Breastfeeding is a hot topic, with celebrity moms like Gisele Bündchen, Kourtney Kardashian and Laila Ali using their star power to publicly tout nursing. Even first lady Michelle Obama is on board as an advocate, hence why breastfeeding has become a public health issue, much like seat belt use or smoking.
The message is clear. Breastfeeding is at its most popular level in more than 35 years, with the Centers for Disease Control and Prevention reporting as many as three out of four women initiating nursing — up from one in five in 1972, the lowest rate noted in the last century, according to a review in The Journal of Nutrition. There are more lactation consultants than ever, government-funded support programs, faster and more affordable breast pumps and even iPhone apps available to help moms succeed at nursing. Yet at the same time, only 22 percent of babies receive breast milk until at least age 1, as recommended by the American Academy of Pediatrics. So what's the problem? Why are so many moms starting and then stopping breastfeeding or never starting at all?
Dozens of booby traps sabotage our efforts. As described by lactivists (lactation activists), booby traps are barriers that hinder a mother's ability to nurse successfully. Physical obstacles, such as low milk supply or a bad latch, as well as social ones, like nursing in public, put pressure on well-intentioned moms to toss out their nursing bras and opt for a bottle. “Nursing problems have become an epidemic,” says Diana West, a renowned lactation consultant who co-wrote the latest edition of The Womanly Art of Breastfeeding. When breastfeeding doesn't come easily, “Moms automatically assume they've done something wrong,” West says. But they haven't. They've just faced some obstacles that can seem insurmountable at the time. Doctors, lactivists, moms and more weighed in on the most common breastfeeding “booby traps.” Here's how to overcome them and maximize your chances of having a successful breastfeeding experience.
“I think I'm not making enough milk.”
Many moms are worried their milk supply is subpar, says Colette M. Acker, executive director at the Breastfeeding Resource Center in Abington, Pennsylvania, and a lactation consultant. But often, they're looking at the clock and trying to feed baby according to an arbitrary schedule, she says, not realizing that newborns nurse frequently and can vary in the length of time they'll want to spend at the breast. Rather than worry about how much milk baby is getting, take cues from his behavior. “Look at baby's weight gain, temperament before and after nursing, listen for audible swallowing and count the number of wet and poopy diapers,” she says. By the first week, six to eight wet diapers, plus three or four yellow, poopy ones are normal per day. You may be making more milk than you realize. If you still think your production is low, schedule a meeting with a lactation consultant who can properly assess your milk supply. She will likely observe a feeding and make recommendations.
Amp Up Your Supply:
Drink plenty of water.
Ensure baby latches well and that both breasts are emptied at each feeding.
Use a breast pump between feedings to stimulate production.
Nurse at night when levels of prolactin, the hormone that stimulates milk production, are the highest.
Ask your lactation consultant about certain foods, such as oatmeal in specific quantities, that may improve milk production.
“My baby won't latch.”
Twenty to 30 seconds of slight pain or gentle tugging when initiating nursing is normal, but if that pain persists longer, a bad latch may be to blame. Those early weeks of breastfeeding weren't pleasant for Carrie Lenkenhoff, a 30-year-old mother of three. A nurse in the hospital told her to hold her breast like a hamburger, not a cigarette, but the advice stopped there. “I felt like it was my first act of motherhood, and I'd failed,” Lenkenhoff says. “It took a few weeks before my baby and my breasts formed a relationship.” Try letting baby initiate a latch on his own. Too often, moms take control, positioning babies horizontally and pouring their boobs into babies' mouths. Acker recommends mom and baby lay together skin-to-skin; baby will show readiness for food by lifting his head. Gently guide his head toward your breast, but let him stay in the driver's seat. Gravity will help ensure a deep latch, beyond just the nipple. Lanolin cream, hydrogel pads and breast milk (just rub it on and let it dry) can soothe sore nipples.
“Formula is everywhere.”
