Why Bother?
Human babies are made to thrive on human milk plain and simple. Not only is breastmilk ideally suited to your newborn, it’s nutritional, fat and enzyme content adjusts as your baby grows in order to meet those developmental needs throughout that particular period of growth. Additionally, breastmilk is chock-full of the healthy fats, nutrients, enzymes and immune boosters that keep your baby healthy and safe – and we’re only beginning to understand all of the physical, psychological, mental, emotional, and physiological benefits. However, breastfeeding can take a bit of effort in the beginning for some mothers, although there are many women who experience little or no difficulty at all. I’ll just go through a few of the reasons why it’s worth the effort to nurse your baby and if you need more convincing, you can view the ProMom website at www.promom.org/101/index.html to read through a compilation of 101 reasons why you should breastfeed…
I’ve often heard people argue that bottle feeding is less work than breastfeeding. However, from a convenience perspective most breastfeeding mothers would probably disagree. Once you consider all of the work that goes into bottle feeding - you have to shop for formula and bottles, clean bottles, sterilize bottles, mix up formula, heat up bottles, etc. – the simplicity of breastfeeding becomes quite appealing. Bottle feeding is not for the lazy! Think about every time you leave the house. Instead of having to lug around a huge bag of bottles and worrying about maintaining the correct temperature to avoid spoilage as well as how and where you’ll heat them up, you are simply free to go and do what you will. At times, night feeds can be tough going for both nursing and non-nursing moms alike, but having to make up a bottle means an extra trip to the kitchen while your offspring is almost certainly screaming his/her head off. Breastfeeding significantly reduces the stress and anxiety of night feeds as your sprog will practically experience instant gratification at the breast. Fortunately, most breastfeeding mamas get to the point where they can snooze through most of the feed and the lovely oxytocin (see below) release helps them to get back to sleep more quickly (if she ever really woke up in the first place). So at the end of the day, nursing moms tend to get more sleep (especially if they have a family bed)! More sleep also means that mom is more likely to look fabulous! Once you get the hang of breastfeeding, which shouldn’t take too long, you just do it! No bottles, no formula powder, no kettles boiling late into the night, no getting out of bed. Simply put, breastfeeding requires less effort and is more convenient.
Mother’s milk costs nothing! And to be honest, I’m actually a little shocked at how expensive formula is – it adds up to about €75/month in the beginning and then goes up from there. Go and buy yourself something nice with all that cash you save by breastfeeding. For every month you breastfeed you can purchase seven movie tickets, four decent bottles of wine (well, five or six if you’re like me – “decent” is a relative term), three recently released CD’s or DVD’s, and €75 should buy your half of dinner at a nice restaurant (and yes, you can actually have a life and breastfeed at the same time).
Every time a mother nurses her body releases oxytocin – the hormone of Luurve – producing a lovely euphoric-like rushing sensation as well as feelings of calm and happiness. Better than a six pack.
As human milk was made exclusively for human babies, it’s gentle on their immature tummies and easy for them to digest. This equates to less belly aches, less wind, less farting, and after a while, less poo (sometimes up to a few days before you have to change a dirty nappy!). As well, breastmilk amazingly changes as your baby grows in order to meet his/her nutritional needs and the nutrients in breast milk are more bio-available to human babies, meaning that the rate of nutrient absorption from breastmilk is superior to milk supplements.
Ever taste infant formula? Yeuch. It’s pretty nasty. What a letdown it must be for all those babies who are thinking (dreaming?) about their mama’s boobs during the last few months of life in the womb. How do I know baby’s want breastmilk? Shortly after birth many a baby will seek out – by smell - the breast (babies partly recognise their mothers through smell). Many babies will actually scramble up their mom’s belly to get to the breast immediately following birth so they can to latch on and begin nursing. They don’t waste any time!
Breastfed babies experience less illness and are less likely to need antibiotics even later on in life. As a parent this equates to a less cranky baby, fewer trips to the GP and fewer GP fees/fewer pharmacy bills, less days taken off work for sick kids (for those working outside-of-the-home folks), and generally less snot in your life, which is always a benefit. Breastfeeding also appears to offer life-long immunological health advantages, helps the body establish a stabilising mechanism for cholesterol levels, body fat and weight, and offers protection in adulthood from heart disease, endometriosis in women, diabetes, some types of cancers. Check out TheEvidence section and the Research section for more information/research on the proven health benefits of breastfeeding.
