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Breastfeeding is nature’s most powerful way of helping mothers recover from birth, learn mothering skills, and fall in love with their babies. It’s also nature’s way of ensuring that babies are well nourished, protected against disease, and allowed to develop optimally. The American Academy of Pediatrics (AAP) recommends that babies be exclusively breastfed (no water, juice, formula, other fluids, or solids) for six months and continue breastfeeding until at least one year. Following are some ways you can get your breastfeeding relationship off to a good start. |
Tips for Establishing Breastfeeding
Breastfeeding in Public: Much Ado About Something
Breastfeeding has been in the news a lot lately. What’s making the news is not information about the health benefits or tips and tricks for new breastfeeding moms — the headlines are all about breastfeeding in public. It generally reads something like this: Mom breastfeeds in local store/restaurant/church. Mom told to cover up or leave. Several moms respond with nurse in. And then there are celebrity breastfeeding sightings that make headlines — just yesterday, it was reported that Beyonce was seen with her new baby girl, Blue Ivy, breastfeeding in public at a cafe in New York city.
So, why the excitement? Why has breastfeeding in public become such a hot button? Advocates assert that making a big deal out of breastfeeding in public helps to normalize a normal way of feeding babies — that it takes away the taboo. Yet others insist that calling excess attention to breastfeeding in public only heightens the controversy, turning something that is normal into a media spectacle.
Regardless of your views on breastfeeding in public, what it comes down to is basic human rights. Mothers have a right to feed their children; babies have a right to eat. And, women have a right to feed their babies — bottle or breast — where and when they need it.
Weigh in: What do you think about the media’s focus on breastfeeding in public — does it help or hurt the issue? Have you participated in a nurse in? Have you experienced discrimination for breastfeeding in public?
Free Weekly Newsletter for Expectant Parents
Did you know that Lamaze offers a free week-by-week e-newsletter for expectant parents? Lamaze…Building Confidence Week by Week is e-mailed to you each week of your pregnancy and provides practical tips, stories and additional resource links to help demystify today’s maternity care system and assist in your decision-making process during pregnancy, birth and early parenthood.
But that’s not all folks! Act now and the e-newsletter will be e-mailed to you competely free of charge! (Ok, so it’s always free.)
Sign up! Tell your friends!
Here’s a sneak peek of what you’ll receive:
Best of the Breast: World Breastfeeding Week Posts Around the Net
Moms and breastfeeding advocates from around the world have been celebrating and writing about World Breastfeeding Week. For your Friday and weekend reading pleasure, take a look at what others have to say about breastfeeding:
- World Breastfeeding Week: Stories of Success [Science & Sensibility]
- Breastfeeding — A Dance [Mama Birth]
- What’s in Breast Milk?
- Affordable Care Act Expands Prevention Coverage for Women’s Health and Well-Being
- Talking to Grandma About Breastfeeding [About.com]
- Breastfeeding in Art
- 10 Facts on Breastfeeding [World Health Organization]
- Social Media and Breastfeeding [About.com]
- Breast Is Not Best, Breast Is Normal [Babble]
- Breast Milk Storage [Green Lite Bites]
- How to Breastfeed in a Ring Sling [Dirty Diaper Laundry]
What are your favorite breastfeeding links?
From the Bedroom to the Board Room: How I Learned to Nurse in Public
Originally published on July 2, 2010.
This post was originally written for inclusion in the Carnival of Nursing in Public hosted by Dionna and Paige atNursingFreedom.org.
***
The first time I nursed in public, I was at a La Leche League meeting. What a perfect way to be initiated to nursing around other people.
Breastfeeding is such a personal act at the beginning, an intimate dance between the baby and the mother that begins at the moment of birth. Slowly (sometimes excruciatingly slowly), they find a rhythm, and open up a little to the outside world. Rituals and routines established in the early days – I sit on this area of the couch with these pillows, and look for the feeding cues, and get the latch just right – give way to a looser, more organic relationship. When the universe widens just a bit, other breastfeeding moms are the perfect guests to invite in. When I give breastfeeding mothers advice, I almost always say, “Find a group of breastfeeding moms to socialize with in the first few weeks, and nurse around each other.”
