Everyone knows breastfeeding is best, yet so many mothers have a hard time, often losing the battle right from the onset. Know the obstacles and prepare yourself and your baby for a positive start to breastfeeding.
There are many reasons given for the low proportion of moms who breastfeed their babies. As a whole, our society prefers to think that breasts are for filling out bikinis, not feeding our young. Some women worry about whether they'll be able to nurse after a Cesarean section, while others are concerned about providing enough milk for their babies. Some new moms worry about pain, while still others are just plain anxious about the whole process. It may help to know that most of these concerns can be promptly alleviated with just a little background knowledge, encouragement, and pointers from experienced mothers and health professionals who are knowledgeable about breastfeeding. By being informed beforehand about the benefits of nursing, the intricacies of good positioning for feeding, and how to cope with common problems, you too can make the all-time miracle of nursing be a beautiful, healthy experience for you and your baby.
Plan Ahead
La Leche League International, an organization of breastfeeding mothers, holds local support groups around the world. Pregnant women are welcome at the meetings, which can be real eye-openers. The sight of women easily nursing (even those with twins!), outside the house, with no nursing "aids", such as special pillows and "bibs" to cover the baby, can be extremely inspiring. You'll find tremendous support online too. Visit the Breastfeeding Community.
Buy a book! This is time well spent in the waiting room during your prenatal visits. Be Strong
Don't accept those gift packs that formula companies send or hand out at the hospital. Many nursing experts compare having formula in the house of a breastfeeding mother to having chocolate ice cream in the house of a person trying to diet. It's best not to let it in your door. The formula companies will do their darndest to try to convince you to "at least" add supplementary bottles of formula to your baby's daily feedings. To help sway you, high-savings coupons will arrive in your mail. I even received an entire case of ready-to-use formula when I was in my ninth month of pregnancy. Instead, give the formula to your local food bank, and put the coupons with the formula that's for sale at your grocery store. You'll be encouraging your family to resist formula's so-called convenience. Experienced nursing mothers know that there is no convenience that compares to breastmilk. It's free, always ready and at the right temperature and there are no bottles to wash or lug around. Furthermore, since our bodies work on a "supply and demand" system, there's no such thing as having to run to the store at midnight because you've "run out of food" for your baby.
Another way your breastfeeding partnership can get off to a great start is to avoid giving your newborn a pacifier. Part of the reason that babies like to nurse is that they enjoy sucking. The "non-nutritive" sucking that a pacifier provides has been shown to decrease the number of nursing sessions, which is exactly what you don't want to happen while your body is getting adjusted to making the right amount of milk for your child. "Nipple confusion" is another reason to forego a pacifier. Some babies get so used to having an artificial nipple in their mouths that they don't know what to do when presented with a real one at nursing time.
Know What To Do
If you have problems nursing, do not assume that you "aren't able" to nurse. Make sure that your hospital's lactation consultant, or a nurse experienced with breastfeeding, watches you and your baby nurse before you go home from the hospital. These experienced professionals can provide invaluable insight into your nursing technique.
Know Who To Call
Remember to call upon your two main resources: your hospital or community lactation consultant, and your local La Leche League leader. Make sure you get the phone numbers before leaving the hospital. Some hospitals also offer support and socialization groups for nursing mothers after they leave the hospital. In a world where it can seem like you're the only one nursing your baby, these groups can be, if not life-savers, then lactation-savers!
After A C-Section:
Many women are concerned about their ability to nurse if they deliver by Cesarean section. With accommodations, you should be fine. One mother of a 3-week-old who was born by c-section, suggests having someone stay with you and the baby: "I wasn't allowed out of bed for the first twelve hours after the surgery, and it was really helpful that my husband was there to bring me the baby as soon as she needed to nurse".
Keeping your baby away from your incision, and using good body posture to not stress your body further than the surgery has, will also help. Lean your bed to a 45-degree angle and put a pillow on your abdomen, above your incision, to support your baby. Having your bed only slightly angled, rather than with you sitting fully upright, helps angle your baby's weight forward, onto your breast and away from your incision. The "side-lying" and "football" holds, discussed below, are also helpful positions for nursing after a c-section.
