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.
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