EPISODE 7

Breastfeeding with a Larger Chest

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Episode Transcript

July 17, 2020

Does having a larger chest impact the way that you should breastfeed?

This is Maureen Farrell and Heather O’Neal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way.

We’re ready. So ready for big boobs. Welcome to our first pod snack. Yep. We need a lactation station pod snack. Yeah. So since Heather and I just out of the blue committed to two episodes which is a little crazy. We’re gonna like throw in our little lactation cookies here. Just a little mini episodes to whet your appetite for the next. The only lactation cookie you’ll ever need, really.

 Yeah, absolutely. And we’ll just talk about that in another pod snack. But today we’re talking about big old boobies and yeah. So Heather keeps looking at my boobs when she says that. Really hard not to. Just objectifying my friend here. It’s fine. I apologize. We have video though now. So maybe if you become a patron, you’ll see, it’s totally worth five bucks a month to watch Heather ogle me.

I’m sorry. Which one is it? Whatever you want, baby. Okay. Okay. So yes, our first pod snack is about tips for lactating with a big chest. Where are we going to start, Heather? I would start at birth. Oh yeah. So the breast crawl. So I always like to tell people that if you are not in an immediate position to manage a breastfeeding position that’s comfortable and effective for you immediately postpartum, just do skin to skin and wait 15 minutes. It is not worth a bad latch and all that stress of trying to finagle a baby onto a large chest and negotiate a lot of breast tissue if you’re still getting stitched up, like you’re still a person.

Hold the phone. Just do some skin to skin. Wait a minute, get your vagina sutured up. Whatever is happening at the time. Maybe you don’t feel good. Maybe, you know, you’re close to passing out. Like a lot of things can happen. Maybe you’re just really scooched down in the bed, but you had an epidural and you can’t scoot yourself back up in the bed, but like just really take some time to get yourself scooted up in bed. Get the right positioning supports and position yourself in such a way that you can manage all your breast tissue and the baby to get a good first latch.

Right. And I, and I want to say that, you know, the position that we typically encourage for the breast crawl, that laid back, kind of semi reclined position can be really challenging with large breasts, but that doesn’t mean that you shouldn’t do that. So usually what I do when I have a client with a larger chest, I still have them start in that position. I let the breast crawl happen because that’s really important for baby to orient and integrate their reflexes and all of that. And it’s an easy position for baby.

And then when it seems like they’re really putting a lot of effort into that latch, then I usually try to facilitate a position change because there’s a lot that we can do to help that latch with a larger chest. Well, first we can talk about props and supports. And also I feel like one of the key things for like managing your large chest situation and your small baby is actually being able to see.

Oh, your chest and your baby. And when you’re semi reclined, you’re like, well, I see these boobies and the baby is somewhere down there. So like a more upright position with like a stiffer chair even. If you are able to make it out of the hospital bed and into a different situation, like the couch that’s there, or a recliner or something, it’s probably going to be better to position. Because the hospital, is there anything worse than a hospital bed for breastfeeding?

No. And I’m also thinking like, since I do home birth, you know, you just had your baby, like in the corner of your bathroom next to the toilet. Cause that’s where everybody has their babies at home. Yeah. We’d probably let the breast crawl happen there, but like, it’s not going to be your favorite place to breastfeed. So we’re going to be like, all right, cool.

We have this awesome physiological bonding, reflex integration, cool stuff. But now you actually want to breastfeed and like, it’s just not happening in that corner of a random floor in your house. So yeah. Ask for some support, we’ll help you get up. We’ll find a good spot where you can sit up and you feel like you’re not going to drop your baby.

And you can also move your breasts into a position where, where they feel good. And my favorite tip, speaking of moving your breasts into a position, because your breasts can be very heavy and you could potentially be nursing for 40 minutes to an hour, especially in the beginning. So if you take a little tea towel or a washcloth or whatever, it kind of depends on how big your breast is on how big of a towel you need. But you can roll it up like a hot dog and kind of cram it up under the crease of your breast to prop it up for you.

