During my pregnancy with my first I did quite a bit to prepare for breastfeeding. I had always known that it was something I wanted to do for my babies. I had done reading on it prior to becoming pregnant and then during pregnancy I took a basic breastfeeding class. I felt pretty confident in my knowledge and was aware of issues that could arise... or so I thought.
Once my son was born things started off smooth while in the hospital. He was latching and feeding every 2 hours and had good diaper output so I felt confident as we left the hospital at 2 days old. As soon as we got home though it felt like everything changed. We started having latch issues, pain, constant feedings, and soon enough low diaper output all within 24hrs. Boy how things change fast in the first week! I knew that we were struggling, I was exhausted (as all new mamas are!) and my mind just kept running in circles constantly feeling like I was doing something wrong.
After 2 nights of this we went in for Adlers well baby check to see how things were going. This visit quickly confirmed my inklings on our struggles and we were met with an instant comment of "he's lost too much weight. It's time to start formula". I had always preached that "breast is best!" and here I was 4 days in and already "failing". I tried to keep it together but I won't lie, I left that appointment sobbing. It was then that my fiancé reminded me "hey babe, what about the lactation consultants at the hospital? you should call them before we do anything. See what they say." I am so appreciative of his support during that time.
In my new mom mindset (which lets face it... is pretty mindless when you are running on very little sleep) I completely forgot about the professionals that were just a phone call away. I called them as we drove home from the appointment. It was already 3pm on a Friday so getting an appointment seemed impossible. I talked with the LC on the phone and after listening and hearing me break down she squeezed us in within the hour. During that appointment she taught me so much about the nursing dynamic and we pinpointed our latching issues and she helped me feel confident again.
Over the weekend things were better but didn't seem 100%. He wasn't having any poopy diapers and we were still constantly feeding. By Monday when we returned to the LC we confirmed that my supply was taking a nose dive. She set me up with an SNS (supplemental nursing system) a device that holds formula/breast milk and clips to your shoulder strap with a small tube tapped to the nipple. It allows supplementation while providing stimulation to increase supply. This device and our LC is ultimately what saved us. After a week of use my supply came back! It took another week for Adler to reach and pass birth weight.
We didn't get out unscathed though.. While my supply was ok it was never restored completely and we were left supplementing 1 bottle a night for 6 months until the introduction of solids. We went on to nurse for 18 months.
Jump to baby number two
At this point I was starting my doula training and in that was Birth Boot Camps "Breastfeeding: The ultimate MRE" (offered in-person in the "homecoming life with a new recruit" and "10 week comprehensive course" or online) along with professional training in breastfeeding. I found it very eye opening into what really went wrong in the first 2 weeks with my son. This time around with more knowledge and knowing who to go to has helped us start off on the right foot. Right off the bat Mia was a little shark as we liked to say but that didn't mean it was all sunshine and rainbows. We had latch issues while in the hospital (I was there for 4 days this time) and I quickly developed blisters and scabbing. I knew it wasn't right and so the LC (who was the one that had helped with my son) stopped in and gave me a fresh set of eyes to determine the issues.
After addressing a shallow latch I healed up pretty quick and we have been doing great. Occasionally she tries to revert to poor latching so she is still learning but I now understand the early symptoms of issues and feel totally equipped to address it before my supply is effected.
The first weeks are crucial to your breastfeeding journey, I'm not saying that if you don't catch issues right away you are doomed or anything like that! there is always hope! But I will say that taking an in depth breastfeeding class in pregnancy and having in person professional support (a doula or IBCLC are great options) will prepare you for ultimate success.
As a doula I have training to help my clients establish breastfeeding in those first hours of life and I check in periodically during the crucial first weeks to make sure everything is going smoothly. I am always happy to visit in person to help pinpoint possible breastfeeding issues, having a second set of eyes is sometimes all you need. Every breastfeeding pairing is unique with its own challenges.
I will note that a doula is not a replacement for a certified lactation consultant but a doula can help you sort through what is normal but may need tweaking vs when there may be a bigger issue at hand and advice you to seek an LC before your supply is effected long term.
I am currently accepting clients for spring and summer 2019 so if you want to learn more about all the awesome benefits you get when you hire me as your doula I would love to discuss them with you!
Call or email me today!
I recently sat down with Cassie Applegate, Certified Nurse-Midwife, to ask her a few questions about her midwifery practice in the Black Hills region. As a childbirth educator and homebirth mom myself, I have found there to be a lot of misinformation within the media and general public surrounding the topic. Hopefully you'll find this post informative and possibly even inspiring. It's good to know all your options when it comes to the birth of your baby.
BHBBC: What inspired you to become a midwife?
BHBBC: Why do you practice out-of-hospital? Why homebirth?
Cassie: I love being out-of-hospital. I worked in the hospital for nearly 6.5 years, and while I believe you can have beautiful empowering births in the hospital, it can definitely be a lot harder. Being at a woman’s home you are an invited guest into their space. They get to be in control in their own environment, and usually labor and birth goes so much more smoothly without interruptions.
