5 tips for pain-free breastfeeding.

Imagine that you had a personal chef who could make you the perfect food, specifically formulated to your own chemical balance and physical needs. Breastfeeding is like this for your baby. The milk you naturally produce is the perfect food for your yummy little gummy worm. The vast majority of mothers are physically able to breastfeed their babies, yet some find it extraordinarily difficult and painful. Quite often the task of breastfeeding can be eased with just one or two basic techniques. Though milk production is often one of the most basic concerns a breastfeeding mother has, in this collection of tips I am focusing more directly on ways to make breastfeeding easier and more comfortable over all. These 5 tips are designed to be most helpful to breastfeeding mothers who are having a hard time with chapped nipples, getting a good latch, releasing a good latch and making the overall experience of breastfeeding more enjoyable.

1. Make your baby a nice breast sandwich.

If your nipples are getting chapped, it is most likely a latching issue. Getting enough of your breast into your baby's mouth so that they can form a good latch is a tricky maneuver. The best way I found was to compress (or pinch, really) my breast between my first two fingers just outside my areola, while pressing my entire breast in toward my chest. This made my nipple and areola somewhat flatter, like a sandwich, and it was easier for me to get more breast into my son's mouth, which made it easier for him to latch on. This tip is especially helpful for mothers who have been overly compensated with volume in the chest area.

2. Give your baby a little cheek tickle.

Of course it doesn't matter how compact and accessible your breast is if your baby doesn't open her mouth wide enough to get more than a nibble. Luckily nature has given babies an instinct to help them open their mouths nice and wide. If you touch your baby's cheek lightly with your nipple, your baby should turn her head toward your breast with her mouth wide open. This opening will only last a second, so be quick about shoving your breast as far in there as you can get it. Don't worry about filling your baby's mouth too full with nature's bounty, she can always self correct after she finds a good latch.

3. Try different nursing positions.

Most of us have burned on our brain one specific visual image of breastfeeding. The mother holding her baby in her arms across her chest in a horizontal position with the baby's belly button facing up, and the head turned into the breast, rests in the crook of the mothers elbow. This is commonly referred to as the "Cradle Hold" and is the image most mothers reflect on when they first imagine breastfeeding. However, what this image doesn't reflect is that for babies with reflux this position would be difficult, and probably painful. For babies with gas, this position is less than ideal, and that mother's arm is gonna fall off if she holds her baby like that for every feeding. There are several different styles of nursing position, and most rely on some sort of nursing-pillow support. The most similar variation is the "Cradle Crossover Hold" in which the mother holds her breast with the hand and arm that she had been using to "cradle" the baby, and uses the other arm to hold the baby belly-to-belly with her hand supporting the head while nursing. There is also the "Football Hold" which is most commonly used to tandem feed twins, but which some single babies find more comfortable as well, where the baby is tucked next to the mother under her arm and she uses the same arm to hold the baby's head to the breast. There are several official positions like these that are easy to find illustrated online, but you should not feel restricted to these exact positions. My son's favorite nursing position as he got larger was vertically belly-to-belly while straddling my thigh. I supported his head and neck from behind though he was pretty good at holding his head up by the time we found this position. I don't think this is an "official" nursing position, but I like to refer to it as the "Koala Hold".

4. Use your little finger to help release a good latch.
Another source of nipple chaffing comes from improper latch-release techniques. Once your darling little rose bud gets a good latch, it can feel like he is vacuum-sealed to your breast. If you need to interrupt a feeding for some reason (like running to the restroom or answering the door), if you need to disengage your baby after you know that your milk is gone or if your baby has fallen asleep at the breast, it can be hard to figure out how to remove him gently. If you simply pull him away until the latch is broken, it will be traumatic to your nipple, and perhaps to your baby's delicate mucus membranes as well. I've seen some mothers even try to pry their baby's jaws apart by pulling on their forehead and chin, it did not look comfortable for the baby and I do not recommend it. Instead, try inserting your littlest finger into the corner of your baby's mouth and pressing into your nipple just enough to let air in. This gently breaks the seal without causing either of you any undue stress or discomfort. It seems simple, but it can really help reduce nipple irritation and pain.

5. Give your baby a little mouth-wash.
Though some nipple irritation is caused by improper latching and releasing, less commonly it could be a sign of thrush (a yeast infection). A yeast infection of your nipple is caused by the growth of yeast in your baby's mouth, due to high sugar content and an imbalance of healthy bacteria. The most important thing you can do to help prevent this from happening is to take a clean, damp baby washcloth and wrap it tightly around your finger and rub it over your baby's cheeks, gums and tongue after every breastfeeding session. Keeping a spray-bottle filled with very weak chamomile tea and a pile of clean wash clothes near where you usually breastfeed will make it easier to remember to do this after every time you nurse. If your adorable little smoochy-face develops an infection in spite your best efforts, some things you can try to help resolve the infection quickly are: eating some unsweetened yogurt ever day for a few days, cutting sugar out of your diet for a few days and replacing the weak chamomile tea in the spray bottle with a very weak mixture of baking soda and water (1/4 teaspoon baking soda dissolved in 1 & 1/2 cup warm water). I also would wash your baby's mouth out before naps and before night-time sleep as well as after breast feeding.

