A Year in Review: Starting Out FAQ

It's November...and we couldn't be more thrilled that this month marks one year of tears, triumphs, and tatas here at Adventures in Breastfeeding!

To kick off our celebration, we're taking a look back at some of our greatest hits. Today I'll share links to posts that would answer questions moms might have when they are breastfeeding newborns. Later this week Missy will highlight AIB posts that would be more relevant for those who are further along in their breastfeeding adventure. Wherever you are on your journey, we are confident you'll find something informative, inspiring, and empowering as we look back on a year's worth of Adventures in Breastfeeding.

Here are a few of our most popular responses to some common questions new moms have when they begin breastfeeding.

I'm pregnant with my first baby! What can I do now to prepare for my breastfeeding adventure?

Congrats! When it comes to finding success breastfeeding, our contributors have 3 important tips to avoid feeling overwhelmed: educate yourself, trust yourself, and get support.

5 Things You Really Need to Breastfeed

Doing It Wrong

5 Things Every New Mom Wants to Hear

I have a newborn and this is HARD! Does it get better?

The short answer is yes. Whether the barrier you're facing is nipple pain (ouch!), postpartum depression, or anxiety about inverted nipples or augmented breasts, chances are you'll find a way to dig in and get through it. A few of our contributors have shared about these obstacles and how they overcame them.

The Vanishing Finish Line

When Life is on Mute

Do Faulty Breasts = Breastfeeding Failure?

 

Am I making enough milk? Do I need to supplement with formula?

Misinformation about breast milk supply and what constitutes a "normal" breastfeeding relationship has got to be the biggest booby trap out there. If you are concerned about your supply, it may be an issue with baby, or it may be an issue with you. It helps to have realistic expectations about how supply is created, how it's not, and how often baby will feed (especially during a developmental leap or growth spurt). But sometimes there may be another issue at play, like a posterior tongue tie. If you've already begun supplementing and would like to try to scale back, you can find some tips here.

4 Myths Busted

Pumping Output is Not an Indicator of Supply

Surviving a Growth Spurt

Diagnosing a Posterior Tongue Tie

How to Stop Supplementing

I had dreams of breastfeeding my baby, but now he's in the NICU. What now?

Any parent who has had a NICU experience knows that it's difficult to put into words the challenges you'll face. Tiffany has shared her story of nursing in the NICU and Analyn wrote about how nursing helped her little girl during a hospital stay. 

Nursing in the NICU

Breastfeeding and Hospital Stays

As I look back at the blog's first year, I feel so blessed by what I see: dozens of posts by women (and men!) telling their stories about fears faced, lessons learned, and victories celebrated. Stories of support and encouragement for moms in tough breastfeeding situations. I know now, more than ever, that I am not in this alone. Boy am I grateful.

Would you add anything to this FAQ list about breastfeeding a newborn? 

Leave a comment below or on our Facebook page!

And don't forget to check out Missy's post on Thursday about FAQs moms have when they pass the newborn stage.

Relax and Enjoy the Journey

I'm a very Type A personality. Some might say I'm a bit high strung at times. I prefer intensely passionate. As a first time mom, I wanted to be sure I did everything right. Or at least what I considered to be the "right" way of doing things. Breastfeeding was especially important to me and I got a little overwhelmed with worry. Worry about feeding her enough. Worry about my supply. Worry about enough wet and dirty diapers. Worry about how long it had been since I fed her. I used a tracking app religiously for almost her entire first year of life. I needed to know (down to the minute) how long she nursed, on what side, at what time. In hindsight, it was over the top.

As time went on, I stopped worrying about some things, but my old worries were replaced by new worries. Now I worried that my supply might be slipping since my breasts didn't feel as firm, especially as she went longer between feedings. I worried that she would never learn to sleep on her own without nursing to sleep. I worried that she would hate solid food and want to nurse forever. Okay, some days I still worry about that one.

As I talk with new moms about their breastfeeding concerns and worries, I see that so many moms worry about common things that are usually just sapping our already low supply of energy. With all the Booby Traps out there, it's easy to get caught up in a cycle of self-doubt and worry. After nursing for 17 months (and still going strong!), I've learned many things. One of the most important things I've learned is that most of the time, the fears are unfounded and a waste of time and precious energy. Are there some women who will legitimately have struggles with low supply or baby gaining "enough" weight? Sure. But these tend to be the exception, not the rule.

