Thursday, August 4, 2011

So you're thinking about breastfeeding...

, it's really is the best choice. This is just a quick letter, written to pregnant Jane Doe, it is not intended to replace medical advice or be a complete article of information, just a start.

The first thing to do, decide you will breastfeed, not "try to" breastfeed. Medically, a very small % of women cannot physically breastfeed. The reason many woman think they cannot is a lack of support or misinformation.

There are lots of "Booby Traps" out there that make breastfeeding more difficult, nursing in public is one of them. Its really not a big deal, I have never had even the slightest negative response about breastfeeding and I rarely use a cover/blanket. The trick is to wear the right clothes, long, loose tops can drape over baby's head for latching and over baby's nose to cover as much skin as possible. A combo of a nursing tank (access from the top) paired with a tshirt (access from the bottom) gives great coverage. Also, position yourself in a place with less traffic or where the angel is right. I ask for a restaurant table in the  corner away from other diners "in case the baby fussed" so nursing wouldnt be a big deal.




I highly reccommend the My Brestfriend Pillow, makes holding baby a lot easier, and save your back. It's much better than the Boppy because it buckles in place so the baby doesn't slip down.




The best way to ensure success is to educate yourself, take a class, go to LLL meetings, a breastfeeding support group at the hospital or WIC. 

Most moms complain that their nursing relationship was ruined at the beginning. Immediately after birth, have them place baby on your bare chest, let her find her way to your breast. Babies will often do what is called the "breastcrawl" you can google youtube videos to see it, it is amazing. The little bumps around on your areola are called Montgomery glands and the make your nipple smell like amniotic fluid. They also excrete a lubrication that helps prevent dry cracked nipples, its a good idea not to wash your nipples with soap, just rinse off. If you noticed your nipples getting darker throughout pregnancy, its so baby can see them better. Just more evidence that babies are designed to breastfeed and your body is designed to nurture after birth just as it did before.

Absolutely refuse bottles and binkies in the hospital. A sign like this can make sure all nurses and CNA's know your wishes. In the hospital is where many moms make a mistake. They are in love, and afraid of any little thing hurting their baby. They will do anything to protect them. They listen to doctors and nurses, who are not properly educated or supportive of breastfeeding. They may think they don't produce milk because it can take up to a week before your milk "comes in" really though, you have milk, it's a thicker ultra concentrated Colostrum which is super mega perfect chalked full of nutrients and very strong antibodies. It is all your baby needs. Her tummy is the size of a marble, she won't starve. Most babies arent hungry right away anyways, remember, they have never eaten before so they dont think they are missing something. It's normal for newborns to drop about 10% of their weight shortly after birth. Don't worry, most is the meconium, the dark sticky poop that was sitting up in their gut before birth. Just give her time, she will put the weight back on.

Plan to see a lactation consultant while you're still in the hospital, even if things seem fine.
If she loses more than the 10% of her weight and you want to supplement, you should be able to rent a pump at the hospital or from WIC. Don't use a bottle though, use a supplemental nursing system (SNS) a medicine dropper or syringe right at your breast to supplement. This prevents nipple confusion or preference as bottles are much easier to drink from than breast. The nursing motion that gets the milk out is great for oral development.

Understand that the pump is NOT as good at getting milk out as the baby is. I say this for 2 reasons. Moms sometimes pump, dont get much out and then worry that the baby isnt getting enough. A better indicator that the baby is getting enough is by counting wet and poopy diapers. Also, I suggest seeing a lactation consultant a few days and a week after the baby is born. She can weigh the baby before and after feeds to see how much she is getting. The 2nd reason is that if you plan to just pump, realize it is A LOT more work than direct feeding. Moms who pump have to do so about twice as often, as the pump isnt as good at keeping supply up. Milk supply happens on demand, the more milk that is removed from the breast the more milk the breast will make.

After coming home, plan to nurse constantly for like a week or so, it's perfectly normal for baby to need to nurse almost constantly, this sounds daunting, but it is a great excuse to continue to rest, as you both need it. Don't let anyone say "she can't be hungry again" because she very likely is. Breastmilk digests very quickly, within about 2 hours. Nursing on demand (whenever she fusses) helps establish your supply. If a baby gets so hungry that she cries, it will be much harder to get her to latch on correctly. Crying is a late hunger cue, fussing, rooting, turning her mouth to the side, sucking her lip, fingers or anything else at her mouth are earlier hunger signs.

Another Booby Trap is other people wanting to feed baby. They have been conditioned by a society where formula is the norm, and that holding a bottle in a baby's mouth is a beautiful thing. They might suggest pumping, or giving "just 1 bottle". That's a slippery slope as it messes with your supply. It doesnt really "give you a break" when you give pumped bottles because you will likely have to pump twice as long as the baby would nurse. Other people's desires are not more important than your baby's needs. They can snuggle, change diapers, do laundry, bring you the baby, talk or read stories to baby while you nurse and not, bring you food and drink, there are lots of non-feeding ways to help out and to bond. If you experience supply issues for one reason or another, there are herbs and foods you can take to boost supply, there are medications that help also. My new treat is Lactation cookies, they have multiple milk boosting ingredients, and are good for you too!.

