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Valerie's Thoughts About Breastfeeding
I originally wrote this for my sister when she was expecting her first baby.
In case it's useful, I thought I'd write down my thoughts about breastfeeding. Here are some things that were helpful for me. I'm assuming that you've read a couple of books about it and that this is fill-in information, not a how-to manual. Some good books on breastfeeding are: The Nursing Mother's Companion by Kathleen Huggins, The Womanly Art of Breastfeeding by La Leche League International, and there was a really amazingly good video that my childbirth instructor lent us; I think it was published by La Leche League.
Don't accept a bad latch-on. If you've been reading about breastfeeding a newborn, you know that the way to latch the baby on is to wait for its mouth to be wide open and then pop your breast in quickly. Arlo never did seem to open his mouth very wide, so I'd try nursing him even when he hadn't opened his mouth wide enough. That meant he wasn't latched on correctly. This was painful for me and probably for him too. He had incredible nursing blisters on his lips. Also, he probably wasn't getting as much milk as he wanted. Eventually I said, "Enough of this!" and started a campaign to unlatch Arlo every time we had a bad latch-on and keep trying again and again until he got it right. It only took a day or two to see a permanent improvement.
If you have concerns, ask for help. The world is full of lactation consultants and La Leche League leaders, all eager to help you. I hesitated when I should have asked for help. I don't think I fully realized that people would have happily sat down with me and taken the time to answer my questions, or to help me to get Arlo latched on better. The hospital where your baby is born will almost certainly have lactation consultants available to visit you in your room and help you get off to a good start.
I've heard that you should be wary of the advice that nurses give you. Some are wonderful. Some will happily give you advice that is flat-out wrong. I've talked to some people who got conflicting advice from every nurse they met while they were in the hospital, and other people who got advice so bad that it made breastfeeding much harder. Also, the doctors and nurses in the hospital will tell you things like, "just one bottle won't hurt" when in fact one bottle can indeed be enough to cause major disruptions to the start of breastfeeding.
If you have concerns, ask for help!
When Arlo was born, I sat there groggily kind of waiting for someone to tell me it was time to nurse him. Luckily someone (the midwives' apprentice) did! If I had it to do over, I'd go right ahead and try to nurse him fairly immediately after birth, without waiting for someone to give the go-ahead. Or I'd ask, "Is it OK for me to try nursing the baby now?" and then try it. But I wouldn't wait around for someone to tell me to do it. I'm not sure how long I would have waited to nurse Arlo if the midwives' apprentice hadn't told me that I could. And nursing early, when the baby is as new as possible, is supposed to be super-helpful to getting breastfeeding off to a good start. Evidently there's a window of opportunity when the baby is first born, and then after that the baby gets sleepy and won't be as interested again anytime soon.
If you have concerns, ask for help!
Tell your partner that studies have shown that one of the strongest determining factors in success in breastfeeding is support from the baby's father.
Don't keep any baby formula in the house. (At this point I'm so disgusted with the baby formula companies that I'm very glad that neither of my kids has ever had any.)
Learning to nurse the baby while you and the baby are both lying down takes some effort, but it is well worth it. It took me and Arlo maybe a month and a half or two months to figure it out. Then it became our primary nursing position forever more. With Kendra too, lying down took some work, but then it became our primary nursing position.
Nursing is hardest at the beginning. I've heard people say that if you're having a rough time, give it six weeks before giving up. This advice didn't entirely work for me, since I probably would have tried to improve Arlo's latch-on much sooner if I hadn't been busy waiting for things to improve after six weeks.
At the beginning, milk sometimes sorts of backs up in the ducts inside your breasts. You'll sometimes feel little lumps of milk. I used to massage these while Arlo nursed, to encourage the milk to keep flowing. That seemed to help. After a while this lumpiness stopped, and didn't occur again, even when I was nursing my next baby.
For dealing with engorged breasts after giving birth, the current recommendation is to apply cold if your breasts hurt. The idea is that the swelling is only partly milk, and partly it is swollen tissue. The cold reduces the swelling and helps make you more comfortable. The way to apply the cold is to put ice or frozen vegetables into a towel or some other kind of cover, so that it's not directly against your skin, and let it sit for up to 20 minutes. On the other hand, while some people get painfully engorged, I personally never did. I got engorged, yes, but not to the point that it was painful enough to need any special attention.
