Breastfeeding: Tips for a Great Beginning

If you're planning to breastfeed your incoming baby, you are definitely not alone! It is well known by now that breast milk truly is the best thing for your baby, and that anything other than breast milk is, to put it bluntly, inferior and associated with an increase in the risks for various health issues.

And the vast majority of women do initiate breastfeeding immediately after birth. According to the CDC's 2014 Breastfeeding Report Card, which lists statistics for babies born in 2011, 79% of babies born in the United States started breastfeeding. But there are a number of things that can make it hard for a woman to achieve her breastfeeding goals, and the numbers also reflect that: only 49% of babies were still breastfeeding at 6 months, and only 27% at 12 months. And the numbers of babies that were exclusively breastfeeding at 3 and 6 months - meaning they were receiving no supplementation with artificial formula milk - are significantly smaller.

The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months, and breastfeeding supplemented with solids until at least 1 year of age (at least; "Babies should continue to breastfeed... for as long as is mutually desired by the mother and baby."). The World Health Organization recommends exclusive breastfeeding for 6 months and "continued breastfeeding along with appropriate complementary foods up to two years of age or beyond."

Whatever your own breastfeeding goals are, there are ways you can improve your chances of meeting them. Here are some suggestions.

     Educate yourself thoroughly about breastfeeding before your baby is born.
Don't make the common mistake of assuming that breastfeeding will come naturally to you! For some women, it is a very natural and intuitive process, but for many more, initiating breastfeeding is a struggle. But the more you learn about it ahead of time, the more likely you will be to have success. Understand how your body makes milk. Get an idea of what a proper latch looks like, some of the positions you can breastfeed in, and some of the ways you can remedy any discomfort you feel. Consider taking a breastfeeding class, either in person or using a DVD, while you're still pregnant to begin learning. There are also many great books out there on breastfeeding; my favorites are The Womanly Art of Breastfeeding by Diane Wiessinger, Diana West, and Theresa Pitman; and Ina May's Guide to Breastfeeding by Ina May Gaskin.

     Be informed about how medical interventions during/after birth can impact breastfeeding.
The way you give birth can affect breastfeeding. Medical interventions are not necessarily going to be the difference between successful breastfeeding and unsuccessful breastfeeding, but it is still useful and important to know ahead of time how the decisions you make (or are made for you, as the case may be...) might affect the beginning of your breastfeeding relationship. Here are just a few things to think about:

• Receiving IV fluids during labor may artificially inflate your baby's weight prior to giving birth, which in turn may make it seem like baby is "losing too much" during the first days of life, which can lead to suggested supplementation with formula. IV fluids can also cause baby to have neonatal hypoglycemia, which means a stay in the NICU and being separated from mama, which can make early breastfeeding very challenging.
• Receiving an epidural (which necessitates IV fluids, if you weren't given them already as a matter of course) can mean that baby is sleepier at birth, and uninterested in nursing. Epidurals can also affect the levels of certain hormones that are important in breastfeeding.
• If your baby is born via cesarean section, it could affect your start to breastfeeding in a number of ways (although many women have great success nursing after a c-section!), including: longer delay before trying to initiate nursing the first time (although more and more hospitals are actively working to counter this); breastfeeding is more uncomfortable due to the incision (try different breastfeeding positions to counter this one); if the events leading up to the c-section were stressful, mama's milk may take longer to come in; a c-section necessitates both IV fluids and an epidural (see above points); the antibiotics prescribed after a c-section can lead to an overgrowth of yeast, which increases the possibility of thrush.
• If baby is given antibiotic eye ointment after birth, it can blur his vision and irritate his eyes, which can interfere with that crucial early window for mama/baby bonding, and can make it difficult to get started breastfeeding.
• If you choose to circumcise your baby boy, you should be aware that the pain from the procedure can make it much harder for your son to learn how to nurse effectively; after circumcision, it is common for babies to withdraw into themselves for awhile and to completely lose interest in breastfeeding, and a study has shown that pain relievers don't help counter this. Pain disorganizes newborns, and circumcision is extremely, traumatically painful.

     Initiate breastfeeding within a hour of birth if possible.
Everyone who's anyone recommends early initiation of breastfeeding if possible (that is to say, within the first hour after birth). Why? For one thing, this ensures baby gets ample amounts of colostrum, that delightful golden premilk that is so beneficial to newborns. This kind of early breastfeeding usually comes hand-in-hand with skin-to-skin, which helps baby regulate breathing and body temperature, among other benefits. Possibly one of the most important reasons is that during the first few hours of life, baby will likely be very awake and receptive to bonding with mama; take advantage of this alertness and get baby nursing!