Trick: Vary your diet while tracking your baby's gas.
This trick doesn't have so much to do with your comfort while breastfeeding as it does with your baby's long-term potential to resist becoming a picky eater. The flavors of the food you eat while breastfeeding come through your breast milk in a very diluted form. Fostering a familiarity with many different flavor profiles while your baby is experiencing her first relationship with food fosters a flavour flexibility which can come in very handy later in life. I especially recommend eating as many different types of vegetables as possible, because they are traditionally the most resisted food group for children. You should be sure to keep a log of the foods you eat each day, and the times that your baby expresses discomfort and excess gas, because this will help you eliminate foods that are causing your baby discomfort more quickly.

Trick: For Chapped nipples use bag balm.
Your baby cannot eat this substance, so you might want to take some time off of the breast for one or two feedings. Pump enough milk to keep your baby fed for about 24 hours, and slather on the bag balm. It is sticky and can be staining, so I recommend for mothers to use breast pads to shield the balm-covered nipples while they heal, and wear a soft sleeping-bra to keep the pads in place. In about 12-18 hours you should see a significant decrease in the irritation, and you may be able to begin breastfeeding again. Be sure to thoroughly clean your nipples before returning to breastfeeding with your baby. Many mothers also recommend lanolin, since it is something your baby could ingest small amounts of with no ill effects. I did not find that it was effective for me, but it is another remedy you might want to try.

Breast feeding is a special and magical bonding time for mothers and babies, especially if there is less discomfort and anxiety involved in the experience. Hopefully these tips will help keep your nipples pain-free and your breastfeeding experience a positive one (for one more great tip for better breastfeeding look here). If you have found these tips to be helpful, please forward them to any new or expecting parents you might know. I also love, and respond quickly to, questions and comments. Happy parenting!

5 tips for treating diaper rash.

I am often asked what type of treatment I would recommend for diaper rash, my response is immediately, "what kind"? Many first-time parents are not aware that there are different kinds of diaper rash, so this question comes as a surprise to them. There are quite a few different kinds of diaper rash, and for each one there are distinct things that will work better than others. So for my tips today, I will focus on 5 of the most recognizable types of diaper rash, and the treatments that I personally have found to be most effective. Commercial treatments for diaper rash usually do a great job of covering the bases for several types of rash, but can sometimes have serious drawbacks if used on the wrong rash at the wrong time (what I look for in commercial brands can be found here). For example, Boudreaux's Butt Paste is a great natural ointment for the most common bacterial rashes, but if your baby has a chemical reaction rash or other weeping or bleeding diaper rash, it can cause a painful stinging sensation, and actually exacerbate the rash. If any ointment you are applying to your baby's rash seems ineffective or looks like it is actually causing your baby increased discomfort, discontinue using it at once and ask your pediatrician for advice.

1. For an acidic reaction diaper rash use yogurt, baking soda and Aquaphor.

This rash is purely a reaction to the heated contact between sensitive baby skin and acidic waste. Acidic waste can be caused by reflux, colic, and high acid content in breast milk as well as diarrhea. This rash looks similar to a rug burn, red and raw and will sometimes be bleeding slightly. The first order of business with this rash is to neutralize the acids, Yogurt is a soothing natural antacid, as is baking soda, and mixed together they make an effective paste. Or you can "wash" your baby's behind with yogurt followed by some sterile cool water and then powder the whole undercarriage with the baking powder. At the next changing (which should only be an hour or two later), be sure to use a sealant-type product like olive oil, Aquaphor, or Bag Balm to create a barrier between the stinging effects of urine, or further burning from another acidic bowel movement.

2. For a bacterial diaper rash use bamboo cloth, hair dryer and cornstarch.
This type of rash is one which thrives on a warm moist bottom. Bacteria are everywhere, but at times the balance between good and bad bacteria gets a bit off, and the result is skin irritation. This rash is a cousin to the bed-sore, and similar treatments are effective in treating it. This rash looks bright red, has an unpleasant odor and is probably weeping (oozing a fairly clear and slightly sticky liquid). There is probably more than one affected area, most commonly one quarter sized weeping area on each cheek. Keeping your baby clean and dry is the most effective treatment for this rash. Wash your baby's rear with cool sterile water using a soft naturally antibacterial bamboo wash cloth. Pay special attention to the deep crevice-type areas, since they are commonly effected as well. Use a hair dryer on low to make sure every part of your baby's booty gets completely dry. Apply cornstarch powder over all of your baby's rear and use bamboo cloth diapers (because bamboo is naturally anti-bacterial), if you have some, until the rash goes away.

