|
There is one thing
that seems to be common to many of the ANRs
(Adult Nursing Relationships) that are having
problems, and that is wanting to know how long
it will take to establish lactation. I would
emphasize to everyone that does not feel they
have achieved the level of lactation they wish
to achieve by this time, that lactation takes a
lot of patience, effort and time to achieve. It
is not automatic for everyone, unless they go
through the 9 months of pregnancy that usually
precedes a woman lactating. I don't think too
many of you are willing to do THAT, just to
establish an ANR. To accomplish re-lactation, it
will require both of you to be very committed to
a strict and regular schedule to make it work.
This also requires a deep commitment to each
other.
Before you start on
this venture, I would strongly encourage you to
visit your OB/GYN or a qualified breast-care
medical facility to bring your mammography
history up to date, and for a good CBE (Clinical
Breast Examination) to be sure that you are
aware of what may be occurring in your breasts
at this time. This is important, because once
you start to induce lactation, your breasts will
become more dense, larger in size, and will
start getting "strange bumps" that you are not
used to finding., but it is also possible that
by paying closer attention through your
increased physical contact, you have noticed
problems that were there before you started
inducing.
When you start paying
closer attention to your breasts (because of
this induction process), you may notice some
changes in your breasts. Any changes in your
breasts that cannot be attributed to known
causes should be checked by your OB/GYN or
breast-health provider, to be sure something is
not happening that needs to be taken care of. If
you have already started to induce lactation,
those changes are likely caused by the oncoming
lactating duties (if you have started to develop
the acini (milk-producing) tissues or producing
milk). If your medical practitioner is not aware
of your lactation intent, the reader of your
mammograms may see cause for alarm. Your age may
rule out the likelihood of your being pregnant,
so breast changes would suggest hormonal
difficulties or breast changes such as
calcification or cancer or a tumor on the
pituitary gland, and further tests will be
recommended. This can be avoided if you make
sure that the doctor that schedules your
mammograms is aware that you are attempting to
lactate. Most women find this difficult to
discuss with their doctor, but it would avoid a
lot of difficulties if you get that settled at
the beginning of your breast examinations. Some
doctors are actually quite supportive of couples
having established ANRs. If they are not,
remember that your doctor works for you, is paid
by you, and can be "fired" by you, and you can
move on to a doctor that is more favorable of
allowing you to choose your own lifestyle.
Some ANR couples have
not achieved lactation, but have been satisfied
with the closeness and bonding that they have
established during the attempt, and are quite
pleased to merely have the time together and the
physical contact, even without the anticipated
milk. That is certainly nothing to overlook.
This article is to help couples to achieve milk
production, but remember that there is much
beauty in the travel, even if you never get to
your intended destination.
What I suggest to anyone that approaches me with
the desire to establish lactation (without the
aid of having delivered a child recently), no
matter what may be their reasons for doing so,
is the following:
POINT ONE:
Tell your body what you want. Reach up and
squeeze your breast as if to squeeze something
out, and you have already started the process.
By requesting your milk from your breasts, your
body will likely do its part and provide that
milk. But not yet. This requires you to express
milk from your breasts on a closely regulated
"schedule" (our bodies really do like
schedules). Your brain, body and breasts have to
"get the message" that milk is needed, and that
can only happen if every 3-4 hours over the
24-hour day, all seven days of each week, each
of your breasts is being completely "emptied".
If you are not producing breast milk yet,
express your breasts AS IF YOU ARE PRODUCING
MILK for 10 - 15 minutes (each breast), whether
anything comes out of them or not. If you
express for less than 10 - 15 minutes on each
breast or you miss one of those sessions your
body begins to reverse the process and reverts
back toward the non-lactating condition, and
that will require several more sessions just to
return to the point you had achieved before you
skipped a session. Do Not Miss A Session! Your
breasts will stop producing milk if you wean
your child, and if you take less milk for one
session, or skip a session or two, your brain,
body and breasts take that to mean that you are
weaning a child, so your breasts reduce their
milk production and shut down.
POINT TWO:
Choose the method by which you will express your
milk. You may use more then one method, of
course, but try to be as consistent as you can
until you reach full milk production.
The BEST choice is using a mouth, and
using it properly. The tongue squeezes your
breast up against the roof of the mouth. The
tongue presses on your breast at a point an inch
or more behind your nipple, not ON your nipple.
The tongue should do a "rolling" action to coax
your milk to move toward your nipple. Think of
your tongue trying to empty a toothpaste tube.
