Mother to Mother: The Truth About Breastfeeding Your Baby

One of the most important decisions that you will have to make when your new baby arrives is how you will feed him or her. No doubt you will receive endless advice from friends and family, your obstetrician, nurses, midwives, and doctors at the hospital where your baby is delivered, as well as your baby's pediatrician. In fact, don't be surprised if well-intentioned strangers stop and offer you advice! You will likely be troubled to find that much of the advice you receive will be contradictory, and at times it may be very difficult for you to sort out the "facts" from old wives tales. Take it from an experienced breastfeeding mom - there is no shortage of information and MISinformation out there about breastfeeding, so think carefully about the source of any and all advice you receive.

First, you should know that the American Academy of Pediatrics (AAP) is very clear in their recommendations about breastfeeding. In part, the AAP position on breastfeeding is: "Pediatricians and parents should be aware that exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life... and... breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child... The AAP firmly adheres to the position that breastfeeding ensures the best possible health as well as developmental and psychosocial outcomes for the infant."

While formula feeding is a safe and proven alternative to breastfeeding (and in the case of women with certain contagious diseases, like untreated TB, the best alternative), it is inferior in many ways to breastfeeding. Thus, the AAP highly recommends that all pediatricians encourage their patients to exclusively breastfeed for the first six months of life at minimum. Unfortunately, many pediatricians have not accepted this AAP guideline, and do not have enough knowledge of breastfeeding to properly endorse it. This is especially troublesome because the early days of breastfeeding can be overwhelming, and mothers often rely on pediatricians to advise them about care in the first weeks of life. If pediatricians do not advocate breastfeeding, what is a mother to do? The most helpful thing a new mother can do is simply to begin the journey with as much information as you can gather.

If you're "on the fence" about whether or not to breastfeed your baby, consider the following data, published by the AAP. Babies that are breastfed are less likely to experience ear infections, stomach viruses, upper respiratory infections, and they are less likely to develop allergies. There are some studies that indicate that breastfed babies are less likely to experience SIDS (Sudden Infant Death Syndrome). Breast milk is made for babies. Most formula is made from cow's milk, which is, of course, made for baby cows. Therefore, breast milk is, logically, the easiest thing for a baby to digest. In addition, no preparation is needed, it costs nothing, and because there are no bottles or bottle liners needed, it is good for the environment.

In addition to the benefits for baby, there are benefits for you as well. Women who breastfeed burn more calories, which can help you return to your pre-pregnancy weight faster. It also will help your uterus return to its normal size much faster. Women who breastfeed are at a decreased risk of developing both breast and ovarian cancers. Breastfeeding builds your bone strength, which can reduce the risk of osteoporosis later, and may delay the return of your period for a period of months, or even years. Clearly, your body was designed to breastfeed, and you will see many benefits if you choose to do so. Once you've committed to undertake this part of motherhood, it is essential to know what to expect in the process.

To begin with, you should know that after your baby is born, you are likely to be exhausted, both physically and mentally. Nevertheless, you should attempt to nurse within the first 30-60 minutes after delivery. During this time your baby will be awake and alert, and thus willing and eager to nurse. However, in the hours and days that follow, your baby will be drowsy and harder to wake, thus less willing and enthusiastic about nursing. If you nursed your baby in those early minutes, he or she will more quickly develop a "knack" for the process.

Some women will tell you that breastfeeding is a natural, blissful experience. Such statements make me very uncomfortable, because, at times, breastfeeding can feel anything but natural and blissful. When my son was born, I was committed to breastfeeding him, but it was a disaster from the start. As they placed this tiny, slimy baby on me, I wondered exactly what I was supposed to do with him. After he had been cleaned up, a nurse tried to help me get him latched on. I was clumsy and awkward and nervous about this woman handling my breasts. I didn't even know how to hold this newborn baby, nevermind hold him in such a way that I could feed him. Once we finally got started, he struggled to open his mouth wide enough to achieve a good latch, and his tongue was not correctly covering his lower gums. The result? Within 24 hours I developed bleeding, cracked, and excruciatingly painful nipples. I took three meetings with a lactation consultant for us to figure out how to get him latched on correctly.