Scientific data demonstrates time and time again that kids who were breastfed as babies developed higher IQ’s than their formula fed peers, have improved cognitive abilities, and repeatedly score higher on development and intelligence exams. Give your kid an edge on the leaving cert exam. Don’t believe me? Just check out the small sample of research concerning breastfeeding and intelligence in the Research section of this web page.
I would never argue that bottle fed babies aren’t as closely bonded to their mama’s as breastfed babes, however, there is a certain satisfaction in nurturing your baby through your own body that only breastfeeding can provide. Also, your baby nurses as much as needed and your boobs respond accordingly to produce milk, encouraging a lovely symbiotic relationship. This satisfaction helps the mother to develop confidence in herself and in her ability to care for her child because she is the only person who can do what it is she does and she can do it perfectly. I believe that this expedites the bonding process, especially in first time mamas who aren’t entirely sure about mothering. As well, there is something to be said for the physical closeness of nursing – skin to skin contact, the beating of the mama’s heart (what the baby heard in utero), the warmth of the breast and the perfect temperature of the milk. Additionally, the prolactin and oxytocin rush that accompanies nursing encourages feelings of love, relaxation and bonding - something that formula just can’t replicate.
Ireland has one of the highest levels of breast cancer in the EU. Fortunately, you can do something about it. Studies show that breastfeeding significantly reduces a woman’s chance of developing cancer of the breast and that the “risk of breast cancer decrease with increasing duration of lifetime lactation experience.” Other studies have demonstrated strong links between breastfeeding and a reduction in the development of uterine cancer, ovarian cancer and endometrial cancer.
How funny it is that we produce the best food in the world for our own babies yet make an artificial product that’s designed to mimic as closely as possible the make-up of what we ourselves make (human milk), spend money on it, take precious time, energy and effort to make it up, stick it in a plastic bottle with an artificial nipple, and give it to our babies. Plus, in addition to all of the unnecessary work that formula feeding requires of parents it also has environmental and ethical implications that go beyond the family. Breastmilk is easy on the environment – no pollution is created in its production, whereas formula production includes:
When you breastfeed, little or no plastic is used or waste created on behalf of your new baby; you’re not contributing to the profits of global corporations who have behaved rather unethically in regards to formula promotion in developing countries (find out why babies in developing countries are dying because of formula feeding and discover who is complying with the International Code of Marketing of Breastmilk Substitutes at the Baby Milk Action website www.babymilkaction.org/ or view IBFAN’s web page at www.ibfan.org/english/gateenglish.html), and you are choosing a clean and largely waste-free method of feeding your child – probably one of the only times in your life you will ever get to do this. Remember, just like Yo Mama (www.yomamasays.org/node/view/1) notes, the parental is political . This means not only supporting various causes but also understanding the connection between our individual choices in life and subsequently making personal lifestyle changes. Breastfeeding is just one small example, but an important one indeed. The Evidence Don’t just take it from me! A number of significant medical, health, research and developmental organisations have come to fully support exclusive breastfeeding of infants. Notably, the World Health Organization (WHO) has led the way in this area and continues to strongly recommend breastmilk to infants as opposed to formula supplements. Read their infant nutrition policy at http://www.who.int/nut/inf.htm. Similarly, extensive research-based evidence has also convinced the American Academy of Pediatrics (AAP) that breast is best and they too endorse at least six months of breastfeeding. Their policy states: “Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months after birth... It is recommended that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired.” View the statement in its entirety at http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b 100/6/1035. In addition to the AAP, Unicef, through its extensive work with children in developing countries now strongly recommends breastfeeding for at least the first six months of life. Read their policy statement at www.unicef.org/programme/breastfeeding/. Even the Food and Drug Administration recommends breastmilk over substitutes for infants! See it for yourself and be amazed at www.fda.gov/fdac/features/895 brstfeed.html! These noteworthy organisations, along with many many others have based their breastfeeding policies on the countless studies that have found that breast milk offers significant:
La Leche League International has compiled a free online resource of approximately “40,000 breastfeeding-related professional articles”. Read through all of the research on breastfeeding to your hearts content at the La Leche League International Center. The Center for Breastfeeding Information Online can be found at www.lalecheleague.org/cbi/cbi.html. Who could ask for anything more? The Basics of Breastfeeding and How to Avoid Problems Like most health care practitioners who have worked with nursing moms, I’ve come to realise that the overwhelming majority of breastfeeding problems can be altogether avoided with just a little bit of knowledge, a little bit of help, and a lot of support. However, first and foremost you must commit yourself. If you think you think that you might like to breastfeed but are not sure, it is crucial that you consider the benefits of breastfeeding and make your decision before you have your baby. If you say “well, I’ll just see how it goes...,” you most likely will be unprepared should you encounter difficulties. Obviously I would like every woman to breastfeed just because of all of the wonderful benefits to both mom and baby, but breastfeeding is a personal choice and I urge you to make a firm decision prior to your birth. I mention this because although breastfeeding in and of itself is relatively straight forward, we live in a society where very few women decide to breastfeed at all (and the ones who do often nurse for a short time only), there’s not enough experienced breastfeeder’s out there to help you along or point out something that could cause a problem down the line. Also, many first time mamas need determination and confidence, as well as help and support, during those first few weeks following the birth. You will need to organise that ahead of time...
