Breastfeeding on the Brain

Just last week I received two separate emails from pregnant readers asking about breastfeeding.  And since it is the last day of August which is “breastfeeding awareness month” I figured it’s a good time to do a breastfeeding post!

Fiona wrote:

I was wondering if it would be possible for you to post a blog about breast feeding.  All the ins and outs: how to do it, how often, what to do when it hurts, how to manage milk supply when expressing, what to expect in the first few hours, days, weeks and months, to feed on demand or by schedule.  Answers to all these questions from someone with experience would be very helpful to me, and I am sure, other expectant mummies out there who read your blog.

The topics that Fiona asks about are pretty big ones, too big to fit into one blog post, so I’m going to do my top 5 breastfeeding tips and ask any of you experienced breastfeeding mommies to add your own in the comments!

Trying to nurse a baby with a bili blanket on and a splint to keep his IV in place was challenging!

Trying to nurse a baby with a bili blanket on and a splint to keep his IV in place was challenging!

1)  I don’t care what anyone tells you, breastfeeding HURTS in the beginning!!!! I never wrote about my mini melt down in the hospital, I was too exhausted to do an in depth post about it at the time, but let me relay it to you now.

I delivered at Phelps,  a fairly progressive hospital as far as rooming in, breastfeeding, natural birth etc, which is why I chose to deliver there. I also knew that they had lactation consultants on staff.  I requested that one come visit with us as soon as possible after Jasper’s birth  ( Here’s another thing about breastfeeding that most people don’t tell you: Just holding your baby and getting them latched on at first is incredibly awkward, be prepared to feel like you have two left hands!) The lactation consultant asked me if it hurt when he latched, to which I answered quite honestly “yes!”

Without even examining our latch she proclaimed “I don’t look, I go by what you are telling me you are feeling. If it hurts, you aren’t doing it right.” So she attempted to assist me in getting him to latch deeper, differently all the while with Jasper screaming every time we unlatched him.

Up until that point I had been feeling fairly confident, even though things weren’t particularly “comfortable” in that area, I wasn’t bleeding, didn’t have any cracked nipples, infections or any other major hurdles.  But that brief visit with the hospital lactation consultant completely undermined what little confidence I had and threw me into a complete panic.. I’m doing it wrong! How do I do it right? If I don’t get it right I’m going to end up with cracked and bleeding nipples which will effect my supply, and then I’m going to have to pump and botttle feed, and then Jasper will get nipple confusion and then OH MY GOD THIS ISN’T GOING TO WORK!

It was in this state of mind that I hobbled down to the nursing station the following (last) day of our hospital stay to request another meeting with the lactation consultant.

“She’s not here” they told me.

“What do you mean she’s not here?” I asked. “Do you mean she’s not here but she’s on call and will come in if I need her?”

“No, she has the day off and there’s no lactation consultant in the hospital today” they explained, as if it was no big deal.

At this point I began bawling… all of the stress of the delivery, the pain I was in, the lack of sleep, the sadness at having Jasper in a little incubator with the bili lights intstead of rooming in with us, the leads and wires connected to his little body, the screaming baby that wouldn’t stop that shared the special care nursery with him.. it all just came out:  “How can there be no lactation consultant? That’s one of the reasons I CHOSE this hospital in the firstplace” I wailed.

Jasper's Birth 031

Jasper under the bili lights in the special care nursery

Later that night, our favorite night nurse was on duty in the special care nursery.  She saw the tears in my eyes while I was trying to feed Jasper (which was further complicated by the wires and bili blanket they insisted he wear even while I fed him) and asked me what was wrong. When I told her that I was worried my latch was wrong because it hurt, she looked me straight in the eye and put her hand over mine and said “I don’t care what anyone tells you, I breastfed six children and IT HURTS!”.

I can’t even tell you the relief this statement brought me.. it wasn’t the pain I couldn’t deal with, it was the uncertainty and anxiety that I was doing something wrong that would lead to big problems later.  After that moment, I felt so much more confident and relaxed and to this day I get annoyed thinking about that first lactation consultant who was so unhelpful.

When I later found my own lactation consultant a few weeks later when Jasper started screaming at the breast (which we later found out was from reflux) she couldn’t believe that the hospital LC said that!  She also examined Jasper extremely thoroughly and discovered his posterior tongue tie and high palate as well as his labial tongue tie (which caused his upper lip to never flange correctly.)  These things SHOULD have been discovered in the hospital by the lactation consultant there. Which brings me to my next point:

2) Make an initial appointment with your own lactation consultant early on. I can’t stress this enough. Even if everything is going well for you in the beginning, I believe it is critically important to establish a first time visit and a relationship with someone you can call in an emergency.  Because you know what? Breastfeeding is not ONLY hard in the beginning!

There will be later challenges too, things like nursing strikes, thrush, mastitis, clogged ducts, low supply and any number of things that I’ve called our lactation consultant about in a panic. Things that were pretty urgent that I wouldn’t have wanted to wait a few days to get seen as a new patient, things that I could call and ask her about immediately.  If you can find a LC that is also a registered health care worker she may even be covered by your insurance like mine is.  And even better if she has proscribing power!

3) Use Medela Lanolin, not Lansinoh Lanolin! It’s so much easier to spread which is a life saver on tender nipples.

4) Generously apply lanolin to your nipples before you pump! I haven’t used lanolin on my nipples for anything but this in probably 10 months, but I NEVER attempt to pump without it – it really reduces the friction between the plastic and your delicate skin

5) Be prepared! Read as many books as you can, attend classes, La Leche League meetings and anything else you can do to raise your awareness of what is and is not normal to expect.  Just having read that it is extremely rare for a baby to self wean kept me going when Jasper started really rejecting the breast around the time he started teething.  If I hadn’t known that,  I may have stopped trying and started giving him bottles instead which would have probably meant the end of our nursing relationship.

