Mommy Tips: Breast-feeding basics

I skipped a week of mommy tips, but now I'm back again! Before I start a post like this I want to remind any readers that although I am a pediatrician and some of this advice inevitably comes from my medical knowledge and experience (it's impossible to separate mommy and MD when it comes to some issues), nothing you read on the internet should ever serve as a substitute to discussion with your own pediatrician! I offer these tips as mommy sharing, not medical advice.

1. If you know you want to nurse your baby, try to read up on it or meet with a lactation consultant ahead of time to give yourself some background. An easy book I read was put out by the American Academy of Pediatrics and had a lot of basic info. I also spent time with a hospital based lactation nurse learning about proper latch.
2. Let your delivery room nurse know you plan to breast feed and that you want to try to nurse your newborn as soon as possible after birth. Don't be afraid to remind them when the time comes. For both my deliveries the nurses were great advocates.
3. It will take time for your milk to come in (72 hours or more is normal!), but colostrum (early, yellow, fat amd calorie rich milk) is there right away. Keep trying to nurse every 2-3 hours to get your body stimulated to make more.
4. Make sure you drink plenty of water and eat enough food, breast-feeding places a lot of demands your body! I didn't do so well with this the first time around and my supply dropped because of it.
5. If you need to supplement formula in the beginning because of jaundice, excessive weight loss, or your baby is too hungry, it's OK. Don't beat yourself up! You can still catch up with the baby and get rid of the bottles in no time.
6. Be prepared for pain. Even if you have the perfect latch, it takes time for your nipples to "toughen up" and you will have to deal with soreness, cracking, and potentially bleeding. Have some lanolin on hand!
7. Even if you have a long maternity leave (or will be staying home), its a good idea to get the hang of breast pumping early so you have milk available if you need to be away (or want your partner to give the baby a bottle overnight so you can get a little more sleep!). I've used only Medela pumps (hospital grade, Pump in Style, and Freestyle), but hear good things about Avent brand as well. To save money, check with your local hospitals about pump rental and with your insurance company to see if a pump purchase is covered.
8. Pumping can be a lifesaver in the beginning once your milk comes in if you are becoming engorged or if you are lucky enough to have an awesome baby like mine who goes to bed at 8pm and doesn't wake up until at least 3am. I made the mistake of not pumping excess with my first, went back to work at 3 months, and ran through all of my excess milk by the time she was 5 months old. Living day to day with only what I pumped the day before was super stressful and pushed me to start solids sooner than I planned. This time I started pumping excess within the first week after birth and now have a stockpile of 40 bags (3-4oz per day) of frozen milk.
9. Use pumping to try and mimic the baby's feeding schedule to keep your supply up - if your baby nurses every 2-3 hours, pump that often too! If you have a job that makes that difficult (residency made it IMPOSSIBLE), do the best you can and try not to stress. The more you stress, the harder it will be to let down while pumping.
10. My safety tips for using pumped milk are as follows: use or freeze anything you store in the fridge within 72 hours, frozen milk is good for 3 months in a regular fridge/freezer or 6 months in a dedicated freezer, and thawed milk is only good for 24 hours.
11. When my supply dipped with my first baby (I tried the progestin birth control pills and was in residency which means I was not pumping nearly enough, was always tired, and wasn't staying well fed/hydrated), I took the herbal supplement called Fenugreek to boost my production. This stuff comes as a tea or as a capsule - I took the capsules and really thought it helped. I've also heard of drinking ONE very hoppy beer (IPAs work well) per day.
12. The best tip I can give overall is to be calm and enjoy yourself! Trust your body and your instincts about what is working for you and your baby. Breast-feeding is awesome nutrition for your baby and will definitely help you loose the baby weight and get yourself back into shape.

OK, I definitely have more tips, but I think this post is too long already. I am going to break this topic down and come back with breast-feeding tips that are more targeted (pain, pumping, weaning, supplies, etc) soon. Happy feeding for now!

