Just a little warning here....this post has some really fun personal details. Don't read it if you are squeamish, I guess. :)
I'm sure you're tired of me lamenting on this blog about how sad I am with regards to weaning my now two year-old boy. But I didn't always feel so positive about nursing. Before my first child was born, I was all gung-ho about breastfeeding. While I had looked forward to the birth of my son as a sort of finish-line crossing, little did I realize what I was in for as I faced numerous challenges in attempting to breastfeed him successfully (I thought many times-- at least labor/delivery is only one day!). I remember losing all dignity as a couple of lactation ladies helped me learn how to breastfeed him in the hospital, as suddenly my girls seemed to become public property, to be flung about and treated as mere machinery to be fiddled with. They tried to sort out an inversion problem on one side, and I enduring heaps of pain for seven weeks plus. My mom had nursed my youngest sister a little past age two, and since I was fourteen when she was born, I remember how much my mom enjoyed nursing. What I hadn't envisioned were clogged ducts, two giant engorged rocks, mastitis, those first few seconds of latching on (just at first), leaking (ha, in my first pediatrician visit, I quickly pulled down my shirt as the doc entered the room, only to notice that milk was literally shooting in a little white arc right out of my sweater, lol), and that I would be so sore that I walked around with no bra and my shirt held out so that nothing would touch my skin. I didn't even dare dry off in the shower because it hurt so badly. And in those first few weeks, even though there are some shining nursing moments (the first time you nurse, it's just so sweet!), my newborn baby wasn't as responsive to me as I remember my sister being toward my mother. I was pretty much just a human bottle, with no recognition just yet that I was Mom (or so I thought). I'm glad that I was determined to stick it out, because it does get so much better, even if there can still be bumps in the road months later (can you say teeth?).
It did. It got so much better. Nursing has been a real highlight for me, and it creates a bond that is so strong. I have felt that my little ones have benefited physically, emotionally, and intellectually from nursing. There are just a few things I wish I had known about beforehand. All total, I have nursed for 7 years and three months. There was a point that I wouldn't have believed that if you told me so.
And one last disclaimer, if you can't nurse for some reason, please don't feel guilty! Later in the post I'll talk about ways to maximize the bottle experience in order to mimic nursing in some beneficial ways. Please don't substitute this for medical advice, just some friendly words from one mom to another.
1) If possible, nurse baby within the first hour post-delivery.
2) Helping baby latch correctly in that first session, and especially in the early days and weeks, aids long-term success. But even if you didn't get it down or didn't get the help you needed, never fear. You can still have success breastfeeding, starting right just makes it much easier.
The nurse who helped deliver my second baby was so finicky about how my baby was latching on (it is important that the baby open his/her mouth wide, or extra soreness can result). I was a little annoyed, thinking that I had nursed my first until just past a year and that she was meddling with my bonding moment. But you know what? Getting it right the first time made that baby my most problem free nurser. Oh yeah, and because I learned with my first that I had one side that he preferred (the other one was more work), I learned to nurse all of my babies on the less preferable side first (just in that first session). I think it helped.
If you are inverted or flat, that doesn't have to spell failure. There are different things you can do to help your body, like pumping a few minutes beforehand or silicone nipple shields. These should only be needed in the first few weeks.
3) Take advantage of lactation consultants, if available, even if it isn't your first baby. I learned there is always something to learn.
4) Nurse on demand. My first baby threw me for a loop on the second day when he wanted to nurse like every hour. I wondered if I was doing something wrong to be offering him food so often, but it turned out he was going through a growth spurt (this will happen periodically throughout the first year). I think that nursing on demand is one of the best things you can do for a child's physical and emotional health. Physically, he or she learns that they eat when they are hungry, and stop when full (there is a temptation with the bottle to get baby to "finish" the bottle, even if he is full). And knowing that his needs are met when needed and not just on mom's schedule helps the child in his earliest days to learn that his needs are important, thus contributing to a sense of significance and self esteem.