6) Yes I know I said there would only be 5 but this is too important to leave out: Make sure you don’t try introducing the bottle too late! I read in several very pro breastfeeding books that you should wait as long as 6 or 10 weeks so as not to cause nipple confusion.. for babies that take well to the breast this can be much too long. In fact my pediatrician recommended NO LATER than 4 weeks.   You don’t want to be in the situation where you can not leave your baby with any one else.

OK, now that I’ve written my own book, here are the books I had in my library that have great breastfeeding information.

And the two best websites for breastfeeding information – the forums are great for asking questions and getting support:

Breastfeeding mommies, please add your tips and advice for our expectant moms!

PS:  expectant moms, you may want to read this old post .  It has a list of some of the things we couldn’t live without those first few weeks. – #6 includes a link to a handy spreadsheet that you can download to keep track of baby’s feedings & diaper changes!

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Rebecca says:

I am a pediatric nurse so I went into pregnancy thinking, “how hard can breastfeeding be?” Wow! I was certainly in for a big surprise! I had a very difficult time breastfeeding my son in the beginning. My milk didn’t come in for 5 days so I did end up giving H some formula along with pumped breast milk using a small feeding tube that I taped to my breast. Those were long days and nights, and I am so thankful that my husband was sitting with me and encouraging me at 3am or I certainly would have given up. H’s milk protein allergy further hampered breastfeeding until I went dairy and soy free at 8 weeks. The following are just a few things I think are important for breastfeeding.
1. Support-I was so happy to read from some of you that you had no problems breastfeeding! I wish I had been one of you! However, for many, it poses an immense challenge. Part of this challenge is that you are suffering from intense exhaustion! I think it is extremely important to have people around you who are supportive of breastfeeding. Your mom, a girlfriend, this website (it has been an huge resource to me on many different topics), a LC and/or your husband/boyfriend/partner. Mothering magazine is a great publication that is incredibly supportive of breastfeeding, and the Le Leche Meetings I have attended have been wonderful. The Medela website (medelabreastfeedingus.com) also offers chat boards to reference.
2. Comfort-I highly recommend spending some time thinking about your nursing space. In the first month or two, you may be spending 6 to 7 hours per day nursing and you need a comfortable place to do this. Make sure that whatever you will be sitting in is comfortable and has a high back that supports your shoulders and neck. (I did not get a glider and I was very sorry that I didn’t!) I would also recommend a short stool (or you can use a phonebook) to prop your feet on. I never had much luck with the boppy pillow, I used the breast friend pillow and I loved it! Keep water, snacks, computer, phone and/or reading materials within easy reach. When your baby gets a little older, the mommy necklace (mommynecklaces.com) that Ariana (thank you!!) featured is an absolute necessity!
3. I, too, found nursing to be very painful in the first 3-4 weeks. I knew it was not in relation to H’s latch because the pain went away after the first minute or two. I used the Earth Mama Angel Baby nipple butter and Ameda Comfort Gel nipple pads that I kept in the fridge. I live in Target nursing tank tops, although, I have heard they aren’t supportive enough for larger chested women (I was a large B small C).
4. I breastfeed on demand. In the beginning, that meant every 2 hours day and night. Somewhere around 3 to 4 months, H went to nursing every three hours during the day and would sleep 3 to 6 hour stretches at night. Now, at 8 months, H still nurses every 3 hours during the day, but it only takes him 5 to 10 minutes and he sometimes wakes one time overnight to nurse. As Ariana suggested, kellymom.com is a must read website as well as the book the Nursing Mother’s Companion by Kathleen Huggins.
5. Is my baby getting enough? -This is such a common stressor for all nursing moms. I am a bit on the “Type A” side so I literally drive myself crazy wondering how many ounces H is taking in when he breastfeeds especially since he has never really taken well to a bottle. He has never had any more than 4 ounces in a bottle and usually it is only 2 or 3. Adequate weight gain of approximately 1 ounce per day and 6-8 wet and dirty diapers are your best indicators that your baby is receiving enough breast milk.
6. Pumping-I pumped a lot in the first month because I was worried about my supply. I have a Medela FreeStyle pump that I love, which I got from addalittlelove.com for $100 cheaper than babiesrus. In order to boost my supply, I would pump for 10 to 15 minutes after H nursed. I also eat oatmeal every day and drink mother’s milk tea. I took Fenugreek capsules for a few weeks in the beginning as well with great success. I also have always pumped one additional time during the day in order to stock pile milk in the freezer and have some on hand to mix in with cereals. Currently, I do this at 10pm but there was a time that I had to do it at 2am. You just have to experiment and found out what works best for you. I would also suggest freezing in relatively small quantities. I usually freeze 2 ounces at a time to cut down on waste.
Thanks for reading my long-winded post. Much love and luck to all of you who choose to take this journey, as it has been an incredibly important part of my relationship with my son. Be good to yourselves!

Katie says:

My baby is 14 months and I would agree with everything you said here. It friggin’ hurts…bad, at first. My husband would let me grab his arm and squeeze it as hard as I could during the latch. He said it made him feel better that he could take some of the pain away from me :)

Jane says:

If you’re returning to work, I recommend reading The Milk Memos. A very encouraging read on a not-so-fun topic: Pumping.

erin says:

And yes, please, a discussion on bf’ing and returning to work would be appreciated! I just went back yesterday. :(

erin says:

Oh… Ariana, can I just say, THANK YOU for sharing your struggles/successes with Jasper and bf’ing? I’ve been a loyal (if somewhat quiet) reader since just before he was born, and very soon after that I found out I was pregnant. I’ve enjoyed “watching” Jasper grow up, and when Hannah was born in May I discovered I had an oversupply and very active letdown as well. Most of the mothers in my mommy group worry about not having enough, and my mother said she did not have enough with me, so it was something of a concern beforehand for me. Lo and behold, I was not “the strange one” who had oversupply/overactive letdown! At the moment we generally have things under control, but it was/is really nice knowing that someone else has dealt with the same issues I have.

And as I said before, if you can, donate!

