As Doulas we always talk about what to expect before and during labor. But something we might overlook prenatally is what to expect after your little bundle arrives. So, I asked mothers to weigh in on their postpartum experiences and what no one had told them about. Here are the top things our clients were surprised by in the postpartum!

Breastfeeding is HARD
Nursing can be painful for some women, especially initially--and it generally is just challenging. Steph says, “I remember calling all of my mom friends and saying, 'Why didn’t you tell me?!'” When establishing a nursing relationship, normal pain may last for the first 30-60 seconds of a nursing session, which could last for up to two weeks, but pain during sessions should not last the entire feeding, and soreness between sessions should improve everyday and not get worse. If pain and soreness persist, contact your local IBCLC--persistent pain can usually be resolved by assessing latch, positioning, and for the potential of tongue and/or lip ties.

Hemorrhoids are a pain in the butt
“Nobody told me what hemorrhoids could/would be like.” Ashley shared. If you have hemorrhoids while you’re pregnant, there’s a chance they’ll come back to plague you post-delivery. Hemorrhoids are a result of stress on the perineum in the months before, and during delivery. For some, hemorrhoids may simply be itchy and annoying but for others, they can be pretty painful. Here’s a few things to help ease the discomfort:

• Postnatal icepacks
• Warm sitz bath
• Peri bottle
• Witch hazel infused pads

This is just crampy...
So you've birthed your baby and...YOU'RE STILL HAVING CONTRACTIONS?? What is that about? Afterbirth pains are caused by contractions of your uterus as it involutes, or returns to its pre-pregnancy size. They are usually mild for first-time moms but may get more intense with each subsequent delivery. Afterbirth pain will be most intense for the first day or two, but it should start tapering off around the third day or so. Nursing can cause afterbirth pains to intensify because your baby’s sucking triggers the release of oxytocin.

The First Poop
Pooping after having a baby can be intimidating to say the least. Linda says, "No one warned me about the first poop. For me, it was worse than recovering from a C-section infected with MRSA.” That sounds terrible, Linda! Voiding your bowels for the first time can be REALLY scary, but it should NOT be terrifying or impossible. Staying hydrated before, during, and after delivery of your baby will help make your first “poo” a little easier. Asking your doctor for a stool softener may help to assuage your fears. Don’t forget to stay hydrated after coming home… I speak from experience on that one, otherwise there’s not enough Vaseline and Jesus to help if you don’t! Utilizing a Squatty Potty may also help you assume as natural and relaxed of a position is possible which should reduce the need to bear down. Many moms don't know that it can also be very normal for bowel regularity to take several days to return to normal after birth.

Second Night Syndrome
More commonly known as cluster feeding, the second or third night after baby is born can make a lot of moms feel inadequate and overwhelmed. “Holy crap that second night in the hospital was probably the toughest in my life to date!" says Kelly. Immediately after your baby is born he/she will most likely be very sleepy, so take advantage of this by limiting visitors and get lots of rest. Charge your iPad so you can binge watch Netflix, have your husband get the snacks you like, act like you're having an awesome slumber party, and just try to enjoy those moments bonding with your baby--sans slumbering.

All over the world, moms are celebrating World Breastfeeding Week, some even honoring the event with traditions like the Global Big Latch On in some communities (come see us at the Global Big Latch on of Escambia & Santa Rosa Counties). In honor of this week, we are keeping it real. 

It seems like the minute you announce your pregnancy, the advice starts to pour in from all directions--not just for pregnancy and birth, but for breastfeeding too. From "Don't eat broccoli or asparagus, it will give the baby gas," to "Never wake a sleeping baby to eat!" we are sure you've heard all the strange (and not-so-great) suggestions there are out there. And while there are some strange pieces of advice that are also mythical, there are also some strange pieces of advice that can be very, VERY helpful and real. 

#1: Give the ladies air time. 
Yes, we are suggesting you go topless once in a while. Letting your twins free while you're breastfeeding can be a very important part of the process--not only because your nipples are not accustomed to friction for 8 hours a day at first, and fabric against them can feel like rubbing shards of glass on them as they heal from any initial damage, but also because wearing a bra or shirt 24/7 can promote bacterial and fungal growth. Yeast and other bacteria thrives in dark, moist, warm places (aka, your nursing bra), and your breastmilk contains carbohydrates/glucose, which also feeds bacteria and fungi. So by going topless, you are not only giving your nipples time to heal and be more comfortable, but you are also allowing them to stay dry so that you can help avoid a thrush outbreak or other bacterial infection in your milk ducts. Wearing a button up shirt or a robe can facilitate this--hey, you could even just cut some holes in an old t-shirt and be set! Just make sure that you don't forget about your state of dress (or lack thereof) and accidentally answer the door for the UPS man. 

