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THE BEWILDERING TRUTH ABOUT BREASTFEEDING

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by Julia Rosien

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If you’ve decided to breastfeed your baby, you’re about to give him or her a gift more valuable than braces or even a college education. Breastfeeding strengthens the immune system and maybe even mental development, and reduces ear infections and allergies. It has been associated with lower incidence of SIDS, and even shores up the bonding process. As an added bonus, you reap the rewards of hormones that can reduce the risk of developing ovarian and breast cancer. It’s no surprise that the American Academy of Pediatrics (AAP) supports nursing for at least 12 months — longer if you can swing it.

But while reading up on breastfeeding, you’ve likely come across the words ‘soreness’, ‘engorgement’ and ‘let-down reflex’. While breastfeeding gets better (why else would so many mothers do it for so long?), it often starts out as a bewildering, frustrating experience. If the first few weeks leave you exhausted, uncomfortable and full of self-doubt, relax. You’re normal. Less than 65 percent of moms even give it a shot, and half of them opt out before their baby is six months old.

To help you stick with your breastfeeding goals, we’ve asked experts from around the country to ante up on what new moms need to know when it comes to breastfeeding: My baby seems to want to suck all the time. I don’t want to give her a pacifier, but I don’t know what to do.

Whenever a mom uses the words “all the time”, it’s important to clarify what she means and to make sure her baby is nursing effectively, says New York lactation consultant Jennifer Herrin, IBCLC, RLC. She says pacifiers cause problems because they require a different kind of sucking. “Although some babies can go back and forth with no problem, others have trouble opening wide and nursing correctly after being exposed to a soother — and you can't predict how your baby will respond.”

Studies show that pacifier use can directly affect weight gain and lead to earlier bottle-feeding. The AAP recommends that "pacifiers should be avoided whenever possible and, if used at all, only after breastfeeding is well established.”

If you’re unsure about whether your baby is getting enough, pay attention to what comes out, says Herrin. “By the fifth day of life, she should be having at least five to six wet diapers a day and at least two to three soft yellow stools.”

My baby doesn’t sleep through the night. Should I offer a bottle?

If you’re doing the rocking chair tango at midnight while your partner sleeps, you might be tempted to supplement with a bottle. Sorry. There’s no link between sleeping through the night and adding a late formula feeding. “In order for the quantity of breast milk to meet the needs of your growing baby, there will be times when your baby feeds voraciously,” says Dr. Paula Elbirt, author of Dr. Paula’s House Calls to Your Newborn. “Adding formula at this time is exactly what not to do if you want to continue to breastfeed exclusively. After a few days, your baby should settle down.”

The best way to switch on those milk-making hormones and ensure ample milk supply as your baby grows is to breastfeed as much as possible now. But that doesn't mean you have to be sleep-deprived, or that you have to go it alone. “Encourage baby to get back to sleep quickly by forgoing a diaper change (unless it's dirty) and keeping lights and other distractions to a minimum,” Herrin says. “When you're finished nursing, hand the baby to your husband for burping and rocking, while you curl up and go back to sleep.”

Help! My breasts are killing me!

Even if you do everything the experts suggest, breastfeeding hurts at first. “Your breasts are already larger because of pregnancy and hormones, but milk production stretches them even further,” says Dr. Adelaide Nardone of the Vagisil Women’s Health Center in New York. “Everyone’s pain threshold is different, but imagine multiplying premenstrual cramps astronomically, and that’s how much most new mothers’ breasts hurt.”

Thankfully, your breasts get used to your baby’s sucking, and the pain subsides within the first few weeks. Dr. Nardone says toughening up your nipples before your baby arrives is a waste of time and can’t mimic a baby’s sucking on them 10 times (or more!) a day. If the pain is more than just discomfort, see a certified lactation consultant right away — she can tell if your baby is latching on properly.

How long should my baby nurse at each breast?

“You can’t put time restraints on breastfeeding because a newborn doesn’t need as much as a 3-month-old,” Dr. Nardone says. “Always begin with the breast you finished on during the last feeding. Your baby is likely to empty the first breast offered, so make sure you alternate and empty each breast regularly.”

A good rule of thumb is to nurse your baby until she stops sucking, releases the breast, or falls asleep. By letting your baby suck as long as she wants, you’ll make sure she gets the calorie-rich hindmilk that comes at the end of a feeding. During her timeout, check your breast to see if it feels emptier than the other one — it should feel a lot spongier. Since her appetite’s been partially sated, she may not want the other breast. Just make sure you start the next feeding with the breast that feels like the melon.

Can I take the Pill while I’m breastfeeding? I’ve heard breastfeeding is a great form of contraception.

Unless you have psychic powers and can predict your first period, and more importantly ovulation, breastfeeding that doubles as birth control is like playing baby roulette. It’s fairly reliable for women whose babies are less than 6 months old and nurse every four hours, but if having two babies in diapers at the same time sends you running from the bedroom, it’s time to look at other options.

“I advise women to wait six weeks before going on the Pill, to avoid decreased milk production,” Dr. Nardone says. “Keep in mind there are progestin-only pills, emergency contraceptives, the patch and the ring. Ask your doctor, and don’t forget to talk about possible side effects and precautions.” My baby gets gassy when he nurses. How can I prevent this?

Your baby’s digestive system isn’t fully developed yet and gassiness is a common complaint. Thankfully, he’ll outgrow it. “Gassiness combined with irritability and watery green stools could mean the baby isn't getting enough of the higher-fat milk that's produced near the end of a feeding, so make sure he's finished nursing on one side before you switch him to the other,” Herrin advises. A reaction to a food in mom’s diet is rare, but it can happen. If rashes, cold symptoms or vomiting accompany the gassiness, you’ll likely have to do some sleuthing to figure out what to eliminate. “The most common culprits are cows' milk, wheat, eggs, peanuts, soy, shellfish and citrus,” Herrin says. “Try eliminating suspicious foods from your diet one at time. If dairy is the culprit, it may take up to two weeks for it to completely clear your system.” Breastfeeding, like giving birth and parenting, is filled with frustration, anxiety and a good measure of trial and error. Fortunately, it's also full of wonder and delight, and the forced lingering on the couch with your baby can be sweet. The chores beckon, but this perfect little person looking up at you is just so captivating. Eventually you’ll trade that blissfully quiet time for chasing a toddler who revels in filling the VCR with Cheerios and flushing your jewelry down the toilet. And like the weird amnesia surrounding birth, you'll eventually forget what all the breastfeeding fuss was all about.

 


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