IF IT IS NOT HER BODY THAT HAS BETRAYED HER?
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WHAT IF IT IS THE BABY? IT TAKES TWO TO TANGO !
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THE BABY NEEDS TO SUCKLE WELL
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HOW CAN WE DETERMINE THAT?
© Kittie Frantz
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THERE ARE THREE PHASES TO THE SUCKLE YOU CAN CHECK
© Kittie Frantz
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THE ANTISIPATORY PHASE
© Kittie Frantz
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THE INNER LIP STIMULUS
© Kittie Frantz
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THE DIGITAL FEEL
© Kittie Frantz
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MAKE SURE BABY IS NOT TONGUE TIED
© Kay HooverGift from patient
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WHEN BABY CRIES, IS HIS TONGUE SLEEK AND CURLED?
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YOU CAN OBSERVE THE BREASTFEED
© Kittie Frantz
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MORE AREOLA ON THE TOP THAN THE BOTTOM?
© Kittie Frantz
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LIPS FLANGED?
© Kittie Frantz
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CHEEKS ROUND?
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DRAWS IN BREAST SKIN?
© Debi Bocar
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FEEL TONGUE UNDER CHIN?
Gift from patient
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WIDE JAW EXCURSIONS?
© 2007 Smillie, Makelin, Frantz licensed from Geddes Productions, LLC Baby-ked Breastfeeding: The Mother-baby Dance www.geddesproduction.com
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SUCKLE/SWALLOWING RATE?
© 2007 Smillie, Makelin, Frantz licensed from Geddes Productions, LLC Baby-ked Breastfeeding: The Mother-baby Dance www.geddesproduction.com
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ALL THROUGH EVERY FEEDING?
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ANY SORE NIPPLES?
Gift from patient
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ANY ENGORGEMENT?
© Kittie Frantz
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THE ELEPHANT IN THE ROOM…..WHY IS HE NOT SUCKLING WELL?
Normal for newborns to take time to organize their suckle in the first five days Gryboski
Does baby have high or low muscle tone?
Is Baby’s central nervous system immature?
Is he sick? Sepsis
Is he a 36 - 37 week late pre-term infant?
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IF IT IS THE SUCKLEHOW CAN WE FIX THAT?
Hand express while baby feeds to increase the flow
Listen for swallows
Can’t get baby to continue to swallow? Switch breasts
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IF THAT DOESN’T WORKSOMEONE WILL SUGGEST SUPPLEMENTING
© Kittie Frantz
© Kalman and Frantz
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BEST TO SUPPLEMENT AT THE BREAST
Medela AG
© Geddes Productions from Supplemental Nursing System DVD
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OK….SO MOM IS OK AND BABY IS OK……SO WHAT NEXT?
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THE OPPORTUNITY?
UNICEF
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HOW OFTEN DOES HE FEED?
Is she just repeating what she was told to do?
I would if I was dead tired
How many of you could recall how often your baby fed in the first week?????
Do a 24 hour recall with her
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HOW OFTEN SHOULD SHE FEED??
THE AAP SAYS….
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IF SHE KEPT A LOG, REVIEW IT
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HOW LONG SHOULD BABY BE AT THE BREAST?
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WHAT SHOULD THAT NUMBER BE AT EACH BREAST?
THE AAP SAYS…
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WHAT HE GOT DEPENDS ON HOW WELL HE SUCKLES
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SO…THERE ARE 3 THINGS NEEDED FOR A GREAT MILK SUPPLY
Frequency of the feedings
Length of the feedings
Quality of the baby’s suckle
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WHAT CAN INTERFERE WITH BABY’S OPPORTUNITY AT THE BREAST?
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SWADDLING
Gift from patient
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PACIFIER
© Kay Hoover
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SWINGS AND “PUT THE BABY DOWN” THINGS
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SCHEDULED FEEDINGS
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UNDERMINING MOM’S CONFIDENCE CAN SLOW THE MILK SUPPLY
You mean he isn’t sleeping through the night yet???
So she tries to make that happen
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SLEEP TRAINING
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LOS DOS COSAS
© Kay Hoover
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BAD ADVICE
© 2009 Geddes Productions, LLC licensed from The Baby’s Perspective www.babysperspective.com
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DA TAH DA DAH…..HERE COMES LLLI AND WIC!!
© H Quimby
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THIS IS WHAT YOU DO BEST !!!
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AHH ….. BUT THERE IS ONE MORE THING TO CONSIDER
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IT COULD BE THE ABSORPTION
Infants with undetected cystic fibrosis
Infants with myotonic dystrophy
Infants with metabolic disorders
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ANY QUESTIONS??