Breastfeeding 101, Again

9-29-08: Week 38


At my latest appointment, the doctor reported I was 40% effaced and 1 cm dilated. This is certainly no guarantee that I will deliver earlier than October 13, but since I delivered early with both Julia and Elise it stands to reason that there could be a chance I see this baby before week 40. In any case, the news put me into the final stage of preparation for the baby's arrival. One important to-do: pay a visit to Anna, my Lactation Consultant, to get some advice and to freshen up my breastfeeding knowledge.

With both Julia and Elise, I experienced some significant challenges. So it was helpful to sit down with Anna this week and discuss how I could avoid the same pitfalls this time around. I left her office armed with a few videos to help me get reacquainted with the nursing process. After watching the videos, and learning from my past mistakes, I feel prepared to get off to a better start this time around.

One possible mistake I made with the girls, was not insisting on immediate skin-to-skin contact with them immediately following their births. Studies have shown that at least an hour of skin-to-skin contact following birth can help a baby latch on to the mother's breast. In Julia's case, the birth was so tiring, I was more than happy to let the nurses tend to her while I took that first hour to recover. So, sadly, I missed out on that special bonding time.

I missed out with Elise, as well, but for different reasons. The labor and delivery floor was especially busy that day. The nurse gently pressured me to let them take Elise down to the nursery shortly after she was born. By the time she was brought to my recovery room, a few hours had elapsed, and Elise was now sleepy and difficult to wake.

That's another thing I've learned: a very sleepy baby does not like to nurse. Anna reminded me to watch for feeding cues. Rapid eye movement is one cue to look out for. REM lets us know that the baby is in a light stage of sleep as opposed to a deep, heavy sleep. The nurses encouraged me to feed every two hours regardless of the girls' readiness. If they were sleeping deeply, I was told to undress them and change their diapers. This technique never worked, and now I know why. This time, I know to look for the correct cues.

The other great thing I learned from Anna was correct positioning. She reminded me about lining up the baby's nose to my nipple. It seems like strange advice, but it works like magic. When a baby opens her mouth, the head tilts back and subsequently the mouth moves into the correct position over the nipple. When I made this change with Julia, it immediately transformed my nursing from painful to comfortable.

Back when I had Julia, I never imagined that breastfeeding could be so difficult. I thought it would be natural and easy. Yet nothing about it felt natural except the instinct to keep with it no matter what. So I did stick with it, and I'm really proud of that. I know I'll stick with it this time around as well. But I'm hoping that the challenges won't be as great. I'm hoping that with a little experience under my belt, some good lactation support, and a little luck, breastfeeding will be everything it can and should be.

Shelley Abreu is a freelance writer living on Cape Cod. She's lucky to live just a short drive from the Healthy Children's Center for Breastfeeding (the largest national provider of lactation management education for health care providers).