Author Archives: Kathie Kendal

About Kathie Kendal

Trained by NEST, I have been a post natal carer/maternity nurse for nearly 5 years. I was very fortunate in finding amazing positions, which have taken me all over the world, and have also allowed me to work with many sets of multiples. I am specially trained in breastfeeding (UNICEF, NEST, NHS peer support, Ilactation) and I am very passionate about it, however I am also happy to work with mums who decide it isn't for them. (or who can't) Going forwards I am looking at ways to specialise further with breastfeeding, and I am currently studying to become IBCLC certified.

Effective Feeding

It is important for us to note at the beginning of this post, that ANY happy time your baby spends at the breast is important for them, whether they are feeding, comforting, sleeping or enjoying cuddles and especially if there is a lot of skin to skin contact, which has been proven to help babies thrive. It is also natural for babies to feed little and often. However, for the purpose of this post, we are going to assume that you would like your baby to be productively feeding when he or she is at the breast, in the hope of implementing a baby friendly 3 hour routine. We use the term 'Effective Feeding'.

How to get started

To begin with, it is important to make sure as with any feed, that you and your baby are positioned comfortably, and that the latch is good - we will talk about latching and positioning in future posts.

Once your baby is latched on, it is likely that they will take short shallow sucks to stimulate your let down reflex (make your milk flow) and then they will take much longer sucks. It is important to watch these sucks, so that you know how it looks when your baby is feeding effectively. Each time your baby takes a mouthful, their chin should drop down and pause (while their mouth fills up with milk) then rise again as they swallow. You may see or hear them swallow, or see their ears waggle a little as this happens. You baby may pause between sucking, mainly because it is hard work! but when it slows to more than a minute or so between sucks, and lots of extra pauses, it is time to make a little easier for your baby.

Breast compressions

When your baby's sucking has slowed, you can help them to keep drinking by using breast compressions.

Place your thumb alongside your breast and your four fingers on the top of your breast. When your baby pauses, squeeze your breast (up near your chest) for 2 seconds and release and repeat every 3-4 seconds for a short period of time. This should stimulate more milk to flow and your baby should drink. If your baby slows down again, you can resume compressions. If your baby does not drink, or falls off the breast, it may be time to switch breasts, or your baby may be finished.

How Do I know my baby is full/ Is eating enough?

When your baby has finished they should come away from the breast content (unless they have an underlying condition). Some babies will be very sleepy, which is completely natural. You know your baby is effectively feeding, and getting enough to eat if they are settled, and happy to settle for at least 2.5-3 hours. If your baby is at the breast much more often, it is likely that they are not effectively feeding. you may need to check your latch, or feed your baby for longer if possible. If your baby routinely falls asleep during feeds, try taking their clothes off and tickling them - naturally being at your breast is cosy, warm and comforting - the perfect place to sleep!

The Baby Show – London Excel Arena

We have spent the day walking around the Excel arena in London for this weekends Baby Show, and we had an absolutely fantastic day!

Some of our favourite baby experts Jo Tantum and Clare Byam-Cook (amongst others) are guest speakers for the weekend. They have some great tips for new mums, and are also available to answer questions afterwards.

Aside from the speakers, the stalls are well laid out and there are plenty of things to look at, and plenty of bargains to be had - Medela have an amazing £50 off of their swing pump! as well as discounts on their other products.

We looked at lots of products today, but we fell in love with Oysterbaby Bamboo slings - midwife designed and chiropractor endorsed, easy to wrap and easy to wear, we can't wait to try it out! And, on the subject of trying something new, we are also going to be trying out the Love to Swaddle Up this month. We couldn't resist trying their swaddle, which is actually more of a sleep sack that still gives babies the cozy feeling of a swaddle. Full reviews to follow...

I think it would be fair to say, that on initial inspection, the baby show appears to be much smaller, and have less stalls than we would have expected. However, it took us the full day to get around all of the stalls (and enter all of the competitions 😉 ) whilst fitting in the speakers we were interested in hearing.