I highly recommend that you contact other breastfeeding mamas and if they are available in your community, go to meetings for nursing mothers (LLL or otherwise). If you become friendly with the people in a group before your birth, it’s much easier to motivate yourself to meet up with them after you have your baby – especially if you’re tired, you’re cranky, you don’t look so hot, etc... These women are the best support you will ever have. They know first hand how to get through the tough times and they also have the evidence of the benefits (no night-time bottles → better night’s sleep → no black rings under her eyes → she looks amazing!). Also, if you plan to breastfeed talk it over with your midwife and/or doctor. Choose health care providers who are supportive and knowledgeable of breastfeeding (this is something you should determine early on in the pregnancy. If you’re not sure, ASK! If they have children ask them if they/their partners breastfed). If you feel that the person that you’ve asked for help is not providing useful advice, is not supportive, is not giving you quite enough attention, etc., find another person to speak with. Be aware that breastfeeding support, especially in hospitals, can be very random. There will be always be a few nurses, midwives, and doctors who are very enthusiastic and helpful and who really know their stuff (unfortunately these women don’t live in the hospitals and are not always on shift). These ladies will stay with you and really give good support. Other people will probably try to be helpful but perhaps don’t have the time, the skills, or the interest in helping (remember, Ireland has the lowest level of breastfeeding up-take in the European Union so hospital staff will not have a whole lot of experience with nursing mothers themselves). Also, know how to get in touch with a breastfeeding counsellor, lactation consultant, or La Leche League leader in your area before your baby arrives so you have a familiar voice down the line should you be in need of their help.
Just as you prepare the house for the new baby, you need to prepare yourself for breastfeeding (and this doesn’t require any bizarre nipple preparation ritual to “toughen” them up. Put that toothbrush away and leave those nipples alone!). Educate yourself, learn as much as you can about your role in nursing beforehand, understand how to avoid problems, and again, speak with other successful breastfeeding mamas. Have a chat with these ladies to get an idea of what the first few weeks will be like. Get yourself a sling, a nursing pillow, and some nice nursing bras (if you live in Sligo the saleslady in the undies section of Lyon ’s is supposed to be amazing!). Tell your friends and family what you’re going to do and let them know that you’re excited about it. Relax. Fortunately, your breasts very effectively prepare themselves for nursing. However, if you have flat or inverted nipples, you will probably need to coax those little guys out and it’s much easier to do so if you prepare them shortly before the birth (to determine if you’re a flat-nippled person gently push back on your areola and see if your nipple protrudes outwards. An inverted nipple is pretty obvious as it actually goes inward as opposed to a perky, sticky-outy nipple). Again, this doesn’t require any sort of weird rituals involving rubbing or pinching, but instead a gentle rolling of the nipples several times a day to help them to protrude. In her book Breastfeeding Pure and Simple Gwen Gotsch describes this straightforward technique (called the Hoffman technique if anybody cares): “to do this, place your thumbs on either side of the base of the nipple. Press in firmly against the breast and at the same time, pull the thumbs away from each other. Move the thumbs around the base of the nipple to a new position and repeat”. Remember, the Hoffman technique is not to toughen your nipples up (it shouldn’t be painful) but to get them to come out. Breast shields (NOT nipple shields) or breast shells as they are sometimes called, can also be very useful in the case of flat or inverted nipples. These are plastic cups that you wear against your breast inside of your bra. They don’t seem to bother people although I imagine it feels a little strange at first. They work by applying slight pressure to the areola which stimulates the nipple and brings it out. Wear them for just a few hours a day at first and gradually increase the amount of time you use them over a period of a few weeks. Usually that does the trick, but if you’re still having difficulties after you have your baby you can wear the breast shields prior to feedings and they will help to bring the nipple out enough for the baby to latch on to. If someone recommends that you wear nipple shields – these are little plastic covers for your nipples with tiny holes at the end for milk to flow through – run for your life. Nipple shields are sometimes offered to women who have flat or inverted nipples, or to women whose nipples are sore and cracking. Although I have heard of the occasional woman who found them useful (one actually), they usually cause so many additional problems that they result in the mother giving up a seemingly impossible situation. Baby’s can’t seem to get enough milk through the holes in the shields which makes them very cranky and have trouble feeding because of hunger and frustration (which frustrates mom and causes even more problems), and subsequently the baby begins to lose weight. Also, it’s important that the baby use your nipple as opposed to a shield, because the suckling on the nipple is what will make it come out in the first place. I would also like to add that there are many flat-nippled ladies out there whose nipples protrude when stimulated and they breastfeed just fine. Or the baby actually pulls the nipple out as they feed and problem solved. However, in my experience flat or inverted-nippled women, depending on the extent, do tend to take a bit longer to get the hang of nursing and potentially have a more difficult time in the beginning if they’re unprepared.
