ABCs of Breastfeeding

"I had always planned to breast-feed, but no one seemed to agree with my decision," says Laura Jones, mother of one, from Milwaukee, Wisc. "My husband thought if I breast-fed, he wouldn't get to feed the baby. My mother warned me that I'd get sore nipples. I tried to ask my doctor some questions, but all he said was, "Try it if you want. The nurse will give you some pamphlets."

Despite these discouraging responses, Laura was confident she was making the right decision. "I knew there were many benefits for the baby. I borrowed a book from a friend who breast-fed her children and took my questions to the midwife in my doctor's practice. I did get an inflamed breast, but a lactation consultant gave me pointers and it only lasted a few days. My husband brought Morgan to me for middle-of-the night feedings, so he felt involved. Even my mother acknowledged that the baby was growing well and rarely got sick," Laura continues proudly. Laura breast-fed Morgan until she was 11 months old.

Breast-feeding isn't as easy as the pictures of serene mothers feeding their newborns would have you believe, nor as hard as some of the old wives' tales may suggest. It does take some work and practice to get both you and your baby used to each other, but the benefits for mom and baby are definitely worth it!

A win-win situation. Breast-feeding is good for mom and baby. Although there are important health benefits for both, one of the most spent together is the special bonding that develops between mom and her new baby as they get to know each other. But here are some of the proven advantages for breast-fed babies and their mothers:

Fewer illnesses, faster recovery. The antibodies found in breast milk provide immunities that make it easier for a baby help to fend off illnesses such as colds and ear infections. So not only do breast-fed babies tend to get sick less often, but when they do get sick, they get better faster than babies who are not breast-fed. Premature babies who get breast milk have fewer gastrointestinal problems.

Long-term health benefits for baby. The positive effects of breast-feeding last well beyond babyhood. A study in the British Medical Journal reports that babies exclusively breast-fed for six months important dividends of this intimate time were 43 percent less likely to become obese as children; if they were breast-fed for more than a year, they were 72 percent less likely to be overweight. Another British study suggests that breast-fed babies have a reduced risk for hypertension later in life. Brian Palmer, a dentist in Kansas City, Mo., found that breast-feeding reduces the risk of snoring and obstructive sleep apnea later in life. He theorizes that bottle nipples change the shape of a baby's mouth in early months and this can contribute to problems later.

Pounds off for Mom. Producing breast milk requires about 500 calories a day, contributing to a woman's weight loss and after her baby is born. "When I breast-fed, the pregnancy pounds seemed to melt off" says Kate Nelson, mother three, from New York City.
Maternal health. Early studies indicate breast-feeding may decrease a woman's risk of pre-menopausal breast cancer. It also appears to protect against osteoporosis.

Expect the unexpected. Breast-feeding takes practice and patience. Many moms experience:

• Sore nipples (usually during the first weeks of breast-feeding)
  
• Discomfort from engorged breasts
  
• Awkwardness while trying to find a comfortable position in which to nurse.
  
• Marilyn Lowe, a certified nurse-midwife in Omaha, Neb., tells her patients to, "Devote two weeks to eating well and working with the baby. This will get you off to a good start." And follow the tips in the sidebar for easing into nursing.

Jean Foland, mother of two from Columbus, Neb., said she and her first baby Sean, a preemie, had a rough beginning. "He was jaundiced and too weak to breast-feed," Foland says. "I had to pump my milk and they fed the milk to the baby through a tube. It wasn't the easiest way to start, but I felt it was the best way for Sean. In just a few days he was strong enough to nurse. The nurses helped me get started breast-feeding." Foland successfully breast-fed for eight months. "Our second baby had trouble choking on too much milk," reports Tawn Bueltman, mother of four, who lives in rural Nebraska, "but I found if I nursed her while I was laying down, she was able to keep up and swallow the milk more easily. After a few months she could nurse in any position."

Pamela Schaffart, a certified nurse-midwife from Columbus, Neb., reassures first-time breast-feeding moms that, "It can take up to six to 10 weeks for mom's body and baby to get into the rhythm of producing milk and getting used to, and comfortable with, the breast-feeding process."

Sibling issues. Older children have to adjust to the time mom spends caring for the new sibling. In the beginning, the time spent nursing the new baby may prompt some jealousy or acting out. Here are a few tips for helping the big brother or sister:

Buy your older child a doll so that he (or she) can feed "his baby" at the same time you are feeding yours.

Be matter-of-fact and explain to your older child that breast-feeding is the way the baby gets the food she needs.

Set aside a basket of special toys that the older child only plays with while, mom and baby are breast-feeding.

Some parents save videotapes of favorite I shows to pop into the VCR when baby J needs to be fed and the older sibling 1 needs attention.

Over time, you may become coordinated enough to nurse the baby while cuddling and reading to the older one.

Use your baby's nap time to do something special with your older child.

Allow time for adjustment!

