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Breastfeeding Preparation Class

As a doctor I have the privilege of being with parents from the beginning of their pregnancy journey, from registering the pregnancy right through to providing antenatal and postnatal care to both mother and baby. The decision whether to breastfeed is one every mother encounters and in my experience while many have good intentions the fall off rate is dramatic. I’m offering a preparation class for the expectant mother who would like to breastfeed their baby. The reason that I have decided to start the preparation class is that I feel many mothers do not adequately prepare or do not have sufficient confidence or knowledge in relation to breastfeeding. As a result, mothers and their babies often have a poor start which knocks their confidence and many times by the 6 week check they have stopped breastfeeding altogether. Over time I have realised that the expectation of breastfeeding doesn’t necessarily match the reality and this is leading to a high discontinuation rate. I feel that if parents were equipped with the necessary knowledge, they would have the confidence in their own ability and would be more likely to succeed. I believe that antenatal breastfeeding education is pivotal and this class aims to foster a fulfilling breastfeeding relationship between mother and baby.

 

 

Tongue Tie Release

What is tongue tie?

Tongue tie is when the membrane under the tongue (frenulum) is short or tight. Depending on the degree of tongue tie it can affect feeding with either the breast or the bottle.

What is the effect of tongue tie on the breastfeeding relationship?

To effectively suck and remove milk from the breast, a baby needs to have full movement of the tongue. If the baby does not it will cause problems for both the mother and her baby;

Signs and symptoms for Mother

  • Pain
  • Damaged nipples
  • Ineffective breast drainage (leading to blocked ducts +/- mastitis)
  • Reduction in milk supply
  • Exhaustion from the constant/prolonged feeds
  • Early weaning

Signs and symptoms for Baby

  • Inefficient milk transfer due to restricted tongue movement
  • Tires quickly or may feed adequately only during “let down”
  • Loses the latch frequently (coming off the breast)
  • Unsettled behaviour during feeds
  • Frequent or very long feeds
  • Clicking noises and/or dribbling during feeds
  • Colic, wind, hiccoughs
  • Reflux
  • Failure to thrive
  • Poor sucking habit may be difficult to correct
  • Premature weaning

Infant oral assessment

If indicated I can perform an infant oral assessment on the baby. This involves inspecting the oral cavity and digital assessment of the palate, gums and tongue. It also involves checking for normal tongue movement (elevation, lateralisation and extension) and function by observing a feed and having the baby suck on a gloved finger.

Tongue tie release

I am able to perform tongue tie release surgery if indicated following infant oral assessment.

This involves dividing the membrane under the tongue to allow the tongue to move freely.

Babies in general tolerate the procedure very well.

Aftercare

It is important to work with your baby and encourage them to move the tongue in all directions. The main way of doing this is by having your baby feed regularly after division. I have updated my practice following the guidelines where I trained (Russell’s Hall Hospital, Dudley) in the UK. There they do not advocate wound massage as they noted that this increased reformation rates as you are traumatising a wound and increasing the probability of scar tissue forming. They have a recurrence rate of less than 1% with this method. And I have not had a recurrence to date.

Fee

The fee for assessment and tongue tie division surgery is €200

 

Medical Services

Medical issues during breastfeeding

Several medical issues requiring the input of a general practitioner can arise during breastfeeding. I can offer practical support for issues like nipple pain, engorgement and mastitis. If these conditions are not recognised and treated early it can have a negative effect on the breastfeeding relationship. I can assess the problem and safely prescribe antibiotics or other necessary medications.

Issues like under or over supply of milk can be troublesome. I can give advice on how to manage and prescribe where appropriate the medications needed to resolve these problems, allowing you to continue your breastfeeding journey.

Medications and breastfeeding

A baby’s ability to metabolise a drug is different to that of an adult. It is important to get professional advice about what medications are compatible with breastfeeding. Before prescribing any drug I can discuss the benefits, risks, alternatives and the consequence of not taking the drug with you, ensuring the safest outcome possible.

Contraception and breastfeeding

There is a misconception that breastfeeding is a form of contraception. It varies from woman to woman and it is possible to get pregnant while breastfeeding. It is therefore important to use alternative forms of contraception while breastfeeding. As a qualified GP and specialist in contraception I can provide you with all options in the postnatal period.

 

 

 

Feeding Routines

I believe that for many breastfeeding mothers the concept of having no routine or a baby that never sleeps is off putting. I want to reassure mothers that there is an alternative. It is possible to breastfeed your baby but also to have a routine and a baby that sleeps the night. This might appear to be in opposition to the traditional breastfeeding ethos of letting the baby lead the mother but the outcome is the same- a happy mother and a content breastfed baby.

I myself found the constant feeding on demand exhausting. So at 6 weeks with my first child I started a routine- I’m happy to say that by 16 weeks my baby was breastfeeding 5 times/24 hours and sleeping 12 uninterrupted hours at night.

I wasn’t sure if it was luck so when my second child came along I did the same routine with her (but started earlier) and again by 16 weeks she was breastfeeding 5 times/24hours and sleeping 13 hours continuously at night. So I hope to dispel the myth that breastfed babies don’t sleep, as I think this can be off putting to some mothers, especially those of us who like order and structure.

I can advise an expectant mother, based on my own experience, on a routine that will work for her.

 

 

Consultations

Medical consultations are available in person at Knocknacarra Medical Centre, Galway. Please use the contact form on the website for further details or alternatively please call 085-1926406 to make an appointment.