Breastfeeding Basics

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By Gail O’Connor

Imagine if a single food could help your baby avoid catching colds and recover from them more quickly, prevent allergies, reduce risk for becoming overweight and even make your little one smarter. You can’t find it on store shelves, but this magical substance does exist, and only you can provide it: breast milk.

So perfect and powerful is human milk that the American Academy of Pediatrics recommends breastfeeding for at least one year (and for however long as mutually desired by mom and baby after that). “Many of the health benefits associated with breastfeeding are greater with longer duration of breastfeeding, so the longer the baby breastfeeds, the better,” says Joan Younger Meek, M.D., clinical assistant professor at Florida State University in Orlando and editor of The American Academy of Pediatrics New Mother’s Guide to Breastfeeding (Bantam, 2002). The benefits extend to mom, too: Nursing a baby reduces the risk of breast and ovarian cancers, cuts your odds of developing osteoporosis later in life and helps you get back into your pre-pregnancy jeans faster by burning as many as 600 additional calories a day.

Breastfeeding may be the most natural thing a mother can do for her infant (after giving birth, of course), but doing it successfully takes some knowledge and technique. Despite an avalanche of evidence touting its unparalleled benefits, only 33 percent of American women still breast- feed exclusively by six months after their baby is born. But with a little preparation, you can pave the way for a happy, successful breastfeeding relationship with your baby. Here are a few pointers…


Get Educated

“I can’t tell you how often I hear women say they go through a six-week Lamaze class for a 14-hour labor, but wish they’d taken one three-hour breastfeeding class,” says Corky Harvey, R.N., an International Board Certified Lactation Consultant (IBCLC) and co-owner of The Pump Station in Santa Monica, Calif. A class (or an individual consultation with an IBCLC) can prepare you for potential pitfalls, such as a baby’s difficulty “latching on” to the breast.

Plus, you’ll have a few answers upfront to all the “Huh?” moments that happen when you’re a new breastfeeding mom—from what the yellowish stuff is that comes before the milk kicks in (it’s colostrum, which is full of antibodies) to what that tingly sensation in your breasts is all about (that’s the “letdown reflex,” which releases your milk). You’ll also learn how to pump and store your milk, so you can have an evening out with your spouse or return to work while continuing to provide breast milk for your baby.

Perhaps most important, a class can give you confidence. “At the class I took, the instructor advised us to give it three to four weeks,” says Catherine Holecko, a mother of two in Neenah, Wis. “She promised it would become much easier after that, and she was right. The first weeks were definitely tough, with engorgement, exhaustion and everything else, but once I got past that, I found it so easy and convenient.”

When you sign up for a class, be sure to make a reservation for two—take your spouse or your mom with you. “In the first few days home from the hospital, a new mother is incredibly spacey and sleep-deprived, so it helps to have another set of ears there,” says Harvey.

Ask around among new-mom friends for a teacher recommendation, or check with the La Leche League ( to find classes in your area. Make note of which consultants’ names keep rising to the top. “A good breastfeeding teacher is worth her weight in gold,” says Harvey.


Prepare to Nurse a Lot

How soon should you start nursing after the baby is born? “We like to see initiation of breastfeeding within the first 60 minutes of life, or in the case of a Cesarean section, within the first two hours, if possible, is preferable,” says Meek. Unlike formula-fed babies, who eat every three to four hours, breastfed newborns typically “cluster feed” or “marathon feed” (nurse for as long as two hours) in their first few days.

While it may seem like your baby is approaching your body as if it were a 24-hour buffet, the truth is that newborns need to nurse that much, says Harvey. Their suckling stimulates nerves in your breasts that send chemical messages to Experts also advise delaying the introduction of a pacifier.

“Some babies are sensitive and aren’t quite as agile at going back and forth between methods of feeding, whether the breast or bottle or nipple,” says Meek. “Once they’ve established breastfeeding, then it’s okay to introduce pacifiers.”

Also, most hospitals allow infants to “room in” with their moms, an advantage that gives moms and their babies a leg up. “It ensures mom is always available to the baby, rather than waiting for a baby to be brought in from the nursery screaming and starving,” says Meek, who notes that crying is a late feeding cue. Don’t worry—you won’t be tied to your glider forever. Over the course of the first week, your baby will settle into a more predictable feeding pattern.


