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Breastfeeding in the Early Weeks

By Jocelyn Smith

A number of mothers in our country start out their new parenthood wanting to breastfeed. In fact, studies show that about 60% of new mothers in the U.S. start out breastfeeding their infants. Those numbers aren’t nearly high enough, but that’s for another article. Unfortunately, by six months those numbers have dropped off to 21%. In the United Kingdom, about 66% of mothers are breastfeeding at the time of their hospital discharge, but by the time their babies are six weeks old those numbers have plummeted to 42%.

What causes these alarming statistics when every parent who even turns on a TV these days is told repeatedly that “breastmilk is best”? Sure, a small number of women physically can’t breastfeed, either because of surgery, genetic abnormality of the breasts, or glandular problems. I’ve seen their number estimated to be between 5% to 15% of all women. So where does that leave the remaining 85% to 95%?

The fact is, most early weaning (and by “early” in this article I mean earlier than two months, although really early weaning is anything under the twelve months recommended by the AAP) is caused by circumstances which, with proper support and information, can be overcome by the breastfeeding mother. Here are some common problems and how to prevent them.

“I’m just not making enough milk.” This is a common complaint, but an uncommon occurrence. What many mothers don’t know is that the breast works on a “supply and demand” basis. The more your baby nurses, the more milk your breast supplies. Therefore, if you allow your baby to nurse as much as she likes, when she wants to, you will always have enough milk (unless your baby is happy-to-starve, which means she is too laid-back to tell you when she wants to nurse). Signs that a baby is hungry include: rooting against your chest with her nose and mouth, making little eager whimpers, and, if you fail to notice the other signs, by crying. Do not schedule your baby, especially in the early weeks! Feeding your baby based on her cues is vital for building up your milk supply to an adequate level, especially in the early weeks. And don’t supplement her with formula, even just one bottle. If you really want to succeed at this, it is important to build your milk supply, and formula can interfere with that at this point.

Sometimes new mommies don’t know about the three-week and six-week growth spurts. What happens at these times is basically your baby seems to cry for your breast constantly. If you don’t know what’s going on, you might assume that you aren’t making enough milk. What’s actually occurring? Your baby’s body signals her that she will soon be growing at a rapid rate. In order to prepare your breasts to make enough milk for her post-growth-spurt body, she nurses at increased frequency for about 48 hours or so. Then, after your milk supply has been built up, she goes back to her every two hour pattern, or whatever is normal for the two of you.

If you are really worried about not producing enough milk, here’s how to tell. Your baby will usually have four to six wet diapers per day after the first three days. Her stool will have changed from sticky black to green to brown in the first week, and as soon as your milk comes in it becomes more yellowish and seedy. Your breasts will usually feel full before feedings, lighter after feedings, and leak between feedings. You can hear your baby swallow and feel your milk let down (this is a feeling that’s tough to describe, but to me it always felt like a pleasant, tingly ache).

“My baby just won’t take the breast.” This complaint can usually be entirely prevented. Sometimes a baby who is exposed to bottle-feeding or pacifiers in the early weeks learns to prefer the ease of feeding through a latex nipple to the greater effort of breastfeeding. This is called nipple preference or nipple confusion. Believe me, it is extremely easy for this to happen to your baby, even after just one bottle. Therefore, you must take steps to ensure that, in these early weeks, your precious little one’s mouth will not come into contact with anything other than your breast. When you go to the hospital, take along a printed sign that says, “Our baby is exclusively breastfed. Do not give her pacifiers or bottles without our express written consent.” Place this sign in a prominent place on her bassinet. You might want to choose the “rooming in” option, which means that your baby stays in the same room as you at all times. That way you can be sure that well-meaning nurses aren’t slipping the baby some sugar water or formula.

