Mandy's Breastfeeding 101

Note: I am not a medical professional, nor do I play one on tv. I'm just a mommy who nursed. And nursed. And nursed. ;-)

As my nursing relationship with Jack is slowing down (and hopefully coming to a close within the next few months), and as I prepare to nurse another baby beginning this fall, I was reflecting on why it "worked out" for me when it doesn't for so many women.

I am a member of a lot (seriously, way too many) message boards online and the breastfeeding misinformation out there is overwhelming. And, unfortunately, a lot of it comes from medical professionals. That really stinks as you would think that they would be the people that could help you the most. Turns out that doctors and nurses get very little, if any, information on lactation in school (or so says my sister the nurse).

In fact, it was a nurse that led me to fail at breastfeeding Spencer. Spencer, the baby who only got to come home from the NICU because he was nursing so well. She basically scared the pants off of me. Here I was, all of 22 years old, taking home (by myself b/c Jake was in Iraq) a 4 pound, 5 ounce baby. I was terrified as much as I was thrilled. As we were preparing to leave, the discharge nurse came in and asked if I planned on exclusively breastfeeding. "Of course!" I said. She then informed me that they don't EVER recommend exclusively breastfeeding a premature baby (apparently, regardless of how well he's breastfeeding or how much weight he's putting on while doing it), and as she told me this she pushed a can of formula into my hands. That, alone, wouldn't have been enough to keep me from succeeding. But then she told me to have him weighed by Friday and, if he hadn't gained enough weight, they'd readmit him. And that is what scared me so.

But I digress. Kind of.

Anyway, before Jack arrived, I read. Man, oh, man, did I ever read. I read books on childbirth. On VBACs. On midwives. And, most important to the topic of this post, on breastfeeding. This is something I failed to do with Spencer, and with good reason; I was too busy researching prematurity to worry about what would happen after he actually got here in one piece. (I'll recommend some books in a moment...)

So, without further ado, these are the things that, I feel, made me a successful breastfeeder:

• Watch the baby, not the clock. This is one of the most important first things I can recommend. New babies nurse A LOT. They nurse often and they nurse for long durations. This is normal. It doesn't mean you don't have enough milk. In fact, new babies aren't even hungry for several days; all the marathon nursing in the beginning is what brings in your milk. About the time they start getting hungry, your milk will come in and they will be sated. The most important tenet of nursing is supply and demand: if you don't let the baby demand it, you won't supply it.
• No bottles or formula in the house. I assure you that I was as dedicated to nursing as a person could be when Jack was born. But let me tell you, when you are tired and the baby has been having a marathon nursing session (Jack's tended to last from 3-6 am, pure torture) the temptation to give a bottle is there. If there is a REAL problem that reveals itself, I promise you can find a 24 hour Wal-Mart and get something. If you deliver at the hospital, they will send you home with a "breastfeeding bag" that has, drumroll please, formula in it. Where is the logic in that? Anyway, leave it at the hospital. At the very least, have your husband hide it and only let you have it if the baby isn't having wet/dirty diapers by the 4th-ish day or has lost more than 10% of its birth weight. And speaking of losing birth weight...
• Please note that IV fluids can increase baby's birth weight. You wouldn't think this would be a big breastfeeding consideration, but it is. Let's say that, before IV fluids, baby weighs 7 pounds. This is the weight s/he would be born at if you got no IV fluids in labor. So you get to the hospital and they hook you up to an IV that is running the saline the whole time you're in labor. Obviously the baby gets what you get, so the baby takes on fluid as well. Now the baby weighs 7 pounds, 8 ounces (and I have no idea how much fluid weight a baby would really take on, this is just an example I pulled out of the air). Baby is going to naturally shuck this water weight after birth. And babies naturally lose some weight after birth anyway (Jack got down to 8 pounds, 4 ounces at his lowest, which was about 9%). So it will appear that baby has lost more weight than he actually has, b/c some of that weight is water and not actual body mass. I hope that makes sense.
• If you are having problems, or just need some reassurance, call someone! But NOT your pediatrician or OB. Sometimes even the lactation nurses at the hospital aren't very good (sometimes they are, but I've heard some bad info come from them too). I recommend calling a mommy friend you are comfortable with who nursed successfully, seeing an Independent Board Certified Lactation Consultant (IBCLC will follow their name), or calling someone from La Leche League (I've linked the Arkansas La Leche League page). I was having some pain when Jack was nursing and, even though there isn't a LLL in my city, I called a leader from the Little Rock chapter and she helped me over the phone and sent me some links with video to help me out. I know that LLL can get a bad rap, but seriously, they can help you! If they are local to you, someone will even come over and help you for free. They want to see you succeed. Also, if LLL is local to you, I recommend you attend some meetings while pregnant. Part of the reason that women have so much trouble nursing is, in my opinion, that we don't see anyone nursing anymore. The formula companies convinced our mothers and grandmothers that formula was superior and so a lot of our breastfeeding knowledge was lost. Go to a meeting, talk to women, get an idea of what is normal and what's not.
• No artificial nipples (bottles or pacifiers) for 4-6 weeks. Of course, YMMV on this, but personally I wouldn't introduce a bottle until 4 weeks and a paci until 2-3 weeks. Babies suck on artificial nipples differently that human nipples and I promise you don't want a baby with a bad latch stuck to your body. Also, bottles generally just pour milk out so baby doesn't have to work as hard. Well, obviously baby could grow to prefer the more free flowing milk from a bottle. The work a baby does to nurse actually helps his/her facial and mouth muscles develop appropriately, so there is a reason they have to work for the milk.
• Watch out for meddling mothers/mothers-in-law. Unless they have successfully breastfed, of course. I will never forget how badly my step-mother wanted to nurse my little sister. Even at the ripe old age of 12, I noticed how often she talked about it and how badly she wanted it. Well, Hannah arrived and she nursed like all new babies nursed (I assume, I was 12 after all): frequently and for long durations. And what did my step-mother's mother say? "That baby is STARVING! Just give her a bottle." And what did my father say? "That baby is STARVING! Just give her a bottle." That is enough to shake anyone's confidence. And so Hannah got a bottle from then on. I've also heard of mothers/mothers-in-law telling a tired mommy to go take a nap while they watch the baby and then sneaking the baby formula. For shame.

Great books:

"So That's What They're For!" by Janet Tamaro (By far my favorite.)

"The Womanly Art of Breastfeeding"

Great websites:

La Leche League

Kellymom (This is like the one stop shop for breastfeeding information. It even answers questions on medications you can take and has a great FAQ section.)

Of course, YMMV. Like I said, those pieces of advice are what got ME through breastfeeding Jack. :-)