Dee B says:

It was interesting and informative reading everyones comment. I am mother of a 7 month baby girl born at the same hospital as Ariana’s Jasper. I was totally unprepared regarding what to do after you have a baby. Infact I had not ready any baby books and didnt goto any of the prenatal/lactation classes. So, it was very difficult for me to figure out what I had to do. The LC who was supposed to visit me, showed up for just 5 mins and left without even explaining what I shld be doing. And also I had no idea that my baby had mild jaundice, neither the doc nor the nurse ever told us. And my baby would frequently cry if I removed her from the nipple and I had no idea whether she was getting enough colostrum! It was very frustrating for me and my milk didnt come in until the 4th day and the pedi said I shldnt stress myself out and give the baby some formula bcoz she was loosing weight. So, my MIL who was with me was stressed out that baby lost wt and I was even more stressed out with all this. I ended up crying after the pedi’s visit not knowing which direction to go. Also I had no idea abt Lanolin and ended up with cracked nipples for the first 3 weeks! But by God’s grace, once the milk started coming on the 4th day, it got better. I havent had the need to use Lanolin after the first month and I am still BFing my lil one along with some solids. However I had to deal with overactive letdown and my clothes getting soaked in the middle of the nite for the first 4 months! Also I agree with introducing the bottle earlier, I waited until she was 2.5months old and she refused to take it. She eventually got around to it but it was quite challenging. So if you plan to get back to work, please make sure you introduce the bottle early enough to avoid any problems. But I am glad I stuck with BFing inspite of the ignorance and the challenges. I think its very important to have a support system becoz it can get frustrating that you almost want to give it up. Thanks Ariana for posting this blog

Kristina says:

I love this post, I’m a little late to the game, but wanted to throw in my two cents about dealing with BFing once you go back to work (if you do). I really had no problems BFing, it hurt at first, but all was well after about a week. When I got ready to go back to work I pumped a lot to build up a reserve, but once I started working, the reserve got used up FAST. Once at work I was pumping three times a day, and even though I never had any problems with supply before, I just wasn’t getting enough during my pumping sessions to feed the little guy the next day. I found myself pumping first thing in the morning (after the morning feed), pumping at work, pumping as soon as I got home and pumping after he went down to bed at night. It was exhausting, it hurt, and it was still barely enough – I was racing home to feed him every night. It was really really hard and I felt like a complete failure. I finally gave in and decided that we should buy some formula to supplement in case there wasn’t enough breast milk on a given day. We feed him formula probably once every couple of days and it has made all the difference in the world for me. I think that I was stressing out so much about having enough breast milk for him that I was not producing as much as I normally would, once I relaxed and let go of my all consuming desire to feed him nothing but breast milk, my supply got better, and now we usually have enough breast milk everyday. So I guess my advice is don’t underestimate how your own stresses and anxieties can effect how the breastfeeding goes. I know how hard it is to try to take it all in stride (particularly when you are sleep deprived and hormonal), but it is so important to keep everything in perspective. Is it ideal for me to have to feed my son formula every few days? No. Does it still make me feel some mom guilt every now and then? Absolutely. Is it having a lasting effect on the health and well-being of my baby? No way! Take it easy on yourselves.

Dawn says:

Know that it might not work out. With my first child I was hell bent on breastfeeding. I never considered it might not work. It had to work. I won’t get into it, but it didn’t. I was so depressed for being such a failure that my spiral into post partum was on the fast track. Completely unrelated to my child’s allergies and why I stopped – I also hated it. It hurt, I was uncomfortable, I was so unsure and confused. I expected it to be natural and easy and beautiful and with my son it was none of those things. BUT with my daughter – it was all of those things. She was an amazing nurser. She knew what to do, how to do it, she was a champ and it was such a different experience. Unfortunately she had even more severe allergies than my son and both were eventually bottle fed but, you know what – they’re growing just fine. I really beat myself up over not being able to nurse them, and this can happen for a number of reasons. It may not be popular to admit defeat but if you need to, know that it doesn’t mean you love them any less. Best of luck!

Judy N says:

Ok…so not to be contrary, but really, I think the fear of pain discourages a lot of moms from BFing. I can honestly say, I have never felt any pain with breastfeeding. I know I’m lucky, but I have never even felt discomfort with BFing. I bought tubes and tubes of the Medela nipple cream, and NEVER even had to think about using it. I had a handpump early on…and THAT HURT! I used a hospital grade pump when I got back to work, and there was some discomfort using that initially, but after a couple weeks, I guess I got used to it. So, if you’re afraid of BFing just because of pain…know that I guess some people honestly don’t feel any. My son’s 10 months, and we’re still going strong…teeth and all…we’re still good.

I do totally echo the introducing a bottle thing. Introduce it early AS LONG AS BREASTFEEDING IS ESTABLISHED WELL!! But, I think you have to do a bottle fairly often. Maybe once a day if you can? We started a bottle at about 4 weeks…and he got it about 1-2 times a WEEK. By about three months of age…when he was smart enough to know the difference…he started to REFUSE the bottle. And I started work 2 weeks later. To this date…he will only play with the bottle and MAYBE take about an ounce…otherwise, he’ll wait for me to come home. :)\

The other thing I’ll say is…trust your instincts! Read a ton, but don’t think that any one book or piece of advice is going to work EXACTLY the same for you. If your baby is growing and pooping and peeing…be glad, all is right in the world.

Jennilynn says:

I’m coming in a little late here, but oh well!

I was in a lot of pain as well, started cracking, and with the 3 week growth spurt (nursing for about 8 hours straight one night) I thought I was going to give up.

But I wanted to add, that as much as I am in favor of nursing and breast milk- new moms, please don’t convince yourself that formula is poison. I was completely against giving my son formula, and when it was medically necessary while we were in the hospital (with horrible jaundice and my nursing & pumping still wasn’t making him poop) I FREAKED OUT. It is not worth the added stress if it is something you must do… because when you are crazy emotional in general, and even more emotional because your baby is needing a little (or a lot) of extra attention, you REALLY don’t want added stress.