When we arrived at home, I quickly discovered that my son was also a nighttime cluster feeder. That meant that from 1am to 4am, he would nurse - constantly. And I mean constantly. Never in my life have I been so aware of how long the night is as I was in the first 12 weeks of his life. I was exhausted, terrified, and overwhelmed. To be honest, I hated nursing. He would cry. I would cry. We would struggle to get a good latch. It was not a pretty picture. My husband begged me to give him bottles of formula. For the first few weeks I refused, frightened that we would worsen our already difficult latch situation. Eventually, out of sheer exhaustion, I relented. My son got a few bottles of formula a week. And I spent every minute feeling like a terrible failure because I was not enjoying breastfeeding. It was neither blissful nor natural for me - it was a daily struggle.

And then, one day, it wasn't so hard. I think he was about 5 months old, and I realized during one feeding that it wasn't so bad. I looked down at him suckling, and I didn't feel tense for the first time. What a relief that moment brought me. Unfortunately, the damage was done. All the stress, the constant daily struggles, the feelings of failure, they had all damaged my perception of breastfeeding - I felt good about what I gave my son in the first year, but I was very grateful when, just before his first birthday, he started to wean. And from that moment on, every time a woman talked about how "natural, wonderful, blissful, peaceful, and transcendent" breastfeeding was, I felt a rising guilt in my gut.

The truth is, for some women, breastfeeding is a struggle. The first two or three months can be excruciatingly hard. But no one had prepared me for the possibility that breastfeeding wouldn't come naturally, so I felt there must somehow have been something wrong with me - that I had failed as a mother in some way. And then my daughter was born. Minutes after she was delivered, I was nursing her, and she caught on like a pro. Her latch was flawless. Her suck was perfect. Her cluster feeding time was 6pm-9pm - a much more civilized hour. She was born to breastfeed, and I never had a sore or crackle nipple. With her, breastfeeding was, in fact, a blissful experience.

Maybe things were so much easier with her because I had expected them to be hard. Or maybe the fact that I had experience made for a better latch. Or maybe she was just a better nurser than my son was. Regardless, the simple fact of the matter is that our breastfeeding relationship has been everything the movies make it out to be, and I am not looking forward to the day she decides to wean. I have learned, through all of this, that I am, in fact, not a failure as a mother. Breastfeeding can be a very difficult and exhausting, or, it can be smooth sailing from the beginning. And if you go into the birth of your child expecting breastfeeding to be all sugar and spice, you're likely to be frustrated and disappointed before you even leave the hospital.

Now that you are prepared for the fact that the first few weeks of this journey may be difficult, you need to know what, specifically, to expect. For the first 1-4 days of your baby's life, your body will produce colostrum, which is a very rich substance that contains essential antibodies for your baby. Your little ones stomach will only be able to handle a tablespoon or so of liquid for the first few days, so this colostrum is the perfect food for baby's early days. Somewhere between two and four days after delivery, your milk will "come in". Your breasts will feel firmer, and may leak what looks to be skim milk. You may experience some discomfort during this time, which is caused by engorgement. To relieve the pressure, nurse your baby as often as you can. If need be, you can apply warm compresses to your breasts. Within a few days your body will figure out how much milk to produce, and your breasts won't feel as full. In the meantime, if you experience leaking, you'll want to use nursing pads to keep your breasts dry. If your nipples get sore, you can express a little milk onto them, and then let them air dry. Or, if you prefer, you can purchase a pure lanolin (Lansinoh is a favorite of many nursing moms) and apply a small amount after each feeding. If you experience severe pain or cracked nipples, you should see a lactation consultant as soon as possible to help you and your baby with your latch.