Breast Feeding News

As part of my membership to the American Academy of Pediatrics (AAP) I get daily e-mails with links to pediatric health issues in the news. I thought it might be worthwhile to repost some of them for any of the interested moms reading my blog. Here's a throwback to some of my early posts on breast feeding...

New Study: Breast Feeding Saves Lives

Breastfeeding - The Facts

I thought it was about time I made a post talking about the activity that has basically consumed my life since my daughter was born. Working in the field of pediatrics, I know a lot about why breastfeeding is the best option for babies and that's what I want to talk about today. More on the actual logistics on learning to breast feed and planning to continue breast feeding after going back to work in future posts.

First, what is breast milk? It is essentially the perfect blend of fat, protein, glucose or sugar, and water that babies need to grow. Each ounce of breast milk contains approximately 20 calories. If this sounds familiar to popular infant formulas, it should! All of the formula companies have spent plenty of time and money trying to replicate breast milk. For the most part, they have done a good job and formulas will provide almost the same blend of nutrients and pack the same caloric punch. The differences? Breast milk protein is easier for babies to digest than the cow's milk protein used in infant formulas. On the flip side, formula is fortified with Vitamin D which breast milk is deficient in. This means myself and other breast feeding moms will need to discuss initiating a supplement (vitamin drops) for their baby around 1 month of age.

What else makes breast milk best for babies? In addition to providing the best nutrition, nursing also provides baby with mom's antibodies to help fight disease before their own immune system kicks in and allows for important bonding time between mom and baby. If that isn't enough, breast feeding actually has been proven to have some pretty impressive medical benefits that include: protection from SIDS, fewer ear and respiratory infections, less risk of asthma, eczema, and other allergic conditions, less risk for both type I and II diabetes, and less obesity later in life. Breast fed babies have also been shown to have higher IQs and better academic performance than their formula fed counterparts.

There are also huge benefits to breast feeding for moms and families. For moms, breast feeding can help take off pregnancy weight more quickly, lowers the risk for postpartum depression, and even lowers risks for ovarian and breast cancers. Families can also save a significant amount of money if moms breast feed. The obvious savings is due to not having to buy formula, but families will also save money due to the health benefits listed above (fewer doctor visits, fewer prescriptions to fill, and less time off for parents to care for sick children). Exactly how much money can you count on saving though? From research I've done, it appears that a large can of powdered formula translates to about 200 ounces of prepared formula. For my baby who is 2 months old and should be eating around 24-25 ounces a day, this would last 8 days. Each can of formula (and this is your basic formula, not any of the special formulas for reflux or milk protein intolerances) costs around $30 where I live. Which means this month I will save approximately $120 by breast feeding.

And finally, how about breast feeding in combination with formula feeding? For some moms, this seems like a much easier option as bottles can be easier to feed the baby in public and will allow breaks for the mom if others can feed baby too (information to come on pumping). Some moms are also worried that they aren't going to be able to produce enough milk and will use formula to supplement their babies (research speaks against this fear as in studies >90% of women were able to produce an adequate supply of milk). In general, some breast milk is always going to be better than no breast milk, BUT research has shown that by an as of yet unknown mechanism, formula decreases the protective affects that breast milk has on babies. Does this mean that moms shouldn't breast feed if they plan to use formula too? Of course not! I just mention it because knowing this provides extra incentive to me to push through the days that breast feeding is hard or inconvenient.

And that's all I have to say about the facts around breast feeding. Much more practical information to come over the following days and weeks. For more information you can visit these legitimate websites: http://www.4women.gov/Breastfeeding/index.cfm and http://www.aap.org/publiced/BR_BFBenefits.htm

***Please note, this blog is meant for the sharing of information only and should not be considered medical advice. Please use this information only to start a discussion about breast feeding, formula feeding, and vitamin supplementation with your child's pediatrician***