With that said, I do think EVERYONE should try it for more than a couple weeks before giving up- I can’t even imagine how much I would regret it if I gave up when I was thinking about it. Rowan has not had formula since he was about 3 weeks old and I have a little bit of an over supply!

I also wanted to add-for those still pregnant mommies- that if your baby IS being watched for how much s/he is eating and the nurses are pushing you around a bit (I had one of those), but you are completely sick of pumping and don’t want to give formula, have your nurse weigh baby before and then after a feeding. This saved my sanity! It took a VERY strong conversation with my night-time nurse to get her to tell me this is what they have done in the past and it works. She wanted the easy way out.

Ariana- how about a convo. on pumping and returning to work?? I just went back last week!

Jen says:

Nothing new to add… just wanted to say a big ditto! I absolutely love breastfeeding now, but yes, it hurt like hell, and no, it was not at all smooth at the start. And yes, the hospital nurses tried to convince me to start formula because it wasn’t going smoothly THE SECOND DAY. And my chunker only lost 5% at his lowest. Good grief. I can only imagine what pressure they put on those who have kids who drop closer to the 10% mark.

I think posts and comments like these should be required reading for all new moms planning on breastfeeding. If it wasn’t for friends and blogs, I’m sure i would have given up, thinking I was doing something terribly wrong.

Kimberly says:

Just a quick note to those who have mentioned “friction” issues, and pain while pumping… if there’s friction that’s a good indication that you may need to get larger diameter breastshields… the pumps come with the standard size, 24mm, but the personal fit system has sizes in 21mm, 27mm, 30mm, and 36mm, and even glass shields in 40mm. Here’s a link from the Medela website. I hope this helps some of you!

http://www.medelabreastfeedingus.com/assets/File/PersonalFit%20Sizing%20Image.pdf

mandoo says:

Breastfeeding has been a challenge for us from the start: latch issues, possible (turned out to be negative) tongue tie, pumping woes (friction, need I say more?), we finally ended up pumping and nursing twice a day for about 15-20 oz of breastmilk and formula supplementation. We’ve done that for the past 6 weeks or so and this week, mastitis struck!

My little guy is 11 weeks on Wednesday and I am seriously thinking about quitting and turning to straight formula once I kick the mastitis. But, knowing me, we’ll probably try to continue on as best as we can… and so, the only suggestion I have to any one who is having breastfeeding troubles is to set a goal for two weeks out, then, when you survive that two weeks, go for another two weeks, repeat. That’s what we’ve done and it’s the only way I’ve managed to get this far and probably the only way we’ll manage to keep going!

Kelsey says:

I would like to echo Cat (#31)–“Unbuttoned” is an EXCELLENT book as it helped me process the emotional aspects of breastfeeding and the joys and challenges that accompany the experience. It offers many perspectives – single women, married women, new moms and moms of many, those who breastfed and those who chose not to, adoptive moms and biological moms… the list goes on. The book helped me and helped me understand the women who don’t share my same perspective. Please read it–you won’t be sorry!

Allison says:

I had a very positive experience with breastfeeding. My son had a great latch and I can honestly say I had no pain the first 3 weeks. No cracking, no bleeding, nothing. Around 3 weeks I started to get a piercing pain in my left breast when he nursed. I just chalked it up to “this is the pain that everyone says happens”. Then it was in my right breast. One week of excruciating pain, I finally called an LC. Turned out, we had thrush. Oh the pain! I wouldnt wish it on anyone. I wish I had reached out for help sooner when I first felt it. So my advice, call you LC or your GYN for anything! Dont be too proud to ask for help.

Cat says:

Let me recommend another book, Unbuttoned. It’s realistic breastfeeding stories. I LOVED it. Stories from women who’ve been through everything, including the inability to nurse.

http://www.amazon.com/gp/product/155832397X?ie=UTF8&tag=youoldcro-20&linkCode=as2&camp=1789&creative=390957&creativeASIN=155832397X

Justina says:

Hi Ariana,
I’ve been following your blog for awhile now and have really benefitted from all your tips and all! Thanks so much! :) My two-cents worth for breastfeeding (aside from agreeing with everything you mentioned!):

1. Have a goal in mind on how long you intend to breastfeed, which will help you to hang in there if there are difficulties. I had bleeding nipples the first week and it was super painful to latch, and similarly people kept telling me it wasn’t supposed to hurt. After surviving mastitis, thrush, milk blisters and a biting baby, I’m still glad I’ve stuck to BFing all the way…

2. Might want to have a few things at hand: Fenugreek which helps to increase milk supply if necessary (it was a lifesaver for me, esp when my supply suddenly dropped after 4 mths), ponstan (mefenamic acid) which is a painkiller, it also seems to clear up inflamed blocked ducts in my case, and a tin of formula, just in case, for the first few days.

3. Get a good electric double pump if you intend to go back to work, single pumps are too slow and manual pumps are really too troublesome!

4. Get a nursing cover which will allow you to BF in public, it really helps so that you don’t need to always run around the shopping centre looking for a nursing room when baby is hungry!

gwen says:

oh how i wish i would of asked you the same questions 3 months ago! i wont go into detail about my failure at breast feeding and how i almost drove my car over a cliff with frustration and was so consumed with trying to BF that i missed the first weeks of my sons life. it is important for any new mom to not be so hard on yourself. between not getting any sleep and the pain of delivering(or in my case having a traumatic c-section)you really need to just trust yourself. also, let the the nurses know that you do not want your baby having a paci or formula if you do happen to be put under and dont come out of it for quite a few hours (3 hours for me!). also know that babys are not born hungry, they dont have the concept (so i learned 2 weeks later)and the colostrum, they only need a tiny bit to get fill them up! (i was not told this and was pumping and pumping and freaking out that i wasnt getting “anything”). before you ask, yes i had a lc as a matter of fact i had 3 highly recommended LC’s and every one was hard on me. my little guy lost almost 15% of his body weight at the first week check up and no one NO one bothered to see if he was tongue tied (he was quite bad)so we got that fixed but by that time it was to late and he wasnt gaining so i had to supplement and there was no going back from there. i still latch him on and pump but its not the same. wow this is longer than i wished, just remember that you know best even if you think you dont and the most important thing is that your baby is thriving! this isnt about you its about the well-being of your baby and the SNS is a bunch of BS!