     Nurse on demand. Completely.
This is quite possibly the most important idea in this post. Nursing on demand (sometimes called nursing on cue) will have a significant impact on your overall milk supply. To simplify the idea, breastfeeding is all about supply and demand, so if you want your body to produce enough milk to feed your baby, you need to let your baby eat as often as he wants to. Nursing on demand will help your mature milk to come in. Nursing on demand will help reduce and ultimately eliminate early engorgement. Nursing on demand will regulate your supply; your body will adjust the amount you make automatically from day to day based on how often your baby wants to eat. Nursing on demand will help your baby to thrive.

     Build a support network.
Who do you have to support you as you navigate breastfeeding? Make sure your partner is on board, as it's been pretty well-documented that when dad openly disapproves of breastfeeding, mama is more likely to stop sooner. Gather friends to you who breastfeed their own babies, who will not be uncomfortable when you feed your baby in the coffee shop or who can offer advice when you hit a rough patch. Find local breastfeeding support groups, where you can get questions answered, receive advice on the actual physical motions of breastfeeding, and even weigh baby before/after nursing if you're concerned about the amount he's getting. (La Leche League is the most well-known breastfeeding support group, but also check in hospitals, local birth centers, and baby stores, or ask local birth workers [midwives, doulas, childbirth educators] about independent groups.) Make sure you have the contact information of at least one local lactation consultant, preferably an IBCLC.

     Stay hydrated.
Think about it logically for a second: when you are breastfeeding, you are using more liquid, so doesn't it make sense that you probably need to drink more liquid in order to stay hydrated? Being dehydrated might not always directly influence your milk supply, but it can increase feeling of fatigue and stress, and those will definitely decrease the amount of milk you are making. Try to drink at least 4 extra 8-oz glasses of water per day to make sure you're getting enough. Carry a water bottle with you everywhere. Make it a habit to always bring a big glass of water with you when you sit down to nurse.

     Eat healthy foods to support a good milk supply.
Remember how everyone urged you to eat well during pregnancy to support your growing baby? You're not off the hook yet! It is important to keep eating a well-rounded, whole-foods diet while breastfeeding to ensure an ample milk supply. Don't stress out too much about what goes in your mouth, though; if you have a hard time eating anything other than take-out and frozen dinners for awhile in the weeks after birth, chances are good that your milk supply will be fine so long as you're eating enough. If you are concerned about the amount of milk you're making, certain foods have a reputation for being galactagogues (a substance that increases milk supply), including fenugreek (an herbal supplement, and often one of the primary ingredients of lactation teas), oatmeal (and other whole grains), nuts and seeds, papaya, ginger, leafy green veggies, and garlic, among other foods. The important thing is that you are eating plenty of real foods and eating to your appetite.

     Don't worry about losing the baby weight!
Seriously. No matter how eager you are to get back to your prepregnancy body, trying to substantially restrict your calories during the early months of breastfeeding can really damage your milk supply. Breastfeeding burns about 300-500 calories per day; a nursing woman should be taking in 1800-2200 calories (or more, as the case may be) every day. Yes, breastfeeding can help you lose weight. Listen to what your body asks for as far as food goes, eat what you're hungry for, and that weight will start to come off eventually. Remember that it took you nine months to put on that weight, so it'll likely take at least that long before your body gets anywhere near to where it used to be. Trying to lose that weight too quickly could mean your body is not getting enough calories to make the milk your baby needs.

     Get as much rest as you can.
Everyone and their mom will tell you to sleep when the baby sleeps, and while that's good advice in theory, in reality it's probably not likely to actually happen much. There is housework to do, food to cook, and, of course, a baby to hold and snuggle. But to be honest, the housework can probably wait, and hopefully you'll have someone else around to help you get nutritious food. Because you really, really need to get that rest! Try to go to bed at a reasonable hour, since you'll be up several times every night. Try to take at least one nap with baby during the day. And otherwise, spend as much time as possible just sitting and snuggling; even if you aren't sleeping, simply resting is going to do your milk supply some good.

     Try to relax.
While it's unlikely that you'll be in the kind of truly stressful situation that can actually reduce your milk supply, the normal stresses of everyday life and new parenthood may still take their toll. Perhaps one of the most noticeable ways is that when you are feeling stressed, your milk may be slower to let down. So this is where a lot of the other tips above get tied together. The more you know about breastfeeding, the less likely you are to stress over your baby's cluster feedings, or to worry that a normal growth spurt (and the seemingly unusual frequent nursing sessions that come with it) mean that baby suddenly isn't getting enough milk. Having a solid support network means that you'll have people who you can bring your questions to, people who can talk about their own experiences, people who understand what you're going through. Occasional naps during the day mean that you'll be able to handle the nighttime wakings with, if not poise, then at least with some semblance of acceptance.

Remember that you can do this! And by taking steps now to get breastfeeding off to a positive start, you're more likely to be able to achieve your goals.

This post has been shared at the Healthy, Happy, Green, & Natural Party Blog Hop on 3/3/2015.