Breastfeeding No-Problem Nursing
BREASTFEEDING
No-Problem Nursing
When Judy was breastfeeding, her friend Marta got the distinct impression that it was all fairly easy. Apart from slightly sore nipples at first, Judy had no problems--and Marta made up her mind that she, too, would breastfeed her baby when it was born.
But for Marta, things weren't so simple. Her baby fussed and refused to take her nipple. ''Something must be wrong with me,'' a frustrated Marta told her husband.
Not so, according to doctors. Breastfeeding usually is trouble-free, but not always. And mothers shouldn't expect to automatically know what to do. Problems arise, but solutions are easily worked out. What makes breastfeeding easier for you usually makes it easier for your baby as well. So here's some expert advice to make the breastfeeding experience go more smoothly for you and your baby.
Choose a good bra. A good nursing bra simplifies breastfeeding, says Ellen Petok, a certified lactation consultant in Woodland Hills, California, and an instructor at the Lactation Consultant Training Program at the University of California, Los Angeles. But don't go bra-shopping until the end of pregnancy. That's when your breasts are about the same size they will be when you are nursing. Look for a bra that will support your full breasts, with a trap-door flap that you can open with one hand (the other will be holding baby). When you're trying on the bra, make sure it is well-fitting but not tight.
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| When to See the Doctor If you have any concerns that your infant isn't getting adequate milk-if your child seems hungry after finishing nursing, persistently refuses to nurse or doesn't appear to be gaining weight--check immediately with your doctor or a lactation counselor, says Paul M. Fleiss, M.D., a pediatrician, lecturer at the University of California, Los Angeles, School of Public Health, assistant clinical professor of pediatrics at the University of Southern California School of Medicine and an adviser on the board of La Leche League International. It's rare that an infant is unable to tolerate mother's milk or that a mother cannot produce adequate milk for her infant, notes Dr. Fleiss. (Most women can produce enough milk to satisfy even the appetite of twins.) More typically, he says, it's just a matter of refining your breast feeding technique. Or your child could be getting plenty of milk and you don't realize it. ''Mothers who are new at breastfeeding are often nervous about whether their babies are eating enough,'' says Barry Herman, M.D., an obstetrician and gynecologist, director of the Southern California Women's Center in Encino and assistant clinical professor of obstetrics and gynecology at the University of California, Los Angeles, Medical Center. Your child's doctor can put your mind at rest by checking your baby's weight. But if you have a red and tender area on one of your breasts along with flulike symptoms and a fever, you need to see your doctor, says Dr. Herman. Although you can continue to nurse, he says, you may have a breast infection called mastitis. Mastitis is caused by bacteria entering the breast tissues through cracks in the nipples. Once it's diagnosed, your doctor can prescribe antibiotics to treat the infection, and the medication won't affect the quality of your milk. For the sake of your own comfort, however, you may want to encourage your child to drink primarily off the unaffected breast until the infection clears up. |
Don't be passive about pacifiers. If your baby is satisfying his need to suck with a pacifier, you shouldn't be surprised if he's not breastfeeding well. ''If you've noticed that your child seems uninterested, start putting him to the breast instead of giving him a pacifier. Judicious use--or, better yet, no use of a pacifier--may help,'' says Betty Crase, manager of the breastfeeding reference library and database of La Leche League International in Franklin Park, Illinois.
Watch your baby's movements. It's important to note the baby's body and eye movements to gauge if he's hungry, says Crase. For a new mother, you should notice if the baby gnaws on his fingers or turns his head back and forth. These are signs that the baby is interested in eating.
Give him a rub-down. Any skin-to-skin contact helps stimulate the baby. When he's stimulated, it comes out in a tendency to want to suckle, says Crase. Any rubbing of the arms, legs or back will help.
Try the football hold. If you're having trouble getting the baby to latch on to the breast, using the football hold will give you better control of his head, making the latch-on easier, suggests Petok.
Here's how: To feed the baby from your right breast, sit upright on a couch or wide chair and lay the baby on a pillow, facing you, at your side. Hold the lower back of his head with your right hand. Support your breast with your left hand, thumb on top and other fingers beneath the breast. Bring the baby to the breast and tickle his lower lip with your nipple. When he opens his mouth wide, pull him in close so he latches on to the nipple and most of the areola. Adjust the pillow under the baby's backside (with your left hand) to help hold him up while he nurses.
Keep on moving. Vary the positions used at each feeding, suggests Petok. During one feeding you could use the usual cradle hold position, and the next feeding use the football hold. That way, you'll avoid putting pressure on the same parts of your nipples.
Time for a wake-up call. Some newborns are sleepier than others and need to be awakened to nurse. During the day, a newborn shouldn't go more than three hours without feeding, says Petok. To gently wake your baby, you can change her diaper or ''walk up her spine'' with your index and middle finger. If the baby seems awake but not interested in sucking, try letting her suck on your clean finger before putting her to the breast. This should stimulate your baby to become more interested in feeding.
This wake-up routine usually works, but if she is still disinterested, try again a little later.
Express yourself. ''Express a little milk and the baby will smell it,'' says Petok. Better yet, dab a little bit of the expressed milk on the baby's lip to get him more interested in nursing.
