The Beauty of Breast
The American Academy of Pediatrics (AAP) recommends breastfeeding throughout baby's first year. "Human milk is the absolute perfect food for an infant -- full of living antibodies and customized for your baby," says Mary Kat Smith, R.N., a lactation consultant at Henry Ford Hospital in Detroit. If the idea seems a bit overwhelming, don't worry. Most moms get the hang of it pretty quickly. When in doubt, pull out this handy breastfeeding guide. And remember:
- Breastfed babies have fewer respiratory problems, ear infections, colds and flu than formula-fed babies. Breastfeeding also reduces a child's risk of type 1 and 2 diabetes, childhood leukemia, obesity, heart disease and SIDS (sudden infant death syndrome).
- Breast milk is easy to digest, so nursing babies are less likely to suffer from constipation, reflux and allergies.
- Oxytocin, a hormone produced during nursing, helps the uterus contract, allowing moms to recover faster post-delivery.
- Breastfeeding reduces a woman's risk of developing breast and ovarian cancers, type 2 diabetes, heart disease, high blood pressure and high cholesterol later in life.
- Breast milk is free, always the right temperature, and the fat content even changes according to baby's needs.
Hold On! A Play-by-Play of Key Breastfeeding Positions
By Valerie Fahey
Cradle Me The cradle position feels the most natural for many mothers, and because it keeps breast exposure to a minimum, it's ideal for public nursing. Cuddle your baby with her head resting in the crook of your arm and her tummy against yours. Her lower arm should be tucked out of the way.
Cross My Heart Positioning your baby in a cross-cradle allows for good control of her head, so it's useful with a newborn who's having trouble learning to nurse. As in the cradle hold, position your baby tummy to tummy, but hold her head with your hand and use your forearm to support her bottom.
Let's Play Football A good choice for mothers recovering from C-sections, the football hold minimizes pressure on the incision. It's also practical for those nursing twins simultaneously. Lay your baby along your side so her back is supported by your forearm and her head is cradled in your hand, the way a running back would carry a football.
This Side Up The side-lying option is good for those middle-of-the-night feedings. Lie on your side with your head on a pillow. Nestle your baby close to you, with her head in the crook of your arm, her mouth level with your nipple, and her tummy against yours.
3 Steps to Latch Success
By Valerie Fahey
If your baby isn't latched onto your breast correctly, he won't be satisfied with his meal, you may develop sore nipples, and your breasts may not produce adequate amounts of milk -- whew! Remember to bring your baby to your breast, not your breast to your baby. The best thing is to wait for baby readiness rather than trying to wake him on a predetermined schedule (like every three hours). If your baby is rooting -- turning his head and opening his mouth widely when you touch his cheek -- he's ready! Make sure he has a good deal of your areola -- the dark area around your nipple -- in his mouth. "Don't be afraid of blocking his nose," says Jan Barger, R.N., a lactation consultant in Wheaton, Illinois. "Babies can breathe well even if the tip of their nose seems to be buried in your breast." If your baby has trouble latching on because your breasts are engorged, express milk (by hand or with a pump) until they soften. Then follow these simple steps for latch-on success:
1 When you offer your breast, support it with your fingers underneath and your thumb on top. Use your dominant hand to support baby's head and the other hand to support your breast. Place your nipple between his nose and upper lip, and when he opens widely, pull him quickly onto the breast, leading with his chin so his chin is making solid contact with your breast. That will keep the nose free, and he can get a big mouthful of breast. If you wait for his rooting, his tongue will automatically come down and out, and you don't have to do anything but pull him on to the breast.
2 Let him nurse as long as he is taking long, drawing sucks. When he slows down and his eyes close, you can compress your breast deeply for about five seconds to get him sucking again. If he doesn't respond to that, you can switch sides. There is no particular number of minutes that he has to breastfeed -- most newborns will nurse 10 to 20 minutes on the first side, and 10 to 15 on the second. They get a lot more efficient as they get older and may not breastfeed as long.