#2: Strange breastfeeding positions are sometimes the best. 
One of the most common issues in the early days of breastfeeding, and then later on during changes that can impact supply, are plugged ducts. This is when fat globules in your milk collect in one part of a duct and form a clog in the flow of milk. Many moms feel this as a hard knot that could be anywhere from the size of a marble to a golf ball. When this happens, one of the best ways to work the knot out is to lay your baby flat, and "dangle" your breast over your baby to feed, with the baby's chin against the knot. This allows gravity and the baby's oral movement to work the knot out. (See this position here). 

Another fantastic breastfeeding position to help clear plugged ducts (or prevent them if you have them happen more than once) is the "over the shoulder" position. Imagine throwing your baby over your shoulder, upside-down, and you've about got the image! In this position, you are laying down on your side or back, and baby is lying with legs literally over your shoulder. (See this position here). These positions aren't just for plugged ducts, though. Switching the position baby feeds in frequently stimulates different parts of the breast, which can increase supply AND help prevent baby from developing a preferred nursing position or side. So, if you've struggled with plugged ducts more than once, or are uncomfortably engorged in the early days, this can be an especially helpful position if you have a very little one. 

#3: Other Ways to Remove Plugged Ducts. 
Plugged ducts can be nasty little boogers that are both painful and a precursor to mastitis (an even nastier booger). Thus, our desire to help you remove them as easily as possible, and avoid them in the future. And there is more than one way to fix this problem. The key with removing the clogged ducts is to dissolve the plug of milk fat--and this can require massage, heat or vibration. So, our favorite tools to suggest for plugged duct removal are:

• A wide-tooth comb in the shower. Coat the comb with coconut oil or conditioner and gently but firmly "comb" the duct toward your nipple. You may even see little pieces of fat come out of your nipple. 
• An electric toothbrush. With the motor on, use the base (not the bristles) of the toothbrush to roll and massage over the clog. You may never look at your toothbrush the same again, but hey. A girl's gotta do what a girl's gotta do. 
• A vibrator/personal massager. Yup. You read that right. Your little friend has more than one use. Simply use it in a similar manner to the toothbrush as described above. The nice thing about this method, is most "massagers" are made of a softer material than an electric toothbrush, which may make the process more, ahem, comfortable. 

#4: Put that stuff on everything. 
This hearkens memories of My Big Fat Greek Wedding where the father of the bride believed that any ailment could be cured by Windex. Well, just switch out Windex for breastmilk and we've got a similar situation going on here. From pink eye, to scratches and cuts, to ear infections, lots of moms are now treating common ailments with a drop or two of anti-body filled breastmilk. In fact, many moms are stashing extra breastmilk in tiny syringes in the freezer just for situations like this. It might sound crazy, but there's lots of evidence that it works!!

So, in celebration of World Breastfeeding Week, maybe stash away these "crazy" suggestions for later use--you might need them. And we'd love to hear about any weird or strange breastfeeding suggestions you've been given that have worked for you!

We are not of the opinion that breastfeeding is "best" for every family--some families benefit so much from reassessing their infant feeding goals and choosing alternative feeding methods (such as pumped breastmilk in bottles or formula). BUT breastfeeding is very important to many families, and since it is the biological norm, many more families are choosing breastfeeding after learning more about it and gaining support as they start out. And, some families are choosing feeding with breastmilk after assessing not only the health benefits but also the cost comparison with formula.
 
Breastfeeding is free! Yes, you can buy nursing bras, nursing clothes, boppys, breast pumps, etc. But none of that is NEEDED to breastfeed. However, to formula feed it's on average $1,733.75 for the first year to buy just the formula; that's enough money to take your family to Disney! When broken down, formula can be as cheap as 9 cents per ounce up to 31 cents an ounce (depending on what brand and type you choose). That cost does not include bottles or the potential increased costs of healthcare for those babies who don’t receive breastmilk. (And all of this doesn't even include the time spent preparing & cleaning bottles, or the money/time spent on obtaining sterile water for safe formula prep.)
 
We want your breastfeeding care to be affordable, of course. So here are some ways to keep it that way:

• Using your HSA/FSA card: we are approved to accept these methods of payment through all of our payment portals. 
• The Belly to Cradle Gift Registry (friends and family can gift you your consultation.)
• Insurance reimbursement. Your consultant will provide you with a superbill and instructions for requesting reimbursement from your insurance company. Many insurance companies, including Tricare, don't hesitate to reimburse your lactation consultation fees. 

