As a pediatrician, I am a big fan of breastfeeding. There is overwhelming data to show that not only is it great for the health of babies, itâ€™s great for the health of moms -- and thatâ€™s on top of the lovely way it bonds babies and moms to each other.As a mother raising five children, the youngest a nursing toddler, I find breastfeeding so much easier than bottle feeding. Thereâ€™s no worrying about having enough milk or keeping it cool or getting it warm; all you have to do is lift your shirt (and it works well to calm Baby when he is fussy, too).
So I totally agree with the recommendation of the American Academy of Pediatrics that babies be exclusively breastfed until 6 months of age (no solids, juices, etc), and that breastfeeding should continue until at least 12 months.
The problem is: Most American moms donâ€™t do this. Current estimates suggest that only 15 to 20% of American moms are breastfeeding regularly over their baby's first year.
Sometimes breastfeeding really isnâ€™t possible, and I fully support the right of mothers to choose how to feed their babies. But what frustrates me endlessly in my practice is that many mothers stop nursing because of problems that could have been fixed, or because of misconceptions about nursing.
Here are the most common reasons moms give me for why they stopped nursing -- and what I wish they knew before they stopped!
Â·Â Â Â Â Â Â Â Â â€œHe wouldnâ€™t take the breast when we were in the hospital.â€
oÂ Â Â Â Â Â Reality: Breastfeeding isnâ€™t always easy at the beginning. There is a learning curve for both the mom and the baby; while sometimes both get the hang of it immediately, it can take a few tries or even a few days to get it right. This may panic new mothers who worry that their baby isnâ€™t eating -- when actually, newborns need very little to eat in those first few days.
Some mothers have flat or inverted nipples, which can make latching and nursing more challenging -- but itâ€™s absolutely possible.
oÂ Â Â Â Â Â Solution: With patience and proper positioning, the vast majority of babies will latch and suck. For flat or inverted nipples, a nipple shield (a thin plastic nipple that fits over the momâ€™s nipple) often does the trick. A lactation consultant, midwife, or friend with nursing experience can make a huge difference.
Â·Â Â Â Â Â Â Â â€œMy nipples were too sore.â€
oÂ Â Â Â Â Â Reality: Indeed, sore nipples are part of nursing a newborn. The pain is right at the moment of latching, not the whole time the baby sucks, but it does hurt for the first few days or weeks until the nipples toughen.
oÂ Â Â Â Â Â Solution: Making sure the baby gets as much of the nipple in her mouth as possible is important. Letting the nipples air dry helps, and some people swear by putting expressed milk or lanolin on them -- but time is the real cure.
Â·Â Â Â Â Â Â Â â€œI didnâ€™t have enough milk.â€
oÂ Â Â Â Â Â Reality: The sad thing about this one is that it can be a self-fulfilling prophecy. Breast milk is more easily digested than formula, so nursing babies get hungry again quicker, something moms may misinterpret as meaning they donâ€™t have enough milk. And because the breast is Babyâ€™s favorite place, nursing babies love to stay there and suck even when they arenâ€™t hungry anymore -- again, something that can be easily misinterpreted as meaning a mom doesnâ€™t have enough milk. The problem with giving formula is that it makes the baby less hungry for the breast. Because milk supply depends on demand, less sucking means less milk.
Babies are getting enough milk if:
Â§Â Â Â Â Â Â Â Â They are nursing 8-10 times in 24 hours, you hear swallowing, and they seem happy after nursing
Â§Â Â Â Â Â Â Â Â They are wetting at least 6-7 diapers in a 24 hour period
Â§Â Â Â Â Â Â Â Â They are having soft stools regularly (from several times a day in the newborn period to at least every few days later on)
Â§Â Â Â Â Â Â Â Â They are gaining weight (it may require going to the doctor to figure this one out)
oÂ Â Â Â Â Â Solution: Lots of nursing. If you nurse him, milk will come. If all the above signs are there, itâ€™s fine to take Baby off the breast sometimes. If you have any questions or concerns, check in with your doctor or a lactation consultant.
Â·Â Â Â Â Â Â Â â€œI donâ€™t like nursing in public.â€
oÂ Â Â Â Â Â Reality: True, exclusive breastfeeding means sometimes doing it where people can see you. While you may get an occasional stare, for the most part people just donâ€™t care what you are doing. I have nursed babies in all sorts of locations from malls to trains to churches, and have never had a problem.
oÂ Â Â Â Â Â Solution: Discreet nursing can be accomplished with nursing clothing, a big shirt, or a blanket. That said, discretion is a matter of personal preference -- thereâ€™s nothing to hide about feeding a baby.
Â·Â Â Â Â Â Â Â â€œI have to go back to work.â€
oÂ Â Â Â Â Â Reality: Being separated from Baby does pose a challenge -- but it doesnâ€™t mean breastfeeding has to end. A good breast pump can supply milk for when you are gone and ensure that your body keeps making milk even though Baby is sucking less.
oÂ Â Â Â Â Â Solution: Invest in an electric pump that can pump both breasts at once. They cost around $200 to $300, which is a lot cheaper than buying formula. The website of the La Leche League (www.laleche.org) has all sorts of helpful information about pumping and storing breast milk (as well as information on all aspects of breastfeeding). If you canâ€™t pump, nurse when you can be with Baby -- any and every drop he gets is good for him.
Breastfeeding is most successful when it happens in a community of breastfeeding mothers who support and teach each other. We have a long way to go toward making that community available to all mothers -- but help is out there. I guess thatâ€™s what I wish most: That women would realize that and reach out by talking to their doctor or midwife, asking friends, or contacting La Leche before they give up. Breastfeeding takes effort and persistence, but the payoffs make it thoroughly worthwhile.
Claire McCarthy, M.D., is a senior medical editor for Harvard Health Publications. She is an instructor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and co-director of the pediatrics department at Martha Eliot Health Center, a neighborhood health service of Children's Hospital. The author of two books, "Learning How the Heart Beats" and "Everyone's Children", Dr. McCarthy was a regular columnist for "Sesame Street Parents Magazine" from 1995 to 1998 and is currently a contributing editor for "Parenting Magazine".
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