3 When it's time to switch sides, slide your pinkie between your breast and your baby's gums to break the suction. When you hear a soft pop, extract your nipple from his mouth and position him on the other breast.
Hey Baby, Meet Bottle
by Melissa Clark Vickers
When baby's milk arrives without the mama, your baby may need some coaching
- Wait three to four weeks until breastfeeding is well established. Introducing a bottle too soon can interfere with your milk supply.
- Let someone else offer the first bottle. A breastfed baby knows mom has the "real stuff."
- Give the bottle when your baby isn't extremely hungry. Bottles are a novelty to babies. He won't understand that this piece of plastic will alleviate hunger pains, and may become too upset to eat.
- Gently introduce the bottle nipple. Use it to tap a little milk onto his lips. Wait for him to open up and draw the nipple in.
- Try different positions. Some babies prefer being held in a nursing position. Others will do better with a bottle if they're facing outward. You can also try standing and swaying gently during the feeding.
- Use your baby's sense of smell. Have the person who is bottle-feeding wrap the bottle in your nightgown or nursing bra. That person should avoid wearing perfume or other strong scents.
- Be patient. Some babies will take to bottle-feeding immediately; others need practice. If your baby becomes frustrated, stop and try again later.
Wow, My Nipples are S-O-R-E!
Solutions to common nursing challenges
The Challenge: Sore Nipples
Although the major cause of severe or chronic sore nipples is trauma from incorrect latch-on and sucking, other factors can exacerbate the problem. Inappropriate nipple care (such as overdrying or excessive moisture) can delay healing, and nipple cracks can become infected by bacteria or yeast in the baby's mouth. Siiiigh.
The Solution: Nurse 'Em!
Once you're certain that your baby is latched correctly, try applying medical-grade purified lanolin after feedings or wearing moisture-retaining hydrogel dressings (such as Ameda Comfortgel Hydrogel Pads, $25 a pair at amazon.com) between feedings. Your doctor can prescribe an antibiotic or antifungal medication if an infection is present. Begin breastfeeding on the least sore side to trigger your milk-ejection reflex. Once milk flow has begun, baby should suck less vigorously when brought to the second, more irritated breast. Frequent, short feedings are preferable, since delaying the interval between feedings results in greater breast engorgement and a ravenously hungry baby -- a combination that can cause further nipple trauma. If your nipple pain is so severe that you must interrupt breastfeeding, temporarily express your breast milk using a fully automatic, electric breast pump.
The Challenge: Blocked Milk Ducts
A plugged duct, also known as a blocked duct or a caked breast, results when one of the milk ducts draining the lobes of the breast becomes partially obstructed. It creates a firm, tender, engorged area of the breast, and often forms a lump near the armpits. If not quickly remedied, a blocked duct can progress to a breast infection. This usually occurs when you haven't breastfed your baby often or long enough. Women who produce abundant milk are particularly prone to it, and being separated from your infant or going for long periods without nursing is another common risk factor. Wearing constrictive clothing, such as a tight underwire bra or straps from a baby carrier that are pulled too tight, also can interfere with milk flow.
The Solution: Nursing as Much as Possible
Begin several consecutive feedings on the affected side, since babies nurse more vigorously and take more milk from the first breast. You can also place your baby so that her chin points toward the plugged duct, a position that will help promote drainage. Warm compresses or a warm shower can trigger your letdown reflex and improve milk flow, and gentle massage of the blocked area can also be effective. Be careful not to press too firmly, however, as causing trauma to your breast increases the risk of an infection called mastitis. Recurrent clogged ducts can be a sign of breast inflammation or low-grade infection; treatment with antibiotics sometimes curbs the problem. Occasionally, a breast lump is mistaken for a clogged duct. If a lump persists for more than several days, have it checked by a doctor.