Help Your Baby Develop a Good Latch

While it’s normal to expect slight tenderness in the nipples at first, you shouldn’t be wincing your way through feedings. If you’re uncomfortable while nursing, your baby isn’t latched on properly. “Breastfeeding should not hurt if the baby is latched on to the breast appropriately,” says Meek. Where do latches go wrong? Most times, it’s because the baby has only the nipple in her mouth. A good latch means an infant’s mouth will encompass the nipple and most of the surrounding areola. “One of the keys is getting the baby to latch on with a wide-open mouth,” says Meek. Sometimes, babies need several shots before getting it right, so if she’s nursing and you’re hurting, insert a finger in the corner of her mouth to release the powerful suction, and start anew. If your nipples are tender, sleep topless with a towel to absorb any spills. Fresh air is healing, as is your breast milk.

In the hospital, ask for help from an International Board Certified Lactation Consultant (IBCLC)—many hospitals have one or more on staff—or a nurse who can show you if your baby has latched on correctly. Ask her to demonstrate comfortable feeding positions, like the “football hold,” which lets you look at that adorable little face as she nurses, or the side-lying position, so you can feed the baby while resting.


Remember: Input/Output

“Every mom hears ‘Is the baby getting enough?’ and if the baby cries, ‘Oh my gosh, you must not have enough milk,’” says Harvey. In reality, the percentage of women who can’t provide enough milk is incredibly small, says Harvey. Usually, by the third or fourth day of nursing, your breasts will look and feel noticeably full with milk. To ease any engorgement, let your baby nurse as much as she likes. You’ll know she’s nursing successfully if she’s swallowing and your breasts feel less full after feedings. Quickly, she’ll progress to between eight and 12 feedings every 24 hours.

Besides her weight (babies should regain their birth weight by day 10, then start gaining 53⁄to 7 ounces per week), you can track whether she’s satisfied by what’s going into her diapers. On her first day of life, your baby will have only one or two wet diapers, and for the first two or three days she’ll pass meconium—a dark, almost tar-like stool— before her bowel movements take on a mustard color. By the sixth day, she should progress to six or more wet diapers and three or more mustard-colored bowel movements a day.


Pump It Up

A good-quality pump is a new mom’s best friend. Pumped milk gives you time to spend a few hours away from the baby, and continue your nursing bond with her if you’re going back to work.

Start thinking early about where and when you’ll use your pump at work. “I wish I’d known that it’s an amazing scheduling and time-management feat to pull it off successfully, and that if you don’t have a lot of control over when you can be at your desk, it can make you really anxious,” says Kara Corridan, a new mom in Springfield, N.J.

Meek concurs. “For all mothers who work outside the home, planning ahead is important,” she says. “A mother should begin by discussing her desire to continue breastfeeding with her supervisor or coworkers, depending upon her situation.” Some parent-friendly companies provide lactation rooms, while some welcome mothers to pump in the company nurse’s office. If private space is lacking, ask other new moms at your company how they made pumping work for them. When you return to work, pump as often as you’d nurse your baby. “The pumping schedule should mimic the baby’s feeding schedule,” says Meek. Your caregiver can use milk you’ve expressed and stockpiled in your freezer. To keep your milk supply steady, breastfeed your baby as often as you can when you’re with her, says Meek.


Nurse When and Where You Need To

For some women, it’s hard to imagine nursing a baby anywhere but in the privacy of home. But many find that too limiting. “I’ve nursed anywhere and everywhere, including parks, restaurants, airports and airplanes,” says Holecko. “Last spring I was visiting my friend, who’d recently had her third child. She thought nothing of standing in her driveway nursing while supervising her two older boys playing in the yard.” Breastfeeding is natural and vital, and while you may want to keep your breasts cloaked as you do it in public, supplying your baby the single most healthful food is something to be expected. So be proud, not embarrassed, to do it.


It may be natural, but doing it successfully takes knowledge. Learn how with these tips.

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