We thoroughly enjoyed our day and can't wait for September, when the Baby show will be back in Earls Court.

How to Initiate or Boost Your Milk Supply

If you are just about to give birth, or have given birth recently, the chances are, you have milk on your mind. If you have decided to breastfeed, then establishing a good supply will almost certainly be one of your biggest concerns.

The best time to initiate supply is within the first hour after giving birth. If it is possible, keep your baby close to you, with as much of their skin touching yours - this is often referred to as 'skin-to-skin' As soon as you can, offer your breast and give your baby a chance to feed. If you and your baby are separated, try to hand express as soon as possible.

The more often you feed (or hand express) in these early hours and days, the better your breast a 'primed' for breastfeeding, and the more they will produce.

If you imagine that your breast are full of pumps, and each pump needs to be plugged in to work. Each time you feed your baby, you plug one of theses pumps in and they begin to produce milk. After the first few days have passed the feeds don't contain any more plugs, and the only way to start these pumps is with hard work. (But it can be done)

Boosting your milk supply

If you have begun breastfeeding and are worried about your milk supply we have some tips for you.

It is normal for your milk to 'come in' on days three to five, and it is important to keep feeding so that you avoid becoming engorged. It is also important to keep feeding, because the more your baby drinks (or you express) the more your body will produce, creating a good milk supply.

If you are already feeding every 3 hours or less, and you know that your baby is feeding effectively (Our next blog will cover this) you can also try:

Eating and drinking plenty - It is not true that you have to 'drink milk to make milk' but if you don't put anything in to your body, you cant expect to get anything out. So often we find mothers who come to us have simply forgotten to eat - have lots of snacks on hand (especially when you are breastfeeding) We recommend dark chocolate hobnobs...
Rest when you can, even a cat nap will do.
Express from one breast, whilst feeding from the other - this will trick your body into thinking it has to produce milk for two babies, and will increase supply.
Lots of people recommend eating oats, and they really are great for milk production, so porridge for breakfast, or flapjacks and oatcakes as snacks etc.
Fenugreek capsules - a great herbal supplement which can boost milk supply.
Express after each breastfeed - just to make sure your breast have been emptied - anything left sends signals to make less milk, but empty breast begin to produce more and faster.
Make sure you don't skip night feeds - the 2-3am feed is THE MOST IMPORTANT feed for milk supply. At this time you milk production is at its best, and if you empty your breast properly at this time (breastfeed and then express) you will certainly boost supply. You should be able to drop this feed again when your supply is better established. If you really cant express after, or miss this feed completely, make sure that in the morning you are sure to fully empty your breasts.

If you are worried and would like more advice, or a plan which is tailored to your individual needs, please to not hesitate to contact us. All of our online advice is free and we are always happy to follow up.

Antenatal Expressing

We LOVE the subject of antenatal expressing! Despite some of the controversial points raised about antenatal expressing, there are so many benefits, especially for babies who's parents suffer from diabetes (or gestational diabetes), or babies who are born with a low birth weight (especially multiples).

What is Antenatal Expressing?

Antenatal Expressing, is expressing colostrum in the last few weeks prior to your baby arriving. It is advised for mothers to wait until 36/37 weeks, although for mothers who are having multiple births, they should start a few weeks earlier than this, due to their higher chance of giving birth from 37 weeks.

Why do the ladies at South West Maternity love Antenatal Expressing?