When my baby was just two months old, I went to my first Lamaze conference. I nursed in educational sessions and the exhibit hall and around the hotel during breaks. I shared a hotel room with women who were well past their childbearing years, and yet welcomed having a baby at the slumber party (and no, my baby most definitely was not “sleeping through the night”). Then I had to report briefly to the Board of Directors about a project I was working on, and I breast fed my baby at the board room table. While I presented to the Board members.
I look back on this time now and I realize how fortunate I was. My earliest experiences of opening my baby’s and my universe to others reinforced that nursing is normal, joyful, and important. In a way, it was totally unremarkable to nurse my baby while addressing my supervisor and her Board of Directors. But at the same time, it was something to be celebrated. The people at the table weren’t weirded out that I was breastfeeding. They loved it - reveled in it. We even talked about how it is important to have babies at our conferences. Our work affects them!
My son weaned 4 months ago, ending what had been six and a half years of continuously being either pregnant or nursing. I have nursed in more places than I could begin to count. Wherever I’ve been when my babies happened to become hungry, I’ve nursed.
Only once – ever – did I get a negative remark. I was sitting in a coffee shop nursing my then-18-month-old son, and a 20-something year old guy behind me said to his friend, “You know what I hate? Babies who breastfeed.” I saw his comment for what it was – ignorance mixed with “I’m-an-’ironic’-hipster-trying-to-impress-my-friend”. But I can imagine a new mom hearing that and feeling like an outcast. I was so thankful to have such confidence that his comment didn’t faze me at all. I mostly just felt sad for him.
Thank you to all of those La Leche League moms for instilling in me that early confidence. And thank you to all of the Lamaze leaders with whom I was so incredibly fortunate to share my early mothering. What a gift.
***
This post was just one of many being featured as part of the Carnival of Nursing in Public. Please visit the other articles listed below:
Making Breastfeeding the Norm: Creating a Culture of Breastfeeding in a Hyper-Sexualized World
Creating a Supportive Network: Your Stories and Celebrations of N.I.P.
Breastfeeding: International and Religious Perspectives
Your Legal Right to Nurse in Public, and How to Respond to Anyone Who Questions It
Breastfeeding Tips: Making Work Work for Your Baby
Originally published on December 8, 2010.
By Jeannette Crenshaw, MSN, RN, IBCLC, LCCE, FACCE and Allison Walsh, IBCLC, LCCE, FACCE
Committed to breastfeeding but concerned that going back to work or school might make breastfeeding too hard? Breastfeeding can make it easier to stay connected. With a little planning, you can do it! Here are some simple ideas that have helped other moms:
- Focus on learning to breastfeed and making lots of milk.
- Delay returning to work as long as possible.
- Plan to go back to work part-time at first, if you can.
- Plan to start work at the end of the week, to ease into your new routine.
The Countdown*
Before your baby is born:
- Take a breastfeeding class.
- Talk with your childcare provider and your employer about your plans to continue breastfeeding.
- Consider childcare close to work or school, where you may be able to breastfeed during lunch breaks.
- Choose a healthcare provider for your baby who supports breastfeeding.
- Join a support group for breastfeeding mothers.
Once your baby is born:
- Focus on learning to breastfeed and making lots of milk. (You don’t need to start pumping yet!)
2 weeks before returning to work:
- Rent or buy a double electric pump, if possible.
- Begin pumping and storing milk.
- Have someone else feed the baby with the new feeding method.
- Find clothes that make pumping easier, such as two-piece outfits and tops that button in the front. (Prints hide leaks better than solid colors.)
4-7 days before going back to work:
- Leave your baby with the caregiver for a short practice session.
- Work out an emergency plan for the unexpected, such as a sick child, car trouble, or traffic.
The night before you go back to work:
- Pack your baby’s bag, and a healthy lunch and snack for you.
- Gather your pump, cooler, and milk storage containers.
- Lay out your clothes for work. Pack extra cotton breast pads and extra tops or sweaters in case of leaking.
