Breastfeeding "Plot Twists" in your Postpartum Rom-Com

The first few weeks of breastfeeding your baby can feel like you’re the main character navigating the ups and downs in a romantic comedy.  

Possible titles for your postpartum rom com

…Sleepless in Seattle  

…How to Lose [Your Confidence] in 10 Days

…While Your Were [Not] Sleeping

…10 Things I Hate About [Breastfeeding]

….Above Last Night

You started off confident. After all, you took all the prenatal classes and read all the books. 

But now that you’re home from the hospital, things feel different. There’s crying (both you and the baby). There’s overwhelm (What does ChatGPT say? What does my sister-in-law say?) 

You take a deep breath and reach out to your IBCLC (international board certified lactation consultant), and you get the support you need. Your overwhelm evaporates.

….If only the breastfeeding journey were as predictable as a Nora Ephron movie. Truth is, you can’t completely plan for a fairy tale breastfeeding journey, but you can understand some of the obstacles and what to do about it.  

8 Breastfeeding “Plot Twists”

Breastfeeding has happened since the beginning of humanity, but that doesn’t mean it’s easy. It takes practice and an individualized approach based on you and your baby. 

Here are a few common breastfeeding “plot twists” and what to do:  

Plot Twist #1: My baby cannot find the breast and is flailing, pulling away.  

Advice: Babies latch based on feel. Bring your baby close by supporting their upper back and shoulder blades with the heel of your hand. Don’t push their head into their breast, rather, bring their shoulders closer to you. Slowly rub your baby’s nose against your nipple to elicit the rooting reflex. When your baby opens up wide (like a yawn with their tongue down) bring them into the breast. A good latch means the tip of your baby’s nose touches the breast, their chin is burrowed into the breast, and your baby is able to stay fixed.

Plot Twist #2: My baby is latched, but is not sucking. They’re sleeping!

Advice: 1) Your baby will respond to milk flow. Gently compress your breast with a flat hand to send milk down the milk ducts. Use the same pressure you’d use to pet a dog or cat. 2) Stimulate the sucking reflex by gently rubbing your baby’s palm. 3) Talk to your baby calmly  4) Compress your breast tissue like you’re putting your hands on a sandwich. This will deepen the amount of breast tissue in your baby’s mouth and make your nipple touch their hard palate, which elicits the sucking reflex.  

Plot Twist #3: I can’t tell if my baby is swallowing or just comfort sucking. 

Advice: It is difficult to hear swallows. A swallow sounds like a quiet “cah” sound, or a gulpy if there is rapid milk flow. Look at your baby’s jaw. Small sucks (their cheeks or chin moving) are not the same as swallowing milk. A swallow is when your baby’s jaw lowers and pauses. The more swallows, the more milk! Time on the breast does not equate to more milk. Look for swallows instead. 

Plot Twist #4: I’m stressed, my baby is crying and won’t latch.

Advice: Have you ever tried to drink a glass of water while crying? It doesn’t go well. First, help your baby calm down and reset. Then we relatch. 

This means– You, your partner or another support person can hold the baby while you both reset. Hold the baby upright, against your chest so they can hear your heartbeat. Let them suck on your finger. 

This also means–You can take some deep and cleansing breaths, drop your shoulders, unclench your jaw. Relaxation helps the flow of oxytocin, which in turn triggers the milk ejection reflex. Try some comfortable breastfeeding positions. 

Lastly, at the next feeding, bring your baby to the breast when they’re showing subtle hunger cues (sticking out their tongue, hands in mouth, rooting). Crying is a late hunger cue.  

Plot Twist #5: My breasts are engorged, full and swollen!  

Advice: Severe engorgement and breast edema can also occur if you receive a lot of intravenous fluids during labor (ex: IV fluids, IV medication like an epidural, pitocin, magnesium). This edema can cause swelling of lymph between your milk ducts, making it harder for milk to be expressed. First try breast gymnastics, a simple but effective practice created by IBCLC Maya Bolman (TR;DL- lift your breast up gently, move down, move left, move right, move in a circle, and then the opposite direction). Breast gymnastics can get stagnant lymph to flow. 

If your nipples are less everted because of the engorgement, you can use reverse pressure softening. This entails pushing with gentle but firm pressure with two fingers on the left and right sides of the nipple, holding for about 30 seconds, then doing that in another position. 

Plot Twist #6: I have a really forceful letdown and my baby is practically choking on my milk when I first start nursing.

Advice: Check out the “laid back” or “side-lying” positions for breastfeeding. You can also hand express until your milk ejection reflex (aka your fast “letdown”) occurs and catch the forceful flow in a passive milk collector like the Boon Trove, burp cloth or diaper. Then bring your baby back to the breast after the forceful flow has passed.  

Plot Twist #7: I think I have a low milk supply. 

Advice: To establish a solid milk supply, you should remove milk via breastfeeding or pumping at least 8 times in a 24 hour period for the first few weeks. In the first six  weeks postpartum, your body is really figuring out how much milk “supply” to create for your baby’s feeding “demands.” After that, it sort of levels off. Remember, it won’t always be like this. If you would like to provide mostly breastmilk and your baby is currently getting some formula, you should pump before/during or after your baby gets that bottle. 

There are also risk factors for supply issues, like hypo or hyperthyroidism, type 1 and type 2 diabetes, hypertension, HELLP syndrome, breast surgeries, and a history of infertility.

• Reach out to an IBCLC who can do a weighted feed (weighing baby before and right after breastfeeding) and help you make a plan to support your supply. 

• Look for 6 to 8 wet diapers and 3-4 stools by day 7 as a sign that your baby is getting enough to eat.

Plot Twist #8: Most of my social and family circle isn’t supportive of my breastfeeding goals.

Advice: Set yourself up with a postpartum doula and an IBCLC, ideally before giving birth. Research and join (virtual or in-person) breastfeeding support groups in your area. Find your circle!

Watch out world, bring that main character energy. You’ve got this!  

For more feeding support, reach out to Kathleen at www.strongnestconsulting.com/