Tell us a bit about yourself and the work you do…
Hi! My name is Eve; I am a mum to 2 gorgeous boys, a Midwife and a Lactation Consultant.
I have been a midwife for 20 years, and I still love every minute of my job.
As a midwife, I always had an interest in helping new mums and babies learn the “natural” art of breast feeding, so I was shocked when I had my first son to find out how challenging it really was! What also shocked me was the lack of continuity in advice and support in breastfeeding education for new families, so I was inspired to become a Lactation Consultant to provide just that.
I am an International Board Certified Lactation Consultant (IBCLC). An IBCLC is a healthcare professional who specialises in clinical management of lactation and breastfeeding. IBCLC’s have a unique body of knowledge and skill to provide breastfeeding care in routine and high-risk situations. IBCLC’s are internationally recognized.
I am passionate in helping both new parents and their babies to achieve the best start on their journey together by facilitating the unique bond that is developed through breastfeeding.
I specialise in managing all aspects of lactation from methods to assist increasing milk supply, dealing with nipple trauma, mastitis, and a range of other common breast feeding challenges and I work together with you and your family to achieve a happy and positive outcome.
Tongue or lip ties are often one of the first things mentioned when a mother describes difficulties breastfeeding. What are ties and what would you advise for parents who may be concerned that their bub has a tie?
An ankyloglossia, otherwise known as tongue tie is a congenital formation of the lingual frenulum (membrane under the tongue) that restricts range of motion of the tongue contributing to reduced function.
“Tongue ties” are a hot topic in breastfeeding at the moment! Let’s start with my personal thought…. Not every feeding issue is caused by a tongue tie. Also… releasing a “tongue Tie” does not fix feeding issues!
There are many reasons why babies do not latch well. The first step to successful breastfeeding is being supported and given correct information. IBCLC’s are trained to assess all aspects of feeding issues; oral structure of the baby’s mouth, function of the tongue, nipple shape, breast size, supply issues, then most importantly the relationship between mum and baby.
Through continuity and great support many breastfeeding issues can be resolved without any invasive intervention. Sometimes there is an anatomical restriction that may impact normal range of motion with the baby’s tongue.
The tongue has an important job in breastfeeding:
- Ideally the nipple and a good amount of breast tissue is drawn into the baby’s mouth and suction is created to hold breast tissue in place
- The nipple is drawn to the juncture of the hard and the soft palate
- The tongue “sandwiches” breast tissue against the palate.
- The tongue protrudes over lower gum to suppress bite reflex, it then moves the nipple and breast tissue into correct position and stabilizes tissue. A vacuum is created, and the tongue works in a peristaltic motion – elevation and extension, anterior to posterior motion. The tongue then depresses to release the vacuum and expel milk.
Some indicators of good attachment are:
- NO PAIN!
- Baby will have full cheeks
- Top lip neutral/flanged
- Bottom lip flanged
- Stable lips
- A good seal/vacuum
- Relaxed at the breast
- Rhythmic sucking
- Audible swallowing
- Baby is satisfied after a feed
- Baby is gaining weight
- Baby has good urinary output
- Breasts are softer after baby has fed
Is it possible to overfeed a breastfed baby? How do mums know if their baby is getting enough/too much?
The million dollar question! What we do know is babies thrive on breast milk, and you cannot control the volume they have throughout the day. Some mums produce litres of milk, some do not. Babies are very clever and feed to their needs. How many feeds is normal in a day? Anywhere between 8-16 times a day! Every baby is different.
I encourage you to watch your baby NOT the clock! Some babies snack feed throughout the day, others take large volumes and space their feeds. They take different volumes each feed. Some babies feed for 6 minutes and will drain 150 mls, others for 20 minutes and take 70 mls… There is no magic number for your baby to achieve.
If your baby is content, your breasts feel softer after a feed, there are plenty of heavy, wet nappies, then your baby is getting enough milk! Remember, weight gain figures are AVERAGE – not a goal.
You CANNOT overfeed a breastfed baby – please do not restrict feeds due to excellent weight gains.
If you are concerned about your baby’s weight gains, please speak to an IBCLC.
What should new mums know in preparation for breastfeeding? Is there any ‘must-haves’ for optimising breastfeeding (ie breast pumps, milk enhancing foods/teas etc)
My number 1 tip for optimising breastfeeding is have lots of skin to skin time with your baby.
Stimulus of the breast and breast emptying will provide optimal opportunity for your body to make more milk. Let your baby feed to their needs, do not clock watch.
There are many “milk boosters” on the market now. Essentially, I think rest, hydration and a good diet are the 3 essentials for helping milk supply. If you are having issues with your supply, it is best to have an assessment with an IBCLC as there may be other reasons. Trust your body – if you need a breast pump in the early days, then they are easy to hire or buy.
What info would be helpful to new mums regarding reflux in breastfed babies?
Many babies suffer from wind and digestive issues in the first few weeks, and it usually resolves around 3 months. Reflux is a medical condition, which can be treated with medicine that are Proton Pump Inhibitors.
There have been studies done that show these are of no benefit to babies under 12 months old. If you feel your baby has wind issues, speak to your IBCLC as it may be a latching issue.
Often babies that have wind also have a poor latch, gulp in air at the breast, possibly mum has oversupply, and through support and an effective breastfeeding plan, wind issues can resolve without medication.
Eve Coote is a midwife, international board certified lactation consultant (IBCLC) and certified infant massage therapist. She owns Perth-based business Best Start Lactation Consultancy.
Services include: home/hospital visits, consulting room appointments, skype consultations, individualised breastfeeding plans, postnatal breastfeeding groups, infant massage – groups or individual, antenatal care and Spectra breast pump sales.
Head to her website : http://www.beststartlactation.com for more information or to get in touch with Eve.