nursing 101

A top lactation consultant offers breastfeeding advice you can really use.

Experts now urge women to nurse their babies for at least one year, because breastfed infants are healthiest. But between sore nipples, engorged breasts and relatives who ask, “Are you still nursing?” it’s not always so easy. Here, one of the country’s best-known lactation consultants, Kathleen Huggins, R.N., M.S., offers reassurance and advice. Huggins is the author of The Nursing Mother’s Companion (The Harvard Common Press, 1995).

How do I get my baby to latch on so that nursing doesn’t hurt my nipples?

Hold your baby with your hand behind his neck and shoulders, not in the crook of your arm. Turn him on his side with his nose facing the nipple, and stimulate his mouth until he opens it all the way; then quickly pull him on. If you do develop sore nipples, pure lanolin can soothe them. I keep hearing about let-down. What is it and what does it feel like?

Let-down is when the milk pushes forward from the back of the breast, where it’s made, to the area below the areola, where it becomes available to the baby. You will notice that your baby starts swallowing rapidly when your milk is letting down, and you may feel thirsty or sleepy. After the first four to six weeks, most mothers will notice a distinct tingly sensation in their breasts when their milk lets down.

I know breastfeeding is important, but isn’t formula OK too?

While babies certainly can thrive on infant formulas, study after study shows that exclusively formula-fed babies simply aren’t as healthy as breastfed babies. Published studies suggest that during infancy, breastfed babies have far fewer infections than do formula-fed babies and that breastfeeding positively affects cognitive development in babies’ first years. Babies who are breastfed also may develop fewer chronic diseases such as diabetes and Crohn’s disease. However, supplementing with an occasional bottle of formula is fine.

How do I know if I can produce enough milk for my baby?

Most women are capable of producing abundant milk for their babies. If your breasts grew during pregnancy, that’s the best predictor that you will have adequate milk production. What’s most important is nursing immediately after your baby is born. The first “milk” is actually colostrum — a high-protein, creamy substance that protects the newborn’s health. Actual milk will appear after about 72 hours. Continuing a healthy milk supply is dependent on draining at least one breast frequently and completely at each feeding. So, if you have a vigorously nursing baby and you breastfeed often, you should have no difficulty keeping up your supply.

To produce enough breast milk, should I drink milk or take calcium?

No. While having plenty of calcium in your diet is a good idea, the milk supply is largely independent of what you eat or drink, except for water.

Are there foods I should not eat or drink while breastfeeding?

Some infants are sensitive to foods in a mother’s diet, particularly, onions, chocolate and citrus fruits. One to four hours after nursing, your baby may become fussy, gassy and fretful. Only 1 percent of caffeine passes into the milk, so very little gets to the baby; however, repeated doses of caffeine throughout the day can cause an infant to be fussy. Alcohol passes into breast milk, and daily drinking by a mother has been linked with developmental problems. However, an occasional drink with meals is probably not harmful. For safety, wait two hours after having a drink before you nurse. Most medications are safe, but avoid frequent use of antihistamines or long-acting cold preparations, and aspirin (take acetaminophen instead). Is there a length of time to breastfeed that is considered too long?

No. Most children will give it up on their own between 2 1/2 and 4 years, and mothers who have allowed their children to breastfeed this long find that they wean on their own and are very secure, happy children. Try not to predetermine the length of time you will breastfeed. Keep an open mind about it.