Sometimes nursing on demand is hard, and sometimes you just...can't, because life happens. But it is so worth it to do your best to try and nurse on demand. Life can feel a bit out of control for a little while, but if you tell yourself that this is in baby's best interest, and even though the days can feel interminable at times they really do go by way too fast, and will be over before you know it, you will be so glad you did it, and you will see the benefits in your child. And you will have some special memories with your little one.
Remember that you can't spoil a baby under six months by meeting their needs when they have them. In fact, your child will be more secure and less whiny/clingy because she knows that her needs will be met within a reasonable time frame.
5) To help prevent mastitis, let baby empty one breast before moving on to the other. Because babies more efficiently nurse on the first side anyway, switch the side you nurse on first each time. When I was a new mom I followed the 10-15 minutes on each side rule, so I'd break off baby at the appointed time. But if you have milk left over, this can lead to mastitis and I think it is a bit hard for a baby who is enjoying eating to be surreptitiously interrupted. If you have leftover milk after baby is full and you are feeling uncomfortable, you can pump the extra and save it for later (or not) or even hand express some milk. The only caveat here is that your body is made to meet the extra demand, so if you pump, your body will assume you need more milk and it will make that much more (and if you cut back on nursing, your body will make less, though never fear because it will make more again when you nurse more). For that reason I rarely pumped, but it did come in handy a few times when I had a problem, like impending mastitis or a crack or a plugged duct.
6) While some pain is to be expected in the first 6 weeks or so, especially in the first few moments as baby is latching on, ongoing excruciating pain is the sign that baby is not latching correctly. This can lead to extra sore and cracked nipples. Sometimes I can go months with no problems and have cracking problems when a baby first gets teeth, too. A friend of mine who is a lactation consultant bought me some Medela gel pads when this happened to me the last time, and can I just tell you....ah. The gel pads offered relief when not nursing and helped me to heal much more quickly. I just wish I had known about them before my last baby!
If the cracking is so bad that you are bleeding and it is super painful to nurse, sometimes a pump is a good option. Then you have more control. I have done this a few times and have been healed enough after 2-3 days of pumping that I can return to nursing.
7) Especially in the early days, there are some other things you can do to help your skin adjust to nursing.
For me, using Lansinoh, an ointment offered in the hospital with my first baby, was a big mistake. I know other women love it, but I had so much pain with my first baby, that just went on and on and on, and I just kept putting on the Lansinoh thinking it would help, but eventually I realized that it was preventing my skin from healing and from getting tough enough to handle nursing. When I stopped using it and allowed myself to air dry for just a few minutes after a feeding (some suggest putting a little breastmilk on after a feeding, this helps too), I healed pretty quickly. Especially since leaking is more common in the first days, I found that keeping the pads dry (oh yes, pads are a must at first! unless you want to be embarrassed by a wet spot) helps with soreness and healing (or just going free and easy under a cotton shirt for a few minutes if you have older kids). (I tried letting myself air dry for 15 minutes a day a few weeks before I delivered, and this seemed to help give a jump start on this process, as I'd be sore for much less time)
8) To help prevent mastitis, wear a good fitting bra and don't sleep on your stomach. Of course, who can go out bra shopping with a brand new baby? As undesirable as it is, I have had to do this a couple of times, with other little ones in tow, because I underestimated the size of bra I'd need before I delivered. A couple of times I've gotten mastitis because a bra was too small; when that happens the pressure can block the flow of milk and cause painful lumps or mastitis. Speaking of bras, if you are concerned about sagginess later, it is important to wear one day and night (just a more comfortable one). I like this one for comfort (and convenience, with built-in discreet removable pads), though it isn't as supportive as some and more expensive than most. "Breastfeeding often gets blamed for sagging boobs, but actually it's pregnancy, weight gain and poor bra support that affect the shape and size of breasts." (Parenting online) Breastfeeding is not to blame for saggy boobs! Gravity, age, pregnancy, poor support (I guess that is related to gravity) are the culprits, not breastfeeding.