Avoid pessimists. Discouragement can come from family members, friends or even professionals. Schaffart says, "It's easier to breast-feed if your family is supportive. But if they're not, find a support person who has breast-fed, and join a local support group if there's one available." Visit the Resources area for support groups.

When you interview your baby's prospective doctor or nurse practitioner, ask about breast-feeding. Ask a female if she breast-fed, and for how long. Ask a male if his wife breast-fed. Ask health care professionals how they deal with breast-feeding problems. Do they suggest working with lactation specialists, or just giving formula?

Hopefully, the hospital staff will support your decision to breast-feed, but if not, you can still successfully nurse your child. As Tammy Edwards of Auburn, Neb., discovered, "When my daughter was born the staff was not very supportive of my decision to breast-feed. They gave her bottles and only brought her to me at hospital-designated times. I left the hospital as soon as my doctor OK'd my dismissal. It was a little harder, but after a day or two at home Alicia adjusted to breast-feeding with no problems." Be confident in your decision, and show that confidence. If people discourage you, just smile and say, "I've made had the decision that's best for me and my baby. I'm confident I'm doing the right thing." Cindy Circo, mother of two from Columbus, Neb., relates, "When I heard discouraging remarks, sometimes I got mad but mostly I just listened (or pretended to), and moved on. When you know you're doing what is right for you and your baby, it doesn't matter what people say or think about that decision."

Returning to work. Returning to work can disrupt the breast-feeding routine you've worked so hard to establish, but with some planning and flexibility, you can continue to breast-feed after your return to your job. "The week before I went back to teaching afternoon preschool, I adjusted our feeding schedule," says Tawn. "I nursed right before I left to teach, and right when I get home. Taylor didn't need a bottle while I was gone." Unfortunately, some bosses are not supportive. "When I returned to work after my baby was born, my (female!) boss forbade me to pump my breasts, even in the privacy of my own office," recounts Buffie Nelson, mother of two, from Rio Rancho, N.M.

Her solution: "I pumped whenever I nursed (pumped on one side and nursed on the other). I had so much milk in the freezer that I never had to worry about running out." Some moms find it difficult to I pump. Instead, they nurse right before they drop their babies off at the caregivers, and right away when they pick the baby up. They leave instructions not to feed the baby, if possible, after a certain hour, so that he will be eager to nurse and relieve mom 's engorged breasts at pick-up time. Some moms use their lunch hours and breaks to breast-feed, if the day care is close to their places of employment. When interviewing caregivers, be sure and talk about their views on breast-feeding and if they will be supportive of your decision to continue nursing.

Moms who breast-feed, even for just a few weeks, are offering their babies a wonderful start in life. Be confident in your decision, and you can overcome any difficulties associated with breast-feeding.

Begin with the basics. Pamela Schaffart, a certified nurse-midwife in Columbus, Neb., reassures first-time breast-feeding moms that, "It can take up to six to 10 weeks for mom's body and baby to get into the rhythm of producing milk and getting used to, and comfortable with the breast-feeding process."

"One of the best ways to prepare for breast-feeding is to read a book about it-I suggest So That's What They're For by Janet Tamaro," says Schaffart. "We don't recommend any kind of nipple preparation or toughening anymore."

If you haven't chosen a hospital in which to have your baby, look for one with a "Baby Friendly" certification. According to Marie Kozel, a lactation consultant at Methodist Hospital in Omaha, Neb., "Baby Friendly" hospitals have a goal to promote practices in the hospital, which will help a mom and baby be successful if they choose to breast-feed." There are only about 24 "Baby Friendly" hospitals in the United States (thousands internationally) but more will be certified in the future.

During the last weeks of pregnancy, prepare a quiet breast-feeding area, complete with a basket full of the supplies you will need while breast-feeding-a burp rag, tissues, pillows to support your back and arms, etc.

Before you sit down to breast-feed, turn on the answering machine, go to the bathroom, and change the baby, so you are prepared and can be comfortable and relaxed while you feed your baby.

Maky sure the baby is latching on well (this will help prevent sore nipples). The baby's jaws should grasp the areola, not just the nipple. Her nose should be touching your breast, but she will be able to breath, but if she's facing you squarely; use your thumb to press your breast out of the way if you have large or engorged breasts.

Experiment with holding your baby in different positions to see which one is most comfortable for you and the baby. If you've had a cesarean section, ask your midwife or health care provider for suggestions so you can avoid pressure on the incision.

*by Shelly Burke

Resources
Use the following resources if you have questions about or problems with breast-feeding.

La Leche League International (LLLI). LLLI supports breast-feeding through meetings, mother-to-mother support, and written material. For more information, call (800) 525-3243, or check the Web at www.lalecheleague.org

Consult a lactation consultant. According to Marie Kozel, a lactation consultant at Methodist Hospital in Omaha, Neb., these professionals "must meet criteria and eligibility requirements (which include having a bachelor's degree and working at least 2,500 hours with breast-feeding women), and pass an international examination. A lactation consultant provides information to help women make informed choices about how to feed their babies, and can help with problems that come up at any time during breast-feeding."