For most women, we can breastfeed our nurslings knowing that we are giving them everything they need. Instead of worrying about potential problems, enjoy the journey of breastfeeding. Each and every day is special, and we never know which one will be the last. So enjoy every aspect of your breastfeeding journey. Your hurdle might be the success story that another mama needs to get past the same thing. And remember...

Source

FAQ: How can I increase my supply so I can stop supplementing?

Of all the questions we hear from new mothers, this is one of the most common. There are a number of reasons that a mommy may end up supplementing her breastfed baby's intake with formula, but many mothers and pediatricians prefer babies to be exclusively breastfed, if possible. Here are some key pieces of information and basic steps you can take to help achieve exclusive breastfeeding for your child.

1) Call a lactation consultant. Every situation, every family, every mother, and every baby is unique. There is no one-size-fits-all fix, so if you're having any difficulty with breastfeeding or your milk supply, the first thing you should do is set up an appointment with a lactation consultant as early as you can. Lactation Consultants are trained to recognize latch and positioning problems, tongue and lip ties, and many other problems that can hinder your breastfeeding relationship. Don't balk at the cost: it often takes only one visit to point you in the right direction, and in the long run, it's much cheaper than buying formula!

2) Breastfeeding is a supply-and-demand system. Particularly at the beginning, as you establish your supply, the only thing that will regulate how much you make is the frequency with which you completely drain the breast. A baby (even a newborn with a wonky latch) will always drain the breast more effectively and efficiently than a pump, which means that a nursing baby will stimulate your supply more than the pump will. If you've been relying mostly on pumping so far, that could be one reason why your supply hasn't caught up yet. Limiting feed times or adhering to a strict schedule instead of feeding on demand can also cause supply to lag.

3) An additional problem that might be going on if you're supplementing is a bottle preference. It's less work for a baby's mouth to get milk/formula from a bottle than it is to get it from the breast (literally, the tongue has to make a completely different motion), so many babies who are bottle-fed develop a bottle preference and become frustrated at the slower flow of the breast. A problem that comes with that is that they can drink more fluid in less time from the bottle, meaning their stomachs (which are TINY and usually can only hold an ounce or two as newborns) expand faster than they would were they drinking from the breast. And finally, breastmilk is metabolized much faster than formula, meaning a breastfed baby is hungry more often than a formula-fed baby.

As long as your baby can get his food from somewhere other than your breast, he won't be stimulating your production enough to increase your supply.

4) As long as your baby can get his food from somewhere other than your breast, he won't be stimulating your production enough to increase your supply. The most effective solution is also the most upsetting: Stop giving baby formula and offer the breast as often as possible. If he still wants to nurse after 40min, let him! If he wants to nurse again only a few minutes later, let him! If he wants to nurse 3 times in 2 hours, let him! Even if you think you have no milk left, you usually do, and better, if he really does manage to suck you dry, that means he's getting the fat-rich hindmilk, which is great for his weight gain! AND having him nurse you completely empty will send your supply into overdrive..... odds are you'll be engorged within 24 hours!

5) Some mothers who have been in this situation often recommend going into a quiet, dark room and just nursing for hours, some recommend trying skin-to-skin, some recommend co-sleeping, and so on: you'll find what works for you. And keep in mind that fussiness is not always hunger..... if she cries after eating, it could be gas, a wet diaper, tiredness, the desire to be held or swaddled, or just frustration. Keep in mind that your baby is likely to be upset and crying the first few days that you withhold the bottle, but as long as she's having regular wet and dirty diapers, she is healthy and there's no need for concern.

Make sure you are in communication and agreement with a pediatrician you trust at all times while transitioning your baby's diet, both for your child's safety and for your own peace of mind.

Keep calm and nurse on, mamas!

3 Booby Traps That Almost Ended Our Breastfeeding Relationship

I knew nothing about breastfeeding when my son was born. The problem with that is that, since nursing is a supply-and-demand system, any mistakes or attempted shortcuts can lead to the relationship ending much sooner than the mother would prefer. While I was usually able to course-correct pretty quickly when I realized my errors, the truth is that there was a lot of luck (and, let's be honest, stubbornness) at work in our ultimately successful breastfeeding relationship, not to mention an active and well-informed support network of mamas.

