From getting off to a stellar start to overcoming problems, we have all the info you need to become a nursing pro.
Breastfeeding has leapt into the lime light lately, along with a big dose of controversy, thanks to a recent U.S. government campaign that treated the issue as a major public-health concern. "You wouldn't take risks before your baby's born. Why start after?" read advertisements put out by the U.S. Department of Health & Human Services.
While the government's campaign may not have been popular with everybody, one point remains undebatable: "Research shows over and over that breastfeeding provides health benefits to babies and their mothers that formula-feeding does not," says Lori Feldman-Winter, M.D., an associate professor of pediatrics at Children's Regional Hospital at Cooper in Camden, N.J., and a member of the American Academy of Pediatrics Executive Committee on Breastfeeding.
Indeed, hundreds of studies have proved the short- and long-term benefits of nursing: It decreases the incidence not only of diarrhea and ear infections, but also of diabetes, obesity, asthma, leukemia, bacterial meningitis, some forms of lymphoma and even sudden infant death syndrome (SIDS). What's more, research has shown that premature babies who are fed breast milk do better on tests of mental development later in childhood than those given formula. These benefits likely apply to full-term babies as well.
There are benefits for mothers, too: Breastfeeding reduces a woman's lifelong risk of developing ovarian and breast cancers, as well as osteoporosis.
3 Keys to Success
To help you get off to a good start with breastfeeding, lactation consultants recommend following a few vital steps:
1. Plan ahead. "You need to prepare," says Mary Lofton, a spokeswoman for La Leche League International. "You wouldn't throw a dinner party without planning the menu, shopping and even preparing dishes ahead of time—think of those first few breastfeeding sessions as the most important dinner party of your and your baby's life." The best way to prepare for this party is by taking a breastfeeding class, either through La Leche League (llli.org) or at a birthing center or hospital.
2. Choose the right hospital. If there's a designated "baby friendly" hospital or birthing center in your area, consider having your baby there. These facilities are certified by the World Health Organization and UNICEF as offering optimal lactation services, with specially trained staff and policies to help ensure breastfeeding success. (For a list of certified facilities and more information, visit babyfriendlyusa.org.) If you don't have a baby-friendly site near you, choose a hospital that has certified lactation consultants on staff.
3. Breastfeed ASAP. Most babies are alert and ready to nurse right after birth but fall into a sleepy period for the next 24 hours or so, which can make it more difficult for them to feed. So let your baby nurse within 30 to 60 minutes of delivery—and be sure to inform the nurses of your intentions before the baby's born. In most hospitals, the medical staff does routine tests and exams, such as measuring the baby's weight and height and administering eye drops, after she's born. "But sometimes they will delay these procedures until after you breastfeed," says Katy Lebbing, a certified lactation consultant in Schaumburg, Ill., and a La Leche League spokeswoman.
If you have a Cesarean section, ask the nurses to bring your baby to you as soon as possible after delivery. They or your partner may need to help you hold the baby due to the effects of your anesthesia, but there is no reason you can't nurse. Also request that your baby be allowed to "room in" with you throughout your hospital stay so you are able to nurse as often as she wants. (This also applies if you had a vaginal delivery.)
Common Problems, Tested Solutions
Just because nursing is natural doesn't mean it's without challenges. Here are three of the most common problems breastfeeding moms face—and simple, proven solutions.
The Problem: You've got pain. You may feel discomfort when your baby starts to nurse, but it should be mild and short-lived. "Feeling tenderness when the baby latches on is normal," says Corky Harvey, M.S., R.N., a lactation consultant and co-owner of The Pump Station stores in Santa Monica and Hollywood, Calif. "But it shouldn't last for more than 20 seconds."
Your breasts aren't the only area where you may feel discomfort: After your baby is born, your uterus starts shrinking back to its prepregnancy size. The accompanying uterine contractions can be painful—and breastfeeding can intensify them. "The baby's sucking stimulates the release of oxytocin, which causes the uterus to contract," explains Lebbing, "but contractions help it return to its normal size more quickly."
The Solution: Remember that a few seconds of discomfort is normal, but shooting pain means something is wrong. If you experience such pain, make sure your baby is latched on correctly (see "How to Get the Right Latch" on pg. 105); if she's not, gently remove her from the breast and start over.
If your breasts become engorged—they're painful and hard to the touch—nursing or pumping frequently should help relieve the discomfort. Also, apply cool compresses or an ice pack. Since engorgement can result from a poor latch, you may need to meet with a lactation consultant to learn the proper technique.
To help reduce uterine pain, you can take acetaminophen or ibuprofen, Lebbing says—both are safe for breastfeeding moms. If you had a C-section, your doctor will give you prescription painkillers. Take them. They won't harm your baby, and if you're in less pain, you'll likely have an easier time breastfeeding.
The Problem: Your baby nurses all the time. Because breast milk is digested more easily than formula, breastfed newborns do need to refuel more often than their formula-fed peers. "Breast milk comes prepackaged with its own digestive enzymes," explains Feldman-Winter, "so the proteins and other nutrients are more readily absorbed by the infant's intestines." This translates to an average of 10 to 12 feedings in 24 hours.
The Solution: Go with the flow. Let your baby set her own meal schedule, and try not to stress about it. "We are a society devoted to efficiency," Feldman-Winter says. "Bottle-feeding may be more efficient, but if you accept that having a baby will change every single thing about your life, you might not worry so much about how often your breastfed baby wants to eat."
There is a common perception that breastfed babies are more "needy," but they are actually wired to eat exactly as much as they require, Feldman-Winter adds. That's one reason they are less likely to become obese later in life. "They learn to self-regulate, rather than drink an entire bottle when it's offered to them whether or not they're hungry," she says.
Some moms also wonder if their baby is nursing because she's hungry or for comfort, but the reason doesn't matter. "Sucking triggers milk production," Harvey explains, "so during the early months, it's important to let your baby suckle as often as she wants, regardless of the reason."
The Problem: You just can't tell if she's getting enough. When a baby feeds from a bottle, it's easy to tell exactly how much she's eating. Not so with the breast.
The Solution: Count wet diapers. "Once your milk comes in, usually three days after birth, your baby should have at least six to eight wet diapers a day," says Lebbing. Most breastfed babies will also have at least two yellow, seedy bowel movements every 24 hours. If you have any concerns, call your pediatrician.