I strongly recommend that you avoid all forms of artificial pain relief if you plan to breastfeed. The drugs used for pain relief in labour are opiates/synthetic opiates which pass through the placental barrier, and just as you are feeling the effects of the drug so is your baby. Babies exposed to these drugs are often dopey following the birth (oftentimes requiring resuscitation) and this can last for a number of days. Trying to get a sleepy, dopey baby to nurse can be quite a challenge – which doesn’t mean that you shouldn’t try but you are certainly less likely to encounter problems if your baby is in a natural, alert state immediately following birth. So do your best to avoid these drugs, plan alternative coping methods with your birth partner, hire a doula, and follow caesarean prevention guidelines. If you do have a caesarean, planned or otherwise, make sure that within those first few days of recovery (the sooner the better) in the hospital you have plenty of help from a lactation consultant. If your hospital doesn’t have one of these ladies or they only have someone on as part-time staff, it might be time to get stroppy. Just about everyone who matters recommends initiating the first feed within one hour of the birth (whether it’s a vaginal birth or a caesarean birth) and this is something you need to inform your birth attendants of prior to the birth, and probably prior to the labour itself. This item should be put into a birth plan and should also be verbally confirmed with your birth attendant. Otherwise routine hospital procedure could take over this crucial hour following birth, especially if you’ve had a caesarean section. Let your partner and family know your wishes as well, and get yourself a doula.
Trying to breastfeed a howling baby can be a disaster for a new mom (although it can be handy later on). Soothe the baby first. Take a minute to relax yourself – stare into your baby’s eyes and have a little chat. Then attempt to bring the baby to the breast. If the baby acts up, calm them and try again. What you don’t want to do is train your baby to associate the breast with stress and upset. On the other hand, attempting to nurse a sleepy baby can be equally frustrating. Stimulate the baby by gently stroking and talking to him or her. Newborns will often be very sleepy as they settle in to life outside the womb and will sleep for long periods of time without waking. You will need to wake your baby from time to time so that they remain hydrated and well-fed, but they quite often fall back asleep by the end of the feed. You will have the most success with breastfeeding your baby if you have a calm yet alert baby.
First of all, make sure that you are comfortable and supported (use a foot stool, support your arms with arm rests or pillows or use a sling), that you’re not straining your body, not leaning over, etc. If you are sitting up in bed make sure to bend your knees and support them with a pillow in order to reduce the strain on your back. I’ll say it again, bring the baby to you and do not lean over towards your baby or your back will be in bits within a short period of time. Once you’ve gotten yourself comfortable and have pulled the baby close to you so that your baby’s belly is snug against yours (tummy to tummy), make sure that the body of your baby is aligned – that is the head, neck and body are all in a straight line and the baby’s head isn’t turned to the side, etc. Other positions include the football hold where the body of the baby goes around your side with your hand supporting his head, or nursing while lying on your side or even on your back. Any decent breastfeeding book will describe these positions – usually with pictures – in detail. You can support your breast as it is nursed using a “C” grasp – this isn’t squeezing but supporting all of the breast with the palm of your hand underneath and your thumb resting on top of your breast. Make sure that you keep your index finger and thumb away from your nipple as this can interfere with your baby’s latch. Also avoid the “cigar hold” where you hold your nipple between your index finger and middle finger as you would hold... well, a cigar I guess. Holding your breast in this way can potentially diminish or cut off the supply of milk leading to the unpleasantness of clogged ducts. To initiate nursing you can stimulate the rooting reflex by gently brushing the infant’s cheek or lips with your nipple or your finger. Usually this is all it takes as these kids are hard wired to open up, latch on and suck away. Wait until the baby widely opens his mouth (like a yawn) pull him towards you (I’ll just say it one more time, don’t bend over to your baby) and use your nipple as a “bull’s eye”. The baby should take the entire nipple, including at least an inch of the areola, into her mouth. Check to see if the baby’s nose and chin is touching your breast (the nose might even look a bit squashed against you but don’t worry. Why do you think babies have such flat noses? Breastfeeding of course!) as this is a good sign that the nipple is far enough back into the baby’s mouth. It’s also very important that the baby’s lips are not curled under his own gums. That is, the lips should be flanged outwards. Breastfeeding should not hurt! If your baby is properly latched on you should be not be experiencing any pain (!!). If you nipples hurt you need to stop and try again. Pain indicates that the latch is probably off and some part of the baby’s mouth is rubbing against your nipple. If you continue nursing in this way you will develop sore and/or cracked nipples. To take the baby off the breast, first break the suction by placing your finger gently into the side of the baby’s mouth in between the gums.
