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Breastfeeding -- Answers to Moms' Most-Asked Questions

Formula, Medicine, and Getting Over Shyness

4. Will giving formula derail nursing?

Though exclusive breastfeeding is ideal, feeding your infant some formula occasionally (a bottle every couple of days or so, for example) most likely won't turn your baby off the breast.

If you're considering whether to bottle-feed once in a while, it's important to take into account your baby's age. It's best to delay formula until he's about 1 month old and your milk supply is well established. Newborns are also more susceptible than older babies to nipple confusion (when they prefer an artificial nipple, which is easier to grasp than the real thing) because they're still learning how to latch on and suckle effectively.

A better option? Expressing your milk and then bottle-feeding it to your infant. Breast milk is healthier, and pumping it won't limit your production.

If, for some reason, your baby begins to prefer the bottle to the breast, don't panic. You can retrain him to nurse correctly, especially if you have a generous milk supply. Until he's back on track, try the following: Stop all convenience bottles; offer your breast as soon as your little one seems hungry -- he's awake, he's rooting, he's bringing his hand to his mouth; and create positive associations by allowing him to nurse for comfort and by holding him skin to skin against your bare chest.

However, if your pediatrician says to supplement with formula, do it. This is usually the fastest way for an infant to regain the pounds he needs to get to a healthy weight.

5. Why does my infant prefer to feed on one side only?

A baby may favor one breast because the nipple is easier to grasp, there's more milk on that side, or the milk flows easier. Sometimes a mom may unintentionally nurse more often on one side (usually the left breast if she's right-handed). The unequal milk supply can cause a woman's breasts to become lopsided.

An unequal supply isn't usually a problem. If your baby is gaining weight and seems content after feedings, she's probably getting enough milk between the two breasts. If you recognize her preference early on, you can increase production on the weaker side by pumping after she feeds or by starting her off on that side, if she'll let you. (The longer you wait, though, the more difficult it'll be to boost milk production on the side that has the lower amount.)

6. How can I get over my shyness about breastfeeding in front of others?

Although nursing in public isn't against the law in any state, many moms feel self-conscious about baring their breasts away from home. But with practice, you can become confident feeding your baby almost anywhere. Some tips:

  • Opt for a bra with a release mechanism that's easy to manipulate with a single hand.

  • Put a receiving blanket or nursing shawl over your shoulder to shield your baby from public view, or use a sling, which lets your newborn breastfeed out of sight while you carry him.

  • Wear two-piece outfits. A vest or cardigan over your blouse can keep your midriff covered when you lift your shirt to nurse. Or undo a button-down shirt from the bottom up for less exposure.

  • Before venturing out in public, practice nursing in front of a mirror to get a feel for doing it discreetly.

    If you still feel embarrassed -- so much so that you postpone a feeding when you're out -- attend a La Leche League meeting or talk to other nursing mothers so you can learn how they've managed to make it work.

    7. Do nursing and medicines mix?

    Mothers are often mistakenly advised to interrupt breastfeeding when they're taking medication, such as antibiotics. The truth is that most drugs are safe for nursing; only minimal amounts actually pass into breast milk.

    But it's best to be cautious. Whenever your doctor prescribes medicine, make sure he knows you're breastfeeding. Let the baby's pediatrician know as well. Ask both about possible side effects -- for you and your infant. (The same is true for any over-the-counter drugs. Check the label and notify both doctors.)

    Try to take any medication right after you've finished nursing, since the peak drug concentration in breast milk will usually be reached between feedings.

    That said, there are a few drugs that are toxic for breastfed babies, such as some antidepressants or those used for chemotherapy. But even if you must take a drug that isn't safe for your infant, you don't have to wean her: You can stop nursing temporarily and pump and dump your milk. This can preserve your supply and allow you to start breastfeeding again when you're ready.

    Armed with the information you need, you can overcome these and other hurdles. It's worth it -- after all, nursing a baby is one of the precious rewards of motherhood.

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