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!