Babies under 2 months will not form any sort of “pattern”, “routine”, or “schedule.” It doesn’t matter how determined you are - even if the baby does the same thing for two or three days in a row - it won’t last. Not yet. Young babies are going through a period of radical adjustment and they are going to be directing you on their needs. Be aware that a newborns need for frequent nursing isn’t just about satiating pangs of hunger. New babies will want to nurse for love, comfort, and calm if they’ve been over-stimulated. Mamas who find the lack of routine a problem - try to develop your own schedule and integrate the baby’s lack of a schedule into yours. This is where a sling comes in handy. You can still go for a walk, do a bit of cooking, read a book, etc. (within reason) with the baby nursing. With a sling, nursing a newborn can be mostly hands-free (and the baby is still very light weight at this time and will not be bothering your back and shoulders). Newborn babies usually feed around 8 – 12 times throughout a 24-hour period. The first few days following the birth your body will produce a creamy, yellowish substance called colostrum. Colostrum is essentially a super-food packed with living white blood cells that protect the newborn along with high levels of protein to get the newborn’s body going. Colostrum also has a laxative effect on the baby in order to flush out waste products and help prevent jaundice. (Colostrum is similar to “beestings” for all those farming women out there). When the milk comes about several days after the birth it can be pretty dramatic for some women. Oftentimes, the breasts fill up with more milk than is needed for just one baby (your body produces excess milk just in case you happen to have multiples) and sometimes a small baby can experience difficulty trying to nurse an engorged breast and they end up choking on the milk. This brief period of overproduction can potentially cause problems to some women if the excess milk remains in the breast. By not completely emptying the breast, the milk ducts can become clogged and ultimately lead to a nasty breast infection. To prevent this from occurring nurse regularly. If your breasts are so full that your baby is having difficulty feeding, use warm water to encourage the milk to flow (nice to do in the shower or with warm compresses), express some of the milk (by hand or pump) to relieve the pressure and then nurse the baby, making sure that you empty the breast every time. After a few days the milk supply reduces and you’re good to go. How to Deal with Problems As I previously mentioned, the best way to deal with breastfeeding problems is to avoid them altogether. For some women, breastfeeding is a piece of cake, for others it can be more challenging. However, after you give birth you should have someone with a good attitude towards breastfeeding and considerable experience spend a bit of time with you to make sure it is going well (I cannot emphasise this enough). The following are some of the problems that breastfeeding mama’s might encounter and how to deal with them...
