Pregnancy, Birth and Breastfeeding Information

I highly recommend all pregnant people look into creating space in the pelvis to allow baby to get into their optimal position prior to birth. I show couples attending my courses the amazing Spinning Babies website for regular exercises, as well as specialised advice for breech babies or posterior babies.

Check out Spinning Babies for more info.

For low risk healthy pregnancies, antenatal expressing (expressing colostrum before birth) is generally considered safe from 36 weeks gestation.

It is a great skill to learn and master before baby arrives, and collecting the colostrum you express allows you to have a small ‘just in case’ stash ahead of time. You may not need it at all, but in some situations it can be really helpful to have on hand.

For a great educational video on how to hand express, check out this link.

For information on how to store your colostrum / breastmilk and how long you can store it for, check out the Australian Breastfeeding Association page on this topic.

Getting a deep, comfortable and functional latch of your baby at the breast is vital for many reasons. It ensures baby is getting a good feed, it stimulates your milk supply to make the correct amount of milk for your baby, it ensures baby is able to drain the breast and it avoids nipple pain and damage.

There are many different techniques and suggestions around on what to do or try to attach your baby at the breast. I always recommend trying all of the different options and seeing what works best for you and your baby! What works will be different for everyone. And what is working may change as your baby grows.

Global Health Media has an excellent video on attachment that I highly recommend.

The Australian Breastfeeding Association also has an amazing video covering a lot of the basics of breastfeeding.

Many breastfeeding women will experience engorgement, breast inflammation or mastitis, or some combination of all three of these at some point in their feeding journey. The management of these three conditions has recently changed - a complete 180 degrees on the recommendations, in fact! Old recommendations used to include deep tissue massage, the application of heat packs and advice to feed or express LOTS….What we now know is that all of these conditions start with inflammation of the breast tissue cells surrounding the ducts that move the milk from the back of the breast to the nipple. When these cells become inflamed, they swell and compress the thin-walled milk ducts. The inflammation of the cells causes the breast tissue to become engorged (either the entire breast, both breasts, or just a small, localised area on one breast or the other). This can feel like the breast/s become large and stretched, or a hard lumpy area. It can be tender or even have redness around it.

When these symptoms present, what women need to do is treat the inflammation, which we treat very similarly to a sprain. Firstly apply ice or cold packs to the affected breast. This will work to reduce the swelling locally and decrease the discomfort. Secondly, take oral ibuprofen or diclofenac (follow packet instructions) to reduce inflammation on a more systematic level. DO NOT massage the breast tissue - this damages the delicate structures in the breast and increases pain, and can also lead to further complications like breast abscesses. What you can do is some gentle lymphatic drainage stroking instead. To do this, gently stroke your breast from the nipple OUT towards your chest wall, at about the pressure that you’d use to stroke a cat. Repeat this gentle stroking from the nipple towards the chest the whole way around the breast. This helps to move the excess fluid caused by the swelling from the breast back into the lymphatic system and drain it away. You should feed your baby, or express if your baby is not feeding directly from your breast, as per normal. Do not increase the amount that you are expressing or breastfeeding; if you feed or express more than normal, it increases your milk supply, which can lead to more pain as it causes more swelling and inflammation in the breast.

These are the first steps every woman should take to manage engorgement (common when your milk “comes in” or after cluster feeding periods), breast inflammation (feels like a lumpy area on the breast) or mastitis (lumpy area on the breast with redness and tenderness). Mastitis is normally accompanied by fevers, chills, shakes and flu-like symptoms. Previous advice was to immediately seek oral antibiotics from your care provider. New research shows that approximately 70% of mastitis is inflammatory, rather than bacterial. When women use the first-line treatment described above, they should see an improvement in symptoms within 12 to 24 hours. If you have the flu-like symptoms of mastitis and first-line treatment does not improve your symptoms within 12 to 24 hours then you should seek out a medical professional to consider oral antibiotics. Again, extra expressing or feeding is NOT recommended. Continue to use cold packs and anti-inflammatories along with lymphatic drainage stroking on the breast while taking the antibiotics. These exercises can also be used to help with lymphatic drainage: Video Blog: Painless Mastitis Treatment Techniques and Protocol - Brisbane Osteopath Centre (brisbaneosteopathic.com.au).

Many healthcare professionals have kept abreast (ha-ha!) of these recent changes. If you are facing push-back from a healthcare professional about the above advice, please refer them (& yourself for reassurance!) to the Australian Breastfeeding Association website for up-to-date information: Engorgement | Australian Breastfeeding Association, Mastitis | Australian Breastfeeding Association.

If you are having ongoing problems with mastitis, please seek professional help by reaching out to the Australian Breastfeeding Association Hotline (on 1800 686 268) and booking an appointment with a reputable IBCLC. Remember most GP’s are not breastfeeding experts!

Tongue Tie (Ankyloglossia) is a midline congenital defect, that can impact a baby’s ability to move it’s tongue around the mouth. A whole range of movements may be impacted; poking the tongue out, lateral tongue movement and the tongue resting on the roof of the mouth for example. This can impact on an infant’s ability to attach well and feed at the breast. It can also impact eating solids and speech later in life.

Not all tongue ties will cause issues or need treatment. An assessment by a professional experienced in tongue tie may be warranted if you have ongoing breastfeeding issues including attachment problems, low supply, a baby who slips on and off the breast or a baby who clicks at the breast and these issues aren’t resolving despite assistance from your midwife, MCHN or IBCLC.

Tongue Tie can be a controversial topic amongst healthcare professionals. Very few GP’s, midwives or lactation consultants have adequate training to assess a tongue tie. If you suspect this may be an issue, please seek an expert assessment.

There is a great wealth of information on tongue and lip ties on this link from askthedentist.com, including the different types of ties, potential complications of untreated ties and treatment options. It is an American website, but the information contained within is still relevant.

The Breathe Institute (also American) also has some wonderful information on infant frenectomy (the process of releasing a tongue or lip tie). You can check them out here.

For discussion and support from Australian providers and families, check out the Tongue & Lip tie support Australia group on facebook. This is a private (closed) group that is a wealth of information and support for those facing a tongue or lip tie diagnosis and treatment. You can find the group here.

Your baby’s visual development goes through many changes in the first year of life. At birth, they are best able to focus on objects about 20 to 30cm away from their face. This is about the distance from the breast to the mother’s face!

Their visual abilities change rapidly as they grow over the first year of life, with the vision reaching 20/20 by approximately 3 years of age.

An infant’s eye colour is also not settled until approximately 12 months of age.

For more information on visual development in infants, including some signs to watch out for and when to seek extra help, check out this link by My Vision.