Pump or hand express your milk first. It helps mothers to pump or hand express their milk before nursing, in order to make the suckling easier for the baby, says Crase. This encourages the milk to ''let down,'' so as soon as the baby starts to suckle, there's a quantity of milk there. ''This is particularly helpful for babies who have been receiving bottles. If you pump or hand express first, they get that instant gratification with your breasts that they get with the bottle.''
You'll know the milk has ''let down'' when you experience a pins-and-needles sensation or tightening and then relaxation of the breast or even a dull or sharp pain (experienced by some mothers). When you see yourself go from drip to a spray, you're ready to nurse, according to Crase.
Aim for the bull's-eye. ''The most common cause of sore nipples is incorrect positioning of the baby,'' says Dr. Herman.
The trick is to center your nipple in the baby's mouth and to place as much of the areola in the baby's mouth as possible. To encourage your baby to open his mouth wider, tickle his lower lip with your nipple.
''Make sure your fingers are well behind the areola so they're not in the way when the baby latches on,'' suggests Petok.
Straighten out tucked lips. The baby's lips should look like a wide-open fish's mouth on the breast. Make sure the lips are not tucked under or retracted, suggests Petok. That could interfere with his feeding. If the lips are tucked under, gently pull them out with the tip of your finger. That will help the baby maintain a proper latch-on at the breast.
Reduce suction. When your baby is finished nursing, gently break the seal between the nipple and his mouth with your finger before you move the baby away, says Dr. Herman. Otherwise, the pull on the nipple can contribute to soreness or can cause tiny cracks on the nipple, which can lead to infection.
Air-dry your nipples. The soreness women often feel during the early weeks of breastfeeding may be partly due to chapping of the skin because of the constant moisture, says Dr. Fleiss. Allow your nipples to dry in the air, or use a hair dryer set on low heat to dry them before you close the flaps of your nursing bra. If you have a sunny place, expose them to sunlight for a few minutes daily.
Eat garlic. When a mother eats garlic, her breastfeeding baby is likely to benefit, according to Julie A. Mennella, Ph.D., a biopsychologist who is the principal author of a study conducted at the Monell Chemical Senses Center in Philadelphia.
| For Working Mothers: How to Help Your Breastfeeding Baby It's possible to breastfeed your baby successfully even if you work outside the home--with some dedication and preparation. Here are some tips from Ellen Petok, a certified lactation consultant in Woodland Hills, California, and an instructor at the Lactation Consultant Training Program at the University of California, Los Angeles. Prepare the baby for work. Get breastfeeding off to a good start but don't wait too long to introduce the bottle. It's a good time to introduce the bottle at three weeks. This lets Dad feed the baby and gives Mom a chance to practice expressing milk. Try this two or three times a week. If you do not start the bottle early enough, the baby may not be ready to take it when you want to return to work. Learn to express yourself. Before you return to work, practice expressing milk manually or with a breast pump. Once your maternity leave is over, you can express milk in advance and store it for the baby. Nurse whenever you can, and have a caregiver give your child expressed milk when you cannot. Breast milk can be refrigerated for later use. It stays fresh in the refrigerator for 72 hours or for three to four months if stored in a separate-door freezer. It's only good for two weeks if stored in a freezer compartment located within the refrigerator. Previously frozen breast milk thawed in the refrigerator is good for 24 hours. Freshly expressed breast milk in a sealed container can stay unrefrigerated and is still good for 5 to 6 hours. Keep the milk flowing. When you're with your baby before and after work, nurse often to help keep a steady milk supply. At work, pump two or three times a day during a regular 8-hour working day. (Some women can get good results with a hand-operated breast pump--and battery-operated pumps are also available. But Petok recommends a fully electric breast pump, available at some pharmacies and medical supply stores.) |
The Monell study showed that when mothers ate a diet high in garlic several hours before breastfeeding, their babies nursed longer. What's more, the babies tended to ingest more milk--without experiencing any additional cramps or other problems associated with spicy foods.
Apparently, the strong smell of garlic changes the flavor of mother's milk. ''What this may do is help the infant learn what types of food the mother eats,'' says Dr. Mennella.
Skip the beer and wine. Folklore suggests that nursing women who drink beer and wine have an easier time breastfeeding, but that's not supported by research. When a mother drinks alcoholic beverages, it actually causes the baby to ingest less milk, according to Dr. Mennella.
''The alcohol tends to stay in mother's milk as long as it stays in her bloodstream--for two to three hours after drinking,'' she says. If you don't want your infant exposed to alcohol, you can time your nursing,'' she suggests.
Keep baby cool. Be sure your newborn is not too warmly dressed at feeding time. ''If she gets too warm while she's up against your body, she'll get sleepy and may not nurse enough,'' warns Petok.
Prevent engorgement. If your baby is feeding frequently enough (at least every three hours), you may never suffer from breast engorgement, says Petok. If your breasts feel overfull and uncomfortable, however, you can relieve the engorgement by putting hot compresses on your breasts before feeding, then nurse until the baby is satiated. Repeat as often as necessary. Engorgement usually passes within 48 hours, according to Petok.
Avoid infant tooth decay. Nursing throughout the night and letting the baby sleep at the breast can also lead to cavities, warns Donna Oberg, R.D., a registered dietitian and public health nutritionist for the Seattle--King County Department of Public Health in Kent, Washington. When breast milk pools around the baby's teeth and stays there for hours, decay can occur.
That doesn't mean you have to wean the child early, says Oberg. ''But once your baby has teeth, you should not let him sleep at the breast.''