Don’t give your baby a pacifier until she is at least three weeks old. It would be better for you to never give one to her, but three weeks is generally okay. Do not give your baby a bottle of anything, be it water or formula or pumped breastmilk, until she is six weeks old. You two are at a very delicate stage of your breastfeeding relationship, and precautions must be taken to ensure its survival.

You’ll probably receive some formula samples in the mail when you get home. Either mark “Return to Sender” on the box, throw them away, or donate them immediately to a shelter. Do not let these tempters stay in your house! You are never so vulnerable to the temptation to bottle-feed as you are in the early weeks.

“It hurts so badly, I just can’t take it.” Pain in breastfeeding is a sign that something is wrong. Some soreness is to be expected during the first week while your nipples are getting used to being used like they never have before. My nipples felt like they were on fire! A little cracking is also common from your skin’s natural moisturizers trying to catch up to their new duties, especially if you are fair-skinned. I recommend to every pregnant mom who wants to breastfeed that she buy a product called Lansinoh, which is medical-grade lanolin. This product is safe to apply to your nipples without removing it before nursing, and works wonders on dry skin.

If, however, the pain persists or gets worse, there is most likely a problem that needs to be solved (and not by weaning). The first culprit to look for is improper latch-on or positioning. I really recommend you go to a La Leche League meeting or visit an experienced breastfeeding mother and ask her to scrutinize your latch-on technique. One common problem that is frequently overlooked is when the baby’s lower lip is sucked in rather than being everted over the nipple. A lot of times just pulling out that little lip does wonders for the pain. Be sure that your nipples are staying dry between feedings. Replace your breast pads as soon as they get wet, and make sure they’re not lined with plastic, which holds moisture in. If you can, just go with your bra flaps down all day. Don’t give artificial nipples, which can train a baby to suck painfully on the breast. If all else fails, call an IBC lactation consultant. These people can work miracles when it comes to breastfeeding problems.

“This takes forever! I don’t have time to sit here while the baby nurses.” The solution to this problem is, buy a sling. Using one of these handy-dandy baby carriers means you can take your baby and breastfeed your baby while running errands (though not while you’re driving around, of course). Most brands come with illustrated instructions telling you how to breastfeed while “wearing” your baby.

“This is so messy. Everything I own is soaked with milk.” This will pass, and more quickly than you think--usually within six weeks. Until then, be sure you stock up on breast pads and change them frequently, as soon as they get damp. If you’re going out you might want to double-up on them just in case your milk lets down unexpectedly.

“I have to go back to work.” Yes, you can breastfeed and work, and it’s well worth the effort, even if just for the protection breastmilk antibodies offer against those daycare germs. Just ask my aunt, who worked as a nurse and breastfed four children! You will have to invest in a breast pump, but compare that to the cost of formula and you will consider it a bargain. I recommend reading up on why and how in So That’s What They’re For! See the end of this article for a link.

“My friends/family think it’s strange to breastfeed, and keep wanting to give the baby a bottle to ‘give me a break.’” A lot of times well-meaning relatives or friends don’t understand the importance of exclusive breastfeeding, especially in the first two months. The key to withstanding this pressure is to read up on the benefits of exclusive breastfeeding, and also to find some new friends who will support you in your breastfeeding endeavor. (I’m not saying you should dump your old friends by any means, just that you should also find some acquaintances who are also breastfeeders.) The best way to do this is find a La Leche League meeting near you. You can do that by visiting their website (see the link at the bottom of this article).

The first six weeks of breastfeeding are definitely the most difficult. If you stick it out, you will be amazed at how easy it becomes. By the time my son was four months old I could apply my mascara while we achieved latch-on. Really! Don’t give up on it--the benefits of keeping going are so many.

RESOURCES:

The Baby Book, by William and Martha Sears

Attachment Parenting, by Katie Allison Granju

So That’s What They’re For! Breastfeeding Basics, by Jane Tamaro

La Leche League Official Website

Breastfeeding Statistics in the United States


copyright 2002 by Jocelyn Smith
Used by permission

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