Ultimately, you may not need to see an IBCLC--while we provide the clinical gold standard of breastfeeding care, and perks like home visits, care/feeding plans, referrals to other providers, and direct phone and email access to your consultant,  we're also huge advocates of lactation educators and support groups as well--whatever it takes to get you support! Lactation educators and support systems available through resources like La Leche League and WIC can be less expensive or even free. In the Pensacola area, we are also fortunate to have very affordable outpatient, in-office lactation care available through Monogram Maternity at Sacred Heart. 

We are here for you no matter what you choose--from how you feed to your baby, to who you see for your lactation care. Let us know how we can support YOU!

Really? Another class? After the childbirth education classes and the infant care classes, and books, and webinars on the interwebs, all in preparation to give birth, there's yet ANOTHER class that needs to be taken? In the words of a YouTube visionary, "Ain't Nobody Got Time For That." Well...we respectfully request to disagree. Why?

After the breathing, and the contractions, and the pushing--then what? The average mom will spend 5-8 hours a day feeding her baby. Yup. Like a full time job. That means that in the first 6 months of your baby's life, you will spend around 1,000 hours--that's ONE THOUSAND HOURS--feeding your baby. So why wouldn't​ you take a class on something you're about to spend up to 40 hours a week doing? Well, let's talk about why you would take a breastfeeding class.

You get to establish a relationship with breastfeeding professional who can then provide support after baby comes, if you need it. Reaching out for assistance after baby comes can be daunting, overwhelming, or even intimidating, especially if the people you need are strangers. Get the niceties out of the way before baby arrives, in class! A familiar face always makes things easier. And during class, you'll learn how to identify reasons why you would need more support after baby comes, so you'll have an action plan in place if you face challenges. 

You get to build the breastfeeding knowledge of your support network so that your partner/auntie/grandpa/sister can better help you. We encourage you to bring your whole posse to our breastfeeding class! Whoever is going to be hanging out with you to help after baby arrives should have the same information you do--not only so they know the whys behind what you're doing with breastfeeding, but also so that they can remind you if you forget something. Sleep deprivation, hormones, and all the newness of the postpartum can give you the infamous Mommy Brain, and having someone to remind you of what you learned in class can be absolutely priceless!
​
You get to learn the NUMBER ONE thing you need to do to get breastfeeding off to a great start and how a lot of families (unknowingly) mess it up. Even if you don't recall anything else from class, you will leave knowing THIS one thing. We would tell you this one thing is but we have to save some of our secrets for class!! 

You get learn what a truly good latch looks and feels like. Since this may be your first time breastfeeding, you may not know what to look for when it comes to your baby's latch right after birth. Or maybe your last baby didn't have such a great latch and you're trying to improve on it this time. Having your family there too will help them be able to see whether or not baby has a good latch--especially since it can be hard to get baby latched on well the first few times with only two arms. 

You get to practice coordinating breastfeeding holds through the use of our weighted dolls. While this may seem sort of strange at first (or even a little creepy--darned little eyes that open and close), it can actually be a real eye-opener (pun intended) to position a doll that weighs close to what your own baby will weigh. Just don't look the doll in the eye.  

Join us as we start our very own breastfeeding class, Belly to Breastfeeding, which will be available every month, starting July 6!

Ever since I became a lactation consultant in 2015, I have encountered misconceptions about what the role of a lactation consultant really is--the main one being that we only approve of breastfeeding, and judge families who choose any feeding method other than breastfeeding. Friends would find out that I was a lactation consultant and say immediately, as though I might automatically judge, "Well, I couldn't breastfeed because..." Patients have told me, with shame, "Last night I gave the baby formula during cluster feeding, but I only gave it one time. I know I wasn't supposed to."

My answer, always and immediately, is that there is no right or wrong way to feed your baby. You have to do what works for you, not what pleases  everyone else. As a lactation consultant, I will reassure you that no matter how you feed your baby, it is never "wrong" or "harmful." 

So let's clear up some of these misconceptions about what lactation consultants do and don't do.

Lactation Consultants DO:

• Specialize in clinical management of breastfeeding--we are THE clinical experts on breastfeeding.
• Believe that breastmilk is amazing in so many ways that the benefits can be endless.
• Help babies who are not gaining enough weight by addressing reasons for lack of weight gain and coming up with feeding plan.
•  Help moms who are having pain while nursing.
• Assist mom-baby dyads with latching difficulties.
• Address reasons and solutions for low milk supply. 
• Communicate & collaborate with other members of the clinical team (OBGYNs, midwives, pediatricians) when and if necessary.
  
• Assure families whether or not their breastfeeding relationship is on the right track!