Emily's Birth Story and Lactation Tips

Emily had to be induced at 38 weeks due to low amniotic fluid levels, a condition known as oligohydramnios, which led to her baby experiencing slow growth in the womb until growth stopped. Fortunately, she reached full term and had a vaginal, unmedicated delivery with an hour of pushing, resulting in the birth of a baby girl. After birth, Emily and her baby had uninterrupted skin-to-skin contact for the first hour. The baby had a slight cone head, which resolved almost completely in the delivery room.

As Emily's birth doula and lactation counselor, Anna Isaiko encouraged her to latch the baby within one hour after birth to ensure proper breast stimulation and future milk supply. During this time, the baby did not latch on the left side but briefly latched on the right. When the doula helped with finger feeding, the baby initially bit, unsure of what to do, but then happily sucked on the finger. The baby did not have a high palate or obvious tongue tie, but despite being interested in feeding, she did not sustain her latch. Contributing factors included Emily's inverted nipples, especially on the left side, and the baby's low birth weight of 6.4 pounds, compounded by the low amniotic fluid levels.

• Impact of Low Amniotic Fluid on Breastfeeding:

1. Preterm Birth: Low amniotic fluid can lead to preterm labor. However, in Emily's case, she was able to reach 38 weeks, considered full term.

2. Growth Restriction: Oligohydramnios can cause intrauterine growth restriction (IUGR), leading to lower birth weight. Emily's baby was born with a low birth weight of 6.4 pounds, which can affect the baby's energy levels and ability to latch effectively.

3. Interventions and Birth Outcomes: Low amniotic fluid often leads to medical interventions such as induction. Despite the induction, Emily had an unmedicated vaginal delivery, which is favorable for immediate breastfeeding but still presents challenges due to the baby's low weight and possible initial feeding difficulties.

4. Respiratory Issues: Babies born with low amniotic fluid levels might experience respiratory complications. Although not mentioned, it is a factor that can affect breastfeeding if present.

• Plan Suggested by Lactation Counselor Anna Isaiko:

1. Use Nipple Everter for Inverted Nipples: To help draw out Emily's inverted nipples, making it easier for the baby to latch.

2. Finger Feeding with Syringe: Latching the baby onto a finger and using a syringe to provide milk, teaching the baby to suck properly.

3. Supplemental Nursing System (SNS): Using an SNS to provide additional nutrition at the breast, encouraging the baby to latch while receiving donor milk.

4. Breast Stimulation for Mom: It's crucial for Emily to stimulate her breasts around the clock, using hand expression and later pumping to ensure sufficient milk production.

Additionally, during the baby's stay at Inova Fairfax Hospital, she received donor milk to support her nutritional needs. This donor milk helped ensure the baby received adequate nutrition while Emily's milk supply was being established and the baby's latch was being improved.

These measures aim to support effective breastfeeding and address the challenges posed by the low amniotic fluid and the baby's low birth weight.