Breastfeeding Special Babies In Special Circumstances - Article Two

Jul 11


Sally Michener

Sally Michener

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This is the second article that provides guidance and information for mothers who have a special needs baby to help them breastfeed these special infants. I hope you have read Article One on this topic.


Breastfeeding is even more important for babies with special needs and their parents. Breastfeeding gives you a higher level of maternal hormones,Breastfeeding Special Babies In Special Circumstances - Article Two Articles which increase your intuition and perseverance to meet the needs of your special baby. Because of its physical, psychological, and medical benefits, breastfeeding is even more important for these babies. A baby has special needs. Parents develop a style of caring for their baby and in so doing elevate their level of intuition and sensitivity toward their baby to match the level of baby's needs. Let's discuss the most common situations in which babies with needs in unique situations bring out a special kind of parenting.

Baby's with Down Syndrome
A baby with Down syndrome needs to have the best start possible. Going through a checklist of the most common medical problems that could be expected, it was determined that although certainly not panacea, breast milk could help each of these problems:

* Babies with Down syndrome are prone to colds, especially ear infections; breast milk provides extra immunity.
* Babies with Down syndrome are prone to intestinal infections; breast milk promotes the growth of friendly bacteria in the intestinal tract, a factor that lessens infections.
* Babies with Down syndrome are prone to constipation; breast milk has a laxative effect.
* Babies with Down syndrome are prone to heart problems; breast milk is lower in salt and is more physiologic.
* Babies with Down syndrome may have a weak suck; breastfeeding has an energy-sparing rhythm.
* Babies with Down syndrome have delayed mental and motor development; breast milk is good brain food, and breastfeeding optimizes oral-facial development and socialization.

There is a lot we don't know about babies with Down syndrome; there are a lot of valuable nutrients in breast milk yet to be discovered. A special baby needs special parenting--beginning with breastfeeding.

Typically babies with Down syndrome have a hypotonic (low tone, weak) suck requiring lots of support, training, and patience until mother and baby get the hang of it. It is possible that not until two weeks will the baby open his eyes and become more receptive to breastfeeding. Until then do what you can to get him latched on. It can be a very scary time, and you might fear that he might never breastfeed well. You may have to initiate most of the feedings. If you wait for the baby to "demand," he may never gain weight.

For the first two weeks you may have to pump several times a day and syringe and finger feed the baby one ounce before each breastfeeding to "suck train" him. Hopefully doing this you may see how well the baby makes up for lost time.

Though most babies with Down syndrome have a more difficult breastfeeding start and need to be taught to breastfeed, they do eventually learn these kills. The profound benefit make the extra work worthwhile. Be sure to contact a lactation consultant who has experience working with babies with Down syndrome.

All of the tips for attachment parenting have magnified benefits for babies with special needs. Constant contact through sharing sleep, breastfeeding, and baby wearing gives you the boost needed for bonding with your baby. Join a support group to help get you excited about your baby. As he gains weight and breastfeed, you will find that you can stop worrying about hi and begin enjoying him. You may discover one day that he responds to high-pitched baby talk from you. Don't let worry keep you from relating to him in a normal way. They are similar in many ways to normal babies. Every baby is to be valued, no matter what his or her handicap might be.

The Baby with Cleft Lip or Palate
Babies with a cleft lip or palate pose a special challenge to the breastfeeding mother, but the benefits of breastfeeding are worth the investment. The location and severity of the clift will determine whether bay can learn to breastfeed effectively and which positions and techniques you should use. Mothers of babies with a cleft lip or palate should obtain professional help from a lactation consultant by the second day after birth. Choose a lactation consultant who has some experience helping babies with clefts breastfeed.

A baby with a cleft lip may or may not have difficult forming a seal on the breast. If baby does have trouble, mother's soft breast tissue will fill in some of the space at the cleft, and mother's thumb can close off the rest of the gap, allowing baby to suck normally. Clefts are repaired in stages in the early months. Some surgeons feel that breastfeeding immediately after the surgery does not interfere with healing; others may insist that you pump you milk and feed it to your baby with a special device until the repair has healed.

