As a new parent there are so many decisions you are faced with. Whether or not to breastfeed is probably one of the biggest ones you will encounter initially. The Academy of Nutrition and Dietetics recommends exclusive breastfeeding for the first six months and breastfeeding with complementary foods from six months until at least twelve months of age. The first few weeks of breastfeeding are stressful and challenging but once you make it through the beginning, I promise it gets easier. I exclusively breastfed my first daughter for the first six months and then I used formula from six months until twelve months. I have currently been exclusively breastfeeding my newborn for the past four weeks. I forgot how time consuming and painful the beginning stages are. Since I am in the depths of it I thought it would be a great time to share some tips and information with pregnant women who are considering breastfeeding and new breastfeeding moms to get you past the hump.
Why breastfeed?
Breastfeeding has many benefits for both baby and mom. The unique makeup of breast milk helps protect babies from illness and that is something that formula can’t do. The cells, hormones and antibodies in breast milk decrease your baby’s risk of SIDS (sudden infant death syndrome), obesity, hypertension, ear infections and respiratory illnesses. Nursing moms also benefit because breastfeeding reduces risk of breast and ovarian cancer, diabetes and post-partum depression and aids in postpartum weight loss. Additionally, it allows mom and baby to bond.
Breastfeeding is free! Formulas can cost a family anywhere from $1,500 to $4,000 per year depending on the formula and brand. Breastfeeding is also good for the environment because it eliminates costs and wastes related to plastic bottles and formula production.
Use your resources
Before your bundle of joy arrives start doing research. There are so many great resources available to breastfeeding moms. Kelly Moms (http://www.kellymom.com/) is a website that provides abundant information on breastfeeding and what to expect. They have a great Q & A section and some wonderful articles on everything from how to breastfeed, spitting up and reflux, storing breast milk, nutrition, and increasing low milk supply and everything in between. Kellymom.com also has a compilation of breastfeeding hotlines to call in your local area if you have questions. Most hospitals have breastfeeding classes or information sessions that you can attend before having the baby. Call your hospital or find out when you take your birthing class if a breastfeeding class is offered.
Once your baby arrives, talking with the lactation consultant in the hospital will be extremely beneficial. The lactation consultant can come in and observe while feeding the baby, show proper technique and answer any questions or concerns. Even though I breastfed my first I still talked to the lactation consultant in the hospital this time around because each baby is different. I wanted to make sure my baby was latching correctly and had her refresh my memory on information that I had forgotten. Take the hospital lactation consultants contact information home upon discharge and call or email her with any questions or concerns, as that is what they are there for. La Leche League (http://www.llli.org/) is another great resource. La Leche League helps mothers better understand breastfeeding through mother-to-mother support, encouragement, information and education. They have online support forums as well as in person groups in local areas that are very informative. If issues arise in the first few days at home, contact a lactation consultant to come to your house. I did that with my first and it made me feel so much more comfortable. The lactation consultant came and spent two hours with us. She observed the baby feeding, gave me tips and pointers, showed me how to feed in several different positions and weighed the baby after she fed to show me she was getting enough. I was also able to email with her after she left to answer any concerns or questions I had. Talking with other moms you know who have breastfed or are breastfeeding is one of the best resources. They have all gone through many of the same challenges and concerns as you and have great advice when it comes to breastfeeding. I feel that there is no better resource than breastfeeding moms themselves.
Nutrition
When it comes to what to eat while breastfeeding the best advice is to consume a healthy, well balanced diet that incorporates different varieties of foods from all of the main food groups including fresh fruits and vegetables, whole grains, protein (from dairy, eggs, lean meat, fish lentils, beans, etc.), and small quantities of healthy fats (olive oil, almonds, walnuts, fish, avocados). The amount of extra calories a woman needs to consume while breastfeeding varies depending on how much body fat and how active she is. A rule of thumb is about 500 extra calories give or take. In my experience my body tells me if I’m not eating enough. If I feel hungry I eat something and I make sure that I have healthy snacks on hand with me at all times such as almonds, cheese sticks, trail mix or fruit. If your diet is varied and balanced and you are eating when you feel hungry then you will automatically be increasing calories and nutrients you need in order to satisfy the additional requirements of milk production. There are no particular foods that should be eaten in order to produce or increase milk supply. The baby’s sucking will determine the amount of milk that is produced.
