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Every woman's body and every baby is slightly different. It is very rare for a woman to not produce enough milk, but each woman's storage capacity within each breast will be unique. Each baby will also have a unique eating speed. Some babies may eat slowly, and each nursing session may take 30-40 minutes. Other babies may eat quickly, or more frequently, and an entire nursing session may be completed in 5-10 minutes. As long as the baby is gaining weight and having dirty diapers regularly, all are fine.
Unfortunately, many women are told to feed the baby a set amount of time, such as 10 minutes on each breast. To understand why this may not work, you must understand breastmilk.
There are two main types of breastmilk: foremilk and hindmilk. Foremilk, the milk that will come out first when the baby latches on, is much more watery, and is great for quenching baby's thirst. Hindmilk has more fat and is much more opaque and white. A woman who has a large storage capacity in each breast may have much more foremilk in each breast as well. If she only lets the baby nurse ten minutes on each side, the baby may be getting mostly just foremilk. Since the milk is more watery, chances are the baby will get hungry quicker, gain weight more slowly, and have fewer bowel movements.
Rather than try to time the baby, the mother should allow the baby to nurse as long as he or she wants on one breast. When the baby lets go naturally, burp him, then offer the second breast. If the baby is still hungry, he will take it. If the baby does not take it, or does not nurse as long on that breast, then begin the next feeding session on the second breast, and keep alternating back and forth. As the mother becomes an experienced nurser, it will become more like second nature to begin breastfeeding on the fuller breast.
If you ever have reason to suspect that the baby is getting mostly foremilk due to symptoms such as
- greenish bowel movements
- slow weight gain PLUS very frequent eating (very frequent eating alone is not a symptom, it can indicate a growth spurt, a needy baby, and a host of other situations)
It may be worth trying block feeding. With block feeding, the mother will feed the baby from the same breast for an extended duration, such as 3-4 hours. This will help ensure that the baby is getting plenty of rich hindmilk.
Breasts do not have to feel full to produce plenty of milk. It is normal that a breastfeeding woman's breasts feel less full as her body adjusts to her baby's milk intake. This can happen suddenly and may occur as early as two weeks after birth or even earlier. The breast is never "empty" and also produces milk as the baby nurses.
Nursing after exercise is perfectly acceptable, and has been shown to have little to no effect on the baby. Studies of women who exercise showed no difference in the amount or composition of their breast milk, nor was there any effect on the rate of the babies' weight gain.
If you participate in extremely strenuous exercise, lactic acid may be present in the breast milk for 90 minutes following the workout. Light and moderate exercise do not generally cause an increase of lactic acid in milk. Regardless, lactic acid does not have negative effects on the nursing baby.
Finally, studies have not shown a difference in how a nursing baby accepts the breast following a mother's workout. Whether the exercise was moderate or strenuous, mothers participating in studies have no reported rejection of the breast following exercise.
It is not true that women with small breasts produce less milk than those with large breasts.
Breastfeeding twins is easier than bottle feeding twins, if breastfeeding is going well. This is why it is so important that a special effort should be made to get breastfeeding started right when the mother has had twins. Many women have breastfed triplets successfully. Twins and triplets take a lot of work and time no matter how the infants are fed.
Breastmilk contains all the water a baby needs and doesn't need extra water in hot weather.
Despite the fables about La Leche League members harassing stalking moms in hospitals, La Leche League members do not cruise through maternity wards. They are actually a mother-to-mother support group who will be glad to offer support and information if requested.
The vast majority of women produce more than enough milk. Actually, an overabundance of milk is common. Most babies that gain slowly, or lose weight, do so not because the mother does not have enough milk, but because the baby does not get the milk that the mother has. The usual reason that the baby does not get the milk is the baby is poorly latched onto the breast. This is why it is so important that the mother be shown, on the first day, how to latch a baby on properly by someone who knows what they are doing.
Breastfeeding babies may need extra Vitamin D only in extraordinary circumstances. For example, if the mother herself was Vitamin D deficient during the pregnancy. The baby stores Vitamin D during the pregnancy, and a little outside exposure, on a regular basis, gives the baby all the Vitamin D he/she needs.
Breastmilk gives the baby everything there is in other milks and more. Babies older than 6 months should be started on solids so that they learn how to eat and so that they begin to get another source of iron, which by 7-9 months, is not supplied in sufficient quantities from breastmilk alone. If the mother wishes to give milk after 6 months, there is no reason that the baby cannot get cow's milk, as long as the baby is still breastfeeding a few times a day. Most babies older than 6 months who have never had formula will reject it, because of the taste.
The amount of milk that can be pumped depends on many factors, including the mother's stress level. The baby who nurses well can get much more milk than his/her mother can pump. Pumping only tells you how much you can pump.
Even the formula makers have no choice but to admit that formula is inferior to breastmilk. Breastmilk is tailored to your baby's needs and is easy to digest. Breastmilk promotes optimum development and offers protection from many illnesses due to maternal antibodies.