3. For a diaper rash caused by an allergic reaction, use yogurt, baking soda and olive oil.

This rash is a combination of allergic-type hives and an acidic reaction. When a baby's body detects an undesirable element in the stomach, like an allergen or dangerous bacteria, it gets rid of it the fastest way it can. Often this means vomiting, but sometimes it means diarrhea. And because your baby's food has been forced out so quickly there is still a large amount of stomach acid in it. The allergen in the waste is giving your baby hives, and the acid is causing the hives to burn. This rash will look almost like your baby has little blisters on his bottom, but the bumps will be hard and not fluid-filled. Also, the bumps will only appear in areas where your baby's skin has come into contact with the waste. The entire area of waste contact will be red too, not just the bumps. To treat the acid, use yogurt (unless you are concerned that the allergen might be a dairy product) or baking soda, or a mixture of the two. Continue to change your baby's diaper regularly, and administer a sealant such as olive oil, Aquaphor or Bag Balm to protect your baby's hiney from further exposure to the allergen. The allergic reaction should go away on it's own, just make a mental note of possible food sources for the reaction and have your baby tested for allergies at your next visit to the pediatrician.

4. For a rash caused by a yeast infection, use yogurt, air, Bag Balm and (at times) an anti-fungal cream.
This rash thrives on sugar, and it will eat it where ever it can find it including in the living skin cells of your baby's sensitive bottom. This rash is particularly devious, because if you treat it with corn starch, the yeast, which love natural sugars, will thrive. While your baby's rear may be fairly red all over, what helps in identifying this rash is the red bumps that are in areas not usually too affected by diaper rash, like above the genitals. The red bumps are usually small and mainly visible outside of the crevice-type areas. Sensitive tissue will be red and swollen, but fairly dry to the touch and there might sometimes be a whitish "cheese-like" substance in some of the crevices of your baby's genitals. While your baby always has yeast bacteria present in their body, certain things, like antibiotics, can destroy the bacteria that usually feed on the yeast. These bacteria are highly concentrated in yogurt, and yogurt makes a great treatment for this kind of rash. Make sure your baby's bahookey is clean and dry, for long periods of time. This type of rash usually responds well to the "air-it-out" method. Try giving your baby some tummy time, on a changing pad instead of a quilt, with no diaper. Then, before nap time apply a generous coating of plain unsweetened yogurt to the affected area. For night sleep, I would recommend not applying the yogurt, but use a sealant like Bag Balm instead. Try using a super absorbent disposable diaper just until the rash goes away, because they will be able to keep your baby's bottom drier than other types of diaper. If the rash does not respond you can also apply a topical anti-fungal over-the-counter cream, ask your pediatrician for the appropriate dosage and dosage schedule for your baby.

5. For treatment of a chemical reaction rash use water, Aloe Vera, vitamin E and Petroleum Jelly.

This rash can be caused by harsh chemicals in diapers, wipes, ointments or even from your baby's own physical development. As your baby begins to grow and develop, chemical changes in her own body will sometimes cause reactions to substances that seemed perfectly safe before. The rash is sudden, bright red, and very dry. It is similar to the acid rash in appearance, but will not respond to the antacid treatment. Sometimes this rash will even have painful blisters. Think of it as a severe sunburn, on your baby's butt. Traditionally the single best way to treat this rash is to shield it from contact with harsh substances. I recommend cleaning it thoroughly and gently with running water, if possible, to minimize rubbing against the skin. Even very gentle cloths can feel abrasive to this rash. After you are finished washing, apply a coat of vitamin E and Aloe Vera, to replenish the skin's natural moisture and promote healing, then apply a sealant. Aquaphor and Bag Balm might be effective, olive oil though, is generally not strong enough. The best sealant treatment for overall effectiveness for this rash is usually petroleum jelly. It creates the best seal, keeping your baby's natural moisture in the skin, and keeping the waste or irritating materials from direct contact with the skin. I also would recommend transitioning to a more natural, chemical-free diaper and not using any perfumed ointments on your baby for some time.

There are several more types of diaper rash, and I will probably revisit this topic again at some point to cover them, but these 5 should be enough to get you through most of the types of rash that you will commonly encounter as your baby grows over the first year or so. I hope you find these tips helpful, and if you do I would encourage you to forward this site to any new or expecting parents you might know. Questions and comments are always welcome. Happy Parenting!