Drinking fluids is important when breastfeeding in order to compensate for the extra water that is used to make breast milk. In general most women feel thirsty when they breastfeed and drinking to thirst is a good rule to follow. Consuming approximately 13 cups per day (this includes fluid that comes from food as well, not just fluids) will help keep you hydrated. Having a glass of water with you while nursing or drinking a glass of water after each time you breastfeed will help to ensure that you are drinking enough. Other good thirst quenchers besides water include low-fat or fat-free milk, juice and tea (just make sure that herbal teas aren’t used in excess as they can be harmful to both mother and baby). If your urine is light in color then you are probably drinking enough fluids.
Nursing mothers often want to know what foods they need to avoid while breastfeeding because there were so many restrictions during pregnancy. The answer is there is no list of foods you need to avoid. Each baby is different. You may notice that your baby is fussier after certain foods you consume, which means they may be sensitive to these foods and you might want to avoid or limit your consumption. It is all trial and error. Some babies are fine with everything and some are sensitive to several foods. If your baby is fussy, keep a log of what you eat and try to eliminate certain items for a few days that you think may be the cause, this can be very helpful in finding out what your baby is sensitive to.
While you don’t really need to avoid anything there are certain items that should be consumed in moderation. Caffeine is always a concern among breastfeeding moms. Drinking a moderate amount of two to three 8 oz cups per day of coffee or other caffeinated beverages should not affect your baby. Again, if you notice that your baby is fussy after you drink caffeine, then try to avoid it. Limit intake of shark, swordfish, mackerel and tilefish because these large bottom-dwelling fish contain high amounts of mercury and exposure to this chemical contaminant should be reduced while breastfeeding. Now that you aren’t pregnant you are probably wondering if it is okay to have an occasional glass of wine or beer. The American Academy of Pediatrics Section on Breastfeeding says, “ingestion of alcoholic beverages should be minimized and limited to an occasional intake but no more than 0.5 g alcohol per kg body weight, which for a 60 kg (132 lbs.) mother is approximately 2 oz liquor, 8 oz wine or 2 beers. Nursing should take place 2 hours or longer after the alcohol intake to minimize its concentration in the ingested milk.”
Is my baby getting enough?
In the first two or three days the milk you produce is called colostrum, also known as liquid gold due to its thick yellow consistency and rich nutrients and antibodies. Don’t be alarmed at the small amount that is produced. Your baby is getting just the right amount for his/her tiny stomach during his/her first days of life. Around day three to five colostrum will change into mature milk, which is thinner and lighter in color than colostrum. Mature milk contains just the right amount of fat, protein, carbohydrates and water and continues to provide your baby with all of the nutrients and antibodies he or she needs to continue to grow.
Weight gain and wet/dirty diapers are the best ways to tell that your baby is getting enough. Most newborns will lose up to 8% of their birth weight upon discharge from the hospital. This is normal and there is no need to be concerned. Once mature milk has come in, breastfed babies will gain approximately 6 oz per week. Most babies go for a checkup within one to two weeks of birth and the pediatrician can check their weight for proper gain.
In the first few days of life, babies usually have one dirty and one wet diaper for each day of life (one on day one, two on day two, etc.) When mature milk comes in then breastfed babies should have about 5-6 or more wet diapers per day and 3-4 or more dirty diapers per day. My daughter has a dirty diaper after every time she breastfeeds and that is completely normal too. Keeping a notebook to track wet and dirty diapers is a good idea as sleep deprivation can make you forget. By keeping track you can ensure that your baby is getting enough nourishment and report back to your pediatrician if there are any concerns.