Minimum suction is needed because the recipient
does not suck milk from your breasts, he/she
merely picks up any milk that has been pressed
out of your nipples. When "latching on" to your
breast, your recipient should literally attempt
to reach their uvula (that little hangly-down
thingy in the back of their throat) with your
nipple. I said ATTEMPT… they cannot actually
reach it unless your breast is pendulous and
very thin (and some are). Stay OFF the nipple;
that has no milk in it. Milk just passes through
it.
The SECOND best choice is manual
expression (expression by hand), either your
hand or your partner’s hand. What you are doing
is putting some pressure on your lobules
(acini), then stroking forward, squeezing the
milk that is inside your ducts, and stroking it
forward to your nipple. You are also emptying
your ampullae that gather your milk behind your
nipple. If you take a look at the following:
http://www.breastnotes.com/anatomy/anatomy-inside_of_the_nipple.htm
or
Click Here
and
http://www.breastnotes.com/anatomy/anatomy-inside_of_the_breast.htm
or
Click Here
you will see what you
are working with. Do not slide your fingers on
your skin… move your breast skin with your
fingers, sliding your skin over the inner parts
of your breast. Move your "grip" on your breast
to express each of your ductal "systems" that
are arranged in a circular arrangement
completely around your nipple. You need to
express from each cluster of lobules to get each
one to send a signal to your brain to activate
each cluster. Continue expressing each breast
for 10 - 15 minutes or until your breast is
empty, which ever is LONGER. Repeat this
procedure for the same amount of time with your
other breast. If you would like a more-detailed
description, please request "Manual Expression
of Your Breasts" from
BreastCare@comcast.net
or XXXXXXXXXXXXXXXXXXXXXX..
The THIRD best choice is to use a breast
pump. The breast pump does not usually do as
efficient a job of emptying your breasts, nor
does it provide the deep stroking that is
beneficial in starting lactation. Manual
expression or expression by mouth will usually
do a better job of providing that deeper
manipulation of your breast tissues. The pump
works quite well AFTER you are lactating fully,
to empty your breasts when your partner is not
there to help you.
If you do choose to
induce with a breast pump, remember that
completely empty breasts send signals that tell
your body and brain that you need milk (or MORE
milk) in future sessions. Do Not Stop Pumping
when your milk stops coming out. Continue to
pump for the full 10-15 minutes to encourage
more milk production. Keep the suction rather
low, because the suction does nothing but cause
pain. If you find the skin on your nipples or
areolae turning white and staying white for a
period of time after you have removed the pump,
you are probably using too small of a cup on the
pump or you are using too much vacuum. Suction
merely picks up milk after it is produced from
your nipple, so if milk is not coming out of
your nipple, do not increase suction. After you
are producing milk, mouth or manual (hand)
expression should also be used after you use the
pump, to completely empty your breasts. Leaving
milk in your breasts can cause your ducts to
become blocked, and that can lead to mastitis,
which is difficult to deal with. It will also
signal to your brain and breasts that you do not
need as much milk, and you will start to produce
less milk.
NOTE #1: If you are
doing manual expression, the use of a pump does
provide some extra stimulation of the nerves
that surround your nipple, and five minutes of
pumping AFTER you complete the full ten –
fifteen minutes of manual expression of each
breast, could be beneficial to you. A good
breast pump provides a rapid-pulsing stimulation
of your areolar nerves which is good to help
stimulate lactation.
NOTE #2: Be sure and
take a note from breastfeeding mothers: Do not
allow your partner to come off your nipple until
the suction is removed. That can cause some
temporary damage and pain to your nipple. If you
are using a pump, be sure to remove the vacuum
before you bring the cup off your breast. A
finger slipped under the cup flange will break
the vacuum.
An ALTERNATE choice
that some ANR enthusiasts are trying is the use
of a TENS module. The theory of the use of a
TENS module is that tiny electrical currents are
used to stimulate the areolar nerves in your
breast, sending the signals to your brain to
turn on the hormones that start your breast
alveoli producing milk. The use of a TENS module
will be most effective during the period of time
before lactation is established, as there is no
way of consuming any milk that is produced by
the TENS unit. The benefits of this unit include
the chance for it to stimulate your breasts
while you are at work or school or in meetings
or fixing dinner or when other members of the
family are around… or whatever, and you wish to
continue to do these things without others being
aware that you are being stimulated. It is
recommended that you not use the TENS for all of
your sessions, but only those where you are not
able to sit and express your breasts properly.