A baby with a small cleft of the soft palate may be able to nurse with few problems, but a baby with a more extensive cleft may not be able to breastfeed at all. Because of the opening in the palate, a baby with a cleft palate cannot use section to keep the breast in his mouth, and with part of the hard palate missing, it is difficult for baby to milk the breast with pressure from his tongue. Milk may run into baby's nose and ears. A lactation consultant can help you evaluate the problems your baby has with breastfeeding and suggest solutions. Even if your baby is unable to breastfeed, you can still pump milk and feed it to him in other ways.

The Adopted Baby
Where there's a will there's a way. Yes, you can breastfeed your adopted baby; it takes high doses of commitment, a few special tools, and professional breastfeeding help. Using a technique called induced lactation it is definitely possible to breastfeed your adopted baby. These are the steps to go through.

* Seek advice and support from mothers who have successfully breastfed their adoptive babies. You can locate adoptive breastfeeding mothers through your lactation consultant or La Lech League, or ask your pediatrician for names of adoptive mothers is his or her practice who have breastfed their babies.
* Consult a lactation consultant as soon as you know you are getting a baby. The ideal situation is to know before the baby is born. A month's preparation is best, but not absolutely necessary.
* Here are the tools you need: Rent an electric breast pump, preferably one with a double pumping system, and stimulate sucking at the breast by pumping your breasts as often as you would feed a newborn, around every two to three hours. Your lactation consultant will show you how to use the pump and work out a schedule. You will also need a breastfeeding supplementer, which is mentioned in my article Breast Feeding Helpers. You may begin to produce drops of clear or opaque fluid and then actually get small amounts of milk even before you have your baby, especially if you have previously or recently breastfed. Lactation is a very individual system, dependent on each individual's levels of milk-producing hormones. (It does not depend on your reproductive hormones.)
* Choose a pediatrician who is experienced in counseling adoptive breastfeeding mothers.
* Make arrangements if possible to be present at delivery so baby can begin bonding with you. In this way your baby knows right away to whom he or she belongs. You, baby's mother, will be the first one to feed your baby.
* While baby is in the hospital try to be present for as many feedings as you can. With the help of your lactation specialist, begin feeding baby formula at your breast with a supplementer. If you're not able to be present for all the feedings (and few mothers are), instruct the nurses to use the finger-and-syringe method of feeding or to use the SNS for finger feeding (See my article on Breast Feeding Helpers.) Try to avoid bottle feeding in the early days and weeks while baby is learning to feed at your breast. This method of feeding takes no longer than bottle feeding.
* Remember, it is the frequency of sucking that stimulates milk. The frequent sucking at your beasts induces your own milk-producing systems to click in. Most mothers will begin producing some milk within three to four weeks. (In addition to pumping and using a supplementer, wear your baby a lot, sleep with your baby, and massage your baby. All these ways of just being close to your infant also increases your milk supply.)
* Do not focus on how soon you will produce milk or how much. Even after your milk appears do not establish milk supply expectations; the quantity of milk produced is not the ultimate goal. The close bonding breastfeeding helps you achieve is the main benefit of breastfeeding your adopted baby.

Breastfeeding is ideal for the adoptive baby, and it does good things for mothers, too. The sucking at your breast stimulates the flow of your mothering hormones, giving you an added boost to become attached to your baby. In breastfeeding the adopted baby, you give the best start to baby; baby gives the best start to mother.

Twins (Even Triplets)
Twice the investment, twice the return. Here's how to both survive and thrive while breastfeeding your twins.

Get the right help early on.
In the latter weeks of pregnancy, consult other mothers who have breastfed twins. Your local La Leche League or Mothers of Twins affiliate can help you find some. Prenatally, attend La Leche League meetings to become acquainted with support persons that you are really going to need. Arrange for a lactation specialist experienced in helping mothers breastfeed multiples to help you within a day or two postpartum and teach you right-start techniques.

Get the Right Start
As an extra challenge to breastfeeding, many twins are premature and tend to be sleepy, not sucking well for a week or two. With the help of your lactation specialist, learn the right positioning and latch-on techniques immediately, before your babies develop poor sucking habits, your nipples get sore, and you don't product sufficient milk. Proper positioning and latch-on techniques are important enough for single babies; double that for twins.

Breastfeed the babies separately, then together.
In the first week or so most mothers find it easier o feed one baby at a time, giving undivided attention to teaching each baby proper latch-on. Once both babies have learned to latch on correctly, you may find simultaneous feeding easier, especially if both babies have similar feeding needs and temperaments. To give each one some individual attention, try mostly simultaneous feedings and give individual feedings once or twice a day, especially when one twin is hungry and the other is asleep. Simultaneous feeding works best if babies are on a similar sleep schedule. As an added boost, research has shown that mothers who breastfeed twins simultaneously have higher elevations of the mothering hormone prolactin than those who nurse one baby at a time.