Going to work:
- Allow enough time so that your morning breastfeeding is relaxed and not rushed.
- Plan ahead for the evening meal. For example, take food from the freezer or place something in a slow cooker.
- Nurse your baby at home and again at the caregiver’s to keep up your milk supply.
- Nurse or pump at work at least 3 times in 8 hours for a young baby.
Picking your baby up from the caregiver:
- Plan to stop and nurse your baby as soon as you get to the caregiver’s.
- Leave the milk you pumped while at work with the caregiver for the next day.
- When you get home, nurse your baby again and enjoy reconnecting.
Every morning:
- Give yourself enough time so that your morning breastfeeding is relaxed.
- Plan ahead for the evening meal.
Did You know?
- Hand washing is the best way to help keep you and your baby well. Wash your hands for 15 seconds before nursing and pumping.
- Your breasts are never empty. Your baby can get milk if you’ve just pumped.
- Try pumping in the morning. Milk volume is greater. (Some women pump on one side while nursing on the other.)
- Three short pumping sessions, about 10 minutes each, are more effective than one long one.
- Gentle massage while pumping may help you pump more milk.
- Start at the lowest suction setting on your pump and increase to a setting that removes milk and feels comfortable. (Pumping shouldn’t hurt.)
- When you and your baby are apart, pump often to maintain your milk supply. Avoid waiting until your breasts feel full.
- Weekends are a great time to enjoy breastfeeding your baby while building your milk supply. Leave pumping and other feeding methods for workdays.
Storing and Using Pumped Breastmilk — A Guide
To Store
- Store breastmilk in a clean, airtight container. Use hard plastic or glass with tight fitting, solid lids or disposable feeding bottle liners or breastmilk storage bags. Leave ¼ of the container empty if you plan to freeze.
- Store it in the coldest part of the freezer, under the icemaker or in a back corner.
- Label the milk with the date and your child’s name. This is important when leaving pumped milk with the caregiver. Expert opinions vary on how long you can safely store breastmilk.**
- Keep fresh breastmilk at room temperature up to 4-6 hours.
- Keep fresh breastmilk in a cooler with frozen gel packs up to 24 hours.
- Store breastmilk in the refrigerator between 3 to 8 days.**
- Store breastmilk in a refrigerator freezer for 3 to 6 months and in a deep freezer with manual defrost for 6 to 12 months. (A freezer is cold enough to store breastmilk if it keeps ice cream hard.)
To Thaw
- Refrigerator thawed: Place container of frozen breastmilk in the refrigerator to thaw gradually.
- Warm-water “quick” thawed: Place container of frozen breastmilk in a bowl of warm tap water. Once the breastmilk is liquid, use it right away or refrigerate.
- Never microwave! “Hot spots” in the milk may burn your baby and the microwave destroys some of the infection fighting benefits of your milk.
- Keep thawed breastmilk in the coldest part of the refrigerator. For example, the back of the refrigerator is colder than the door. Do not refreeze. Use thawed milk within 24 hours or discard.
To Use After Refrigerating or Thawing
- Warm cold breastmilk by holding container under running warm water or in warm water for a few minutes.
- Gently mix breast milk before feeding because breastmilk components separate when thawing.
- Discard leftover milk if the bottle has been in the baby’s mouth.
To Transport
- Keep breastmilk as cold as possible. Use insulated carriers and reusable frozen gel packs (not ice cubes).
To Clean Your Pumps
- Rinse pieces that came in contact with breastmilk with cool water.
- Wash pieces with warm soapy water, rinse, and air dry on a clean towel or wash pieces in the dishwasher.
*You will need to adapt this schedule if you work or go to school at night.
**This information should be considered a supplement to, and not a substitute for, care by a health care provider.
The photo used in this post comes from blogger, doula and childbirth educator, Stephanie, who blogs at Mama and Baby Love where she shares many excellent tips and anecdotes derived from her own breastfeeding experiences.
Breastfeeding Information for the First Few Weeks of Life
Originally posted on March 30, 2011.