“We hear from moms who are angry at the hospitals, doctors and nurses for undermining their attempts at breastfeeding by quickly recommending formula when it's not medically indicated,” says Bettina Forbes, co-founder of Best for Babes, a breastfeeding advocacy group. Her solution? “Be resourceful and ask a lactation consultant for a second opinion,” Forbes says. If you plan to deliver in a hospital, find out beforehand if it has strong pro-breastfeeding policies.
“My baby has reflux.”
Just because baby is spitting up doesn't mean she has reflux. Look for the signs: discomfort when eating or swallowing, crying before spitting up or an arched back while crying. Acker suggests shorter and more frequent feedings. Hold your baby upright after a feeding and offer a pacifier, which can help keep digestive juices down instead of coming up. Talk to your pediatrician about whether your diet could be affecting baby.
“Breastfeeding feels weird.”
Although the initial latch may feel foreign, many women find comfort by nursing their babies. Visiting a lactation consultant — who will want to watch you nurse and may need to touch your breasts — also may be awkward for some women. West urges moms to seek out other moms for added support and help overcoming emotional reservations. Breastfeeding is not something women are meant to do on their own, she says. “Find your nursing network,” West says. “Make friends with other nursing moms. Find an online support group or a local nursing moms group. Attend a breastfeeding class.” Local hospitals may offer nursing support programs.
"My breasts are for the bedroom."
Keva Zeigler counsels low-income expectant moms about the benefits of breastfeeding, but she wasn't always a believer. The Detroit mother of four was always turned off by breastfeeding until her last child was born. It wasn't until Zeigler witnessed a friend nursing that she realized just exactly how it worked.
Zeigler tells her story so other women can stop believing myths and instead learn the truths: Breastfeeding is natural, and sex while nursing can still be spicy. Just get creative in the bedroom! Zeigler tells women to talk openly with their husbands or boyfriends about why breastfeeding is important and to nurse often in front of them. Let your partner see breasts as something other than bedroom playthings, Zeigler says. “I tell them to just go with it; so what if there's a little milk in the bedroom?” she says with a laugh. “That usually gets the moms laughing and we can move on to other concerns.”
“It will all be on me.”
We say: Only if you let it be. Enlist your partner's help for diaper changes, baths, burping and cuddle time. When she's about 6 months old, dad can help by feeding baby her first solids.
“I can't afford a lactation consultant.”
Start with your local breastfeeding support group. The mothers or trained counselors there may be able to help at no cost. You can find La Leche League groups in almost every large town and city by calling 877-452-5324 or at llli.org. You can also find information online at kellymom.com. If your problem requires the advanced expertise of an international board-certified lactation consultant but your insurance doesn't cover visits, you may still be eligible for reimbursement in a flexible spending plan. Some hospitals offer low- or no-cost outpatient lactation consultations. You can also consider asking for a consultation as a baby shower gift.
“I have flat or inverted nipples.”
If you're one of the 3 to 9 percent of women with flat or inverted nipples, talk to a lactation consultant before your baby is born for tips to draw your nipples out. She may recommend devices or suggest pumping briefly before nursing to draw out your nipples. If all else fails, she may show you how to use silicone nipple shields to help baby latch.
“None of my friends or family members nursed.”
Seek out nursing moms via online or local support groups. Facebook's “Breastfeeding” group boasts more than 55,000 fans, and many regularly provide comments to questions. Or check out the forums at kellymom.com or theleakyboob.com.
Your Best Bosom Buddies
1. The Expert
Lactation consultants come armed with answers whether your question is about the frequency of feedings, pinpointing an infection or something else. Find one near you during pregnancy so you're prepared after delivery. Some offer services at pediatrician offices. Visit llli.org or, for immediate assistance, call La Leche League at 877-452-5324.
2. The Been-There-Done-That Buddy
Look for other nursing mothers at local moms' groups, in an online forum or in your own circle of friends and family. Your local La Leche League leader can also pair you with an experienced nursing buddy.
3. Your Other Half
Your partner may not be able to breastfeed, but he or she can still encourage you. Ask for help with other chores to ease workload stress and remind him that he can bond with baby during baths, bedtime, diaper changes and more. Show your partner how you nurse and describe how it feels.
