Mothers have been doing it since the beginning of time. So when breastfeeding doesn’t come naturally, you might blame yourself. Don’t.
“You need to have lots of patience, especially with your first baby,” says Marianne Peck, MD, FACOG, an Ob/Gyn at Memorial Hermann Medical Group The Woodlands. She’s also a mother of five. “It takes lots of practice. And while some babies are good at latching on, others are not. If you can survive the first two weeks, it becomes better,” says Dr. Peck.
Though 81% of new mothers nurse their babies at birth, by six months only 52% are still nursing, reports the U.S. Centers for Disease Control and Prevention.
Most moms said they quit nursing before they expected or hoped. After all, American Academy of Pediatrics’ recommends that babies be fed exclusively breast milk for their first six months of life.
“That’s when breastfeeding has been shown to have the most benefits, by reducing infections and respiratory illnesses in babies,” Dr. Peck says. “Then you can introduce other foods to their diet. But you’re no worse a parent if you supplement nursing with formula.”
At a time when your world may be upended by a precious delivery, you may feel inadequate or fear being shamed or judged for breastfeeding difficulties.
To make the process less stressful, Dr. Peck shares her personal and professional tactics, tips and reassurance as she responds to some commonly asked questions.
Q. My day-old newborn barely nurses. My milk looks weird. Is that normal or am I doing something wrong?
No need to fret: The mammary gland’s first secretion is yellow and watery, Dr. Peck says. “It’s called colostrum and still is nutritious and rich in disease-fighting antibodies.”
As for quantity, “On day one, infants’ tummies are the size of a little hazelnut or cherry so they won’t drink much,” Says Dr. Peck.
By day two or three, mom’s milk becomes white and your newborn’s tummy starts to expand.
Still, it’s tough to gauge how much milk you’re producing, she notes. “But babies give clues. When they’re hungry, they lick their fists and fingers or bob their heads looking for your nipple,” adds Dr. Peck. “ A satiated infant is relaxed, calm and drowsy after nursing.”
Most newborns drop a few ounces in weight after their arrival, but return to their birth weight by day 10.
“You don’t have to be concerned unless the baby’s urine is dark yellow, which signals dehydration,” she says. “At that point, contact your physician or a lactation consultant and have your baby weighed.”
Q. Is it normal for nursing to hurt?
Yes. Engorged breasts can be painful in themselves, as can your little one’s latching onto the nipple.
“For the mother it’s like the first time you work out a muscle,” Dr. Peck says. Petroleum jelly or lanolin cream can moisten and thwart cracking of the nipple skin. “Usually the discomfort is done within the first two weeks. And with subsequent pregnancies, breasts have become accustomed and don’t hurt as much.”
If nursing is too painful, you can express your milk with an electric breast pump. “If that hurts, adjust the pump’s pressure,” she suggests.
Q. I’m not producing enough milk. What can I do?
According to Dr. Peck, you can cut calories after childbirth, but don’t overdo it.“If you’re not getting enough calories to support your own body’s needs, you won’t produce as much milk, as the needed calories are diverted elsewhere,” she says.
You also can pump up milk volume by emptying breasts fully when nursing or pumping regularly.
“Breast pumps are the best friend of the mom who wants to work,” says Dr. Peck, who pumps on the way to the office and back, and every four hours in between. The rub: You’re hooked up to a machine rather than cradling a cute, cuddly baby, which would activate your milk glands.
Massaging them or hearing the baby cry primes your mammaries.
“When you don’t have your baby around, watch cute videos of him or her,” she says. “That’s my trick to stimulate milk production.”
Q. I’m small-breasted. Will I be able to feed my baby enough?
Size doesn’t matter. Milk is produced in cell clusters called alveoli and then travels via ducts to nipples. The surrounding adipose, or fatty, tissue is irrelevant.
Q. Do I have to nurse every two hours?
Most likely your baby will need feeding every 2 to 4 hours during the first week. After that, babies get on a schedule and have growing tummies, allowing gaps as long as 6 to 8 hours by the sixth week. “As more milk is produced and babies latch on better, the less often you have to nurse,” Dr. Peck explains.
Q. Do I have to give up spicy foods?
It’s fine to eat spicy foods,” Dr. Peck says. “They may change the scent of milk, but the sugar, protein and antibodies within all stay the same as long as you eat enough calories.”
Q. I'm sick. Should I stop nursing?
That’s all the more reason to nurse, she says. “Your body makes even more antibodies, and they’ll be present in breast milk, protecting your baby from your illness.”
Q. I take prescription drugs and crave a glass of wine. Are they safe for my baby?
“Alcohol does get into breast milk so you want to avoid it and any recreational drugs,” she says. “If you take prescription drugs, make sure your doctor knows you’re nursing.”
Q. I've got implants. Does that mean I shouldn't nurse?
Implants placed beneath muscle usually are fine. “If nerves around the nipple are damaged, you might still produce milk but it may not be able to make its way out of your nipples. “Unless implants rupture, they don’t harm the quality or safety of breast milk.”
Q. Will my breast sag more if I nurse?
Just going through pregnancy can cause breasts to swell, in part from weight gained and possibly from heavy milk production. The stretched tissues may not return to their original shape.
Q. When should I stop nursing?
That’s your choice, Dr. Peck says. By baby’s first birthday, he or she should be eating mostly solids and many moms switch from breast milk to nutritious alternatives. “Breast milk remains a healthy drink that’s easily accessible,” adds Dr. Peck.
Q. Why is nursing urged by the American Academy of Pediatrics and others?
According to Dr. Peck, nursing reaps health benefits for mother and child. Infants are able to digest human milk better than formula. The antibodies within cut risk of diarrhea, ear infections and respiratory ailments – even when supplemented with formula. “Any amount of breast milk can help reduce the incidence of Sudden Infant Death Syndrome,” she says.
Breast feeding also slashes moms’ risk of breast and ovarian cancers, type 2 diabetes and heart disease. The release of the hormone oxytocin helps the uterus return to normal size faster, which reduces bleeding post-partum.
“It’s an awesome bonding for mom and baby,” says Dr. Peck of breastfeeding and breast-pumping alike. “And knowing you’re doing something nice for your baby even when you’re away is a nice feeling, too.”