In a new post on our sister blog, Science & Sensibility, blogger and International Board Certified Lactation Consultant and clinician Edith Kernerman discusses key breastfeeding information for the first few days and weeks. As an expectant or new mom (and dad/partner too!), it’s helpful to understand what’s happening in your body during this transition, including what’s normal and what may signal a problem. Below are tips and information from Edith’s post.
COLOSTRUM
“We know that newborn babies require nothing other than colostrum and that though it is not there in plentiful amounts it is adequate for baby’s growth and health[1].”
Colostrum, known as “liquid gold,” is the nutrient-rich substance that is produced in your breasts before and up to 10 days after birth. Many mothers and uninformed family members and care providers can become concerned that your baby is not getting enough to eat prior to your milk coming in. Except in very rare cases, the colostrum that is made in your body is all that babies need. Using a breast pump to encourage more milk is not necessary. It’s helpful to keep in mind that a newborn’s stomach holds 5-7mL, which is equivalent to the size of a marble or cooked chickpea. At seven days old, it’s the size of a ping pong ball.
LATCH
“We know that a baby who is well latched with an asymmetric latch will get the colostrum that is there, and a poorly latched baby won’t[2], and yet we see thousands of mothers in our clinic who have been taught to latch baby symmetrically.”
An “asymmetrical latch” is one in which the baby takes more of the breast below the nipple than above. Once latched properly, baby’s top lip will rest just above mom’s nipple and baby’s nose will point up and away from the breast. A
good latch is the key to baby getting enough nutrition as well as comfort for mom and baby. Often, if a baby does not appear to be getting enough, adjusting your latch — not pumping — will fix the issue. And as a side note, Edith tells us:
“Colostrum does not respond well to a pump, it responds better to hand expression. And so when mothers can pump nothing, they are told they have no milk. Best to adjust the latch and use breast compressions[3]and watch for baby’s drinking (don’t listen, you are unlikely to hear a baby drinking at that age)[4].”
ENGORGEMENT
“Contrary to popular belief engorgement is not a sign mother has a lot of milk. Engorgement is a sign things have gone wrong.”
Edith offers several tips to reduce and fix engorgement:
- Adjust latch so that it is asymmetrical and deep
- Use breast compressions while baby is feeding (find video and how-to here)
- Remain skin-to-skin as much as possible to read baby’s early feeding cues in order to feed frequently, as necessary
- Do NOT pump engorged breasts or massage downward toward the nipple
SORE NIPPLES
“We also know that a well-latched baby should not cause mother pain[8] and yet women are told around the world to put up with the pain, or grin and bear it because it is supposed to hurt.”
As a veteran nurser myself, I will tell you (and most moms would concur) that breastfeeding does take some time for your body to adjust to the sensation. There is some initial discomfort, yes. But cracked, bleeding and “raw” nipples are NOT normal. If you do experience severely sore nipples or soreness beyond mild discomfort, seek the help of a lactation consultant. Many hospitals have these wonderful professionals on staff. If not, seek one in your area. Most likely, the cause of your soreness is a poor latch and a lactation consultant can observe and help you fix latch issues, or determine if something else is causing the pain. Edith also cautions:
“Mothers are also told to prepare their nipples (a completely non-evidenced informed practice!!) and to apply various creams and ointments on their nipples: petroleum jelly, lanolin-based creams, nipple balms—none has been supported by research. Some make matters worse.”
World Breastfeeding Week
This week, August 1-7, is World Breastfeeding Week! What does that mean? It’s a week to promote awareness of global breastfeeding concerns, created by the World Alliance for Breastfeeding Action (WABA) and celebrated by breastfeeding advocates in more than 170 countries across the world.
WABA further explains:
“As global exclusive breastfeeding rates continue to rise, we may wonder – why talk about breastfeeding?Isn’t it a normal, physiological process? The reality is that most talk is confined within the health careand related spheres. WABA’s call to action is for celebrants to reach beyond these borders, in newways, and include traditionally un-involved parties, such as young people, to join in WBW. This year’s celebration is spearheaded by some of the breastfeeding movement’s newest faces along with several veteran champions. In association with the United Nation’s International Year of Youth, WABA commissioned a dedicated group of young people to carry out the United Nation’s call to actionand create awareness, mobilize and engage, connect and build bridges across generations, cultures, religions, and civilizations” on breastfeeding.”