The conventional wisdom says to nurse your baby on both breasts at each feeding, starting each feeding with the opposite breast from the one you started the last feeding with. My midwives started me off doing each entire feeding from just one breast. This is thought to be a good idea, because that way your baby gets a good mix of the different types of milk (watery foremilk and rich hindmilk) at each feeding. Sometimes if you switch breasts too much the baby can get too much of the watery foremilk, which can cause indigestion and make the baby hungry again too soon.
I think before pregnancy my breasts were about the same size as each other. I never really paid attention. Once I started breastfeeding I noticed that the two breasts had different personalities. One breast was smaller, more likely to leak milk, gave milk faster, and seemed easier to latch Arlo onto. The other breast was physically bigger and seemed to have a bigger milk supply. They say that if this happens you should nurse more often on the smaller breast to increase its milk supply and even your breast sizes out. I found that I had to do a lot of favoring the smaller breast before things evened out. For a long time I started almost all feedings on that breast, especially when I'm away from home. All sorts of things worked much better once I gave myself permission to start most feedings on that same breast. I haven't heard other people mention that happening to them, but for me it was a big deal.
Leaking really does decrease over time.
There are two types of breastmilk during each feeding, "foremilk" and "hindmilk". The foremilk is available right away, as soon as the baby latches on. It is waterier and lower in calories. The hindmilk arrives when your breasts have a "letdown", which is when the muscles inside your breasts squeeze the milk sacs to send freshly made milk down to the baby. Hindmilk is higher in fat and more satisfying to the baby. You want to nurse on each side for long enough for the baby to get plenty of hindmilk. I found that the foremilk often seemed to run out and leave the baby frustrated while waiting for the hindmilk to arrive. It takes about a minute of nursing for my body to have a letdown and release hindmilk to the baby. Arlo was generally frustrated until the letdown occurs. I gave Arlo lots of verbal encouragement when he seemed frustrated. Kendra went through a phase where she would unlatch and need to be latched on again. Some other moms I know will sometimes massage their breasts to get a letdown before the baby started nursing, to shorten or avoid the minute of frustration at the beginning.
If you plan to pump and give your baby bottles, you don't want to start bottles too soon or you may cause nipple confusion, which is where the baby can't figure out how to nurse from a breast. You also don't want to wait too long before starting a bottle, or the baby may simply refuse them. If I remember right, 4-6 weeks is the optimal time to start with bottles of pumped milk. But check the books early -- I may have the numbers wrong.
All sorts of things tend to make moms think their milk supply is inadequate. Don't get fooled! And especially don't get fooled into using formula. For a lot of reasons, your milk is the best possible food for your baby.
Formula can be a slippery slope. Your body knows how much milk to make based on how much the baby has nursed in the previous day or two. If you give your baby a bottle of formula, then your body has produced that much less milk, so it will continue to produce less milk over the next few days.
If the baby wants to nurse a lot and seems hungry, it is going through a growth spurt. The thing to do is to let the baby nurse as much as it wants to. This will increase your milk supply so that more milk is available in the next few days. There is always one more drop of milk in the breast, so if the baby nurses for long enough it gets more food. If you give the baby formula during a growth spurt because the baby is hungry, this can interfere with the needed increase in your milk supply.
This may or may not be useful to you, but lots of the books suggest bringing your child to bed with you because it makes night nursings much easier. Me personally, I have very mixed feelings on the subject, but it did indeed seem helpful, especially in the beginning.
The books say, "babies don't like the taste of milk during ovulation". I figured this meant the milk tastes slightly odd, but that it's no big deal. I don't know how different the milk actually tastes, but it sure does throw Arlo, so I think it must taste pretty bad. He also doesn't like the taste of my milk right before I start my period.