In the early weeks of life, your baby will eat 8-12 times in a 24-hour period. Remember, breast milk is designed for babies, and as such it is very easily digested. You need to allow your baby to feed "on demand". Whatever you do, don't watch the clock. If your baby is cueing you that he or she is hungry (nuzzling against your breast, rooting, sucking on his or her hands, or crying), feed him or her. It doesn't matter if the baby just ate 30 minutes ago. Or ten minutes ago. The baby really, truly is hungry - you can not overfeed an infant. Each time you nurse, start on the opposite breast. Some babies will only nurse on one side per feeding, and others will nurse on both. If you start a feeding on the left, and then switch to the right, for your next feeding you will start on the right and then switch to the left. It can be helpful, at least for the first few weeks, to keep a rubber band on your wrist to remind you of which side to start nursing on.

Remember that newborn babies are sleepy, so you may need to wake your baby to feed. A newborn should not be allowed to go more than 2-3 hours without eating. It may be a struggle to keep your baby awake long enough to feed. You may have to strip your little one down to the diaper, and even sponge the baby off with cool water in order to keep him or her awake enough to feed. Don't worry, within a month or two that will no longer be necessary - your baby will be more alert and thus will be more eager to feed. As your baby grows, feedings will naturally space out, and by the end of 8 weeks, you should see a pattern emerging. By then, your baby may go 3-4 hours during the night without waking, but may still eat every 1.5-2 hours in the late afternoon.

Prepare yourself now for the following "milestones" of nursing. Your baby will go through frequent growth spurts during the first year of life. During these spurts, your baby's schedule may suddenly change. A child who was sleeping through the night might suddenly wake every two hours to feed. Your baby may become fussy, pulling away from your breast, refusing to nap, and generally behaving like an inconsolable little monster. These growth spurts occur on a fairly predictable schedule, although it is important to remember that babies can not read a calendar! Expect the worst of the growth spurts to hit at roughly three weeks and six weeks of age. Other growth spurts typically hit at about 3 months, 6 months, and 9 months of age. These periods can feel like they go on forever, but you need to remember that they don't really - just nurse your baby as much as he or she wants, and within a few days things should return to a more normal (and sane) schedule. Even if your breasts feel empty, they are NOT! Do not feel like you need to give your baby water, juice, or formula. Your breast are constantly making milk - the more baby sucks, the more milk they make. If you offer other liquids, you tell your body to make less milk, not more.

Unfortunately, the reality is that in addition to the physical and emotional challenges, there are also many social obstacles to breastfeeding in the United States. People may push you to offer your baby a bottle, including your own mother or mother-in-law. They may criticize you for feeding on demand, and insist that your baby should be put on a schedule. You may be told to offer your little one water on a hot day, or cereal if he or she is not sleeping through the night. People might imply (or out and out tell you) that your baby is too old to still be nursing. In addition, because of the sexual nature of breasts in our culture, you may feel uncomfortable nursing you baby in public during the early days and weeks. However, remember that your body, your breasts, were designed to feed your baby. You have a moral right to feed your child when he or she is hungry, and you should feel free to exercise that right. (If you feel truly uncomfortable, consider buying a nursing shawl or other cover.) Most importantly, prepare to defend your decision - have a script pre-rehearsed for when those rude or inappropriate comments come your way. Consider the following statements published by the AAP.

1. "During the first 6 months of age, even in hot climates, water and juice are unnecessary for breastfed infants and may introduce contaminants or allergens."

2. "Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child."

3. "There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer."

Make these "talking points" your mantra. Remind people who comment on your choice that this is your baby, and your body, and that in choosing to breastfeed your baby, you are doing what the American Academy of Pediatrics says is the very best thing for both of you. And, when you look down at your precious child and he or she is nursing, remind yourself that you are a wonderful mother, you are giving everything you have to your child, and no matter how hard it gets, you can do this. You can do this.