Breastfeeding {Month by Month}

"A nursing mother and her infant have a special bond, and there is no reason any woman should be in a hurry to give it up." '— corky harvey

For some women, breastfeeding goes smoothly; for others, it can be difficult. That’s when advice from a certified lactation consultant is invaluable. “We help women separate fact from fiction,” says Debi Page Ferrarello, I.B.C.L.C., director of the Breastfeeding Resource Center in Glenside, Pa. “There is so much conflicting advice—our job is to help new moms feel confident.” Even if you haven’t had questions or challenges, chances are you will at some point. Here’s a look at some of the most common concerns.

Month 1} I’ve heard that getting a proper latch is essential for successful breastfeeding. Is it really that important? Yes, it’s that important. If you don’t get a proper latch, your baby may not get enough milk, and you could develop cracked and bleeding nipples. Following are tips from Corky Harvey, a certified lactation consultant and co-owner of the Pump Station in Santa Monica, Calif., on how to get it right: n Position your baby so he is lying on his side, his belly tight against yours. n Prop up the baby with a pillow and hold him up to your breast; don’t lean over toward him. n Place your thumb and fingers around your areola (the dark area surrounding the nipple). n Tilt your baby’s head back slightly and gently touch him with your nipple just above his upper lip. n When his mouth is open wide, “scoop” your breast into his mouth by placing his lower jaw on first, well behind the nipple. n Tilt his head forward, placing his upper jaw deeply on the breast. Make sure he takes the entire nipple and at least 1 1/2 inches of the areola in his mouth.

Month 2} How do I know if my baby is getting enough milk? The best way to tell is by monitoring his weight (your pediatrician will watch it closely, especially for the first few weeks) and his stools: They should be dark and sticky until about 3 days of age, after which they should be “seedy” and mustard-colored. But you also need to pay attention to the number of wet diapers he has. “After the third day of breastfeeding, a well-fed baby will have at least four wet diapers every day, and six to eight daily by seven days,” says Jeanette Panchula, I.B.C.L.C., a member of the International Lactation Consultant Association. “As long as your baby is gaining weight consistently and his diapers show that he is eating enough, you can assume that he’s getting plenty of milk.” If you’re still concerned, schedule a weight check with your pediatrician.

Month 3} I’m going back to my full-time job in a few weeks. What do I need to know about pumping? Now’s the time to tell your employer that you plan to continue breastfeeding. “It will help make things go more smoothly if you can figure out where and when you will pump before you actually get back to work,” Panchula says. You already should have begun pumping, both to get your baby used to taking a bottle and so you’ll have a supply of breast milk stored in the freezer. If you haven’t started, get going! You either can rent a hospital-grade pump (for about $1 a day) or buy an electric pump (expect to spend between $100 and $350). How often you need to pump will depend on your baby’s demands and how long you will be away from him every day. “Some women pump three times a day at the same times their babies would normally nurse,” Panchula says. “But some get away with pumping just once.”

Month 4} Is it OK for me to have a glass of wine yet? An occasional drink—one serving or less of alcohol per day—hasn’t been shown to be harmful to a breastfeeding baby, according to La Leche League International. However, moderate or heavy drinking can have a negative effect on your milk production and on your baby’s weight gain. If you do choose to have an occasional glass of wine, it’s best to drink slowly and on a full stomach.

Month 5} Should my breastfed baby be sleeping through the night yet? First, keep in mind that “sleeping through the night” at this age actually means five or six hours, not eight or nine. Second, every baby is unique. Some will start sleeping through at 3 months; others won’t until much later. “Babies sleep through the night when they’re ready, whether or not they’re breastfed,” Panchula says. That said, because breast milk is digested so completely and more quickly than formula, breastfed babies do tend to eat—and therefore wake— more frequently than formula-fed babies.

Month 6} My baby seems ready for solids. How and when do I introduce them? “Breast milk still is the most important part of your baby’s diet at this age, so breastfeed right before you offer cereal or other food,” Page Ferrarello says. When you do offer solids, start with rice cereal and gradually add a cooked or mashed fruit or vegetable. Be sure to wait three to five days before introducing a different food so you can trace the cause of any allergic reaction.

Month 7} Can I take birth-control pills if I’m breastfeeding? “Yes. But opt for a progestin-only ‘mini-pill,’ since pills containing estrogen can decrease milk supply,” Page Ferrarello says. Depo-Provera (injections given every three months) is another progestin-only contraceptive that is safe to use while breastfeeding.

Month 8} I keep getting clogged milk ducts. What causes them, and what can I do to treat them? “One of the risk factors for clogged ducts is a change in a baby’s feeding pattern,” Page Ferrarello says. “Milk ‘stasis’—when the milk sits in the breast—can cause the ducts to clog, so if your baby is nursing less frequently because he’s eating more solids, your breasts can become overly full.” The best way to treat clogged ducts is by nursing or pumping often from the affected breast, applying warm compresses, and getting plenty of fluids and rest. If you have a fever or flulike symptoms, see your doctor; you may have mastitis, an infection that requires antibiotics.

Month 9} My baby keeps biting me! How can I make him stop? Take him off the breast as soon as he starts to bite, say, “No biting!” and keep him off the breast until the next feeding. Biting usually happens toward the end of a feeding, Page Ferrarello says, so if you can tell that your baby is almost finished nursing, remove him from the breast before he bites.

Month 10} My baby seems uninterested in nursing. Is this normal? “This is completely normal at this age,” Harvey says. “Babies are curious about their world and really start to explore now.” Your baby may be distracted by every noise he hears, which causes him to pull away from the breast; or he may be crawling, in which case he really wants to explore. While this might be a frustrating time for you, it will pass.

Month 11} My baby is eating more solids. How many times a day should he be nursing? “A minimum of four times a day is what we expect,” Harvey says. “A baby this age should be getting about 16 to 20 ounces of breast milk per day.” At the end of the first year, half of a baby’s calories should be coming from breast milk.

Month 12} I’m not sure I’m ready to wean. What are some reasons to breastfeed for longer than a year? There are many reasons to continue nursing, but one of the best is your baby’s health: Breast milk continues not only to protect him from many illnesses, but it also will help him recover more quickly if he does get sick. “As long as your baby is drinking breast milk, he’s getting all the immunological benefits nursing provides,” Harvey says. But there’s more. “A nursing mother and her infant have a special bond, and there is no reason any woman should be in a hurry to give it up," Harvey adds. "As long as she and the baby are happy, there is no reason to wean."