9) If you do get mastitis (symptoms: a hard painful lump that is red on the surface, sometimes there can be red streaks emanating from this spot, and sometimes you can have a fever), never fear, but do call your doctor. Even though there are some good home remedies that can help you heal from mastitis, it is still better to play it safe and have some antibiotics called in and ready to use should things turn south fast (learned this the hard way, when my husband had to leave the house at 2am once to get me antibiotics). A warm pack can help, as can massaging the area as baby nurses (ouch, but it helps). And whatever you do, keep nursing on that side! If you don't, it will only get worse. In fact, I will often nurse on the sore side first until things are better, and you definitely want baby to empty things out, so let them nurse and nurse on the sore side.
10) Get in a comfortable relaxed place, physically and mentally. This will help your milk let down.
11) Set goals. I really, really wanted to nurse at least a year, as I had read that was optimal. I had some troubles with my oldest that seemed at times insurmountable but because I wanted to go a year, I made myself push through them (I did have a time, when he was 10 months old, when I got super cracked and sore and would pump and get all sorts of blood in the milk, just beautiful, and everyone told me I was close enough and I should just quit, but I had to keep going, and now I'm so glad I did. I never had a problem that bad again, and realizing I made it through that, gave me the confidence to get through new teeth and here-and-there challenges with other babies). I would say give yourself at least six weeks before you call it quits. By this time the worst is over, and baby has had some good immunity benefits, and baby will start needing less feeding at this point. If you can stick it out (you can do it!) it only gets better and better after the first six weeks. I found that the older a baby is, the more fun they are to nurse, because they smile at me and interact and we can enjoy each other. Sometimes this is the only time a busy toddler will slow down and snuggle.
12) Don't worry about what other people think. Before I had a baby, nursing sounded just plain weird. And I bought into the cultural stereotypes that say that breasts are sexual beings. And yet, nursing is what they are actually made for! I have seen some women stop nursing because they were just too embarrassed, and the embarrassment stemmed from cultural pressures. If you become comfortable that you are doing what is best for your baby, and become comfortable with the role of breastfeeding in growing a healthy human being, then it doesn't really matter what others think. I have almost always used a blanket or some other cover-up when I nurse around others. This helps, but I also think that you can discreetly breastfeed without a blanket. I don't use a blanket around my other kids when we are home. At first, I was worried that I may embarrass them. But they have gotten so used to seeing me nurse that after the first month or so, they didn't bat an eye in my direction, as they went about their business-- I was just another something in the room, like a painting or a toy or a couch. And I think this goes a long way to helping my kids have healthy attitudes about sexuality and breastfeeding.
I have had to whip 'em out a few times when I really would rather not have, like an airport security line, on a bench at Disneyland, or even a couple of times in church (once at a swimming pool on vacation, while using a beach towel for protection, while I struggled to wrestle my suit and my newborn wailed away and some other mothers stared at me, ouch, but I couldn't leave my other kids unattended). Sometimes you just can't find a secluded spot and baby can't be reasoned with (I didn't always want to find a secluded spot, because I would get feeling isolated if I were always going off alone to feed). And it was just fine (I used my jacket to cover up baby in the airport security line).
13) Pay attention to gas. :) If baby is fussy after a feeding, and he/she has fed long enough, try a couple of things to make sure it's not trapped gas. I like to keep my babies upright and relatively still after feeding, either on my shoulder or in a baby seat (car seat, etc), even if it is just for a few minutes, but preferably for half an hour, unless it is naptime. This is why I like to burp a child while upright and not while on my knee or something like that. This seems to help keep the spit-up under control, though I do think the amount a baby spits up is genetic (I had a couple of big spitter-uppers). Spit up in and of itself is not a sign of reflux and therefore not a reason to quit nursing.
I found that some foods made my babies irritable in the first few months of nursing. For me, the main culprit was chocolate. I found that no amount of chocolate was worth a fussy baby, and before I knew it, I could eat it again. For some women, there are other foods that irritate their babies, including broccoli/cabbage/cauliflower/dairy products/spicy foods.
14) If you are worried about how much milk your baby is getting, here are a few tips.
* Pay attention to how many wet/poopy diapers she has.
* Listen for gulping sounds as baby nurses.
* Determine whether baby seems satisfied after a meal.
* Weight gain that seems acceptable to your doctor.
