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Deciding to Breastfeed

Breastfeeding

Deciding to Breastfeed Hannah, then age three: "Mummy, what are you doing?"
Me: "I'm feeding the baby."
Hannah: "Yuck!"

That conversation took place the day after I delivered our third child, Emma. The girls were visiting the hospital along with my husband and mother. The baby was hungry, so I began to nurse her. As I did, the older girls gaped in surprise. That's when Hannah weighed in on breastfeeding. We adults had a good laugh about Hannah's remark, and the memory of her reaction still makes me smile nearly two years later.

As Hannah and Hayley became accustomed to my nursing Emma, I would often point out that a mother's body is perfectly designed to feed a baby. In trying to figure out breastfeeding, the girls would pose all sorts of different questions, including: Does it hurt? How do you make milk? and Where does the milk come out?

No doubt, you have your own questions about breastfeeding, particularly if you're contemplating nursing a baby for the first time. Don't feel embarrassed by your lack of nursing knowledge. Knowing how to breastfeed is not the same thing as knowing how to make your mother's pot roast recipe. Generally speaking, our mothers and grandmothers did not breastfeed, because it was largely discouraged at the time. Unfortunately, that limits our information sources about the benefits of nursing, never mind the practical aspects of how to actually breastfeed a baby.

In My Experience: Call in a Consultant
Moms new to nursing a baby (and even experienced breastfeeding women) need all the encouragement they can get. If you're having any sort of difficulty with breastfeeding, you need a caring, knowledgeable expert to provide advice and to cheer you on. Certified lactation consultants are just the ticket. After having some trouble with pain and improper positioning during the initial weeks of nursing my first child, I paid for a home visit by a lactation consultant whom I had met in the hospital. Getting together with Michelle for an hour was one of the smartest moves I have made to date as a parent. She assured me that I was doing a good job, and that my problems would soon be resolved. That cheered me up and gave me the necessary confidence to go on breastfeeding Hayley and two more children after her.

Hospital-based breastfeeding classes are a boon, but you may run into problems when you get home. When you need help, rely on International Board Certified Lactation Consultants (IBCLCs). As health care professionals who meet the eligibility requirements set by the International Board of Lactation Consultant Examiners, members possess the knowledge and positive attitude needed to provide quality breastfeeding advice for nursing moms and their babies. IBCLCs work in hospitals, community settings, and in private practice.

BenefitsBreastfeeding Benefits
Without question, breastfeeding is best for baby. Breast milk is one of nature's most perfectly designed foods. It contains all the right nutrients in the correct amounts to foster baby's brain development and physical growth for about the first six months of his life. Breast milk is tailored to meet your baby's needs, and its nutrient composition evolves to accommodate his growth.

Several health organizations, including the American Dietetic Association and the AAP, recommend nursing a baby for at least a year (longer if desired). The AAP encourages Mom to breastfeed exclusively until baby reaches six months of age. You may think these are lofty breastfeeding goals that most mothers are unlikely to achieve. But please don't be put off. Any amount of breastfeeding is better than none. Even a few months of nursing while on maternity leave counts toward your baby's good health. That may come as a happy surprise to women who are planning to switch over to infant formula once they return to work. Working does not have to interfere with breastfeeding, however. Many women nurse their children in the morning and at night and pump their milk to be fed to baby from a bottle when they are not around. That way, baby reaps the benefits of breast milk while being cared for by a sitter.

Breastfeeding:

• Inspires maternal confidence. It's wonderful to see how baby thrives from the milk Mom's body produces. It's one of the greatest miracles of life.
• Is a one-of-a-kind opportunity for Mom and baby to bond. Your infant can snuggle up close to you while receiving the nurturing he needs in the way of food and physical contact.
• Is a money-saver. You may need to eat some additional food to keep up your milk production, but food costs don't come close to the price of infant formula, which the AAP puts at upwards of $1,000 for the first year.
• Is convenient and saves time. Your baby's food supply is always with Mom. There's no shopping for and preparing formula and no water, bottles, and nipples to clean every day, either.
• Promotes better digestion and quicker maturation of the intestinal tract. Breast milk is easier for baby to digest than infant formula. It provides substances that ensure that an infant's body properly breaks down the protein and fat in breast milk.
• Helps Mom's uterus get back in shape faster, protects against breast cancer, and keeps blood pressure in check. As baby sucks on the breast, the hormone oxytocin makes its way into Mom's bloodstream. Oxytocin prompts the uterus to shrink to its regular size, and more. Researchers at the University of North Carolina at Chapel Hill found that nursing promotes blood pressure control, and they credit oxytocin for inducing calm. According to the American Medical Association (AMA), nursing a baby for at least three months reduces your chance of developing breast cancer later in life.
• Lowers the rates of allergy and asthma, diabetes, digestive tract infection, and respiratory and ear infections in babies. That's not to say that nursing guarantees immunity. Many other factors contribute to your child's susceptibility and contact with germs, including siblings, day care, and pacifiers, which can convey germs by coming in contact with unclean surfaces and hands.
• May reduce your baby's chances for cardiovascular disease in adulthood. At least one study, published in the Archives of Diseases in Childhood, found that babies who were exclusively breastfed for at least ten days had fewer of the risk factors for cardiovascular disease some fifty-plus years after birth.
• May foster weight control later in life. German researchers have found that five- and six-year-olds who were nursed the longest as babies before beginning formula or food were far less likely to be overweight.
• Enhances baby's brain function and fosters peak eyesight. Breast milk supplies two fats, AA and DHA, found lacking in cow's milk. AA and DHA are associated with improved cognitive powers and well-developed vision. The longer you breastfeed, the greater the effects on your child's mental acumen, motor abilities, and vision. Mom's diet can influence the amount of AA and DHA available to baby's brain by way of breast milk.
• Promotes softer, sweeter-smelling stools than those of formula-fed infants.
• Reduces health care costs. A study done by the University of Arizona Department of Pediatrics found that exclusively breastfed babies had a lower incidence of ear infections, respiratory infections such as colds, and intestinal infections. That meant fewer doctor's visits, hospitalizations, and costly prescriptions than for formula-fed children.
• Helps lower leukemia risk in children. A Journal of the National Cancer Institute report found that breastfed infants might have a lower risk of developing some forms of childhood leukemia than their bottle-fed counterparts. The longer children nursed, the greater the protection.

BarriersOvercoming Breastfeeding Barriers
You're considering breastfeeding, but you're just not sure it's right for you. Perhaps you've heard nursing horror stories that make you want to run to the nearest store to stock up on formula. Maybe you fed formula to your other children, and now you're considering breastfeeding this baby.

In the end, you must do what's best for you and your family. But first, you need the facts to make an informed decision. Here's some straight talk about breastfeeding that I hope will help.

Barrier: You think that you may flunk breastfeeding.
Solution: You're afraid, and that's to be expected. But you can't fail at something you've never tried. Stop listening to friends and relatives that did not have a good experience with nursing. Stick with health professionals and seasoned breastfeeding pros, including experienced mothers, who can provide you with facts while offering support.

Barrier: You have to work at breastfeeding.
Solution: It may be a natural function, but it doesn't always come naturally at the start (neither did toilet training). Both you and baby will probably go through a period of adjustment as you learn the breastfeeding basics, but it's worth it. Many babies and their moms get the hang of nursing soon after birth and go on to have a successful relationship that lasts for months afterward.

Barrier: You are concerned about producing enough milk.
Solution: Not to worry. The more you nurse, the more milk you make. Some women do not have enough glandular tissue to produce adequate milk to nourish their babies, but this condition is rare. Even if you think you are small breasted and can't produce enough milk, don't be concerned. Your breasts can make just as much milk as larger ones.

Barrier: Inverted or flat nipples.
Solution: Many times, inverted or flat nipples don't hinder breastfeeding. Wearing breast shields during your third trimester and between feedings once the baby is born may help, so ask your doctor about this.