If you would like to explore this idea, or have
questions regarding the use of a TENS module,
please request "How Do I Use A TENS Unit To
Re-Lactate?" from
BreastCare@comcast.net
or XXXXXXXXXXXXXXXXXXXXXXXX. No cost to you, of
course.
POINT THREE:
AFTER you are producing the amount of milk that
you want to produce, you can cut back on the
number of expression sessions that you do per
day. If you notice that you start to produce
less milk per session than you want to settle
with, then add another session back during the
24 hour day. The more milk you request beyond
what you currently produce, the more you will
make. It is a case of supply meeting demand.
POINT FOUR:
…and this is actually a very important step.
Your milk will not come out of your breasts
until your breasts RELEASE it. You have some
teeny tiny muscles in there that can either shut
you down or allow milk to be released. Your mind
controls them, and will only release the milk if
you are emotionally "into" the activity. This is
referred to as the "Let-Down Reflex", and is
stimulated by your deep emotions and your desire
to provide milk to your child and recipient, and
is influenced heavily by your seeing images of
things such as your baby, hearing sounds like a
crying baby or your loving partner, smelling
aromas such as baby powder or your partner’s
cologne, and deep concentration on what you are
doing (turn off the TV news). After you become
used to it, like any ‘reflex action’, it becomes
automatic and requires less outside stimulus,
but if you are having trouble establishing
lactation, add those stimuli back into the
session. Warm baths and warm (not hot) hot tubs
work too.
POINT FIVE:
When you are lactating with a newborn, you have
the advantage of certain natural hormones in
your body that sort of jump-start all of the
previously mentioned steps for you, thank
goodness. Seldom does a new mother have trouble
lactating, but more often, they will have
difficulty understanding the "latching on"
process with the baby and the nipple (remember,
your nipple does nothing but feel good and look
good. You do not squeeze your nipple to get
milk). When a baby (or partner) latches on,
he/she places as much of your breast into their
mouth that will fit, and your breast will
literally take on a more flattened (temporary)
shape to allow proper expression of your milk.
In lieu of those natural hormones, some people
(women or men) may rely on herbs to fill that
service. I usually do not recommend using them
unless you have exhausted the other steps and
find that after several months of true conscious
efforts, milk has just not come through. Many
perceive the use of herbs to be an easier and
faster road to lactation, and I certainly have
no problems with those that use them. I support
anyone that is trying to lactate, no matter what
methods they use. Some may tend to rely on the
herbs to do the ‘work’, hoping to bypass the
physical part of the lactating process or trying
to reach their goal quicker. Some women do not
get the results from the herbs they expect and
become frustrated. Some have the same
frustration from lack of success while not using
herbs, hormones or other "stimulants"
(galactagogues) also. Everyone is very
different in how their bodies function. I am
concerned about side-effects that some herbs can
have on some people, as well as possible
interactions with drugs that they may currently
be taking, and I would encourage that they
discuss usage of herbs or hormones with their
doctor o r
medical care-provider before they use them for
lactational purposes. If the herbs are working
for someone, then that is good.
POINT SIX:
Also, remember to
hydrate yourself. You should drink at LEAST what
you SHOULD be drinking each day normally. Too
many of us do not drink what we should. It is
suggested that you can determine the amount of
water that you should drink daily by using the
following formula:
(Your weight (in pounds) divided by two equals
the number of OUNCES of
water you need). If you weigh 120 pounds, then
it would be:
120 lbs / 2 = 60 oz of
water per day
I don't personally reach that goal either. :-)
Be aware that you CAN
over-hydrate, and lactating does not really
require much more water then you normally
require. Just getting up to the normal amount of
water should help you lactate.
CONCLUSION:
If, after a couple of
months of doing what this article says, you are
still not successful in achieving lactation,
look this article over again and see if there is
any part that you may be missing, or perhaps if
there may be something that you can do longer…
or better… or with more concentration. The more
closely you can follow these steps, the easier
it should be for you to reach lactation.
Please do not hesitate to ask other questions,
or ask about something that you may not
understand clearly in this article. If reading
this has brought other questions to mind, just
ask.
I hope that this helps
you reach your exciting and natural goal.
Ken L. Smith
Breast Health Facilitator for the American
Cancer Society
http://www.breastnotes.com/
Breastcare@comcast.net
This article is only
my opinion and does not reflect the philosophy
or opinion of the American Cancer Society.
POST SCRIPT:
There are some very
common questions and concerns that are
frequently asked so I will address them here:
- "How long will it be before I see milk?"
This is probably the most frequently asked
question, and the answer is not available.