BHBBC: How long have you been a nurse-midwife?
Cassie: I have been a Certified Nurse Midwife for 4.5 years. I did my clinical rotation while getting my master’s in one freestanding birth center and several hospitals. After I received my Master’s of Science and passed my midwifery boards, I worked as a CNM (Certified Nurse-Midwife) in the hospital/private OB/midwife practice for 2 years prior to starting my homebirth practice 2.5 years ago.
BHBBC: How many births have you been to?
Cassie: Good question! As a CNM, I have attended approximately 200 births, and as an L&D nurse prior to that, I attended around 200 as well. So, 400 in total!
BHBBC: Do you have children? If so, were they born at home?
Cassie: Yes, I have two beautiful boys. Neither one of them were born at home! I wanted to have my first at home with a midwife, but could not find a homebirth midwife that “fit.” Instead we had him at a freestanding birth center in Denver. My second was a hospital waterbirth with a wonderful group of midwives.
BHBBC: Many people are afraid of the “what ifs” in regards to having a baby at home. What do you say to that? Is homebirth safe?
BHBBC: Do you work with the hospital and/or local OBs? If someone needs to transfer to the hospital, do you stay with them?
Cassie: Yes, we are working on building strong relationships with the hospital and local OBs. I have had great experiences thus far. I do not currently have privileges at the hospital, so if we need to transfer they will transfer to an on-call OB. I will call and give report, transfer records, and stay as long as my client wants me to.
BHBBC: Some people are afraid of homebirth because they want to be near a NICU. How do you handle emergencies with the baby?
BHBBC: Do you take insurance? How much does a homebirth cost?
Cassie: I am not currently in-network with insurance. Homebirth costs around $5,000 with payments made at each visit, if needed. After the birth, I can provide my families with an itemized statement if they would like to attempt reimbursement from their insurance company.
BHBBC: What is the biggest baby you’ve ever caught?
Cassie: 10 and a half pounds!
BHBBC: What is the craziest birth you’ve attended?
Cassie: I can’t think of the craziest birth I’ve ever attended, but the most beautiful birth was the first baby I caught as a student midwife. The baby was born en caul (with the amniotic sac intact) in a gentle waterbirth. Will never forget it!
BHBBC: If you could give just one bit of advice to an expecting couple, what would it be?
Cassie: Listen do your intuition. This is your baby and your birth. Do your research. Don’t be afraid to ask questions, and don’t be afraid to transfer care if you do not feel supported.
We appreciate Cassie taking the time to share a bit about herself and her practice. If you have more questions about homebirth or Cassie's practice, she can be reached at Appletree Midwifery or on Facebook.
Birth Boot Camp teaches a childbirth class specific to couples planning a homebirth. The next 4-week series begins Tuesday, Feb 5, 2019. To register, contact firstname.lastname@example.org.
1. Outside In- this fabulous NEW indoor playground is a parent's dream. The whole place is set up just as the name alludes to, outside-in. There is an adorable mini camper playhouse where kids can pretend to camp plus “hills” created on the floor for kids to climb all over. The place has two distinct playgrounds. One is for the little toddlers, the other for 5 and up. I found that my son was perfectly fine on the “big kids” playground, but it all depends on your child's ability and your comfort level as a parent. The prices are fair for Outside In, plus your pass is good for the day so you can conceivably leave for nap, and then return later in the day if you wanted. I can't say enough good things about this place.
2. Public Library- the downtown public library not only has a children's area with some toys and craft supplies, but they also have weekly story times on Tuesdays and Thursdays. Each story time only lasts a half hour, so it is well within the realm of toddler attention span. The “teacher” also sings songs and has props to help keep even the most active child's attention. After story time we usually stick around and play and visit with other moms in the kids area. I appreciate that they have craft supplies for the kids since my clean freak self cannot allow glue and glitter in my home.
3. Outdoor Campus West- This was a real gem when I first stumbled upon it. It is run by the South Dakota Games, Fish and Parks department. It's purpose is hands on nature education. Indoors they have taxidermy exhibits to teach about different habitats in South Dakota as well as a huge aquarium. As well as the exhibits, they have a play area with outdoorsy things. When the weather allows, they have hiking trails and outdoor classes to learn all about hunting, fishing and boating. Best part of this place? It's FREE. I couldn't believe that you can go play or attend the nature kids class for free. Blown away.
4. Rushmore Mall- when all else fails, the mall does have a play area for little kids. It's not my first pick place, but it works when you just have to get a change of scenery. The bonus is that I have never seen it busy, we are often the only people there, AND, it has a Starbucks close by. Who doesn't love a good latte while their kid gets some energy out??
Where do you go when you need to get out and the weather isn't cooperating? I'm always on the hunt for something fresh to explore. - Annika
This blog is written by Mallory and Donna - at Black Hills Birth Boot Camp. Expect birthy topics, parenting triumphs and trials, and community resources and interviews. Have a topic idea you’d like us to address? Drop us a note!