Something that has really helped our breastfeeding relationship is cosleeping. This isnt right for everyone, and there are differnt options for different situations. At first I didn't intend on having her in our bed with us, but instead had a bassinet next to my side of the bed, but after having my daughter I learned it was much easier to have her sleep with me. It just felt right to hold her. My husband was concerned with safety, as co-sleeping has gotten negative publicity. It felt right, and safe to me though, so I researched and less than 2% of infant sleeping deaths occur while in a parents' bed. (the rest of them are in cribs and bassinets etc) The info about the danger is usually published by consumer agencies who want you to spend $ on cribs and bassinets! If you're more comfortable, put a bassinet or crib with the side down right next to your bed so you don't have to get up.
My daughter and I get plenty of sleep, she barely wakes up when she needs fed, just squirms and grumbles a bit, I pull out my breast, adjust if necessary and she can eat, often times, we both fall right back to sleep. If she were in a crib in another room or even across the room shed have to fuss quite a bit to wake me up, I'd have to get outta bed, go get her, stay awake while nursing and put her back to bed, then go to my own bed and settle back down. I am a much better mom because I get plenty of sleep, she is very secure and rarely cries.

You will likely get lots of coupons, literature and free samples of formula, before you even have your baby, toss the junk mail in the recycling, and donate formula to a women's shelter or food bank, you won't need it. (if you end up really needing it, you can get a new can, or get WIC. If you get bottles, binkies, formula portioning cups, or anything for bottle feeding at your baby shower, return/exchange them for nursing bras, easy access shirts, bra pads or anything else your baby needs.

You may hear about mastitis or thrush, they are infections that sometimes happen to breastfeeding moms/babies it's nothing to stress over, it doesn't happen as often as you hear about because women who don't get sick don't post questions or complaints about being perfectly healthy. The worry about you getting sick is not reason to not breastfeed because the antibodies only found in breastmilk keep your baby healthy.

About binkies. You might hear that breastfed babies should have a binky because they like to suck for comfort. Yes, the motion of sucking does comfort many babies, not just breastfed babies. At first though, your baby should suckle on you, it is ok, and good for both of you for you to be "a human pacifier" (kind of a backwards phrase really, since breasts came first. it should be the NUK is a "plastic nipple"). Or you may hear that binkies help with their ability to suck, this is only the case of preemie babies. Babies dont only suck, they use their tongue to rub the milk out, sucking is secondary. Giving a binky too soon could mess with your baby's latch and with supply. All of the comfort sucking tells your breasts to make more milk, a very good thing. I didn't want to give my daughter a binky but she was one of those babies who really NEEDS to suck for comfort. She would get frustrated when she would get milk when she wasn't hungry. At 1 month old, we gave her a binky. We didn't have any supply issues so we weren't too concerned, I try to offer my breast whenever possible, until she gets frustrated. Some moms chose a binky because they need to have a break from the baby, and want others to be able to help the baby sooth/fall asleep. This can help save your sanity and help you continues breastfeeding through rough times, like colic or teething. As with anything, get to know your situation before deciding for or against something.

"Is is painful?" No, not in relation to anything else in life. At first, as you are both learning, you might have some nipple pain, this means that something isnt right, this is why seeing a Lactation Consultant is a really good idea. If your tooth hurt, you would see a dentist, if your heart hurt, you would see a cardiologist, etc. Breastfeeding is natural, but so is walking and that usually takes practice and guidance. Grinning and bearing it wont do anyone any good, if the baby's latch isnt right, they may not get enough  milk, or they may swallow air, causing gas & gas pain. Books, classes, youtube videos and blogs can give you images and information on how a correct latch would look, but a lactation consultant can give you one on one help. It is normal and good for you to cramp, like period cramps, for about a week while nursing sometimes. Breastfeeding releases oxytocin, which is the same hormone that triggers contractions in labor, after birth, the cramping is your uterus retracting back to prepregnancy size, this is important because it slows bleeding and helps with recovery. Another thing that might hurt a bit, is "let down" babies nurse fast and hard at first when they latch, this gets the milk flowing, then they slow down when the milk is flowing and have long even draws of milk. You might feel a cramp in your breast, for me, it was the opposite breast, while nursing, it lasts maybe 10 seconds and is no big deal, it just reminded me to make sure that I had a bra pad or wash cloth to absorb leaks. I would occassionally remind myself that this 10 seconds occassionally is much better than washing and sanitizing bottles! Do not worry if you dont feel "let down" some moms don't, that doesnt mean you dont have milk flowing.

Engorgement can hurt too, when your milk "comes in" a few days after birth, your breasts can be very full, this can hurt, it can also be harder for the baby to latch on, imagine latching on to a basket ball. It is not a good idea to pump, pumping + feeding will tell your body to make more milk causing even more supply. The exception is if you are going to have to pump for work shortly after birth, then pump and store the milk in the freezer. To alleviate the engorgement, hand express just enough to soften and then let the baby do the rest, I had to hold my breast into a smaller shape near the nipple so she could get a good latch, it gets better, and not nursing, it would be much worse.

I am not a doctor, I am not a lactation consultant (yet), this was not inteded to be the only place you find information, just a introduction letter. Breastfeeding, for me has been one of the most empowering choices and enjoyable times I have with my daughter. No mom ever regretted breastfeeding, yet many many moms regret NOT breastfeeding, or weaning before time. You CAN breastfeed.

If thinking of nursing your baby full term overwhelms you, check out this article If You Nurse Your Baby
If you love Facebook, find http://www.facebook.com/#!/TheLeakyBoobthere are tons of great moms available for quick questions, deep support or just a high five.
If you think formula is just as good as breastmilk, read this article.

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