We talk to lactation experts to get the information all moms need to know before nursing.
Published: October 1, 2018
By: Paige Townley
Breastfeeding. It’s something that some mothers make look so easy, and something other mothers struggle with from day one. Despite it being very natural, breastfeeding doesn’t really seem so natural when you’re in the moment and trying to manage it for the very first time. Whether you have immediate success or struggle through problem after problem, there is a lot to learn on the topic to help master it. Here we talk to lactation experts to get the information all moms need to know before nursing.
Labor Impacts Breastfeeding. A mother’s milk supply can be delayed by things that happen during the birth process, notes Marcia Davis, IBCLC, a birth navigator at Princeton Baptist Medical Center. For example, Davis explains, inducing labor can delay a mother’s milk from coming in, and so can having a C-section. “More and more mothers-to-be are turning to unmedicated childbirth and allowing for their child to be born whenever nature decides,” she says. “That certainly works best when it comes to breastfeeding.”
Newborns Don’t Eat Much. One aspect of breastfeeding that is often overlooked or just completely misunderstood is the size of a newborn’s stomach, Davis adds. A newborn’s stomach is around the size of a cherry or large marble. “Most people have no idea what the true size of a newborn’s stomach is,” Davis says. “It’s important for moms to understand that so that she doesn’t get discouraged early on and give up. People’s perceptions on this are often way off. They think babies need more than they actually need.”
Pay Attention to Feeding Cues. It’s important for mothers to respond to baby’s hunger cues (such as licking, smacking or putting their hands to their mouth) by offering the breast. To help learn those cues, says Heidi Powell, IBCLC, owner and founder of Central Alabama Lactation Services, it’s best to avoid using pacifiers or formula supplements (unless medically indicated) until breastfeeding is well established. “Breastfeeding functions on the principles of supply and demand,” she says. “That means the more you breastfeed a baby when he or she is hungry, the more milk you will make.”
Common Issues. Some of the most common issues mothers experience when breastfeeding include problems with baby latching, nipple pain, under supply or over supply of milk, clogged milk ducts and mastitis. A common misconception is that breastfeeding should hurt, and the reality is that it shouldn’t. While tenderness can arise in the first few days, especially for first time moms, it should be mild and subside after the first 10 to 15 seconds after baby has latched, Powell explains. “Bruises, blisters or bleeding from nipples, as well as ‘pinched’ nipples need to be addressed immediately by a lactation consultant,” she says. “Not only can they cause issues such as low milk supply and breast infections, but they can also signal inadequate intake at the breast by baby. So seek help early if you are having pain or supply issues. Sometimes a few tweaks in technique, positioning our routine can keep a molehill from turning into a mountain.”
Tongue-Tie. Sometimes these common problems are actually caused by tongue-tie, which happens when the band of tissue that connects the bottom of the tongue to the floor of the mouth is too short or tight. In this situation, the baby’s tongue range of motion is greatly restricted, and it can seriously interfere with breastfeeding.
Some of the most common symptoms of tongue-tie include a shallow latch, the baby sliding on and off the nipple, the baby getting frustrated while nursing, poor weight gain, acid reflux, colic, a clicking or smacking noise and even spitting up often.
When a child has tongue-tie, mothers can often experience flattened, blanched or bleeding nipples, pain, poor milk supply and even mastitis, notes Dr. Richard Baxter, DMD, MS of the Alabama Tongue-Tie Center. Baxter says that approximately 20 percent of newborns potentially suffer from tongue-tie, which can actually easily be fixed with surgery. “The procedure can be performed with a laser, and a full release takes just about five to 10 seconds,” Baxter says. “Typically, mothers notice an immediate difference in nursing right the same day with a deeper latch and less pain.”
Don’t Take Shortcuts. When it comes to boosting milk supply, a mother shouldn’t take shortcuts (like trying certain foods or herbal remedies) unless she is doing something to consistently increase the demand for the milk supply (such as nursing more, pumping more, or hand expressing more).
“A general rule of thumb for the early months is that it takes eight to 10 breast emptyings (nursing or pumping) to maintain a milk supply and 10 to 14 emptyings to build a supply,” Powell says. “A lactation consultant can help navigate the path to making more milk, as well as offer tips and tricks to build a supply and save time.” And if trying to build a milk supply, be patient. Often it takes three to five days to see the reward, Powell adds.
Don’t Fall for the Food Myths. There are many food myths about a mother having to really restrict her diet and give up lots of foods while breastfeeding. That’s actually not true, notes Davis. “Mom doesn’t have to give up all the foods she likes,” she says. “She also doesn’t have to drink excessive amounts of water. And mothers actually don’t have to completely give up caffeine. It should be restricted because it acts as a diuretic and can affect the milk supply because it can lead to dehydration.”
Prep Early. When a new mother takes baby home from the hospital, life gets real. There are numerous appointments and distractions that will require mom’s attention in those first few weeks, so trying to figure out the do’s and don’t’s of breastfeeding at that point is just too difficult. That’s why soon-to-be moms should learn as much as possible about nursing as possible prior to baby’s arrival.
“I honestly believe that 95 percent of breastfeeding is education,” Powell says. “If you know all about it ahead of time, it makes it so much easier. There are prenatal classes, books and websites are great ways to learn, as well as attending local breastfeeding support groups before delivery.”
Paige Townley is a Birmingham-based freelance writer.