Sometimes you think everything is going well, but after a few days you suddenly begin to notice that your nipples are a bit sore. Hmmm.... Better to nip that one in the bud or it will only get worse. Sore nipples are caused by the baby’s tongue, gums or palate rubbing against your nipple. Ouch! This is the result of a poor latch and is usually related to a problem with positioning. So, what do you do once you are afflicted with this cursed condition? First of all, it is important that you set right the improper positioning and latch. Get a knowledgeable person to spend time with you and provide you with assistance. Secondly, go bra-free for a few days if you’re able to. Walk around in your housecoat and use a cloth nappy or piece of flannel to absorb any leaking milk. If you have to wear a bra make sure it’s a cotton one. Beware of nursing pads as well - while useful for the occasional outing it’s not advisable to wear them all of the time because it’s important that you keep this area clean, dry, and free of bacterial growth. That said, do not use soap on your nipples or any other type of “product” such as powders, washes, etc.! Warm water is sufficient. Gently rinse and dry your nipples after each feed. You can apply lanolin (ask your chemist for a lanolin product that is safe for breastfeeding) or even express a little bit of milk and allow it to air dry on the nipples. Herbalist extraordinaire Susan Weed recommends the use of warm comfrey compresses on sore nipples or breasts – handy if you live in the countryside! However, do not soak your nipples with these compresses for long periods of time, again, it is important that your nipples remain dry. Aloe vera gel (without additives or preservatives) applied on sore nipples can also help in the healing process, but be sure to gently rinse off the aloe with warm water before you nurse. Vitamin E can also be applied directly onto sore/cracked/bleeding nipples after you’ve nursed and will help to accelerate healing. Expose you nipples to sunlight (ok, I realise this is Ireland but it does come out sometimes) and fresh air. By correcting the position, caring for your sad, sore little nipples, and making sure you look after yourself (vitamins, water, good food, as much sleep as possible, rest, light activity) this should clear up shortly (yes! Sore nipples do heal rapidly!).
Unfortunately sore nipples will often progress to any or all of these if not promptly addressed. If your nipples have progressed to this stage I would strongly advise that you get some help! Follow the recommendations above but with the assistance of a professional to guide and assist you.
Engorgement is most likely to occur within the first week of nursing (usually on the 3 rd, 4 th, or 5 th day postpartum as the milk is coming in). Engorgement, although uncomfortable, will subside in a few days if nursing continues as usual. However, it is important that the baby has a good latch and is drinking well from early on and before your milk comes in. Continue to breastfeed on demand while keeping an eye on the latch, positioning, and the feedings. Again, ensure that you empty the breast with every feed. If the engorgement is severe, you can do a bit of expression at first to relieve the pressure and then feed the baby. As I mentioned previously, if engorgement is extreme the use of heat and water can be really helpful. Some women even find that dipping their breasts into a bowl of warm water can feel fantastic, or that simply expressing a little bit of milk while in a hot shower prior to a feeding can be enough to reduce the pressure and nurse comfortably. Other women prefer to use cold compresses such as crushed ice or cold water. Amazingly, green cabbage leaves have been found to be helpful in reducing the swelling associated with engorgement. Make sure leaves are thoroughly washed and then wrap them around the breast for about 20 minutes. You can crunch the leaves up so that they fit more comfortably. Repeat this several times a day until the engorgement improves.
Clogged ducts occur when a milk duct hasn’t been completely emptied and they manifest themselves as hard, painful and sometimes hot and red lumps on the breast or in the armpits. This can happen from either cutting off the flow of milk or not entirely emptying the breast and can be caused by squeezing the breast instead of supporting it while nursing, wearing an ill-fitting bra or a bra with underwire (I know there are underwire nursing bras out there now, but I’m not convinced....), not nursing long enough (and the milk ducts are not being emptied), or having an incorrect latch. To clear up a clogged duct, continue to nurse on demand, keep an eye on the baby’s position and the baby’s latch, and ensure that the breast is emptied with each feed (and go ahead and nurse a little longer on that side just to make sure). Have an experienced person spend a little bit of time with you while you’re nursing. Be warned that terminating or reducing the feeds at this point can result in a serious breast infection – what you want is to keep the milk flowing so that the duct unclogs, empties, and heals. This condition does not bother or hurt the baby in the least. Use hot comfrey compresses in between feeds and immediately prior to nursing (comfrey is excellent for soothing and healing sore and swollen tissue). Parsley and calendula compresses can be used as well. You can also gently massage the lumps to loosen them up with a dilution of tea tree oil in an almond oil base (before you put any product on your body first make sure that it doesn’t irritate your skin and you aren’t allergic to it. Also, when using essential oils be sure to read the instructions on the bottle, do not apply directly onto the skin, and follow directions for dilution). The wonderful Weed suggests applying raw grated potatoes to the area to draw out the heat and infection. I often advise women to take immune-boosting supplements such as echinacea root, propolis, and vitamin C. Clogged ducts often indicate that a woman is overly-exhausted. If this applies to you, please do ask for help whether it’s in the form of a doula, your mother or father, a sister, brother, or friend, or your partner. Get into bed with your baby, nurse like crazy, and have others take care of you. Ensure that your needs are met in terms of eating, hydration, bathing, vitamins, and rest and relaxation. See to it that you take time for yourself, even if it means allowing someone else to look after the baby for half an hour or so. Drink some chamomile and lemon balm tea, daydream, nap, and remind yourself that you’re doing a great job and that this issue will quickly pass.
