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Will breastfeeding come naturally?

How do I learn how to breastfeed? Do I need to use formula? My mom and grandmother say it comes naturally and I don’t need to worry about it. But my friends have had trouble. Have I done what I need to do to be ready for breastfeeding?

First of all, I can tell you from experience that breast-feeding does NOT (necessarily) come naturally. HOWEVER, I can also tell you from experience that a newborn left to his own devices will (almost certainly) find the breast and latch on. So the key is to educate and prepare yourself, but not stress out.

One of the trickiest things is ensuring that first time moms keep their newborns on an appropriate weight trajectory. Doctors and midwives will (and should) generally keep first babies on a close follow-up schedule. This might feel frustrating when all you want to do is lay in bed and nurse and sleep, but it’s extremely important to ensure that your baby is gaining appropriately every day. Once a newborn gets even a little behind on intake, she will get tired and therefore “lazy” at the breast; then she’ll get more behind on intake and more tired, and the vicious cycle begins. This is usually the point at which mom is ordered to go to the lactation consultant, pump after every feed, and supplement pumped breast milk or formula.  (If you are told to give formula, please do so, and please do not feel guilty or stressed by it.  Yes, breast is best, but many moms have to give formula at some point.  It does not mean you failed!)

Can this cycle be avoided? Likely. Here’s how:

Lactation support.

Find a lactation consultant before you give birth. Call her and have a conversation.  Ask if she has any tips for first time moms. Ask if she does home visits, group classes, or just in-office visits. Get a sense for her availability, her fee schedule, and whether she takes insurance. Call your insurance and find out if they offer lactation benefits and what they are. If you don’t know of lactation consultants in your community, check out “Find a Lactation Consultant” on the IBCLC website.

Get a pump.

A hospital grade, electric, double pump. Call your insurance to find out what they cover (the ACA ensured breast pump coverage for all). You may not plan to pump to store up milk. Maybe you’re not planning to return to work and you’ll be with baby all the time. Maybe you don’t want baby to ever take a bottle. You probably need a pump anyway. Many first time moms will need to pump after initial feedings to increase supply. You also may need it to relieve engorgement.

Skin to skin contact immediately after birth.

Medscape has a lovely article outlining the many benefits of immediate skin to skin contact; most notably, it helps baby’s brain develop optimally, and makes it more likely that you’ll start breastfeeding and continue breastfeeding longer.  Plan with your provider well before your due date: it can happen even after a C section.

Stay in BED! 

Most moms are terrible at this.  The laundry, the kitchen, and the cooking CAN WAIT.  A good rule of thumb is to stay in bed the first week, on the couch the second week, and around the house the third week.  It may start to feel extreme, but the longer you stay in bed, resting with baby, skin to skin, nursing on demand, the more likely you’ll nurse often enough to produce ample milk. (Ask your friends and family for help with the chores so you can rest.)

EAT!

Do NOT start dieting and do NOT put off eating.  Nursing moms are hungry and need to eat well and often.  (I once ate 4 pieces of pizza as a snack, one hour before dinner.)  If you’re feeling pressure to lose the baby weight, remember that for many women it will drop off just because you’re nursing. If you aren’t that lucky, you’ll have the opportunity to lose the weight soon enough.  Give yourself a break. You should particularly make sure you consume enough high quality protein and fats (not just snack foods!).  If you tend toward vegetarian or vegan, you may need to increase your consumption of animal products, at least while your body gets used to the high demands of the early days of breastfeeding.

Hydrate.

Nursing makes you thirsty.  Support yourself by drinking water throughout the day.

Nurse on demand.

Don’t try to implement a nursing schedule.  If baby cries, fusses, or roots, offer the breast, even if you just fed her.  Newborns have tiny stomachs and high nutritional needs.  They need to eat quite frequently.  Feed on demand, even at night.  Don’t worry; it won’t last forever.  You will feel like all you do is nurse, but this too shall pass, before you know it.

Eat the right foods (and take the right herbs).

Many foods and herbs are professed to be galactagogues, or substances that increase milk supply.  Some of the most well known foods are brewer’s yeast, oats, and fennel; some of the most popular herbs are goat’s rue, milk thistle, fenugreek, blessed thistle, hops (contained in dark beer, a beverage often proclaimed to be a galactagogue – see #9). Will consuming these foods and herbs (probably in large amounts) increase your milk production? Most likely. Will it be a huge difference? How much do you have to consume? It varies by person! Discuss specifics with your midwife, lactation consultant, or ND, but these foods and herbs are safe and can be quite helpful. (So can making sure you are eating enough in general-see # 5.) For more information about galactagogues see our article Herbs to increase milk supply: a guide to galactagogues.

Avoid alcohol (even dark beer – see #8).

Alcohol has actually been shown to decrease milk supply. As mentioned in #8, hops may increase breast milk, so take them in tincture, tea, or tablet form. Alcohol can be appealing for its relaxing effect, but there are plenty of herbs that can be taken for relaxation (see your ND or herbalist). For more on alcohol and breastfeeding, see my previous blog post.

Address the pain.

Breastfeeding should only hurt at the initial latch, and not for more than a few minutes. (The pain will likely disappear completely once you’ve nursed for a while.) If you have pain throughout a feed, or if you have shooting pain, see a lactation consultant! NOW! It will be well worth the money to have your pain relieved. Often it’s as simple as getting help adjusting baby’s latch. However, nipples aren’t used to being wet and pulled on all the time; that plus a bad latch can lead to cracked or bleeding nipples, which must be addressed immediately! Make sure they are dry when not in use. Use one of the many products available for healing the dryness and cracking. My favorite is lanolin – it’s an animal based product, but it works. I’ve linked the brand I used personally; I’m sure other products are great too. If you see white discharge or the lanolin doesn’t help, see your doctor or midwife; you may have an infection. Always keep an eye out for early signs of mastitis and clogged ducts, and get treatment ASAP. There are many products on the market aimed at decreasing nipple pain.  They may or may not help you, so try them if you like; however, only use a nipple shield under the guidance of a lactation consultant as they can decrease supply over time.

Before long, you and baby will be a breastfeeding pros, able to do it in public while talking to your friends and eating lunch. But in the beginning, if you’re like most mom/baby combos, it will take some practice. Hang in there. It gets easy fast.




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Teresa Neff
Teresa Neff

Dr. Teresa specializes in pediatric and adolescent medicine and women’s health. After earning her doctorate from Bastyr University, she spent over two years at The Kids Clinic, in north Seattle, first as a medical resident, and then as a staff physician. At The Kids Clinic, she became comfortable managing urgent acute matters as well as chronic health concerns. Dr. Teresa loves combining her life long love of teaching children with her passion for natural medicine.

As a primary care provider, she offers well child exams, well woman exams, sports physicals, lab studies, vaccines and vaccine education. In addition, she uses the various tools of naturopathic medicine, including Craniosacral Therapy, Visceral Manipulation, and Classical Homeopathy, among others, to build healthy foundations and to promote health and empower her patients.

Dr. Teresa also studied breastfeeding and lactation with the Simkin Center and holds a certificate as a Certified Lactation Educator (CLE). Having experienced the struggles and the joys of breastfeeding herself, she is happy to help moms establish or continue breastfeeding. Dr. Teresa sees patients at Seattle Nature Cure Clinic in Seattle, Washington. Schedule an appointment with Dr. Neff in Seattle, Washington

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