Ava says:

Oh, I will agree with your LC experience. The very first LC that came to our bedside was horrible — she latched G on and just left, no explanation, nothing. I had taken classes before but it’s one thing to hear the “theory” behind breastfeeding and another thing to “live” it. You never really know what it’s like until you try to do it. It’s like swimming — you see it, it makes sense watching until you have to float yourself.
It wasn’t until a kind nurse came by and spent a good 30 minutes with me, getting G to be in the right position (yes this matters). All of a sudden he stopped latching on my nipple and our nursing relationship was a TON better.

Please seek the advice of more than one LC. Even if the one you saw you think is good, see another one. Then talk to one again a few weeks after you go home.

Tip wise:
* wear loose clothing around your breasts. Tight shirts/improperly sized bras can cause blocked ducks which are painful
* get a comfy nursing pillow. I LOVE the double blessings twin pillow (http://www.amazon.com/Twins-Feeding-Pillow-Soft-Denim/dp/B000QX0DGW/ref=sr_1_2?ie=UTF8&s=baby-products&qid=1251778176&sr=8-2) even for a single baby. Having hands free is SO life-changing. After week or two, you realize you spend so much time nursing, it’s nice to be able to hold a book, or do SOMETHING…

That’s all I can think of right now, but I’ll add more if I think of others.

Shane says:

I forgot to add my thoughts on the Bottle. Yes, start early after you get the initial BFing going. Some of my fondest memories are of the middle of the night bottle feeding sessions. It let A sleep for longer periods and it gave me some quality time w/ G — Just the two of us in the middle of the night. It was bitter sweet when he started sleeping through the night — we got to sleep more, but I lost the night time sessions.

Laurie says:

First and foremost, the best advice I ever received on mothering was to not take other’s advice and do what worked for me. I loved what Shane said about “What worked for us was…” My daughter is almost six months old and we are still going strong on breastmilk. She was born at 9 lbs. 3 ozs., and is now a whopping 22+, so clearly she is loving the breast!

What worked for us was…

1: The lactation consultant. The hospital where I delivered had an excellent LC staff, and an LC sat with us for 90 minutes the first night with our baby, coaching me in positions and helping my daughter latch and suck. I haven’t had to call one since, but I wouldn’t hesitate should the need arise.

2: Lanolin IMMEDIATELY! I brought it with me to the hospital and applied after every single nursing session for the first 2-3 weeks. I had it in my diaper bag and all over the house.

3: Books can offer contradictory information, so trust your gut and figure out what works best for you. With information and support, it will work out.

4: I waited on nursing bras and used sleep bras for the first 3 weeks. By 3 weeks, my breast size had leveled out so I could be properly fitted. As we realized, fit is incredibly important in preventing infections, so after three weeks, I took the time to work with a saleswoman and try on lots and lots of bras until one fit.

5: Yes, it hurts. It will get better, but in the meantime, grit your teeth, squeeze your eyes closed, and dig your toes into the carpet.

6: Don’t set yourself up for failure by feeling like you HAVE to make it one year or more. Take it a week at a time for the first month, then a month at a time, and so on. This has helped it all feel much more manageable for us.

Good luck! It will be okay!

ariana says:

Lelu, thank you for your wonderful and unique perspective as mother of 5 BF babies!!

You are so lucky to have a mother and grandmother that were that supportive. My mom was unbelievably supportive in many ways (I couldn’t have survived the first few months without her) but her response to me reading breastfeeding books and taking a class was “why do you need to do that, don’t you just put the baby on the breast and nurse?”

The irony is that she had TERRIBLE problems bf my sister, cracked nipples etc and probably would have benefited greatly from some help which I guess she didn’t know was available to her.

I don’t say this to knock my mother or your advice, I just think you are incredibly lucky to have had that sort of family community around you – many moms of women in our generation didn’t even breastfeed and even more rare that their mothers would have breastfed them!

lelu says:

I never had a lactation consultant but was so blessed to have my mother and grandmother with me during the first weeks of my first baby’s life. While it’s great to get advice from friends that are going through it, I really appreciated the perspective that these older women offered. They told me it would hurt and that just as soon as I felt like I couldn’t take another day of it, it would stop hurting. And they were right. They told me to relax. That yes, this was all new and I would learn as I went. But that my baby wouldn’t hold it against me. He was learning as we went too. And how great it is that we could learn how to be a mother and a son, together. They taught me to enjoy each moment. The dishes and laundry will be there tomorrow but your baby won’t be a baby forever. This lesson became more and more valuable with each child that I had and I am so grateful that I took the time to sit and nurse and cuddle all five of my children. It even allowed for special moments for older siblings to get some cuddle time and read a book or listen to a story. I think too often we get too caught up with what this book or that expert said and we overlook the wealth of knowledge and experience that our parents may have.

I know others have mentioned how important it is to not compare your baby to others. Having had five kids, none of them are the same. I had one that seemed to be born starving and I had to supplement with formula the first few days. And she still was a great nurser when my milk came in. With my last baby, once my milk came in I had to express a little bit before he nursed because he couldn’t latch on. One of my babies would take about ten minutes to nurse, both sides. Another took almost a hour. Do what you feel is right for your baby.

I think the most important thing to remember is that you are giving your baby something that no one else can. And that while it might be hard it is so worth it. When I weaned my last baby a few months ago I was thinking that I had spent five years of my life breastfeeding. Wow! And I wouldn’t trade it for anything.

ariana says:

Sarah, I had some of those same problems! I wasn’t aware ahead of time that OVERsupply can be such a problem for the baby. Jasper choked on my let down for probably the first 5 months.. it was terrible, and made for fairly stressful feedings. I ended up block nursing (offer one breast only) until 7 months or so because of it.