How often and for how long should you breastfeed?
In the beginning if you feel like you are breastfeeding all day long it’s because you probably are. For the first two months your baby will eat anywhere from 8 to 12 times per day. That means that they are eating anywhere from every 2 to 3 hours. Nursing frequently helps to build up your milk supply, so feeding on demand when the baby shows signs of hunger such as rooting or hands in mouth, they are ready to eat. There is really no schedule those first few months, just feed your baby when they are hungry to ensure they are getting proper nutrition. Feedings can be long and that is why it feels like you are nursing all day because the baby will eat 2 to 3 hours from when they started feeding, not when they end feeding. This means that if the baby began eating at 2pm and finishes at 3pm, if they are eating every 2 hours, their next feeding will begin at 4pm. My daughter currently eats every two hours and sometimes she will give me a three-hour stretch. It can be exhausting, but know that once they begin to put on weight and their stomachs become larger they will go longer stretches and develop more of a pattern so it really does get easier. They also become more efficient, which means they may only take 20 minutes to nurse as opposed to an hour. Babies can be very sleepy in the beginning and may fall asleep while feeding. The American Academy of Pediatrics recommends that newborns (healthy, full-term newborns) should nurse 8 to 12 times in each 24-hour period, which means if a baby isn’t waking up to feed every two to three hours you may have to wake them. Some good tips to keeping your baby awake during feeds is taking their clothes off and having skin-to-skin contact, talking to them, changing their diaper and burping them before offering other breast.
As far as how long to breastfeed, there is really no time limit. Offer your baby one breast and make sure that they are sucking for at least 10 to 15 minutes on one side to ensure that they are getting nutrition (if baby falls asleep try the tips above to wake them up to continue to feed). After the 10 to 15 minutes offer them the other breast, which they may or may not take. Your baby will give you signs and cues and a pattern will develop. If you notice that your baby usually takes thirty minutes to nurse, have them feed for 15 minutes on one breast and then 15 minutes on the other. Be patient, the first few weeks are all about learning for both you and your baby. As long as your baby is gaining weight and has wet and dirty diapers they are being nourished.
Challenges
Breastfeeding can be challenging and time consuming in the beginning. With the baby eating every two to three hours you may feel like you never get a break. In the beginning your nipples will be raw and sore. It will take about two weeks for your body to get used to breastfeeding and the soreness will pass. I found lanolin cream to be extremely helpful and it is not harmful to you or the baby and does not need to be washed off before the baby feeds. I also used Lansinoh Soothies Gel pads. These pads provide cooling relief to soothe and heal sore nipples so that you can continue to breastfeed. I put mine in the refrigerator to make them even cooler and it is so helpful.
Engorgement is another challenge that you may be faced with. This is when your breasts feel very full, hard and painful to touch. This can make it difficult for your baby to latch on, so expressing some milk before you breastfeed can help alleviate pain and allow your baby to properly latch. Using a cold compress can also help lessen pain. Engorgement can lead to plugged ducts. This is when you feel a sore lump in your breast because the duct isn’t able to drain properly and becomes inflamed. Breastfeeding on the side where your duct is plugged can help loosen the plug. Massaging the area or using a hot compress may also help. Mastasis is an infection of the breast and is of most concern out of all the challenges mentioned. Mastasis is a lump or soreness in the breast and can also include a fever or flu-like symptoms and may include a yellowish discharge. If symptoms don’t improve on their own (within 24 to 48 hours) contact a doctor because you may need medication to treat the infection.
This information is very basic and using the resources above will be helpful in answering your questions and concerns in more detail. By choosing the path to breastfeed you have already accomplished so much. It is important to remember that it does get easier and that you are not alone. There is plenty of support out there to ensure that you have a successful breastfeeding experience.
