Having breastfeeding problems? Most nursing moms run into some kind of snag at some point, and each stage of breastfeeding brings different challenges. Fortunately most can be resolved with help, and often in surprisingly simple ways. Cherie Tannenbaum, a family nurse practitioner and lactation consultant in private practice and at Parents Place in Palo Alto, shares her tips for overcoming the issues that breastfeeding moms ask her about most.
My #1 piece of advice to new moms is to get help as soon as there’s a problem. Most of the breastfeeding horror stories new moms hear about—pain, supply issues, the baby not gaining enough weight—are preventable. Though we’re programmed to think that breastfeeding comes naturally to moms, the truth is that it doesn’t. Assuming that “it will get better” without help can lead to more problems.
Breastfeeding should not hurt! No matter what anyone tells you, breastfeeding only hurts if something is wrong! That something can usually be fixed by a simple change in position or help with the way your baby is latched on. If you’re having pain, it’s very possible that your baby isn’t getting as much milk as he needs. This can lead to very frequent, unsatisfying feedings and even a decline in your milk supply. An IBCLC (International Board Certified Lactation Consultant) can help.
What helps for pain: It’s really important for you to hold your baby in a position that’s comfortable for both of you. If you’re crouched forward because you’re trying to keep your breast in your baby’s mouth, it can cause severe shoulder, neck, and back pain. Make sure your baby is held very close to your body, her tummy up against yours, so that she can have more of the breast, not just the nipple. A lactation consultant can help you and your baby find the most comfortable and efficient position for you both, based on your anatomies.
What helps for supply issues: It’s very common to have a delay in milk production, especially if you’ve had a very long and difficult labor and/or a c-section. If this is the case, I tell moms to make sure to hand-express some of the early colostrum and spoon-feed it to their newborns until milk becomes plentiful, both for continued breast stimulation (crucial for getting the milk supply to come in) and to keep the baby hydrated. This is actually helpful for increasing early milk production for all moms.
Breastfeeding isn’t all about you and your breasts. In reality, breastfeeding is a two-person job (at least!). Your baby has to do his part too. Especially in the very early days, newborns often fall asleep before they can get in a full feeding, so this is where it can become a three-person job—have your partner or helper try to keep your baby awake during feeding time by stimulating his skin, rubbing his feet, moving his arm, etc.
Changing your baby’s diaper can be a great way to awaken your baby, and then breastfeeding can be resumed. Another way to keep your baby swallowing milk rather than dozing is to compress your breast, giving her a more plentiful flow of milk, reminding her what she’s “supposed” to be doing (drinking, rather than sleeping!).
Another common misconception is that your newborn should be on a schedule. Newborns tend to sleep when they want and wake up (and fuss) when they’re hungry. Don’t worry if your newborn decides that prime feeding time is between midnight and 3 am—you’re not doing anything wrong, and your baby will fall into a more predictable pattern as she gets older, usually by about 6 weeks. If you’re really worried about it, or it’s cramping your own sleep efforts, try a simple sleep consultant’s trick—keep her room dark and quiet at night, and expose her to light during the day when she’s awake to help her establish her circadian rhythms.
A pumping secret that helps: Help your hormones by thinking about your baby, not work (even if that’s where you are) or anything else. Put on headphones, listen to relaxing music, and look at some baby photos on your phone when you pump.
Another good tactic for breastfeeding moms who work is to add in a pumping session at night before you go to bed, to add to what you were able to pump at work.
Something I wish every mom knew: Having a baby—whether he’s your first or your fourth, and whether he’s feeding like a champ or you’re having some problems getting your feeding routine in sync—can be lonely and isolating. Support groups can help, both practically and emotionally. In the many years that I’ve been facilitating new parent support groups, I’ve seen parents form wonderful, close friendships, described as “lifesaving,” with other parents in these groups.
The #1 rule for breastfeeding is FEED THE BABY. As a lactation consultant, I want to help you feed your baby breast milk straight from the source, but if that’s not working for you, there are workarounds, like hand-expressing milk or pumping. If your baby’s still not gaining enough weight—the first priority—then sometimes we have to look at other options like breast milk from a milk bank or formula. It doesn’t have to be all or nothing! Any amount of breast milk is valuable to your baby because of all the beautiful immune factors it contains.
Photo: Slava Basovich/Kinstantly
- Cherie Tannenbaum is a family nurse practitioner and lactation consultant based in Palo Alto, CA.
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