Shane, I loved everything you said – (no, not just the kudos to me ;) particularly about no right or wrong. So true and not just about breastfeeding but about everything related to parenting! Nicely put.

Shane says:

Let me TRY to add a comment from a father/husband’s view. Talk to your DH about your concerns, desires, fears around BFing BEFORE you deliver. Nothing’s worse than a meltdown while trying to BF and not getting support from DH. I didn’t realize the pressure a mother can put on herself — — that the personal importance was SOOO high and that issues are often taken as personal failures. The stress induced during these periods can then cause more issues (See the post bday post). So support from all sides of your life really helps.

If possible (and you feel comfortable) try to bring DH along to any LC sessions. Or call him right afterwards to give him the debrief will info is still fresh in your mind. It’s good to have 2 sets of ears to hear the advice (and remember it) and to help along the way. Our LC had me helping w/ latch position during one period because the extra hand helped get G’s jaw positioned right.

As friends of new mothers, also keep in mind that each of your own experiences are based on a very single example (or a few examples if you have >1 kid). Making bold statements about Right/Wrong techniques can be difficult for new mothers dealing w/ issues. I know I’ve tried to say “What worked for us is…” vs. “You need to do …”. This applies to all topics not just BFing.

I found myself listening more closely to one friend just because of the way the advice was delivered.

NOTE: Becoming Mom – I really like the way your info is presented! It’s about sharing your experience and then opening up for other views/advice. The meat of these topics takes place in the Comments!!!

Alicia says:

Hmmmm… I must be a rare bird – I nursed for 17 months or so and never had any pain or complications at all – no infections, no supply issues, no pain at all even in the beginning. But I like what Catherine said, and I wish I knew this then: it is possible to overfeed! Also, I was HORRIBLE at watching my diet while I was nursing, and being the cheese- and dairy-addict that I am, my baby was getting all that dairy and REALLY had a hard time digesting it all. So, I think the *BEST* advice for new moms is not to worry about technique so much (all babies have a slightly different style anyways), but really just watch what you eat (and drink) – because its a straight shot to your baby’s belly.

Joelle says:

My mother told me that I should expect breastfeeding to hurt – and wow was she right. I ended up crying on more than once over the pain, but determined to breastfeed I powered through the pain. I ended up with a crack on one nipple, that I put polysporin on every day until it healed.

Concerning the bottle – Give your baby a bottle early on. So concerned about nipple confusion, I waited a month. My baby took two ounces from a bottle and that was it, never again. I bought every bottle and nipple (seriously, every one) that babies r us sold. She refused. She would just scream until she fell asleep – it didn’t matter who gave her the bottle, where I was or how they gave it to her, no luck. I’m now dealing with a 10 month old who has never had a bottle and I work outside of the home full time. Mother Guilt? YES!
Also I agree with the comparing – don’t do it. I was blessed with a baby who weighed 6 lbs 14 oz and was 21 1/2 inches long – and she is still the skinniest thing around. But she is healthy and happy and so are we. That is what matters.

Sarah says:

Oh — and I agree with Ariana about not waiting too long to introduce the bottle! Everyone scared me about nipple confusion and so I waited a little over a month; for Finn, it was too long. I tried all different types of “natural, breast-like” bottles, and it still took me a long time to get him to accept one.

Sarah says:

I didn’t have a lactation consultant, but it definitely sounds like good advice. I don’t know how common my experience was, but I had such issues with engorgement, overproduction, and CRAZY letdown that I had to pump just so that Finn could manage to latch on and drink. I would wake up every night with soaked clothes and sheets, no matter HOW many breast pads I used. I was frequently in tears throughout the first weeks, and still felt pain and discomfort for a couple of months. I also suspected and worried constantly about foremilk/hindmilk imbalance since Finn spit up so much. Looking back, I wish that I had had some expert advice on how to handle these problems, as it really was all-consuming until things settled down. These days, thankfully, it’s GREAT: like second nature. Just like everyone says, IT GETS BETTER, no matter how it is in the beginning.

In addition to recommending support, I’ll also add that after trying many different types of breast pads (washable and disposable), I found Avent disposables to be the softest in the beginning when I was really sore. It also helped to wear really tight jogging tanks to sleep.

Sarah says:

The advice seems good, but wanted to add that Earth Mama, Angel Baby nipple butter is the most awesome thing ever. It’s made with an olive oil base, and is super soft and moisturizing. I tried lanolin and found it sticky and not helpful at all.

When I went to deliver my son, I brought my doula, my Nursing Mother’s Companion, my breast pump (with all parts already sterilized), my boppy and nursing bras. And I still had issues. We were in the hospital over a holiday weekend and had no LC’s when real trouble came in the form of jaundice and a night under the bili lights. My book and my pump saved me, us, our nursing relationship. It had numbered steps to follow to get us through any nursing hardship and was available at 1 am when I needed it (when the hospital LC’s and my doula were not).

I still got cracked bleedy nipples but my book gave me the perfect advice to fix them and it worked (get breast shells (not nipple shields) and let them heal with air and breastmilk).

Good luck!

Catherine B. says:

I should have included this with my last post!

I read many books on breast-feeding while I was expecting and one thing that stood out to me in all of them was that as the baby grows, they will become more efficient eaters and in turn, will cut down on the amount of time it takes them to nurse. Well, at 2 1/2 months, Nathan was still eating as long as he was as a newborn and he was spitting up and vomiting more and more each day. He was only spitting up after nursing, not when he was given a bottle. I explained this to his pedi and he recommended cutting his feedings by 5 minutes. We did this and it really worked for us. Nathan is 3 months old now and he is not spitting up or vomiting like he was. He will have a little spit up every now and then, but that is expected!

The moral of the story is to listen to your baby! Once we cut the 5 minutes, Nathan kept his same sleep schedule and he went his usual 3 to 3 1/2 hours between feedings during the day and he still slept through the night. If Nathan did not seem satisfied or if he was not gaining weight at the same rate, I would have added the 5 minutes back to his feeding in a heartbeat.
Some babies do have problems with their esophagus and in turn with malnutrition, but sometimes the vomiting is only because the baby loves to suck!