“I have the baby blues.”
Many new moms experience mood swings. However, if the baby blues last longer than two weeks or if you've become angry or resentful, talk to your doctor. When left untreated, depression can hurt milk production. A 2005 study in MCN: The American Journal of Maternal/Child Nursing found that mothers who are stressed, fatigued or depressed had lower prolactin levels in their milk and blood, which can decrease milk supply. Several antidepressants are compatible with breastfeeding, which means you don't need to quit nursing. Many experts agree breastfeeding actually enhances a woman's mental health.
“My baby seems smaller than others his age.”
Ask your pediatrician to use growth charts specifically for breastfed babies. Healthy breastfed infants tend to grow more rapidly than formula-fed infants the first two to three months and less rapidly from 3 to 12 months. The key is to keep all of your well-baby visits so your doctor can track baby's weight. (Find weight charts for breastfed babies at who.int/childgrowth/standards/en.)
“It will ruin my body.”
Breastfeeding often gets blamed for sagging boobs, but actually it's pregnancy, weight gain and poor bra support that affect the shape and size of breasts. During pregnancy, the glandular tissue in breasts increases and the ligaments that support your boobs may stretch as your breasts get fuller. This stretching may contribute to sagging after pregnancy — whether or not you breastfeed. Breastfeeding and gradual weaning may help redeposit fat into the breasts and return them to more of a prepregnancy appearance. La Leche League says women who are more concerned with the shape of their bodies are less likely to want to breastfeed. “The longer a woman breastfeeds, the lower her risk for developing breast cancer, ovarian cancer, Type 2 diabetes or cardiovascular disease,” says Melissa Bartick M.D., an internal medicine physician in Massachusetts. Keva Zeigler, a breastfeeding peer counselor, says: “I tell women, ‘Take pride in your superpower. You make milk. You grow people.’”
“It will spoil my baby.”
Untrue, says Williams Sears M.D., pediatrician and Babytalk contributing editor. Parents worry that nursing on demand will create clingy and dependent children. The truth is you can't spoil a baby by promptly meeting his needs or by breastfeeding, Dr. Sears says.
“Bottle feeding is easier.”
The time it takes to mix, heat, feed and clean bottles, as well as having to shop for the formula, adds to the preparations, Zeigler says. “Moms I counsel will walk me through all of the steps they take to make a bottle or plan an errand,” Zeigler says. “Usually, I could have breastfed my baby by the time they're finished.”
“My baby has thrush.”
Two to 5 percent of babies experience thrush — a yeast infection in baby's mouth that can be transferred to your breasts — and, yes, it hurts. Call your pediatrician and get a prescription of antifungal medication for both of you. Air-dry your nipples after each feeding and wash bras daily. If both mom and baby are being treated, continue breastfeeding. If not, speak with your pediatrician about your options.
“I don't want anyone to see me nursing.”
Nursing in public can be done without drawing attention. Practice in front of family, other moms or even a mirror. A nursing cover (try Bébé au Lait brand, available at Motherhood Maternity) or nursing clothing (we like the selection at milkstars.com) can help too.
Making It Work at Work
The first thing you'll need is a good breast pump. Electronic pumps are available for rent or purchase. Pumps and all breastfeeding supplies are tax-deductible, thanks to a new IRS ruling. For working moms who are paid hourly, work outdoors or have limited flexibility, pumping may be difficult. Fortunately, there are new laws to protect working women. In workplaces with more than 50 workers, employers are required to provide a private area and adequate breaks for nursing moms. If these laws don't apply to your workplace, get creative and be your own advocate. You may need to think of ways to reorganize your work to allow you to visit baby at noon for a lunch-break feeding, cut back your hours, suggest a different schedule or talk to your boss. (You may want to tell your boss that because breastfed babies have lower incidences of illnesses, you may use fewer sick days!) Some working mothers choose not to pump but to continue breastfeeding in the mornings and evenings — just know that this could affect your milk supply.