Breastfeeding certainly proves that the best things in life are free. It's not always pain-free, guilt-free, or fancy-free, mind you. But if you're aware of the possible pitfalls, you can lower the number of long crying jags (yours, not the baby's) and times that you swear like a sailor at your husband for not having breasts. Simply put, once you know what to expect, you've laid the groundwork for a successful breastfeeding experience -- one that's rewarding, exhausting, magical, and, of course, free of charge.
"My baby doesn't get it!"
Challenge: Your nipples are the size of dinner plates and as dark as overripe berries, yet your baby still can't hit the mark? After repeated attempts to shove part A into part B, it's hard not to shout "Come on!" to your precious newborn. An unsuccessful breastfeeding "latch" can be the beginning of the end, say experts, leading to aching nipples or decreased milk supply.
Solution: Establishing a good latch can begin while your baby's in utero: You can take a breastfeeding class at your local hospital and ask if the lactation experts on staff are available for advice after you return home. Or, to find a lactation consultant in your area, visit the International Lactation Consultant Association website
When you're ready for that first latch-on, hold your baby with one arm. Then use your free hand to cup your breast (with your thumb on top and fingers underneath in a "C-hold") and offer it to your baby. Once your baby has the hang of it, you won't need to hold your breast (see our expert breastfeeder, at left), but it helps when you're starting out. When your baby's mouth is open wide, adopt "rapid arm movement" (RAM), advises Babytalk contributing editor and pediatrician William Sears, M.D.: Rather than hunching over to reach your baby, quickly bring your arm and baby to your breast ("RAM the baby on"). Aim to have your infant's gums land at least one inch past the base of your nipple with his lips protruding out. Think "fish lips," says Dr. Sears.
As you continue to nurse, you can help your baby grab the breast and areola (the area around the nipple) more effectively by trying an "asymmetrical" latch, says Marianne Neifert, M.D., a pediatrician and the author of Dr. Mom's Guide to Breastfeeding. Instead of centering the nipple in your baby's mouth, aim for his nose, so that his lower jaw takes in more of the breast. If your baby has a bad latch, insert your pinkie into his mouth to break the suction, then try again.
"Ouch -- this hurts"
Challenge: Since nursing is natural, it shouldn't hurt. Of course, childbirth is natural, too, and we all know what a breeze that is, right? Here's the deal: Most women can expect the initial uterine contractions that breastfeeding triggers. You may also experience "pins and needles" when your milk is released. Then there's engorgement, when your breasts look like zeppelins (make that lead zeppelins, because they're harder than rocks); blocked ducts (when breasts can't be emptied completely, leaving knots under the skin); and cracked or sore nipples.
Solution: Before you refuse to let your baby near your breasts, know that any nursing pain should be mild and temporary. Head off uterine cramps, which go away after the first week, with ibuprofen or acetaminophen (yes, they're safe). For any other discomfort, start by checking your baby's latch. Signs of a bad latch include a crease across your nipple or a downward tilt to its tip. Still, pain -- make that toe-curling pain -- is the best signal that your latch isn't working. Nursing shouldn't be like a test on Survivor: If you can't win immunity from a bad latch yourself, get help -- from a friend, your pediatrician, or a lactation consultant. Meanwhile, olive oil, a baby-safe balm, or medical-grade lanolin will soothe those sore nipples and can be worn while nursing.
If a poor latch-on leads to poor drainage of milk from the breast, you may become engorged or develop a clogged duct. Apply cool compresses to reduce swelling, and feed more often on the affected side or use a pump to express milk until it's properly drained, says Kathleen Kendall-Tackett, Ph.D., a lactation consultant and health psychologist in Durham, New Hampshire. To soothe engorgement, many new moms swear by putting crumpled cold cabbage leaves or frozen peas inside their bra.
Babytalk contributing editor Kitty O'Callaghan is a freelance writer and mother of three in White Plains, New York.