Get Positioned
Varying your nursing position each time you feed your baby allows different parts of your breasts to be emptied best. The variation also helps take the strain from your back, neck and arms that can occur if you constantly nurse in the same position. Remember to alternate the breast your baby nurses at first with each feeding. This will help ensure even milk production in both breasts, and make sure that both breasts' milk is drained well several times a day.
While it seems natural that we should be able to bring our children to our breasts and let nature take over, understanding the various positions commonly used in nursing can be a big help for new parents. The initial few seconds of nursing my first baby found me thinking: "this feels like a vacuum cleaner!" The attentive nurse watching helped us reposition, and then, almost miraculously, I felt absolutely fine. At that moment I gained a very great appreciation for the subtleties of various nursing positions!
Cradle Position
The most common position in nursing is the "cradle hold". The mother holds (i.e. "cradles") her baby in her right arm while offering the right breast (using the left hand to help). It is crucial to make sure that the baby's tummy in ON your body. If your baby's body in facing the ceiling, or otherwise turned away from you, nursing will likely be painful, and you may not have a good letdown of your milk. Your baby's head, shoulder, and hip should be lined up. While you don't need to check with a ruler, do look to see that no body part is thrown back away from your body. Remember, the better arranged both you and your baby are while you nurse, the more likely you are to nurse easily, comfortably, and well.
Also, use pillows to assist in positioning. One on your lap will raise your baby's bottom up. You may also want one under your baby's head, if your chair's arms are not high enough.
You can try using the cradle hold position while sitting up in bed. I find that a "TV Pillow" (sometimes also called a "Dorm Room" pillow) is a great help for this. These pillows offer good back support, and come with attached arms. At 3 a.m., it can be a true gift not to have to fuss to get pillows positioned at your back, head, and under each arm.
The Cross Cradle
The "cross cradle" hold is a variation on the basic cradle position. While your baby is positioned on your right breast, hold her with your left hand and arm, and, voila, you've mastered another nursing position. This can be helpful if you need to use your dominant hand and arm for something else while you nurse. Being left-handed, I found it easier to use my left hand to help my babies latch-on (LINK A). The cross cradle position allowed me to do that, even when I was nursing on my left breast.
The Football Hold
While relatively few of us compare our babies to an oval of pigskin, the "football" hold is a terrific one to have in your portfolio of nursing positions. Tuck your baby's body under your left breast so that only his head emerging from beneath your underarm. Your left arm and hand do the work to support the baby's body. It is helpful to tuck a pillow under your baby's body, and above the arm of your chair while you sit up.
Side Lying Position
A beautiful position for dozing off while nursing is "side lying". This may be difficult to master in the beginning of your nursing career, but is an absolutely wonderful configuration to allow Mom to nap during, or after, nursing. Lie down with a big pillow behind you to support your back. A body-length or king-size pillow is best, if you have one. Place another, smaller pillow between your knees to keep your back properly aligned. Lie on your side while facing your baby, who should also be lying on his side. A small, firm pillow or a rolled up towel will help keep your baby properly positioned. To nurse, tuck baby (and his back support) up close to you, using your top hand to help your baby latch-on. This position is incredibly helpful for mothers who birthed by c-section and need to protect their incision sites.
"Back-lying" is basically the cradle hold while lying down. If your baby is nursing on your right breast, place a pillow under your right arm, and use your right arm and hand to support your baby's head and neck. This is a wonderful position for babies who frequently splutter or choke a bit during milk let-down. In the back-lying position, the baby, working against gravity, is much more in control of how much and how fast the milk flows (In contrast, when nursing in the "upright" positions, the milk often just falls into a baby's mouth during let-down).
Try to experiment with various positions, possibly inventing your own. Using a Sling baby carrier, I was able to easily nurse my little one while walking around. As is so often the case with mothering, using your intuition allows you to find what works well for you and your baby.