Here are the 3 "Booby Traps" that tripped me up, along with a few tips to avoid them yourself!

1. Cluster Feeding? What's that?

I left the hospital with a packet of breastfeeding information that I barely skimmed before heading home to cuddle my newborn in idyllic domestic bliss.... only to discover that not only did my baby not want to eat for 30 minutes every 3 hours, but he wanted to be attached to my boob nonstop for 4 hours at a time. Any attempt to remove him was met with screaming. Sometimes he would calm for a few minutes and I would think he was finally satisfied, then he would start crying again and not calm until I put him to my breast. I didn't understand how he could still be hungry, or how I could still have milk after it appeared that he had emptied both breasts. Deciding that he must just be comfort-sucking (and needing a break for my poor aching nips), I gave him a pacifier at just 4 days old. This seemed to work, but when we learned his weight gain was much too slow, I began to doubt.

In time, I learned that my new babe was cluster-feeding, and that this non-stop need to nurse actually served the vital purpose of establishing a solid milk supply. I was also told that newborns metabolize breastmilk so fast that they need to nurse again shortly after in order to get all the calories and nutrients they need. In retrospect, it's clear that I was risking my supply by replacing the breast with a pacifier so early, and that I was hampering my child's weight gain by not offering my milk as often as he wanted it.

2. Skipping a Night Feeding

As any new parent knows (and yet, nothing can prepare you), caring for a newborn is utterly exhausting. Having that infant constantly attached to your breast? Even more so. So, it wasn't long before I felt that I needed a break. As detailed in a previous post, I found myself one night feeding my baby a bottle of formula, and going to bed: I was absolutely desperate for even one hour of sleep. This happened several times, and even after I stopped giving formula and started giving pumped milk instead, I regularly missed a night feeding and had my husband give a bottle instead.

I now know that missing feedings so early or at all is to seriously jeopardize the breastfeeding relationship, but I didn't learn until recently that night feedings in particular are especially important. Not only does night feeding promote milk production, but nighttime milk is actually much richer and denser in nutrients than daytime milk. Even though I was replacing the missed feeding with an earlier pump to counteract negative effects to my supply, by skipping the nighttime feeding, I was withholding from my baby much-needed nutrients and fat that would help him grow and be healthy. Furthermore, since a pump is not as effective as a suckling babe at removing milk from the breast, the replaced feeding was probably still impacting my supply. Worst of all, the whole reason I was missing the feed-time was to get some sleep, but studies show that cosleeping moms actually get more sleep than non-cosleepers! I could have fed my baby more and gotten more rest!

3. No Paced Bottle-Feeding

It started harmless enough: I was pumping more than my 2-month-old was eating in a day, so when our daycare provider told us he was eating more, I thought "No problem" and started sending extra ounces with him. Then they kept asking for more, and more, and more, until I was sending at least 20 ounces of pumped milk for a 10-hour separation. I could only pump 16 or so ounces a day, so I was having to fit in extra pumps at night and dip into my meager frozen stash to make up the difference. It was stressful and exhausting, and still it seemed he wanted more. Before long, we decided to move up to a faster-flow nipple on the bottles. One day, I learned that he had had 25 ounces that day. I felt the end was near.... I would never be able to keep up with that pace.

Then, disaster struck: I got laid off. My mostly bottle-fed baby suddenly became an exclusively breastfed baby, and his fury at and rejection of the "slow flow" of my breast made me suspect that he had developed a bottle preference. Someone recommended this Expressed Milk Calculator on Kellymom, and I learned that we had been WAY overfeeding our kid.

A breastfed infant needs an average of 25 ounces of breastmilk in a 24-hour period..... and that's what we were feeding in only 10 hours! A baby does not have to work as hard for milk from a silicone nipple as he does from a breast, so many of them also develop a preference for the bottle, as ours clearly had. While I'm certain they meant well and it was my responsibility to be informed, clearly the daycare had been using feeding as a pacifier, and had I not lost my job, we probably would have needed to start supplementing, which could have led to our nursing relationship ending much sooner than either of us wanted. My layoff was a blessing in disguise, but many mothers remain unaware of the effects of overfeeding, as do well-meaning caregivers.

And Yet....