Here at Giving Birth with Confidence, we will celebrate World Breastfeeding Week by publishing a new post each day with breastfeeding tips, resources and stories. On Friday, we will share a “Best of the Breast” with helpful posts from around the ‘net. We encourage you to share your own stories and tips in the comments section of each post.
Happy World Breastfeeding Week!
Breastfeeding Information for the First Few Weeks of Life
In a new post on our sister blog, Science & Sensibility, blogger and International Board Certified Lactation Consultant and clinician Edith Kernerman discusses key breastfeeding information for the first few days and weeks. As an expectant or new mom (and dad/partner too!), it’s helpful to understand what’s happening in your body during this transition, including what’s normal and what may signal a problem. Below are tips and information from Edith’s post.
COLOSTRUM
“We know that newborn babies require nothing other than colostrum and that though it is not there in plentiful amounts it is adequate for baby’s growth and health[1].”
Colostrum, known as “liquid gold,” is the nutrient-rich substance that is produced in your breasts before and up to 10 days after birth. Many mothers and uninformed family members and care providers can become concerned that your baby is not getting enough to eat prior to your milk coming in. Except in very rare cases, the colostrum that is made in your body is all that babies need. Using a breast pump to encourage more milk is not necessary. It’s helpful to keep in mind that a newborn’s stomach holds 5-7mL, which is equivalent to the size of a marble or cooked chickpea. At seven days old, it’s the size of a ping pong ball.
LATCH
“We know that a baby who is well latched with an asymmetric latch will get the colostrum that is there, and a poorly latched baby won’t[2], and yet we see thousands of mothers in our clinic who have been taught to latch baby symmetrically.”
An “asymmetrical latch” is one in which the baby takes more of the breast below the nipple than above. Once latched properly, baby’s top lip will rest just above mom’s nipple and baby’s nose will point up and away from the breast. A good latch is the key to baby getting enough nutrition as well as comfort for mom and baby. Often, if a baby does not appear to be getting enough, adjusting your latch — not pumping — will fix the issue. And as a side note, Edith tells us:
“Colostrum does not respond well to a pump, it responds better to hand expression. And so when mothers can pump nothing, they are told they have no milk. Best to adjust the latch and use breast compressions[3] and watch for baby’s drinking (don’t listen, you are unlikely to hear a baby drinking at that age)[4].”
ENGORGEMENT
“Contrary to popular belief engorgement is not a sign mother has a lot of milk. Engorgement is a sign things have gone wrong.”
Edith offers several tips to reduce and fix engorgement:
- Adjust latch so that it is asymmetrical and deep
- Use breast compressions while baby is feeding (find video and how-to here)
- Remain skin-to-skin as much as possible to read baby’s early feeding cues in order to feed frequently, as necessary
- Do NOT pump engorged breasts or massage downward toward the nipple
SORE NIPPLES
“We also know that a well-latched baby should not cause mother pain[8] and yet women are told around the world to put up with the pain, or grin and bear it because it is supposed to hurt.”
As a veteran nurser myself, I will tell you (and most moms would concur) that breastfeeding does take some time for your body to adjust to the sensation. There is some initial discomfort, yes. But cracked, bleeding and “raw” nipples are NOT normal. If you do experience severely sore nipples or soreness beyond mild discomfort, seek the help of a lactation consultant. Many hospitals have these wonderful professionals on staff. If not, seek one in your area. Most likely, the cause of your soreness is a poor latch and a lactation consultant can observe and help you fix latch issues, or determine if something else is causing the pain. Edith also cautions:
“Mothers are also told to prepare their nipples (a completely non-evidenced informed practice!!) and to apply various creams and ointments on their nipples: petroleum jelly, lanolin-based creams, nipple balms—none has been supported by research. Some make matters worse.”