Mastitis is an infection of the breast and is usually preceded by engorgement and/or clogged ducts. A breast infection is often accompanied by a high fever, fatigue, nausea, and the breast is often hard, painful and red, and possibly streaky. If you think that you have developed mastitis, let your midwife or doctor know, especially if you have had symptoms for more than 24 hours. If are prescribed antibiotics, be sure to finish the entire course of treatment as your doctor instructed and follow the above advice concerning clogged ducts, regularly apply hot comfrey/parsley/calendula compresses, get into bed and nurse often, keep hydrated and eat well, and please, have someone come and look after you. If it is simply too painful to nurse, express your milk to the best of your ability (please please please have a lactation consultant help you out here) and begin nursing as soon as you feel is possible – nursing will help clear up the infection more quickly. Again, as with clogged ducts, mastitis will not affect your baby. Once treatment begins symptoms usually last for a few more days but the fever and pain should clear up in 24 hours. In the mean time, it’s ok to take pain medication if need be (but first ask your doctor, midwife, or pharmacist). How to Cope with Despondency If you have reached a point of despondency you’re definitely going to need the assistance of a highly-skilled breastfeeding consultant or counsellor who can provide a tremendous amount of support. Have someone who is sympathetic, caring and supportive come and take care of you - because in addition to a breastfeeding consultant, that is what you will need most of all (a doula, perhaps?). Call on your support network to come to your rescue. La Leche League ladies are well used to consoling distressed mamas over the phone (why do you think they have a 24 hour number?). Set yourself some realistic short-term goals and loosely plan a simple schedule for each day that includes time for yourself. And remember, like labour, this too shall come to pass. The Importance of Dads
Dads, so much depends on you. Your support, your encouragement, your willingness to be helpful so she can be free to nurse, your intuition of what her needs are, your initiative to meet those needs, your confidence in her, your attitude. You will most likely be her number one influence in her decision to carry through and continue with breastfeeding, especially if times get tough. Your role is this experience is huge, and your kid’s health (and his/her brain) depends on it. Where to Get Help and Find Resources Women today need as much assistance as they can get to succeed at breastfeeding. Fortunately, resources are out there. Professional who are medically trained in breastfeeding and have an expertise in nursing problems, called lactation consultants, are available for more difficult cases, such as a babies born with a cleft lip and/or palate, premature babies, babies with Down’s syndrome, or babies who don't gain weight. Contact your local health board to enquire about a lactation consultant. Also, some Lactation Consultants offer private consultations and I believe there are a half dozen or so women in Ireland who provide this service. See Kellymom’s page on “How can I find breastfeeding help?” where she provides information on how to locate a Certified Lactation Consultant where ever you might happen to be, including Ireland - www.kellymom.com/bf/concerns/bfhelp-find.html. Most people are aware of the La Leche League. This international organisation provides an on-line database of breastfeeding research, has published a number of books on breastfeeding, holds international conferences, offers training for healthcare professionals, and most importantly, advises and locally supports moms on their breastfeeding journey. LLL International is located at www.lalecheleague.org/. Closer to home, the La Leche League Ireland web page can be viewed athttp://homepage. tinet.ie/~lalecheleague/. The Irish Childbirth Trust/Cuidiu offers information and support to breastfeeding families. Contact details can be found at www.cuidiu-ict.ie/. A list of breastfeeding groups in the North can be found at www.healthpromotionagency.org.uk/Work/Breastfeeding/north.htm. Also, the Association of Breast Feeding Mothers in NorthernIreland provide their own listing of regular breast feeding support groups which include the “Yummy Mummies” and the “Bumps and Babies”. Information on these groups and others can be viewed at www.abm.me.uk/supportni.htm. Mama’s from the North can borrow or rent breast pumps through the Northern Ireland Mother Baby Appeal (NIMBA) at ( 028) 9332-9933 or from the National Childbirth Trust (NCT) at (0870) 444-8708. Websites
...and of course all of the other wonderful organisations that I’ve mentioned above, including La Leche League at www.lalecheleague.org/ and the Irish Childbirth Trust/Cuidiu at www.cuidiu-ict.ie/. A Few Useful Books on Breastfeeding
...any suggestions, reviews? Breastfeeding Titbits
The Baby Orchard is a Cork-based on-line business that focuses on attachment parenting. They provide products that are geared towards the breastfeeding mama and infant and can be found at www.thebabyorchard.com/. Happy Baby Slings is a family-based business located in Dublin . To view slings and make an order see www.happybabysling.com/. Once Born is an Irish company that offers tasteful yet distinctly un-dowdy nursing clothing and bras, which they describe as “discreet and stylish”. They offer a mail order catalogue and can be reached at 01-667-5953, their products viewed on www.onceborn.com. Mayawrap is an American company that makes slings and sells baby slings on-line, but they also provide on-line instructions on how to make your own at www.mayawrap.com/.