Jenna says:

All great advice! One thing I couldn’t have lived without is Soothies. http://www.amazon.com/Soothies-Gel-Pads-Nursing-Moms/dp/B00005BTKP

Eli had an insane latch from day one. He was an 8.5 lb. kiddo who is now 9 months old and has been hungry since the day I delivered him! Although breastfeeding was pretty painful for the first couple of weeks, my nipples never cracked or bled. Soothies are little gel pads that are reusable for up to a week and take the place of the Lanolin/disposable pad combo. For some reason I couldn’t stand the feeling of any of that stuff on my nipples. And after three weeks of using Soothies I was good to go!

Good luck new mommies! You’ll hit many bumps in the road, but every struggle, whether it be delivery, breast feeding, or a 9 month old who is cutting molars and won’t sleep, is so worth the payoff of holding that sweet little bundle!

Jane says:

We had a lot of the same issues, and I actually just wrote about this last night!

I’ll just add re: #3, if you have the lansinoh, don’t despair. Just put a pea-sized bit on your fingers and rub and it will become soft. The Medela is better though if you have the choice. Also, put it on before you shower! It prevents a lot of the pain of shooting water on sore nipples!

Kimberly says:

I absolutely agree with Medela lanolin over Lansinoh. Not only is it smoother and easier to apply, it also doesn’t have such a funky smell. And it works wonders on Mommy’s chapped lips, too! (And baby’s, if he gets them!)

For me, breastfeeding got off to a difficult start because James was so sleepy and didn’t latch well… then once he did get latched and we thought he was getting a good feed, the lactation consultant said he was only getting a few grams… not nearly enough for the length of time he was nursing. So she had me use a shield to give him a little more to latch on to, just to teach him how to nurse. (We used it for about a week after we got home from the hospital, then I pulled it cold-turkey and we did fine.) It definitely hurt every time he would latch, but once he got going it was ok. And by about 6 weeks, the pain was gone… a couple more months, and I could barely feel anything. That’s what the expression “nipples of steel” means. ;)

Keys to our success (13 months and going strong!)…

1. Be upfront about your intentions to breastfeed when you enter the hospital to give birth. Alert your nurses that you want to have a lactation consultant ASAP following birth, and if you want to avoid formula supplementation, be VERY clear about that, as well.

2. Have a GOOD lactation consultant… there were several on duty at my hospital, but the first two who came in to see me were quite forceful, taking my breast and pretty much jamming it into James’ mouth. Not pleasant. The third LC who came in to see me was Robyn (God bless her) and she was gentle, holistic, and all-around wonderful. I requested her for the rest of the time I was in the hospital(4 days, post-c).

3. Don’t let baby go too long between feedings… James was a very sleepy newborn and would often sleep for 4+ hours at a time, making him VERY hungry and frantic when he woke up. In the meantime, I was VERY full and that made it really hard for him to get latched. So two tips… make sure to feed every 2-3 hours in the first weeks until you get established with technique and supply, and if baby does have a hard time getting latched because you’re too full, pump off an ounce or so before attempting to latch… that will soften the breast enough to make latching easier. Unfortunately, it took me a couple of major meltdowns (for me and for James) before I figured out to do this.

4. Due to the aforementioned difficulties and my vehement opposition to giving him formula, the nurses started me pumping with a Medela Symphony pump starting when James was 12-ish hours old. I’d then give him the colostrum via a syringe because I was also against giving him a bottle. Eventually I had to cave on that, because they wouldn’t release us until he was nippling well, either on breast or bottle. So I would nurse, then pump, then give him what I’d pumped in a bottle. My milk came in smoothly and fully by the time we left the hospital and I NEVER had any problems with engorgement, cracking, bleeding, clogging, etc. I know, I was very lucky. But the pumping early on was a good thing for us. Started me off with a nice freezer stash, too.

5. Learn how to breast feed lying down on your side. We weren’t able to master this until James was probably 3 months old because he was so tiny, but if you have a bigger baby, you might be able to pull it off younger. Total lifesaver, especially in the middle of the night. Co-sleeping is also very helpful for those middle-of-the night feedings if you’re comfortable with it.

And I agree with the others… DON’T COMPARE YOUR BABY TO OTHERS!!! Compare his growth to his OWN growth chart (Ariana!) As long as the child follows his own curve, he is growing well. It really does NOT matter if he’s in the 20th percentile or the 50th or the 90th. Worry ONLY if his curve flattens or if he falls off his curve (or if he’s consistently below the 3%ile). Individual babies grow very differently, influenced by a variety of factors including genetics. Two petite parents should not expect to have a huge baby tracking in the 95th percentile!

Erin says:

I completely agree about how important it is to be prepared, to do your research, to hear from moms firsthand and know where you can go if you have questions. However, it is also important to know that your experience is going to be just that “yours”, it is not going to be exactly like anyone else’s. So be prepared for the unexpected.

From my own experience then, I do have to disagree with #1.

I am a newish Mom, my little guy will be 5 months old next week. Maybe I am just extremely blessed, but breastfeeding has been a breeze from the get go. No pain, no latching problems, no need for creams or lotions. Everyone told me how hard it would be, how painful, to make sure I had the lotions/creams, and to expect issues. It completely stressed me out. I was so nervous about breastfeeding and was prepared for the worst. And then my son was born and there was no pain, no awkwardness, and it was easy. I was so relieved. Looking back I wish someone would have told me not to freak out, that many people have good breastfeeding experiences too and that not everyone struggles.

Now, since the beginning it hasn’t been perfect, I’ve had to deal with the occasional plugged duct, engorgement now and then and have recently questioned if my supply was getting low (thankfully it is not). But I’ve learned not to stress out about it, I know where I can get information, have an LC to call if I need to, and friends and family around for support.

erin says:

I agree with everything, except the lanolin cream… I never used it, so I can’t say how it would work.

