You Can Breastfeed!

by Kitty O'Callaghan

You Can Breastfeed!

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.

"I'm exhausted. I need more sleep"

Challenge: Sure, babies sleep 15 hours a day; they're just not consecutive. Needless to say, taking care of yourself is not an easy task. Even if you were able to get a full night's sleep, chances are you'd still be wiped out.

Solution: The most common advice is "sleep when the baby sleeps," which is a pearl of wisdom. But unless you adjust your priorities during your awake time, you'll never sneak in the shut-eye you need, says Will Wilkoff, M.D., a pediatrician in Brunswick, Maine, and author of The Maternity Leave Breastfeeding Plan. Clear your calendar those first few weeks, he advises, limiting visitors and your daily duties. Ask your husband to be a bouncer, nudging visitors out the door when they cut into naptime. He can also pick up burping and diapering tasks, which will give you 10 to 20 extra minutes of sack-time after a feeding. Delegate daily tasks, such as folding laundry, cooking, or emptying the dishwasher, to anyone around who is willing to help.

Other lifesaving tips: Put bills on automatic payment, and consider a temporary housekeeper. Once nursing is going well, you can express milk so that you can hand off one night feeding to your partner.

"I'm a terrible mom"

Challenge: It's 2 a.m. Your baby is crying, your milk has let down, but all you want to do is hide under the covers. You curse in the dark and angrily wish you weren't Mommy anymore. Just as suddenly, you take it back, afraid of a wrathful parenting god who will surely make you pay. As your baby takes his nighttime meal, guilt consumes you.

Solution: Although breastfeeding can tap hitherto-unknown feelings of love and wonderment, it can also evoke guilt and resentment of your husband, parents, and  — gasp!  — your baby. But the challenge here isn't how you can eliminate guilt  — that's like trying to stop blinking or breathing  — it's preventing guilt from growing until it paralyzes you.

The best way to minimize guilt is to remember the three R's: recognize, reiterate, and relax. First off, recognize that guilt is a normal human emotion, says Kendall-Tackett. There are no warning labels issued for breasts, but if there were, they might say: "Warning: Despite your best intentions, you will not enjoy every moment of breastfeeding.

Be sure to take proper precautions, including taking naps, drinking plenty of water, hogging the remote control, and patting yourself on the back for choosing to breastfeed."

It can help to confide in a trusted friend, says Dr. Neifert, one who can reassure you that it gets easier, that feedings get shorter, and that the baby will sleep longer between meals. Or try keeping a journal or seeking out other nursing moms in your community or online.Next, reiterate your needs to others  — ask for and accept help with anything that you need, whether it's grocery shopping or emotional support. Finally, relax. Just because a negative thought comes to your mind, it isn't transmitted via breast milk to your baby's brain. To him, you're still the alpha and the omega. Hail be to Mommy!

If for any reason  — illness, a colicky baby, a spouse with extended work hours  — you're simply overwhelmed by the demands of breastfeeding exclusively, it may be time to introduce a bottle of pumped breast milk or supplement with formula. It depends on each mom's individual situation, says Dr. Neifert. If doing the combo of breast- and bottle-feeding keeps you nursing longer, then so be it.

If guilt is keeping you from caring for yourself or your baby, it could be a sign of postpartum depression. Seek help from a doctor if you're down (and don't feel guilty about it). To learn more, visit the National Women's Health Information Center

"I need more help from my husband"

Challenge: Not only did you carry, labor, and deliver your baby, now you're his sole source of nourishment. An important privilege, it's true. But when your husband heads out the door, your spitup-encrusted nursing chair can feel as if it's equipped with leather straps holding you down.

Solution: There's no doubt about it: Breastfeeding takes away some of your freedom. (Then again, so does having a baby.) In the early months, you're constantly on the clock, with your newborn whistling "time's up" every two hours. (Actually, by the time you feed, burp, and change your baby, you have only about one and a half hours of downtime.) Meanwhile, your husband has no such timekeeper confining him. So even when he's running out to pick up a pint of your favorite ice cream, you may resent him for it.

When you're ready to burst with anger because he doesn't understand what you're going through, remember this: He doesn't understand what you're going through. And, as you've probably already guessed from other situations in your relationship, he's no mind reader.

To get the "me" time that you need  — whether it's to take a nap, take a walk, or take a spoon to that ice cream he just fetched  — you will have to be vocal about your needs and perhaps shift some additional baby duties his way. If he can provide extra help, it will go a long way toward preventing resentment from taking root, says Dr. Neifert.

"I can't take the nagging!"

Challenge: Sure, breastfeeding is a private choice, but make no mistake, it's a public issue. Everyone from the security guard at the mall to your Aunt Sadie wants to have a say in when, where, and how long you breastfeed.

Solution: No mom should have to explain herself to others, says Dr. Neifert, but that's exactly what you can expect. The comments ("How long are you planning to nurse?" "Isn't he on solids already?") will be annoying, like a mosquito buzzing in your ear. Unfortunately, no one makes bug spray for these intrusive folks, so you'll need your wits and some valuable medical information to shoo them away.

People who offer criticism, however well intentioned, are trying to control you, says Marcia Brubeck, a psychotherapist in West Hartford, Connecticut. Don't be afraid to remind others when they're out of bounds. A response as simple as "I will bear that in mind" may be enough to change the subject. If not, Dr. Neifert suggests bringing up that the American Academy of Pediatrics recommends that moms breastfeed for at least a year, and how breast milk is proven to boost a baby's immune system.

It's also helpful to remember that most people aren't knowingly trying to sabotage your efforts, says Kendall-Tackett. If your aunt's kids are grown up, chances are she doesn't have the latest information. If it's your husband who's resisting your efforts, have your pediatrician tell him about the health benefits of breastfeeding.

There's no getting around it: Very few women can simply put baby to breast for the first time and experience instant maternal nirvana. You need advice from experts, other moms, and a support system that will pull you through tough times. Most of all, you need to know that you can breastfeed, and that you deserve a hug, your partner's gratitude, and a nap every time you feed your baby. Give yourself these gifts of help and praise and you may come very close to nirvana, and even closer to your baby.