The Challenge: A Not-So-Pretty Infection Known as Mastitis
This breast infection occurs in about 10 percent of breastfeeding women. Flulike symptoms are typical: fever, chills, headache, body aches and fatigue, along with an area of the breast that is tender, red and firm. Mastitis is often preceded by a clogged duct, an infected cracked nipple, irregular or ineffective milk removal or simple exhaustion.
The Solution: A Round of Antibiotics
This nursing challenge requires a trip to the doctor's office. If infection occurs while you are breastfeeding a healthy baby, continue nursing or your milk production may decrease. Nurse on the unaffected breast first and move her to the painful breast only once the letdown reflex has been triggered. Ibuprofen can help reduce inflammation and pain, and warm packs can provide comfort. If direct breastfeeding is too painful, pump. The best way to avoid another bout of mastitis: Nurse and/or pump as often as you can.
The Challenge: Another Not-So-Pretty Thing Called Thrush
This fungal infection sometimes occurs among moms who are diabetic or have recently completed a course of antibiotics. Signs include milky-white spots or a coating inside baby's mouth. The infection can also appear on your nipples as pink, shiny, oozy or flaky spots, and you may feel a burning sensation during or after nursing.
The Solution: Antifungal Medication
If you see spots on you or your baby, contact your respective doctors. It's important for you and baby to be treated simultaneously for about two weeks to keep the two of you from spreading it between each other. If you pumped and stored breast milk while you were infected, your doctor may advise you to toss it out. However, you may continue to nurse. To prevent thrush, keep your nipples clean and dry, and wash everything that goes into your baby's mouth with warm, soapy water.
Pump It Up!
Plan to pump at work? Supplement with bottles? Here, a new mom's best bets
by Kim Hays
Serving expressed breast milk in a bottle allows a mom to give her baby the best nourishment possible even when she's not around. (Think going back to work, girls' night out or a quick trip to the gym.) It also gives dad and grandma a feeding role-and can help mom snag some zzzzzs while dad picks up those 3 a.m. feedings. Luckily, there's a pump for just about every mom.
If you're not sure how long you'll breastfeed You might want to start by renting a hospital-grade electric double breast pump (around $1 to $3 a day and up to $60 for your own collection kit), especially if your baby is unable to nurse. Hospital-grade pumps are the most efficient because they closely mimic the natural suck and release cycle of a baby. Best bet: To find out about rentals, call your hospital or local La Leche League International (illi.org).
If you're going back to work You won't want to lug a heavy hospital pump into the office. You'll need something more portable. Machines that allow you to pump both breasts simultaneously, hands-free, work the hardest and the fastest. Best bets: the Medela Pump In Style Advanced Breast Pump ($280; target.com) or the Philips Avent Isis iQ Duo Twin Electronic Breast Pump ($250; amazon.com). Both can pump both breasts at the same time and come with an insulated milk-storage bag and a carrying case. Attach nipples to the storage bottles and they're ready for baby.
If you don't plan on pumping much A single pump operated by hand will do the trick at a low cost. Best bets: the Simplisse Manual Breastfeeding Companion ($40; amazon.com) or the Ameda One-Hand Breast Pump with Flexishield ($34; amazon.com).
If you plan to store milk Expressed breast milk should be kept chilled, so if you're pumping at work, for example, you'll need access to a refrigerator or cooler, an insulated bag and a cold pack for transport home. The AAP recommends storing your milk in hard plastic cups with tight caps or heavy-duty bags that fit directly into a baby bottle. Best bet: Playtex Nursing Necessities One Step Breast Milk Storage Kit ($8; kmart.com). For more on safe storage of breast milk, visit the AAP's website, healthychildren.org.
What would happen if everybody breastfed?
If 90 percent of mothers breastfed exclusively for the first six months of their infants' lives, the United States could save $13 billion in health-care costs as well 911 babies' each year.
-- According to a recent study in Pediatrics, the journal published by the AAP, on how breastfeeding could promote a healthy bottom line for society at large. (Megan Aquilina)