Many twins have similar birth weights and nutritional needs, but oftentimes one womb mate robs the other of placental nutrition, so that one twin shows obvious signs of having been nutritionally shortchanged. This baby is likely to need more-frequent feedings for catch-up growth. Sometimes one twin is a high-need baby, the other easy; and one may simply be hungrier than the other. Let the hungrier and more frequent feeder set the pattern. As you are about to feed the hungrier baby, periodicall7y wake the less demanding baby for feeding to ensure that you get at least some simultaneous feedings during the day. Otherwise you may find that you are always (literally) feeding one or the other.

Holding Patterns for Twins
Experiment with all these positions to find which combination works best for you and your babies.

* Unless sitting in bed, use a footstool to elevate your lap to better contain both babies. The double clutch hold allows you to control the babies' head movements in case one or both tend to throw their heads back during breastfeeding. When breastfeeding in this position, be sure to support yourself and the babies with lots of pillows, or purchase a specially designed nursing pillow (available from La Leche League).
* For the cross-cradle position, put one baby in the cradle hold, then put the other baby to the other breast in the cradle hold -- they'll have their heads apart and their legs and feet crisscrossing. Again, the lots of pillows for support.
* In the parallel position, one baby is in the cradle hold and one is in the clutch hold so that their bodies are lying in the same direction. The cradled baby is on your arm (on a pillow) and the clutched baby is on a pillow, the back of his neck held by your hand.

Dad as the second mother.
Father should be involved in the breastfeeding relationship with any baby. With twins it's an absolute must. In parenting twins the mother-father roles are not so well defined. It is true that only mom can make milk, but dad can do everything else. Fatigue is what does most breastfeeding mothers in. Mothers who have been successful at breastfeeding twins have mastered the art of becoming armchair household executives directing traffic and delegating responsibilities to any friend or family member they can draft. Father can give supplemental feeding, bring babies to the "executive" for feeding (especially at night), and do or delegate household chores. One father of twins proudly described their shared parenting: "Our babies have two mothers; she is the milk mother, and I'm the hairy mother." Breastfeeding twins: double the commitment, double the sense of humor.

Breastfeeding While Pregnant
Yes, you can! Mothers are often cautioned not to breastfeed during pregnancy. Here's the reason. Breastfeeding stimulates the release of the hormone Oxytocin into your bloodstream. In theory this hormone could stimulate uterine contractions, possibly inducing a miscarriage. Knowledgeable experts have been interviewed about the hormonal system during pregnancy and the following go-ahead was received: The uterus is not receptive to hormonal stimulation by Oxytocin until around twenty-four weeks of gestation. And with a healthy uterus and cervix, this Oxytocin is not sufficient to bring on labor unless your pregnancy is term and your cervix is ripe. Many mothers breastfed during part or throughout all of their pregnancy without doing any harm to themselves or their pre-born baby. If, however, you have a history of frequent miscarriages or experience unusual uterine contractions during breastfeeding, or if your doctor advises against breastfeeding because of your individual obstetrical situation, it is wise to stop. If you are at risk for preterm labor, any and all stimulation of your nipples (even showering your nipples) and orgasm must be avoided beginning at around twenty weeks of gestation, when the Oxytocin receptors in the uterus activate.

If your doctor gives you the green light, here's what to expect. You may experience nipple tenderness, making breastfeeding rather uncomfortable. You can negotiate with an older toddler, or enlist father's help to carry around and distract a younger one, to get the frequency and number of minutes of breastfeeding to a level you can tolerate. Some of the ideas in the which will be presented in my article on Weaning will be helpful. In the final trimester or earlier, expect your milk to develop a different taste, and in the middle trimester expect your supply to diminish.

Some mothers begin to resent breastfeeding one while carrying another, as though not only your breasts but also your mind is telling you it's time to wean. Like so many things in parenting, if it isn't working, change it. This is usually the time at which a toddler will naturally wean, although a few hardy souls (very giving mother, very high-need toddler) continue through pregnancy.

There will be more articles on breastfeeding, raising baby and other related topics so be sure to keep an eye out for my articles.