* Make sure you are getting enough rest (ha ha right?) and not trying to do too much too fast. Also, make sure you are getting enough to eat. It is tempting to try and get your body back, but give yourself some time. It took nine months to get that way, give yourself at least that to get it back. And you can't get this special time with your baby back, so for me it was worth being patient with my body for a little while (and I have always eventually gotten it back, sometimes even a little better than before...with this baby I'm still waiting for that to happen).
15) Remember the benefits.
This excerpt from Parenting online:
- 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.
16) If you can't nurse, for whatever reason, don't beat yourself up about it! Guilt doesn't help you move forward and be the best mom you can be. There are still ways to imitate some of the best parts of breastfeeding even if you are bottle feeding. I think some of those are:
* Holding a baby while bottle feeding. There have been so many studies that show the cognitive and health benefits of touch on growing babies. I think this is one of the main benefits of nursing, is that it increases physical contact and closeness. See here for an article about all the benefits babies derive from touch.
* Letting baby stop when full, even if there is milk left in the bottle. This will help start out a child with healthy attitudes about food, and will help them start out on the right foot where weight is concerned.
17) Structure your life and wardrobe to be nursing friendly. You don't have to buy nursing tops, just find tops that stretch, or provide coverage in the back, etc. I wore a dress to church once and promptly regretted it when I had to figure out how to feed my hungry baby, and ended up half indecent in the mothers room with my whole dress piled up above baby's head. If you are always having to make frustrating or difficult accommodations in order to nurse, you are going to resent it as a big hassle and you'll undermine even your best intentions. I try to make changes that will make nursing easier, and then I try not to think about what I'm missing, whether it be chocolate or wearing a dress (not to say you can't have a night out and wear that dress!). When the time comes that I do get to do those things again, it feels in some small way like Christmas, as I have a few new options open back up. But there is always a little sadness, too, as I realize my baby will never need me in quite the same way again.
18) In the early few weeks, avoid nipple confusion (here) by breastfeeding exclusively and keeping away from bottles and pacifiers. Because bottle feeding and breast feeding require a slightly different sucking technique, bottle feeding can confuse your infant and undermine breastfeeding (it requires a little more work, though it is actually more calming and satisfying to baby, go figure). That said, well meaning nurses have given a couple of my babies a little bit of formula or a pacifier (I did room-in with baby, but a couple of times I was exhausted and let them take baby for a few hours while I slept), and it wasn't the end of the world. You must make your wishes known to your nurses and any family who helps with baby if you want to avoid this trap.
19) Weaning. I have found that gradual weaning (I like to take a week or even two, until there is a single feeding, then maybe one every other day, etc) is the easiest on both of us. Even very attached babies forget much quicker than you'd like them to, the first couple of sad cutting back days are the hardest. I learned the hard way with my oldest child that I experienced some mild depression when I quit nursing. I don't know, blame it on the hormones, or the fact that a special time is coming to an end, but it helps me to be prepared now that I know this happens to me.
20) See nursing times as an opportunity. An opportunity to connect emotionally with your baby, to give her some attention, to sing songs or stroke her little head or even to read a story. I read both the Bible and Jane Eyre to my oldest child when he was an infant and he is still super smart! I don't know if that had anything to do with it, but it certainly didn't hurt! It can also be a time to rest, when you are still tired and sore from giving birth, and it can be a time to connect with other children.
21) Involve siblings. This can be a time they aren't fighting for your attention, and it can be a time that you bond together over the new baby. If you involve siblings, they are less likely to resent the new baby and more likely to have a better long-term relationship. It can also help motivate future nursers! Just make a quick check now and again to make sure there is nothing within reach of a toddler sibling that can cause trouble, grief or danger while you are occupied. :)
22) Enjoy it. Don't wish it away. It will be gone before you know it. Your body will someday be back, and no one will be depending on it anymore, and you will miss the days when you had a little someone whose growth and development came thanks to your nurturing care. I look at my babies at some point and have this huge surge of pride when I realize that thanks to me, they have grown so healthy and big.
If you need some more practical nursing tips, see here. For a post about nursing that makes me cry, see here (don't go if you are squeamish about nursing photos).
Nursing my babies has been such a highlight, in spite of some early days that made me think what the? have I done? So so special. I would do it again a million times over.