What prevents your periods from coming back is nursing every few hours during the night and day. Though even if you do that, eventually your periods will start again. I've read that on average breastfeeding moms get their first postpartum period when their baby is 14 months old. But that sounds awfully high to me. My first postpartum periods have started when my kids were 7 1/2 or 8 months old.
I've read several wildly contradictory theories about whether or not you can get pregnant if you haven't had your first postpartum period yet. Some sources say that if you're nursing night and day, if your baby is less than 6 months old, and if you haven't had a postpartum period, this is as effective a form of birth control as if you were on the pill. Then I've read other sources that say not to count on it. My feeling is that if you are lucky enough to find time for sex, it's a good idea to use birth control. I'm surprised by how many people simply forget to use birth control after their baby is born. What are they thinking?
My milk supply gets low in the days before my period starts. Sometimes it gets so low that it's scary to see how few wet diapers Arlo has had. My milk supply and Arlo's wet diapers come right back as my cycle progresses forward, but it's always a little scary.
I'm fascinated by the way the mother's and baby's body interact with each other. When the baby is first born, it nurses a lot, so the mother doesn't have periods. Later on, as the baby matures, it starts eating other foods and sleeping longer at night. This signals the mother's body to start having periods again. The mother's menstrual cycle causes her milk to sometimes taste bad or be in short supply, which nudges the baby toward finding other food sources and eventually weaning. This frees up the mother's body to create another baby. I'm intrigued by all the signaling back and forth between the mother's and baby's bodies.
Nursing in a side-lying position takes some work to figure out, but it is way worth figuring out. (It took Arlo and me a month or two to get the hang of it. Kendra and I figured it out faster, but it still took some work. Hey, didn't I already write this earlier in this page?)
There are several ways to switch breasts when you are doing side-lying nursing. Some moms roll onto their back with the baby on top, then ease the baby down onto the other side. Other moms get into a crawling type of position and shift the baby across. Also, it really is possible to nurse the baby on both breasts without switching sides. At first I thought I was too small-breasted to be able to do that, but later on I discovered that I can. I did that a lot with my first baby. For my second baby this question never really came up, I guess because I usually nursed on just one side at each feeding.
At first I was very careful to be discreet in public. Later on, I found that it made me sad that so many moms didn't breastfeed their kids because they thought that everybody bottle feeds, and so even though breastfeeding is so much healthier they fed their kids formula. After that, I found that if I was able to nurse discreetly and nobody noticed, I was happy, but if my baby got a little wild and everybody around us saw that we were breastfeeding, I figured I was doing a service to humanity by making it more acceptable to breastfeed, so that was OK too.
Some moms find it useful to have a "nursing necklace" that the baby can fiddle with while nursing. It's much nicer than having the baby fiddle with your nose and mouth!
If you pump, you can store your milk in the freezer in Ziploc freezer bags. If you lay the bag flat when the milk is liquid, it freezes very quickly, and later on it's very easy for someone to thaw the milk by running it under warm tap water. Ziploc bags have a space where you can write in the date that you froze them. Some moms call frozen breastmilk "liquid gold". When Arlo was a baby, I used to call it my "ticket to freedom". (When Kendra was a baby, I never did get around to pumping.)
If you have a mildly hungry baby and you're a few minutes travel from home, it's always better to feed the baby first and then go home, rather than hope to make it home before the baby starts yelling. The trip home is much more peaceful if you don't have a baby that could burst into flames at any moment.
Pregnant women, and new moms and their children are welcome at La Leche League meetings. I highly recommend going to at least one before your baby is born, and also continuing to attend afterward. You'll make contact with a leader who can answer your breastfeeding questions after your baby is born. You'll see moms with new babies. It's a good place to ask questions about breastfeeding or baby care.
Some excellent books for later are: The Nursing Mother's Guide to Weaning by Kathleen Huggins and Linda Ziedrich. The Womanly Art of Breastfeeding has a chapter where it discusses starting solids. And the American Academy of Pediatrics Guide to Your Child's Nutrition is excellent -- and very readable, too. I adore the book Super Baby Food by Ruth Yaron -- if you've ever considered making your own baby food, that is the book for you.
If you have questions, thoughts, things to add, things you disagree with, things that are outdated, please let me know
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