And it’s going to help to push that nipple towards a more like outward facing direction than a downward facing direction. So you can see, and you won’t have to be doing as much holding up of the breast because when you get tired, your arm is going to slip down. Baby’s going to slip down as you, as you can’t hold an eight-pound baby and a 10-pound breast at the same time for 40 minutes.

Yeah. And then your latch is going to become affected and then it’s going to get painful and then you’re going to be like, this isn’t worth it. Right. And we also see a lot of back and neck pain and even like carpal tunnel from people with the, with these breastfeeding positions where they feel like they have to bring breasts to baby.

So I want to say always, always, bring baby to the breast. So situate your breast. Another tip, that’s kind of like the tea towel that I found, maybe not in the immediate postpartum, but just for like functional breastfeeding, especially when you’re out and about. Is if you wear a slightly more structured bra, like with a little bit of padding, don’t unclip it, just pull your boob over it. Yeah. And then it kind of props you up. It does restrict blood flow a little bit. So I don’t recommend doing this all of the time. We don’t want to get clogged, but yeah, that was my accidental wonderful discovery. That’s awesome. Yeah. Yeah. So we’re looking at some props. If you want to hold your breast for baby, that’s fine too.

But again, with these larger breasts a lot of people because they can, kind of pull that breast toward the baby. And even if you have enough breast tissue that you feel like your breast can kind of move without the rest of your body moving, that’s not what’s happening. You’re going to be moving your neck, your shoulder, your back.

And you’re going to have a lot of tension along those lines. So situate yourself, make sure your back’s nice and straight and you’re relaxed. And then with your other hand, you’re pulling baby close to you. You know, in the most extreme cases, I have seen hospital lactation consultants who are desperate to get the baby latched on a very large chest and the breast is so heavy, there’s like nothing you can do. I have seen them use the bedside table where they put the breast on the table to hold it and then lay the baby on the table sideways to eat. And so, yeah. So side lying position, which you can’t do in a hospital. Well she had a C-section, so that’s the reason that they did that is because she had a C-section and side lying can be very painful when you’ve had a C-section.

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So instead of doing that, they kind of modified it by laying the breast on the bedside table. And of course supporting the baby and not ever walking away and just letting the baby lay on a table but helping the baby latch on that way. And it worked, it worked fine. Yeah. But creative, I mean, she was wondering how she was going to continue that one somehow at home. But also that initial time of feeding is more difficult because baby is a lot more contracted. They don’t know what’s going on. Like they would just require a lot more effort to help them. But I, I really love side lying for larger breasts and chests. I think that it, it gives you a lot of opportunity to position the breast, to point the nipple the way you want and to also move baby without having to support the weight of either of those things.

I agree. And also one of the things to think about is where your nipple is on your breasts, because if you have large breasts with nipples that are outward facing, I argue that that’s easier. Yeah. Because you can do football position. You just like, hold that baby. You can’t see me gesture, but I did, it was good.

Kind of tuck the baby in on your side and it’s easier that way. But one of the hardest positioning challenges that I’ve had with patients are large chests with inward facing nipples because you’re holding the breast and the baby inward, and it puts a lot of strain on your triceps/ deltoid area. So there’s actually a pillow that they make now that’s like $15 where you put your arm through it. Oh yeah. That thing is cool. It’s like a triangle. And you kind of just use it to prop your arm up, which is great for inward facing breasts. And if you like it, fantastic. If you hate it, 15 bucks. Yeah. And, and there’s a couple of pillows and props. I don’t particularly like to rep any one of them because I feel like you kind of have to like go into the store and sit down and be like, which one of these fits around my specific waist and also helps with my breasts? But like the one that has like a clip on it, that kind of goes around your body. I think that one’s nice. Right? I think it’s called the breast friend.

