The Challenges of Breastfeeding; With a Little Help from Your Friends....

Kim Messinger thought breastfeeding would be easy as making an apple pie. Before her first son was born, she and her husband attended a breastfeeding class and practiced positions on a model baby doll. In the hospital, her son, Samuel, latched on fine. But when she got home, hers became a story of pain and suffering.

Not everyone goes through such trials. But it often comes as a surprise to new mothers who want to breastfeed that there is much to be learned. Myths about the process add confusion...

Myth #1: Breastfeeding is easy. Despite the wonderful, warm, fuzzy feelings evoked by pictures of breastfeeding mothers and infants, the process takes some adjustment, especially for modern women accustomed to rigid schedules. In Messinger's case, her baby did not have a strong suck, so was unable to take out enough milk. Messinger's breasts grew painfully engorged, swollen and hard with milk. She dispatched her husband quickly to buy a breast pump. He bought a hand-held model at the local toy store. Her nipples began to crack and bleed.

Myth #2: Any breast pump will do. Most of the breast pumps sold at toy stores and made by formula companies don't have enough power and can cause nipple damage. Buy or rent a medical model from the hospital or a specialty store. "It is not unreasonable to spend $70 to $180 for a powerful, efficient electrical pump, considering you would spend more than four times that for a year's worth of formula," says lactation consultant Denise Franz-Poling. Despite these setbacks, Messinger stuck to her desire to breastfeed. She says she was helped by a registered nurse and certified lactation consultant, Bernadine Geary, who acted as a coach and technical consultant. Today Messinger is happily nursing her four-month-old son.

Myth #3: Baby should be timed at this breast or that. "Breasts are glands which don't go empty, just like your tear ducts. The more baby takes out, the more you make," explains Geary. Babies sometimes have preferences, however. If you are right-handed, the baby might prefer your stronger right side, for example. Milk supply does increase with the stimulation of sucking, so it is important to alternate breasts from feeding to feeding, rather than within one feeding.

Myth #4: Babies need cereal when they start fussing, most often at two or six months. At about two months, babies go through growth spurts and require more food - and consequently fuss. Most mothers who quit do so during these growth spurts, thinking they are inadequate.

"Nurse frequently so baby gets time to increase the supply," says Geary. As the new policy from the American Academy of Pediatrics states, breast milk is wholly adequate, without addition of juice or cereal, up to age six months. "Until a baby is able to sit up on her own, you don't need to worry. That is the outward sign that the digestive system is mature enough to digest food," adds Geary.

Myth #5: Babies should avoid fat in their diets. Breast milk is full of cholesterol, a key ingredient in brain development. A recent study in the journal Pediatrics asserts that children who were breastfed scored higher on standardized tests than those who were not. "Nervous system development requires a lot of fat. Certain fatty acids are present in breast milk but not in formula," says pediatric nutritionist Jeanne Cox.

Myth #6: Mothers and babies shouldn't sleep together. Sleeping with your baby in the same room means fewer steps at night and more frequent feedings for baby, since mother is awakened more easily. "The best-rested women sleep with their babies. Getting up and going into the baby's room two or three times is physically exhausting," says Denise Franz-Poling. "By putting the baby in bed, everybody gets more sleep."

Myth #7: Babies shouldn't nurse beyond their first birthday. The American Academy of Pediatrics recently issued a position statement recommending breastfeeding for one year, and two, if possible. New research showing the impact of nursing on reducing illnesses prompted the update.

Myth #8: All mothers can produce milk. Just as some of us have kidneys or lungs that don't work quite right, there are those whose breasts don't deliver, especially if the mother has had silicone implants or suffers from hypothyroidism or some other ailment. But the most frequent cause for unsuccessful breastfeeding stems from mismanagement, says Franz-Poling. Pre-term babies, for example, often don't have sucking power to remove enough milk. However, a high quality pump can bring the mother's milk up, she says.

"There is no one pat answer. It has to be tailored to the needs of mother and child." Sometimes the matter of milk supply is a badge of motherly accomplishment. When the supply seems low, the mother feels somehow incompetent. Deedee Franke, who teaches breastfeeding classes, recently received a call from a distraught woman whose mother insisted that she stop nursing because the baby was fussy and losing weight. However, a trip to the doctor revealed all was on track.

Before you quit because you think you are depriving your infant of nourishment due to inadequate milk supply, do a weigh-in at the pediatrician's office.

Another guideline is wet diapers. Once you've established your nursing routine, a good rule of thumb is six to 10 wet diapers and a minimum of three stools per day. "What goes in comes out," says Franke.

Myth #9: It's impossible to keep breastfeeding when you return to work. Geary has been working to make the workplace more breastfeeding-friendly. With efficient breast pumps, which are neatly enclosed in a case that resembles a briefcase, and regular times for breastfeeding (similar to coffee breaks or lunch), women can keep the supply of mother's milk going.

But it isn't easy. One mother recalls some difficult moments in the bathroom stall at a restaurant where she was forced to breast-pump during her part-time job as a waitress. A number of hospitals nationwide offer breast-pumping stations, a comfortable room set up for their employees to pump their breasts as necessary. The benefit of babies with less sickness translates to fewer missed work days, in the view of their enlightened management.

Myth #10: You don't need preparation for breastfeeding. While it is natural, techniques can be learned. Most of our mothers fed us with formula, so try not to be influenced by their biases. Bone up before the baby comes with pre-natal nursing classes.Resources