References:
www.eatright.org
www.womenshealth.gov
www.kellymom.com
www.lli.org
Written By: Melissa Gosser, RD
About: Melissa Gosser is a Registered Dietitian that specializes in prenatal, postnatal, pediatric and general weight loss nutrition. Melissa started the blog Fit Fab Mommy as a way to help fellow moms and moms-to-be by offering tips on nutrition, exercise, family and fashion so that they can live a healthy and fabulous life. Follow Melissa on twitter @FitFabMommy, on Facebook at www.facebook.com/FitFabMommy or on her blog at www.FitFabMommy.com.
Why breastfeed?
Breastfeeding has many benefits for both baby and mom. The unique makeup of breast milk helps protect babies from illness and that is something that formula can’t do. The cells, hormones and antibodies in breast milk decrease your baby’s risk of SIDS (sudden infant death syndrome), obesity, hypertension, ear infections and respiratory illnesses. Nursing moms also benefit because breastfeeding reduces risk of breast and ovarian cancer, diabetes and post-partum depression and aids in postpartum weight loss. Additionally, it allows mom and baby to bond.
Breastfeeding is free! Formulas can cost a family anywhere from $1,500 to $4,000 per year depending on the formula and brand. Breastfeeding is also good for the environment because it eliminates costs and wastes related to plastic bottles and formula production.
Use your resources
Before your bundle of joy arrives start doing research. There are so many great resources available to breastfeeding moms. Kelly Moms (http://www.kellymom.com/) is a website that provides abundant information on breastfeeding and what to expect. They have a great Q & A section and some wonderful articles on everything from how to breastfeed, spitting up and reflux, storing breast milk, nutrition, and increasing low milk supply and everything in between. Kellymom.com also has a compilation of breastfeeding hotlines to call in your local area if you have questions. Most hospitals have breastfeeding classes or information sessions that you can attend before having the baby. Call your hospital or find out when you take your birthing class if a breastfeeding class is offered.
Once your baby arrives, talking with the lactation consultant in the hospital will be extremely beneficial. The lactation consultant can come in and observe while feeding the baby, show proper technique and answer any questions or concerns. Even though I breastfed my first I still talked to the lactation consultant in the hospital this time around because each baby is different. I wanted to make sure my baby was latching correctly and had her refresh my memory on information that I had forgotten. Take the hospital lactation consultants contact information home upon discharge and call or email her with any questions or concerns, as that is what they are there for. La Leche League (http://www.llli.org/) is another great resource. La Leche League helps mothers better understand breastfeeding through mother-to-mother support, encouragement, information and education. They have online support forums as well as in person groups in local areas that are very informative. If issues arise in the first few days at home, contact a lactation consultant to come to your house. I did that with my first and it made me feel so much more comfortable. The lactation consultant came and spent two hours with us. She observed the baby feeding, gave me tips and pointers, showed me how to feed in several different positions and weighed the baby after she fed to show me she was getting enough. I was also able to email with her after she left to answer any concerns or questions I had. Talking with other moms you know who have breastfed or are breastfeeding is one of the best resources. They have all gone through many of the same challenges and concerns as you and have great advice when it comes to breastfeeding. I feel that there is no better resource than breastfeeding moms themselves.
Nutrition
When it comes to what to eat while breastfeeding the best advice is to consume a healthy, well balanced diet that incorporates different varieties of foods from all of the main food groups including fresh fruits and vegetables, whole grains, protein (from dairy, eggs, lean meat, fish lentils, beans, etc.), and small quantities of healthy fats (olive oil, almonds, walnuts, fish, avocados). The amount of extra calories a woman needs to consume while breastfeeding varies depending on how much body fat and how active she is. A rule of thumb is about 500 extra calories give or take. In my experience my body tells me if I’m not eating enough. If I feel hungry I eat something and I make sure that I have healthy snacks on hand with me at all times such as almonds, cheese sticks, trail mix or fruit. If your diet is varied and balanced and you are eating when you feel hungry then you will automatically be increasing calories and nutrients you need in order to satisfy the additional requirements of milk production. There are no particular foods that should be eaten in order to produce or increase milk supply. The baby’s sucking will determine the amount of milk that is produced.