We, yeah, we stole their name. I’m not really, but anyway we just like puns. So that one’s good, but the ones that are like the boppy can be a little bit tricky sometimes with a larger body in general, which often comes with a larger breast. So it’s something that I think if you can try before you buy is really nice. If you have friends with them and you can borrow them and try it out.

Yeah. Body pillows are great. And also my, this has kind of turned into a positioning support pod snack, but I’m fine with that. Whatever. My favorite positioning support is actually made for twins and it’s shaped like an M. And the middle part of the M flips up in the back as back support, which is fantastic because it creates a little bit of space between you and whatever is behind you.

So baby’s feet can stick back there and have some room because otherwise baby’s going to push off of the headboard. Like if you’re in bed, they’ll push off the headboard and unlatch themselves. Oh my gosh, yeah that football hold like works great with newborns. And then as soon as your baby starts to kick vigorously, you’re like, what the fuck?

Yeah, I do this. Yeah. But I had to use that a lot with my son and I found that that was the easiest position at first, when I was like, what am I doing? I don’t know how to breastfeed. Holy crap. And I kind of found that, so a lot of people, when they do the football hold, they basically put their baby flat on their back.

And while that works for some babies, It makes it hard for them to swallow often, like imagine you’re lying flat on the floor and someone’s like, here’s a bottle of water. I’m just going to pour it down your throat, swallow. So what I found was easy, easier for me and my baby and for a lot of my clients in that football hold. We have a prop under baby’s head and shoulders. So they’re kind of like in a crunch. They’re a little bit more inclined. Gravity’s going to help them a little bit more with like managing the flow of milk and not choking. They’re not going to roll out and pull on your nipple. And that also like curling them up a little bit, creates a little more space behind you with their feet and whatever’s behind you too.

And then like you can really see their mouth better and your breast isn’t totally blocking it. Yeah. And actually speaking of that, if you, if baby is nursing well, and they are clearly able to breathe, if they are nursing, so don’t take your finger. This is a do not do. Do not take your finger and stick it down and compress your breasts down to see what’s going on.

Right. If it feels good, if baby is latched and nursing, they are breathing. If they can’t breathe, they will unlatch themselves and you will know that it’s a problem. You can initially compress right behind the areola and make a boob sandwich to help control that tissue a little bit to get it in the baby’s mouth.

But once they’re nursing, you don’t want to hold that forever because you’re going to be blocking milk from flowing. So after they go in and they get a good latch, you’re going to let go and you’re just gonna let it happen. And don’t, don’t do the peek. Don’t do the pushy and sneaky peek because that’s going to create an air pocket and you can potentially get a blister on your nipple from that. I’ve done that. Or they’re going to just unlatch and you’re going to have to start over.

It’s super annoying. I made that mistake. But like pretty much everybody I work with now has a smartphone. You can like put your camera on selfie mode and check out what’s going on. You can use a mirror. If you’re like at all worried about what’s happening with baby and you feel like you can’t see that because of your breast tissue or the position you guys.

And like involve your partner and be like, Hey, look at, does this look like the book? Can you see what’s going on? Ha-ha yeah they’re like what book, I didn’t read the book. Read the books. Anyway, I think that that’s gonna be it for our pod snack today. And we’re going to have another episode sometime about like more breast shapes, more chest shapes, how to manage feeding with that.

But I hope this gave you just a little, couple useful tips you guys can use at home. And let us know as always email us. Leave reviews, leave ratings. Yep. Check us out on Facebook, all kinds of stuff. [email protected] We would love to hear from you. And we also really love baby pictures. We just, we love everything. Share everything with us. All right. Best of luck to you large chested women like Maureen. Goodbye.

Thanks for listening to The Milk Minute. If you haven’t already please like, subscribe, and review our podcast wherever you listen. If you’d like to support our podcast, you can find us on Patreon at Patreon.com/MilkMinutePodcast to send us feedback, personal stories, or just to chat, you can send us an email at [email protected]

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