Latching on
When a new mother is physically uncomfortable or in pain while nursing, the problem is usually that the baby or mother is not in a good position, or that the baby is not correctly latched on to the breast. Make sure your baby is very close to your nipple when nursing and has the nipple and a good part of the aureola (the "circle" around your nipple) in her mouth when she nurses. Pillows to prop up your baby can be helpful. If you continue to experience sore or irritated nipples try using cloth nursing pads inside your bra instead of disposables.
Engorged breasts
If your breasts become engorged when your milk comes in a few days after birth, soaking in a very warm bath or shower can bring some relief. Some women find that ice, wrapped in a soft washcloth, is very soothing. Green cabbage leaves placed on your breasts can, surprisingly, be a wonderful help for engorged breasts (look at it this way: there are no side effects and if it doesn't work for you, you've only spent about $.50!). Resist the temptation to pump lots of milk out. This is a special time for your body and your baby to work out just how much milk you need to make, and pumping at this time only confuses your body by telling it to make evan more milk than you already have. By all means, though, do nurse frequently, and, if your breasts are overly full and your baby can't latch on easily, pump just enough milk out so that your baby can nurse.
Breast Infections
Some women get a bacterial breast infection called mastitis. If you are having severe pain, fever, or there is a red lump or streak on your breast, call your health practitioner. You many need antibiotics. However, your milk won't make your baby sick, and it is fine (and actually helpful to your body) to keep nursing during a breast infection.
Weigh In
While most women (95-98%) have no problem making enough milk for their baby, if you are curious about your baby's weight gain, you can use the "input/output" system to help check if your child is getting enough milk. A breastfed baby should have 5-6 wet disposable diapers per 24-hours (cloth will be wet more frequently, and it is much easier to tell when the diaper is actually wet), as well as 2-5 bowel movements. Although babies frequently lose some weight in the few days after birth, babies should be back to their birth weight by the end of their second week of life. A child from birth to four months old should gain 4-8 ounces of weight per week, according to La Leche League. Your pediatrician's office will schedule more frequent weight-checks if there is concern over your baby's weight gain. Some baby stores have infant scales so that you can check your baby's weight on your own. The low-tech way, of course, if for you to get on your home scale while holding your baby, then to get on it alone. Subtract both figures to find out your baby's weight. However, this doesn't work well when you're trying to be precise about ounces!).
Work With Your Partner
Sometimes women receive pressure from their partners, or believe that they are being "selfish" by doing all the feeding of their baby. It's important to remember that there are plenty of things that go into being a parent aside from who feeds a child in her early days. Holding, rocking and snuggling are important to a baby's growth and development, and can be done by both parents.
Once your milk supply is well established and things have settled down a bit (around 4-6 weeks, ask your health provider for advice in your specific case), you might want to try pumping some breast milk for your partner to feed the baby. There are several ways to pump breast milk to put in a bottle: by hand, manual pump, electric pump, and hospital-grade electric pump. You can pump by hand by massaging your breasts and then gently working from the bottom third of the breast downward. Don't just squeeze the nipple; milk is made in ducts all the way through the breast. Some women have terrific results by using the Marmet Technique for hand-expression of milk. This is explained in-depth in "The Womanly Art of Breastfeeding" book.
Breast Pumps
For those of you going back to work, hospital-grade pumps are available for rent, or you can buy a pump such as Medela's "Pump In Style" that looks like a briefcase and runs quietly and efficiently. There are also fairly inexpensive hand pumps available on the market. The Avent Isis is one that I particularly like. It's easy to use, inexpensive and quiet, and a good choice for women who don't need to pump every day. Pumps you may have been given upon discharge from the hospital are usually uncomfortable, difficult to use and generally not a good choice. Which makes sense when you consider that these pumps are often given out by formula companies who have a vested interest in seeing that nursing mothers give formula, not pumped breastmilk, to their babies.
Education, perseverance and trust in yourself and the beauty of using your body for what it was intended for, will help ensure that you get off to a good breastfeeding start. Good luck, and enjoy your baby!