Drinking fluids is important when breastfeeding in order to compensate for the extra water that is used to make breast milk. In general most women feel thirsty when they breastfeed and drinking to thirst is a good rule to follow. Consuming approximately 13 cups per day (this includes fluid that comes from food as well, not just fluids) will help keep you hydrated. Having a glass of water with you while nursing or drinking a glass of water after each time you breastfeed will help to ensure that you are drinking enough. Other good thirst quenchers besides water include low-fat or fat-free milk, juice and tea (just make sure that herbal teas aren’t used in excess as they can be harmful to both mother and baby). If your urine is light in color then you are probably drinking enough fluids.
Nursing mothers often want to know what foods they need to avoid while breastfeeding because there were so many restrictions during pregnancy. The answer is there is no list of foods you need to avoid. Each baby is different. You may notice that your baby is fussier after certain foods you consume, which means they may be sensitive to these foods and you might want to avoid or limit your consumption. It is all trial and error. Some babies are fine with everything and some are sensitive to several foods. If your baby is fussy, keep a log of what you eat and try to eliminate certain items for a few days that you think may be the cause, this can be very helpful in finding out what your baby is sensitive to.
While you don’t really need to avoid anything there are certain items that should be consumed in moderation. Caffeine is always a concern among breastfeeding moms. Drinking a moderate amount of two to three 8 oz cups per day of coffee or other caffeinated beverages should not affect your baby. Again, if you notice that your baby is fussy after you drink caffeine, then try to avoid it. Limit intake of shark, swordfish, mackerel and tilefish because these large bottom-dwelling fish contain high amounts of mercury and exposure to this chemical contaminant should be reduced while breastfeeding. Now that you aren’t pregnant you are probably wondering if it is okay to have an occasional glass of wine or beer. The American Academy of Pediatrics Section on Breastfeeding says, “ingestion of alcoholic beverages should be minimized and limited to an occasional intake but no more than 0.5 g alcohol per kg body weight, which for a 60 kg (132 lbs.) mother is approximately 2 oz liquor, 8 oz wine or 2 beers. Nursing should take place 2 hours or longer after the alcohol intake to minimize its concentration in the ingested milk.”
Is my baby getting enough?
In the first two or three days the milk you produce is called colostrum, also known as liquid gold due to its thick yellow consistency and rich nutrients and antibodies. Don’t be alarmed at the small amount that is produced. Your baby is getting just the right amount for his/her tiny stomach during his/her first days of life. Around day three to five colostrum will change into mature milk, which is thinner and lighter in color than colostrum. Mature milk contains just the right amount of fat, protein, carbohydrates and water and continues to provide your baby with all of the nutrients and antibodies he or she needs to continue to grow.
Weight gain and wet/dirty diapers are the best ways to tell that your baby is getting enough. Most newborns will lose up to 8% of their birth weight upon discharge from the hospital. This is normal and there is no need to be concerned. Once mature milk has come in, breastfed babies will gain approximately 6 oz per week. Most babies go for a checkup within one to two weeks of birth and the pediatrician can check their weight for proper gain.
In the first few days of life, babies usually have one dirty and one wet diaper for each day of life (one on day one, two on day two, etc.) When mature milk comes in then breastfed babies should have about 5-6 or more wet diapers per day and 3-4 or more dirty diapers per day. My daughter has a dirty diaper after every time she breastfeeds and that is completely normal too. Keeping a notebook to track wet and dirty diapers is a good idea as sleep deprivation can make you forget. By keeping track you can ensure that your baby is getting enough nourishment and report back to your pediatrician if there are any concerns.
How often and for how long should you breastfeed?