One Dad’s Survival Experience with Postpartum Depression
When Tony and I had Ziggy, the first few months were nightmarish. It was Christmas time in Seattle, and I remember having insomnia so bad I thought I had lost the ability to sleep. In an attempt to heal, I decided to ask Tony 10 questions about his experience of being a partner to someone suffering from postpartum depression/anxiety and PTSD.
When did you realize something was wrong?
I knew something was wrong right away. But I didn’t realize the extent of the problem. I kept thinking it would get better. But instead it got worse. I didn’t know where mild baby blues ended and where postpartum depression began. Nor did I have any information on how to get help.
What was that experience like for you?
Extraordinarily frightening. I didn’t know what was happening during labor. We were so connected as a couple and it began to shift in a way that was very scary. Once the full force of the PPD began to level itself in our lives in the first few weeks of being home with the baby, I felt confused and helpless and I was experiencing extreme anxiety. When you passed out from lack of sleep and fell to the floor behind me as I was holding the baby, my anxiety changed to terror.
What would you do differently now that you know about postpartum depression?
I would have reached out immediately to health care professionals for help. I would have encouraged formula feeding and weaning of breastfeeding right away to facilitate more ease of movement for you to be away from the baby for treatment or even just a break. I would have encouraged proper prescribed medication under the guidance of a psychiatrist to begin to ease the terrible burdens of the disease. It is so difficult to remember how helpless I felt and how under the influence I was of all the media hype about breastfeeding and bonding. That really affected my ability to act.
Were you aware of the PTSD in birth?
I think that my first clue that something was beginning to happen was during labor. It was specifically during transition that I noticed a slow but clear change in your presence. It appeared as though you began to dissociate from not only me but the world, as if your body had been left behind to experience the rest of the experience without you. It changed after we were home with the baby but for me, that was the moment it began.
What surprised you about PPD?
The insomnia. I was used to seeing depression and how it affected your daily life due to your chronic condition, but the affects of the insomnia were devastating.
What scared you the most?
The scariest thing was the constant fear that you may try to hurt yourself.
What advice would you give a partner?
To act quickly. To know that no matter what the level of depression, anxiety or insomnia your partner is experiencing, they should be seen by a health care professional and there are lots of options.
What do you think women need most if they have PPD?
They need people in their lives who are willing to acknowledge it for what it is and are willing to be there with them no matter how scary it is. They also need good professional medical care as quickly as possible. Whether it is therapy or medication, they need to be under the care of a professional. They also need to know that they are not permanently damaging their baby and that they can take time away during the day or night, whenever possible, for a break.
How did you see the interaction with our son?
I was worried about him a lot at first. Not just because of your depression but also because of my own stress and anxiety. I was very afraid that it would affect him adversely. But having watched him grow and mature over the last ten years, I am completely convinced that having the treatment that you finally did receive, starting around his third month of life was an invaluable change in the dynamic between the three of us. It was not all smooth sailing after that but it continued to improve because of it. I shudder to think of what might of happen, had you not found and accepted the treatments of the wonderful therapist and psychiatrists that first saw you.
How did the next pregnancy and birth of our daughter differ?
Everything was different, but for me, the most notable difference was choosing to bottle feed with formula from the start. That gave you a much greater sense of freedom. You were able to be away without the constant fear that the baby would starve without you. I can’t recommend that enough to other parents. I know it goes against the conventional wisdom of the day regarding breastfeeding. But in my humble opinion (which is grounded in personal experience) they are flat out wrong. Our daughter is attached, loving, kind, deeply in touch with emotions and easily able to connect to others. Not to mention she is flipping brilliant (state test score fact…not merely a parental opinion) and she was bottle fed from infancy.
Postscript from Lamaze:
Every woman and family’s experience with PPMD is different, along with every set of solutions to address the illness. We at Lamaze honor Walker and Tony for their courage in sharing this story, as well as the means by which they engaged to seek treatment and healing. We also stand behind evidence-based research that in most cases, breastfeeding is the healthiest choice for mom and baby and can be relaxing, calming and healing in and of itself.
Ask our resident obstetrical expert, Henci Goer, any question you have about conception, pregnancy, birth, and newborns. 