Alcohol, exercising immediately before nursing (apparently exercise makes breast milk taste for up to one hour), sage & parsley (these herbs will dry up your breast milk), various other herbs (please ask an herbalist before you use any herbs during pregnancy or lactation!), certain types of oral contraceptives (make sure you let your doctor or midwife know that you are breastfeeding if you decide to use an oral contraceptive), nicotine, caffeine, decongestants, aspirin, narcotics, and some types of antibiotics. There are a number of prescription medicines that you should not take while nursing so be sure that you discuss all medications – prescription and over the counter – with your doctor, midwife, or pharmacist in detail prior to use.
All thistles (artichoke, blessed thistle leaves, milk thistle, etc.) are galactagogues – that is they encourage the flow of milk. Use the dried herb to make several cups of thistle tea a day and mix it with any of the following: fennel seed, oatstraw, nettle leaves, milkwort, raspberry leaf, borage leaf, fenugreek seed, alfalfa leaves or red clover buds, or hops. Brewer’s yeast, while not an herb, also helps to increase the milk supply. Remember, babies have growth spurts and there will be times when your sprog suddenly seems hungry all of the time. It might take you a few days to catch up in milk production so feed your baby more often (remember the rule of supply and demand) and you will begin to produce more milk. Also, try using a galactagogue to speed up the process and encourage a greater milk supply. There are two common herbs that are used as anti-galactagogues which are to be avoided while nursing, to be used with guidance and caution in the case of engorgement or mastitis, or for mama’s who are ready to wean – and they are sage and parsley. Again, drinking either one as a tea over a few days will do the trick.
If you are breastfeeding you do not need to supplement your baby’s feedings with water, formula, sugar water, cow’s milk, juice, or anything else. Dummies are unnecessary, harbour bacteria, and lead to a dummy addiction which can be terrifying to adults should dummy withdraw occur (God help you should you misplace, lose, or attempt to break a child of a dummy habit). Should you decide to go ahead and use a dummy or introduce bottles (perhaps for combined feeding - that is, using both breast and bottle, whether pumped milk or formula, or just to get the child used to taking a bottle for whatever reason), wait until breastfeeding is well established (four to six weeks) before you introduce any other type of artificial nipple to your infant. Just to note... I do know several ladies who breastfeed during the day and have dad bottle feed (pumped breastmilk preferably) at night so mom can get some more sleep and dad has an opportunity to participate in the feeding of the baby. If you decide to do this, again, please wait until the breastfeeding is well established before you use a bottle. Also, keep in mind that if the baby sleeps nearby or in the bed with you, night feeds can be pretty straightforward and most moms can manage them for the short period of time the baby is waking at night (in the big scheme of things this is a relatively short period of time - you’ll look back on this time with rose-tinted glasses when your is suddenly a sullen teenager). As well, most mothers are delighted when the baby gets older and dad naively agrees to take over several solid-food feedings a day and all of the smeared food that goes along with this exciting period of child development (smeared and crusty food all over their faces, your face, the family dog, the floor and just about anything within reach). Be strategic, “yeah, I’ll feed the baby in the beginning and you feed the baby when s/he goes on solids,” heh heh heh. New dads fall for this one all the time thinking that they’re the ones getting off easy, the fools.
I realise that a lot of bottle-feeding moms out there who sometimes feel like they’re under attack from breastfeeding moms. I do think that it is an unfortunate development amongst women – to feel pitted against one another on how we nurture our babies. I would encourage all women to think through all of their parenting decisions and then feel confident in their decisions, which after all, you’re making out of love. Bottle-feeding mamas, for whatever reason you decide not to breastfeed, remember that you can still encourage the closeness that occurs as a by-product of nursing by using slings, skin-to-skin contact, co-sleeping, and holding your baby as they’re having their bottle. Keep in mind, feeding a baby isn’t just about filling their bellies (whether it’s with breastmilk or formula) - but is also about building a relationship with your new baby. A Sampling of Breastfeeding Research...
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