In the beginning if you feel like you are breastfeeding all day long it’s because you probably are. For the first two months your baby will eat anywhere from 8 to 12 times per day. That means that they are eating anywhere from every 2 to 3 hours. Nursing frequently helps to build up your milk supply, so feeding on demand when the baby shows signs of hunger such as rooting or hands in mouth, they are ready to eat. There is really no schedule those first few months, just feed your baby when they are hungry to ensure they are getting proper nutrition. Feedings can be long and that is why it feels like you are nursing all day because the baby will eat 2 to 3 hours from when they started feeding, not when they end feeding. This means that if the baby began eating at 2pm and finishes at 3pm, if they are eating every 2 hours, their next feeding will begin at 4pm. My daughter currently eats every two hours and sometimes she will give me a three-hour stretch. It can be exhausting, but know that once they begin to put on weight and their stomachs become larger they will go longer stretches and develop more of a pattern so it really does get easier. They also become more efficient, which means they may only take 20 minutes to nurse as opposed to an hour. Babies can be very sleepy in the beginning and may fall asleep while feeding. The American Academy of Pediatrics recommends that newborns (healthy, full-term newborns) should nurse 8 to 12 times in each 24-hour period, which means if a baby isn’t waking up to feed every two to three hours you may have to wake them. Some good tips to keeping your baby awake during feeds is taking their clothes off and having skin-to-skin contact, talking to them, changing their diaper and burping them before offering other breast.
As far as how long to breastfeed, there is really no time limit. Offer your baby one breast and make sure that they are sucking for at least 10 to 15 minutes on one side to ensure that they are getting nutrition (if baby falls asleep try the tips above to wake them up to continue to feed). After the 10 to 15 minutes offer them the other breast, which they may or may not take. Your baby will give you signs and cues and a pattern will develop. If you notice that your baby usually takes thirty minutes to nurse, have them feed for 15 minutes on one breast and then 15 minutes on the other. Be patient, the first few weeks are all about learning for both you and your baby. As long as your baby is gaining weight and has wet and dirty diapers they are being nourished.
Challenges
Breastfeeding can be challenging and time consuming in the beginning. With the baby eating every two to three hours you may feel like you never get a break. In the beginning your nipples will be raw and sore. It will take about two weeks for your body to get used to breastfeeding and the soreness will pass. I found lanolin cream to be extremely helpful and it is not harmful to you or the baby and does not need to be washed off before the baby feeds. I also used Lansinoh Soothies Gel pads. These pads provide cooling relief to soothe and heal sore nipples so that you can continue to breastfeed. I put mine in the refrigerator to make them even cooler and it is so helpful.
Engorgement is another challenge that you may be faced with. This is when your breasts feel very full, hard and painful to touch. This can make it difficult for your baby to latch on, so expressing some milk before you breastfeed can help alleviate pain and allow your baby to properly latch. Using a cold compress can also help lessen pain. Engorgement can lead to plugged ducts. This is when you feel a sore lump in your breast because the duct isn’t able to drain properly and becomes inflamed. Breastfeeding on the side where your duct is plugged can help loosen the plug. Massaging the area or using a hot compress may also help. Mastasis is an infection of the breast and is of most concern out of all the challenges mentioned. Mastasis is a lump or soreness in the breast and can also include a fever or flu-like symptoms and may include a yellowish discharge. If symptoms don’t improve on their own (within 24 to 48 hours) contact a doctor because you may need medication to treat the infection.
This information is very basic and using the resources above will be helpful in answering your questions and concerns in more detail. By choosing the path to breastfeed you have already accomplished so much. It is important to remember that it does get easier and that you are not alone. There is plenty of support out there to ensure that you have a successful breastfeeding experience.
References:
www.eatright.org
www.womenshealth.gov
www.kellymom.com
www.lli.org
Written By: Melissa Gosser, RD
About: Melissa Gosser is a Registered Dietitian that specializes in prenatal, postnatal, pediatric and general weight loss nutrition. Melissa started the blog Fit Fab Mommy as a way to help fellow moms and moms-to-be by offering tips on nutrition, exercise, family and fashion so that they can live a healthy and fabulous life. Follow Melissa on twitter @FitFabMommy, on Facebook at www.facebook.com/FitFabMommy or on her blog at www.FitFabMommy.com.