From short nipples to pumping in public, some surprising nursing challenges and how five women overcame them.
Breastfeeding may be nature's way of feeding babies, but not all new mothers and infants take to it naturally. In fact, for many, the whole process is so challenging that it can only be compared to using a computer while riding a unicycle. (Cirque du Soleil's got nothin' on us!) But that's not to say that it can't be done; with a little preparation and a few tricks from a professional, the vast majority of women are able to breastfeed their babies successfully.
Here, we explore different travails encountered by new mothers (the working title of which might be "We Shall Overcome"), followed by expert counsel from Ellen "Binky" Petok, a board-certified lactation consultant and owner of The Pump Connection in Woodland Hills, Calif.
THE PAIN, THE PAIN!
The challenge: Robin Webber never thought that something as natural as breastfeeding could be so painful. But when she gave birth to her twin girls 19 months ago, she found out just how uncomfortable it could be.
"For the first few weeks, I was in tears because it was so painful," says the mother from Omaha, Neb. "My nipples were actually bleeding. I was also exhausted from the constant feeding, so I tried nursing my babies at the same time by holding them like footballs—otherwise, I was up all night feeding them."
Webber put lanolin cream on her nipples to help soothe and heal them. After three weeks, her skin toughened from the intense regimen of breastfeeding two babies, and she was actually able to nurse her twins without weeping. "Despite the initial pain, I'm glad I did everything I could to continue nursing my girls," she says.
What the expert says: Even if you're not nursing twins, it's not unusual to become sore during the initial phases of breastfeeding. "Most nipples haven't gone through the kind of rigorous activity involved in nursing," Petok says. Discomfort usually subsides within five days, when breast tissue "habituates" to an infant's constant feeding, but if it takes longer for the pain to stop, or if your nipples start bleeding, a visit to a lactation consultant is in order.
The best way to prevent nursing pain is to make sure the baby is latched on properly (see How To Breastfeed: Deep Latch Technique). Beyond that, mothers who experience cracking or bleeding should wash their nipples with warm water once daily and pat them dry. "Nipples can become colonized with bacteria, and the little germs in there prolong soreness," Petok says. Once the nipples are dry, apply breast milk to them, followed by glycerin gel pads. Breast pain also can be allayed by holding the baby in different positions while nursing.
The challenge: When Marcy Walsh realized her daughter wasn't able to latch on after birth, the Los Angeles mother visited a lactation consultant. The consultant immediately grabbed Walsh's nipples and announced, "No wonder she isn't latching on! Your nipples are too short!" The consultant advised Walsh to wear nipple shields (silicone "nipples" that are worn over the actual nipple) when nursing until her baby learned how to latch on.
"My kid loved the silicone so much that it took her 17 weeks to latch onto my actual nipple," says Walsh, who pumped for 10 minutes after every feeding to increase her milk supply. "Then one day, I said, 'If you don't latch on, I'm going to try formula,' and bang—she latched on."
What the expert says: While Walsh's use of nipple shields helped her baby nurse successfully, many babies are able to nurse from flat or inverted nipples without shields. Nipple shields can reduce milk flow, as Walsh found, but pumping makes up for the shortfall. And when a baby weans off a nipple shield to the actual nipple, he usually is able to drain milk from the breast more efficiently, which in turn likely increases the mother's milk supply.
As for the fear that a baby will come to favor the stand-in nipple, there's nothing to that. "Parents often ask, 'Will my baby become a nipple-shield junkie?'" Petok says. But she says that in 20 years as a lactation consultant, she has yet to see a baby fail to wean off nipple shields to the breast.
BORN TOO SOON
The challenge: Born five weeks premature, Becca Williams' daughter had difficulty nursing because of her early birth. "I would try to nurse her and she wouldn't wake up," Williams says. "I was sore and engorged." She pumped to relieve the engorgement and applied hot washcloths for the discomfort.
Five weeks later, when Williams' original due date arrived, her daughter was mature enough to nurse—and to stay awake long enough to do so. But the baby wasn't latching on properly, and at her seven-week checkup, the pediatrician determined that she had a tight frenulum, a thin membrane that extends from the floor of the mouth to the underside of the tongue. To correct the problem, he recommended a simple procedure in which the frenulum is clipped by a specialist, after which the baby latched on like a champ. "Once she latched on, she liked nursing so much that she wouldn't quit," Williams says.