One of my girlfriends asked me the same thing, and I gave her the same advice one of my other girlfriends gave me: YES breastfeeding hurts the first couple weeks, but you just have to power through it. I rather dreaded breastfeeding for the first two months of Hannah’s life (she’s 3 1/2 mos now), but then suddenly it all got better and now it is exactly the intimate experience I had hoped it would be.

The other thing I told her was to see an LC, and if that one didn’t “click” with her to see another and another and another until she found the right one, who would help her and support her positively and constructively with breastfeeding. My LC is AMAZING – I came to her practically crying after 4 weeks. I told her that if this was what bf’ing was like, then Hannah was going on formula because I could not do this for another 11 months. She encouraged me, we worked on latch, and I told her the same thing after 8 weeks. She encouraged me again, we worked on latch, and everything has beenn sunshine and roses since. But man, those first few weeks… !

BTW, I would also recommend donating milk if one has enough. I have an oversupply and so I donate to a milk bank. A lot of people do not know about milk donation, so I try to get the word out whenever I can.

Anh says:

I really agree with Ariana’s note about visiting a lactation consultant before you deliver so you’ll have someone on-call when you really need someone. They might think you’re crazy or overly cautious and not want to help you. Just make sure you find someone who is receptive to seeing you and being available after you deliver. Because you know what … there is a reason why breastfeeding support groups exist. You may not find the right LC to help you the first time but don’t be deterred. I went through five after my little one was born! I even overheard when LC tell another that she thought I would quit 2 weeks into it. It makes me so upset just thinking about it again. Not trying to sound discouraging but I was never one of those Moms with an overabundance of milk so I really had to work at it. It was the most exhausting yet gratifying experience. I was a little sad to stop breastfeeding when my baby turned 1 and we completely stopped at just over 13 months. Looking back, I would do it all over again in a heartbeat.

Here’s another excellent podcast resource: http://www.mommysmilkandmore.com/

Best of luck to you!

kari says:

Great post!
and YES… they LIE when they say “it doesn’t hurt when you do it right”… it hurts and its frustrating, but SO worth it!
my yoga instructor said…”stick with it for 3 weeks. if you can just make it past those first three weeks… you are golden” those words kept me going, and she was right – i was so glad i stuck it out.
Our goal was 6 months, and I was happy to have made it through 8!

ariana says:

Good point Victoria – one I had a bit of an experience with as well, but wow, kudos to you for sticking it out and staying dairy free that whole time!

Natalie, you bring up a good point that I forgot to say in my post – it does hurt, but it does get better too. I think by 3-4 weeks the pain was a distant memory. Well, except the pain I had during let down because my let down was so forceful it felt like an elephant standing on my boobs!

Chantal, great advice about comparing to others- something I STILL need to keep in mind when I get upset about Jasper being so small :)

chantal says:

I’m allergic to lanolin, so I had to get a prescription from my doctor for another cream. It was TOTALLY worth it. A friend of mine never used a nipple cream and complained constantly about how much breastfeeding hurt, even after the initial two week period. My nips were in much better shape than hers and I attribute it to the cream. I used it after I took a shower and after each feeding – it was a lifesaver.

Ariana, I’m so glad you mentioned the pain thing. Annora had a fabulous latch right from the beginning and I was stressing because it hurt A LOT. My right nipple was starting to look pretty bad, too… but after the first week things started to get better, and at the end of week two I couldn’t feel any pain when she nursed except if she had latched on correctly. Those two weeks were hellish at each feeding, but I’m so glad I stuck it out because nursing was awesome after that. But yeah – expect pain at the beginning. A lot of it.

I didn’t have any problems like engorgement or mastitis or anything, I was super lucky. But I was concerned about not having enough milk, because my daughter has always been a light eater and a tiny baby. What was really hard for me to wrap my head around was the idea that each baby eats and grows at different rates. Please don’t compare your child to your friend’s. My nephew is one month younger than Annora and he weighs about 10 pounds more than her, and has always been heavier than her. I was convinced there was a problem with my supply and that’s why she was so light. When in reality, she’s just a light eater and a smaller girl. So please, don’t compare your kidlet to someone else’s and create a problem where there isn’t one. This caused me a lot of unnecessary stress.

Natalie says:

Oh yes, Medela lotion hands down. My DH made the mistake of buying Lasinoh once I ran out of Medela, and it was awful. It’s way too thick to spread without having to rub, and who wants to rub when you’re in that much pain initially?

Great article – very honest and useful information for new mothers.

New moms – just stick with it because it DOES get better. Those first few weeks are grueling and so painful, but it does get easier over time. One day you realize that you’ve jumped the hurdle and can finally enjoy it!

Lindsay says:

Thank you for this! I’m due 11/27 and think about breast feeding A LOT. I added all 3 books to my library book list!

Victoria says:

Very good tips!

Also be prepared for possible milk allergies which is more and more common. I was so not prepared for my son to have a milk protein allergy and when he was diagnosed at 9 days old, I almost quit breastfeeding. That was a huge load of over information for a sleep deprived new mommy. Prepare for the unexpected.. I had to be on a strict diet for 8 months but it was so worth it and I’m so glad I didn’t quit and switch to a prescription formula!

ariana says:

Hi Catherine, so nice to see you here :)

I’m not really sure about the overfeeding, babies spit up, some spit up ALOT and it’s not because of overfeeding, it’s because their esophageal sphincter is underdeveloped.

I don’t want to give new mom’s the impression or worry that they can overfeed, everything I’ve heard or read says that you should let baby decide when he/she is done – to do otherwise can risk both your supply and baby’s nourishment.

Catherine B. says:

And one more thing.. you CAN overfeed a breast-fed baby. They will just spit up everything they cannot handle, and it will end up everywhere except the burp cloth!

Catherine B. says:

I totally agree with number 3. I used Lansinoh Lanolin ONE time and went back to Medela. Lansinoh is so think that it hurts to apply!

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