Barrier: Breastfeeding is messy.
Solution: Nursing is not always a tidy business. Let's be frank. Your breasts leak, and they are capable of shooting milk clear across the room! When does that happen? When a baby suckling at the breast suddenly stops but your milk flow continues. Invest in lots of breast pads to take care of any leaks, and wear appropriate clothing, that is, two layers, to disguise minor leaks. Each time you nurse, have on hand a cloth or towel you won't mind getting wet. Cloth diapers work well to clean up during and after nursing.

Barrier: Breastfeeding hurts.
Solution: Nursing may be a bit uncomfortable at the start because your breasts are not accustomed to a baby's powerful suckling. I had this problem a couple of times, and I used acetaminophen, patience, and perseverance to overcome it. The initial pain you may have with breastfeeding should go away within days to a week, however. In the meantime, ask your licensed health care provider about over-the-counter pain relievers to alleviate the discomfort. If breast pain persists, improper positioning is most likely the cause, although there may be other reasons. Here's why: Your baby gets milk by pressing on the areola, the dark area surrounding the nipple, not from the nipple itself. Baby must be encouraged to open her mouth very wide to get as much of the areola into her mouth as possible. If she doesn't open wide enough, she will end up suckling on the nipple, and you will end up in pain.

Mastitis could also be a source of breast pain. It's a bacterial infection that usually develops in just one of your breasts. You feel tired and achy, like you've got the flu. You do not have to stop nursing, however. In fact, breastfeeding helps clear up the infection by draining the breast. You doctor may prescribe antibiotics that are safe to take during nursing.

The absence of fever combined with reduced milk flow and a sore breast may mean you have a plugged milk duct rather than mastitis. Breast tenderness may be treatable by massaging the affected area, frequent nursing, and applying moist heat. In any case, call your doctor immediately.

More barriersBarrier: Breastfeeding is a lot of responsibility for Mom.
Solution: You may be the sole food provider, but you are not the only one capable of feeding the baby. Purchase a breast pump before baby is born, and read up on how to use it. Wait a couple of weeks or more after delivery to begin pumping milk. Allow your infant to get accustomed to taking small amounts of expressed breast milk by having your husband, partner, or other adult give your newborn milk from a baby bottle. Forget about the dire warnings that baby will become confused about how to suck on the bottle's nipple and your own. Taking the chance that he won't become confused buys you some much-needed freedom. Expressing milk and allowing others to feed my girls helped me think more positively about nursing, which perpetuated breastfeeding in my case.

Barrier: Breastfeeding in public can be difficult, uncomfortable, and embarrassing.
Solution: Some people are offended when they see women feeding their baby the way nature intended. Truth is, you may want to be more discreet, but it's not always possible. Very few public places provide private spaces for nursing moms. Whenever I brought the kids to a nearby mall, I would silently curse the mall management for overlooking the fact that nursing mothers would like to be more comfortable when breastfeeding (although it did not stop me from going out with all three kids in tow). You can avoid embarrassment by covering up with a towel or receiving blanket when nursing in public, feeding the baby in the parking lot before going into a mall or restaurant, or requesting a more private booth or table when dining out.

When Nursing is not an Option
Despite its benefits, breastfeeding is not always the smartest feeding choice. If you or your baby have a chronic medical condition, formula feeding could be best. Women who use illicit drugs or who take certain prescription and over-the-counter medications on a daily basis should check with their obstetrician and pediatrician about the safety of nursing their babies. Here are some of the situations that preclude breastfeeding.

HIV and other infectious diseases: Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). HIV can be transmitted from mother to child through breast milk. Experts at the Centers for Disease Control and Prevention recommend women who test positive for the HIV antibody not breastfeed their baby. Moms with T-cell leukemia virus infection or untreated tuberculosis should also avoid breastfeeding to reduce risk of transmission to baby.

Chemotherapy and other medications: Women receiving chemotherapy and certain other medications for chronic illness should not breastfeed. A number of drugs that are unsafe for a developing baby are passed on through breast milk.

Illicit drug use: Moms who use any amount of marijuana, cocaine, heroine, or any other recreational drug should avoid nursing.