What the expert says: This baby's problem was twofold: premature birth and a tight frenulum. Prematurity can make nursing difficult because of a lack of physical development, but this problem usually corrects itself once a baby hits her due date, as it did for Williams' baby. As for the tight frenulum, once a pediatrician or lactation consultant determines the problem, it's easily corrected with a simple (though not always necessary) procedure.
Engorgement and soreness can be a consequence of nursing a baby who is unable to nurse properly, and Williams managed her situation well. The best treatment is to apply heat (warm washcloths, a hot shower or a heating pad will work), then massage the breast while nursing, and follow that with pumping, if necessary, to empty the breast. "If the breast is not drained well, it can cause a backup of milk, which can in turn lead to a breast infection," Petok says. Symptoms are fever, pain and redness in the breast, chills and flu-like aches. If any of these occur, call your doctor immediately.
"I WANT BABA!"
The challenge: When Susan Hayden began breastfeeding her son six years ago, she didn't know she would find the nurturing and bonding that breastfeeding creates so fulfilling. The bedtime nursing, the eye-to-eye contact, the break from the daily chaos were so gratifying that neither Hayden nor her son were motivated to give it up. That is until Mason, then 31¼2, opened up his mother's blouse and weighed in.
"He said, 'Mama, you got a new bra,'" recounts the novelist from Santa Monica, Calif. "He commented on how it was black lace, and I thought, this is just too Freudian for me. The fact that he was able to have a conversation with me about my lingerie made me wonder whether it was time to wean."
Shortly after the lingerie remark, Hayden's son bit her while nursing and she knew it was time. She started by substituting a sippy cup at bedtime. "He asked a few times for Mama's baba, but I told him he was a big boy and didn't need it," Hayden says. "Despite all the stories you hear, it really wasn't that hard."
What the expert says: His lack of resistance shows that Hayden's son was ready to wean. "Many children will eventually wean on their own, but it may not be soon enough for mom," says Petok. She adds that the decision about when to wean is highly individual, though she supports the American Academy of Pediatrics' recommendation to nurse a baby for a year or more.
When a woman is ready to wean, she can start by setting limits on nursing, such as only at certain times and in certain places. She also should not sit down or talk on the phone when a child is acutely interested in nursing, as this is often interpreted as the equivalent of an "Open" sign on a cafe door.
If a child really doesn't want to wean, postpone it for a month or do it more gradually. Or you can adopt the tactic of one mom who had to wean her 2-year-old because of a medication she was taking: She put Band-Aids on her breasts and told her child: "Mommy's nonnies have owies." Guess what? It worked.
"YOU WANT TO DO WHAT?!"
The challenge: When Noelle Hawton returned to her job as a public-relations executive after the birth of her son, she brought along a breast pump in a briefcase carrier, pumped twice a day in her office and stored the milk in the company refrigerator. All went well until her son was 6 months old and she had to travel to a conference where she was meeting three people from regional offices to present a proposal. Hawton and the three colleagues, all men, met in a hotel room to create a presentation.
"The whole time I was working on the presentation, the clock was ticking, my breasts were filling, and I was worrying about how I was going to say what I needed to do," says the mother of two from Minneapolis. "I finally blurted out, 'You guys, I'm a nursing mother, and I need to take care of business.'"
One man offered reassurance by saying that his own children were breastfed. The other two men were apoplectic. Hawton retreated to the bathroom and pumped, all the while sure the whooshing sound was echoing through the walls. "I had to tell myself to relax and not think about those guys—otherwise, I was never going to get any milk out," she says.
All the extra work to breastfeed her son was worth it. "Despite the challenges of working, I nursed my son until he was 1," Hawton says.
What the expert says: "I tell moms that when they're at work, they're in a strange place for pumping, which can make it more difficult to express their milk," Petok says. Women in a formal work environment should create a ritual to help them pump their milk more efficiently: Arrange an official break, drink a glass of water, listen to music, gaze at a photograph of the baby. But the most important thing is that women pump often while at work—preferably at the same times their babies normally nurse.