Lactastrophe

You have seen it, a mother who runs into every problem possible as she attempts to begin breastfeeding.  One problem is solved, another one pops up.  How do these lactastrophies happen?

Usually it is related to a series of unwitting and unintentional circumstances during the newborn period in the hospital.

Perhaps it was no skin-to-skin contact immediately after birth

Or no initial feeding during the first hour after birth

Or separation of mom and baby for the initial bath, routine newborn care, or temperature stabilization

It could be a sleepy and sluggish baby due to maternal anesthesia during labor and/or surgical delivery

Maybe it was a lot of intrusions from visitors, cell phones or care providers interrupting the privacy of mom and baby

Maybe it was separation with the baby in the nursery so mom could sleep

Or a bottle of formula due to the infant’s excessive weight loss

Sometimes it is excessive IV fluids during labor causing both pathological engorgement and excessive infant weight loss

Sometimes is it a poor latch that leads to cracked nipples that leads to mastitis

Or a pacifier used to calm a baby when all he really wanted was to be held and fed

Perhaps to mother requests formula feeding due her misperception she has “no milk “ and  then her baby learns to prefer the bottle nipple

Or the mother’s confidence is shattered in her ability to breastfeed by inconsistent or even incorrect advice from her nurse or physician

We can stop this from cascading into a lactastrophe by getting mom and baby together right from the beginning, avoiding separations and the need for supplementation.  If we as a team of health care workers get most of this right, we can help avoid the next problem. 

But if many of these events occur, it is a lactastrophe waiting to happen!

Thank you to Alison Stube MD for coining the term lactastrophe and for inspiring this blog.