Everyone will react differently. How well
you follow your schedule, how well you
express your breasts, what level of
production your various hormones are in your
body, how long it will take for your acini
(lobules) to develop, how long ago you were
actively breastfeeding (if you did) and
whether you have ever been pregnant (but did
not breastfeed your child), what other
hormones you may be taking at the time
(birth control? Hormone Replacement
Therapy?), and many other factors will
affect how long it will take for you to
lactate. I can tell you right now that it
will take a lot longer then you would like
for it to take. I would encourage you to
expect it to take several months to
establish a good supply of milk, and I would
tell you that you may not be able to produce
as much milk as you would like to produce.
It would be great if you produce sooner then
this and produce a lot of milk if that is
what you desire, but remember that you are
asking your body to do something that is
natural but not in a normal sequence.
- "I see liquid coming out after only one
week. Is that milk?"
Any breast
at any age will produce some liquid if you
squeeze it. That is normal. It may even be
anywhere from clear, yellow, brown, green or
black, and that is normal too. If it is pink
or red, it indicates blood in the ducts and
should be checked this week by a breast
surgeon or gynecologist to ascertain what is
causing it. The liquids are basically
keeping the inside of your breast ducts
healthy. It will be several weeks before any
milk will possibly come out, and it will be
yellow or white. No matter what the color
is, it is ok to be consumed.
- "I am pregnant. Can we stimulate
lactation and nurse so I will have milk
ready for my baby?"
I would strongly
encourage you to take a break and NOT ltry
to induce lactation during your pregnancy.
If you are already lactating, and you become
pregnant, I encourage you to cease your
lactating during the third tri-mester.This
time is when your breasts will naturally
prepare themselves for lactation and you
will have to do nothing. It is a ‘freebie’.
Your body is reacting to a finely-tuned and
natural schedule of hormone balances and
your stimulation for lactation at a schedule
different from your body may confuse the
situation. Another important issue is that
your breasts will provide a pre-milk liquid
that is colostrum and after providing life
itself, colostrum is the second-most
important thing that you will give to your
infant. It carries most of your
naturally-developed anti-bodies to many
diseases in the world and transplants them
into your child to give him or her the best
start on life possible. You do not really
want to mess up that process.
- "Can I feed my partner when I am feeding
my child?"
Absolutely, but you need to
keep two things in mind. One is that you
need to be sure that ALL of your colostrum
goes to your infant. After a week or two,
that will pretty much subside, and then your
partner can share. Secondly, make absolutely
sure that your infant gets ALL the milk that
he or she wants. After the feeding session
is over and his or her needs are met, what
is left can be shared. Try not to wait too
long for your partner to become involved
because your breasts will need time to
"re-group" for the next session. Giving milk
to your partner shortly before your child
nurses will take milk from the child. That
is not good. If you are not making enough
milk to satisfy your partner, have your
partner suckle for five minutes on each side
beyond your milk running out. That will tell
your breasts and brain and body to make more
milk. Be sure your child or your partner
removes all of your milk or it could cause
plugged ducts and mastitis. If you do not
want more milk your partner should stop
sucking when your milk stops.
- "While I am trying to re-lactate, should
I tell my doctor?"
I want to cover this
again… it is very important. If you need to
see your doctor for any reason that will
require him or her to examine your breasts,
or if you need a mammogram, I would
encourage you to tell your doctor of your
intent. A good doctor will respect your
choice and not hassle you about it. If you
do not tell them, they will suspect any of
several conditions that may make your
breasts to be full and firm, leaking milk
from your nipples, or cloudy mammograms, and
you do not want them to draw an incorrect
conclusion and put you through unnecessary
tests to find out "the reason". If they know
ahead of time, they will be able to accept
what they are seeing and move on. Also, If
you are working with any type of hormone
treatments or after-market or
over-the-counter drugs or hormones, I would
definitely encourage you to work with a
doctor due to interactions with your
medications, or possible side-effects that
your current medications may experience from
your hormone changes.
- "Do I need to worry about the medicines
I take and my partner’s receiving the
medication through my milk?"
Absolutely.
And this brings up something that is
different from breastfeeding a child. Your
partner may be taking drugs that no infant
would be taking and your meds may conflict
with his meds. Anything that you take in
should be considered as being safe for
breastfeeding mothers, just as if you are
actively breastfeeding an infant. If they
are not to be taken by breastfeeding
mothers, they probably will either dry up
your breasts or they will be passed through
your milk. I again encourage your checking
with your doctor on these issues. You do not
want to cause problems with your partner’s
health …or yours.
End Of Article
(Rev. 0510)
|