In spite of all these Booby Traps and the many other trials we have faced on our breastfeeding journey, we recently passed a full year of breastfeeding and are still going strong! If you've fallen victim to a Booby Trap, don't give up! Your body and baby are designed to do this, and with the right information, you can still have a healthy and rewarding breastfeeding relationship!

4 Myths Busted

My adventure in breastfeeding started about three years ago when I started working as a night RN in the newborn nursery. There were no night shift lactation consultants at my hospital and most of the time, since company was gone for the day and things had settled down, night shift was the perfect time for first-time breastfeeding moms to ask for coaching. It was also the time that breastfeeding moms wanted to give up and get sleep. I took on the challenge, even though I had never breastfed, and instantly fell in love with lactation. During my journey of trying to conceive and pregnancy loss then finally my pregnancy with C, I was envious of all of the breastfeeding mothers. All I wanted to do was nurse my own baby and I prayed that all of the advice I gave new moms over the years was worth taking!

Working in the hospital with new moms during their first few days, I hear so many reasons why moms don't think they can nurse right away, exclusively, or at all. Here are some of the most common myths - busted.

I can't squeeze anything out so my baby isn't getting anything.

If only we could be so lucky! Most women aren't blessed with the ability to squirt milk across the room right after the cord is cut (and yes, I actually say that at the bedside because I'm awesome like that). It takes time and effort to establish supply.

Think of it as breast milk economics. Create the demand for a supply and generally it will come.

It can take 4-10 days to beef up milk supply to the point of feeling full or that milk has come in. Even after this period, it is normal to have highs and lows of production throughout the day, so don't be discouraged if you see colostrum dripping out during the first feeding and not the second or more commonly, morning and nighttime feedings.

Check out my next post for yummy recipes and ways to modify your diet to help increase supply!

My baby is in a low weight percentile so I need to supplement with formula to help him gain.

In the words of my son's pediatrician, someone has to be down there! Anywhere from the 1-99 percentiles is considered normal. If a baby is below the 1st percentile or starts dropping weight rapidly, that can be cause for concern, but some babies just gain slower than others and that's OK.

Exhibit A - My son's growth chart

He was consistently under the lowest little line but thanks to a great pediatrician, supportive family, and a hint of genetic stubbornness, we are now 9.5 months into our breastfeeding relationship without supplementing and he is now in the 31st percentile for weight and 69th for height. We are lucky to have a great pediatrician who told us that C would just follow his own curve and around 6 months he was expecting him to shoot up - that's exactly what happened.

Usually, as long as baby is having adequate wet diapers and not showing any signs of dehydration or other distress, even with slow weight gain, exclusive breast milk feeding is the way to go.

I have sensitive nipples. 

Oh yeah? Me, too!

Can it hurt a little in the beginning? Yes. Should it hurt the whole time? No.

If the latch is good, (which is a topic on the shelf for another day) it should not hurt for the entire duration of your breastfeeding relationship. A good way to initially check a latch is to assess if your baby is tugging or biting. It should feel like a strong tug so if it feels like a bite, break suction, start over and get the nipple deeper in the mouth until you feel a tug. This helps alleviate a lot of tenderness in the early days.

A question I get asked often by mothers experiencing tenderness is if it goes away. I'd love to tell you it does but the jury is still out. Does it go away or do we just toughen up and get used to it? 

Regardless, that wincing, piercing, OMG-why-am-I-doing-this feeling should subside in the first week or so. In the meantime, air out your nipples, wear gel pads, use lanolin cream, coconut or olive oil and ensure that your baby has a good latch.

My baby is hungry an hour after I nurse. There's no way he's getting enough.

The simple answer: You and your baby are designed to grow at the same rate. As long as you exclusively breastfeed, baby's tummy and your supply will grow together. In the first few days, when you just have colostrum -aka liquid gold- baby will probably want to eat small, frequent feedings and as milk gradually gets more calorie dense, there may be longer stretches between feedings.

Baby's tummy probably isn't going to be bigger than a marble on the day of birth and it will gradually increase in size.

As baby sucks more, mom will produce more, then baby's tummy will grow. If a bottle is introduced in these early days, baby will suck it down really fast and it is super easy so the tummy will expand faster than mom's supply can catch up.



What myths, wives' tales, or opinions did you have to combat in the early days of your breastfeeding relationship? Were you able to bust or overcome them?

Keep calm and nurse on, mamas. Til next time...