Though mothers introduce a bottle for various reasons, there is no reason a baby must learn how to use one. There is no advantage in a baby's taking a bottle. At about 6 months of age, the baby can start learning how to drink from a cup, even though it may take several weeks for him to learn to use it efficiently. If the mother is going to introduce a bottle, it is better she wait until the baby has been nursing well for 4-6 weeks, and then give it only occasionally. Giving a bottle when breastfeeding is going badly is not a good idea and usually makes the breastfeeding even more difficult.
There is a difference between "being on the breast" and "breastfeeding". If a baby is actually nursing for most of 15-20 minutes on the first side, he/she may not want to take the second side at all. If he/she drinks only a minute on the first side, and then nibbles or sleeps, and does the same on the other, no amount of time will be enough. The baby will breastfeed better and longer if he is latched on properly. He can also be helped to breastfeed longer if the mother compresses the breast to keep the flow of milk going, once he no longer swallows on his own.
Premature babies are less stressed by breastfeeding than by bottle feeding. A baby as small as 1200 grams and even smaller, can start at the breast as soon as he is stable, though he/she may not latch on for several weeks. Actually, weight or gestational age do not matter as much as the baby's readiness to suck, as determined by making sucking movements. There is no more reason to give bottles to premature babies than to full term babies. When supplementation is truly required, there are ways to supplement without using artificial nipples.
Although some tenderness during the first few days of breastfeeding is relatively common, this should be a temporary situation which lasts only a few days and should never be so bad that the mother dreads nursing. Any pain that is more than mild is abnormal and is almost always due to the baby latching on poorly. Any nipple pain that is not getting better by day 3 or 4 or lasts beyond 5 or 6 days should not be ignored. A new onset of pain when things have been going well for a while may be due to a yeast infection of the nipples. Limiting feeding time does not prevent soreness.
It is true that breast reduction surgery does decrease the mother's capacity to produce milk. Since many mothers produce more than enough milk, mothers who have had breast reduction surgery sometimes manage very well to breastfeed exclusively. However, if the mother seems not to produce enough, she can still breastfeed, supplementing with a lactation aid (so that artificial nipples do not interfere with breastfeeding).
A baby can be nursed anywhere, anytime, and thus breastfeeding is liberating for the mother. There is no need to drag around bottles or formula, worry about where to warm up the milk,nor to worry about sterility. You will not worry about how your baby is, because he/she is with you.
If you are bleeding from the nipple, it makes the baby spit up more, and may even show up in bowel movements. This is not a reason to stop breastfeeding the baby. Bleeding is not a problem, it is the pain the mother is having that is the problem. This often occurs in the first few days after birth and settles within a few days. The mother should breastfeed! If bleeding does not stop soon, the source of the problem needs to be investigated, but the mother should keep breastfeeding.
There are very few medications that are contraindicated for nursing mothers. Do research and discuss options with your doctor before weaning needlessly. Read Medication and Mothers Milk or call your local LLL leader to see what medications are safest.
Breastfeeding is made difficult because women often do not receive the help they should to get started properly. A poor start can indeed make breastfeeding difficult. But a poor start can also be overcome. Breastfeeding is often more difficult at first, due to a poor start, but usually becomes easier later.
Breastmilk contains just enough iron for the baby's needs. If the baby is full term he will get enough iron from breastmilk to last him at least the first 6 months. Formulas contain too much iron, but this quantity may be necessary to ensure the baby absorbs enough to prevent iron deficiency. The iron in formula is poorly absorbed, and most of it, the baby poops out. Generally, there is no need to add other foods to breastmilk before about 6 months of age.
It often seems as though there is not enough or no milk in the first few days after birth because the baby is not latched on properly and therefore is unable to get the milk. Once the mother's milk is abundant, a baby can latch on poorly and still may get plenty of milk. However, if the baby is latched on poorly, he/she cannot get milk. This accounts for "but he's been on the breast for 2 hours and is still hungry when I take him off". By not latching on well, the baby is unable to get the mother's first milk, called colostrum.
There are a very few women who cannot produce enough milk (though they can continue to breastfeed by supplementing with a lactation aid). Some of these women say that their breasts did not enlarge during pregnancy. However, the vast majority of women whose breasts do not seem to enlarge during pregnancy produce more than enough milk.
There is no foolproof way to measure exactly how much breast milk the baby is getting, but this does not mean that you cannot determine if the baby is getting enough. The best way to know is that the baby actually drinks at the breast for several minutes at each feeding, in an (open--pause--close) type of sucking.
If a woman has had breast augmentation, there is no evidence that breastfeeding with silicone implants is harmful to the baby. Occasionally this operation is done through the areola. These women do have problems with milk supply, as does any woman who has an incision around the areolar line.
|Sheri Ann Richerson|