All of the books, studies and advice from fellow moms say the same thing – breastfeeding is the most natural, healthy way to feed your newborn. But what happens when nursing doesn’t come all that naturally? Lactation consultant Judy Eastburn talks about common breastfeeding problems and gives expert advice to help you stay the course when that bottle of formula is calling your name.
My two-day-old baby wants to nurse almost constantly: This is fairly normal. Your body produces colostrum, which some refer to as pre-milk. Colostrum is low in volume but concentrated. Babies don’t need much of it, and very frequently, nursing helps to tell your body to make more milk. Your milk “comes in” usually around Day 2 to Day 5, and then most babies settle down to nursing about 8–10 times per 24 hours, or every 2–3 hours. If your baby’s weight has dropped more than 10 percent of his birth weight, supplementing may be temporarily necessary.
My breasts are engorged: When the milk comes in, there is also extra fluid and blood that comes into the breast with the transitional milk. It’s often worse if the mother was given lots of IV fluid during the birth. This engorgement subsides more quickly if the baby nurses early. If nursing doesn’t help and the breasts are still really full, mothers can hand-express or use a pump to help remove milk, and that will make the breasts more comfortable. As the milk is removed regularly, the extra fluid and blood recede and the breasts are more comfortable and softer. You can place cold packages of frozen peas or corn on the breasts for about 15 minutes between nursings to help reduce the swelling. Don’t be afraid to pump for fear that it will make the engorgement worse. At this stage, the key is to resolve the engorgement fast.
My nipples are sore: If the breasts are engorged, it’s much harder for the baby to get a deep latch. Try hand-expressing or pumping briefly before offering the breast. If breasts are not engorged, the nipple pain might be caused by poor attachment, tongue tie in the infant or other issues. To get a deep latch, your baby should be snuggled in very close to you with the nipple just under baby’s nose. When he opens, bring him in close so the nipple goes deep into his mouth.
I’m afraid I don’t have enough milk: Most mothers can make enough milk for their babies, although there are exceptions. Mothers who’ve had breast reduction surgery, fertility problems, hormonal imbalance or insulin resistance are at risk for not making enough milk. In many cases, mothers think they’re not making enough because their babies are feeding very often, which can be normal. If there is a concern, the baby’s weight should be checked to confirm good growth. If your baby is growing well, the milk production is appropriate. If your baby is not growing well, the problem could be with the mother or with how the baby is sucking. Some mothers start out making lots of milk, but if the baby isn’t sucking well and therefore not removing the milk well, the milk production will slow and the supply drops.
Judy Eastburn was a certified La Leche League Leader from 1975–1988. She became an International Board Certified Lactation Consultant and started her private practice in 1987, serving mothers and babies throughout the Dallas area. She has three sons and three grandchildren, all of whom were breastfed.
Published September 2013