Antenatal expressing gives a mother a chance to learn the valuable skill of Hand Expressing. A mother who is confident when expressing, and handling her breasts, will be confident she can produce milk, and has a much better chance of a great start when breastfeeding her baby. She is also much more likely to continue to breastfeed for longer.
When a baby is born, a blood sugar level is taken. Even in healthy babies, this level can sometimes be considered low (although it is much more likely in babies with a low birth weight) and often the hospital will suggest a formula 'top up' (or just go ahead and administer one if you have signed consent forms). This top up can often stretch a baby's tummy and can make the initial days of breastfeeding that little bit harder. If a mum has expressed antenatally, she will have a store of frozen colostrum, which she is able to give to the hospital staff in the event of a top up being needed.
Babies who's parents are diabetic, are much more at risk of needing a top up due to low blood sugar levels. Studies have shown that the bovine serum albumin in formula, can trigger an auto-immune response, which is linked to an increased risk of Type 1 Diabetes. In simple terms, Babies with diabetic parents are more likely to receive formula. which increases THEIR risk of also becoming diabetic. If a mother has been able to express antenatally, she will have a store of colostrum which can be given instead of formula. Further to this, mums who breastfeed decrease their chances of gestational diabetes in subsequent pregnancies.
Babies who may have difficulties after birth, and need hospital care, benefit greatly from ALL breast milk, and if you have already been able to begin a supply antenatally, your baby will have that much more support from you.

How do you Antenatally Express?

We would suggest starting at 37 weeks if you are experiencing a normal pregnancy, and 35 if you are having a multiple birth, or are at risk of delivering early.
After your shower (when you know that you are clean, warm and relaxed) begin by massaging your breasts gently toward the nipple.
You can begin to hand express - Use your thumb and forefinger to create a 'C' shape, and place them on your breast, about an inch back from your nipple. Press in towards your chest and then squeeze gently together. Your fingers should stay in the same place, and not slide down the nipple, as this would be likely to cause you pain.
Continue for up to 5 minutes, once or twice a day (if you have not had a shower, it is important that you make sure that your hands are clean)
If you experience ANY cramping in your uterus, STOP IMMEDIATELY - some studies have show that excess (4hrs plus) nipple stimulation can cause early labour. This is due to the oxytocin released. BUT you also release oxytocin when arroused, and no one advises you against night time activities 😉

How do you collect and store the colostrum?

Pick up some 2.5ml syringes from your local Chemist (or boots)
Use the syringes to suck up the drops of colostrum from your breast. (this can take a little practice!)
You can use the same syringe to collect for 24 hours, as long as it is placed in a sterile container in the fridge in between sessions. (even 1ml expressed is a great amount - so don't be disheartened if you only are able to produce a small amount - it is all useful!)
After 24hrs freeze the syringe in a sterile plastic bag, and remember to label it with how much was in the syringe and the date it was expressed, along with your full name.
Remember to take the syringes with you to the hospital in a freezer bag (so that they remain frozen on your journey)
Make sure that the hospital store them for you and that they are aware you have brought them! This can also be written into your birthing plan. Some hospitals may even allow you to bring some in prior to labour, so that you know it is safely stored before your arrival.

We hope that you have found this interesting, and if you have any questions at all, please feel free to ask us!

‘Tippett Timings’ and our online advice.

A few months ago, a lady came to South West Maternity for some online advice. It started with a little about latching her baby, and what she might look for, to make sure her daughter was getting the most out of each feeding session. We also discussed how to teach her baby the difference between night and day.

At 6 weeks we had a small chat about increasing milk supply, and storing any excess safely, for use at a later date.

At 16 weeks, we were very pleased to hear that She had an amazing breastfeeding routine and relationship with her daughter. She asked us if we might possibly be able to give her a little advice, on suitable sleeping routines. We discussed how her daughter was behaving on a day to day basis, with her rough timings etc, then were able to devise a new routine which would suit them both. We were able to outline a plan for her to put the routine into place, and of course, we were on hand at any time for tips and tricks.

We were thrilled to receive this comment in an email 2 weeks later.

" (Our daughter) is sticking to the Tippett timings well, eating well and has done 8pm-6am 4 out of 5 nights now!!!! I'm pumping like mad thing, enough to freeze some, which is ideal!!"

It makes our day when our clients achieve their goals, and we take pride in the fact that our advice really does make a difference to families. We also love it when they coin new phrases for us! 'Tippet timings' has definitely stuck in the South West Maternity Office!