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.

Mythbusters: 4 Myths About Starting Solids

I have a background in education. One of the things that frustrated me most as a teacher was when I encountered families who had received bad advice from other teachers. This shouldn't be all that surprising though. Teachers today are burdened with unrealistic expectations from administration and the state, not to mention standards that change more rapidly than a growing toddler.

I am not a medical professional, so I don't presume to know better than my pediatrician. However, if  the field of healthcare is anything like teaching, then it's possible that the everyday demands of the job may prevent some doctors from keeping up to date with current research and AAP recommendations. This is why I think it's important for parents to do their research (which is not the same as one Google search) when it comes to making decisions about the health of their child. In this post I'll provide a few links to get you started, but please understand that I am not an expert and there is a lot more information out there!

Click here to use the AAP's interactive infant timeline

The American Academy of Pediatrics currently recommends that parents introduce solid foods into their baby's diet when s/he is about 6 months old. On their website they remind parents that "babies who start eating solid food too early are more lilkely to be overweight or obese in childhood and adulthood." They also recommend introducing a variety of tastes and textures and encouraging self-feeding early on.

In spite of the AAP's efforts to communicate these current guidelines, there are a few pervasive myths out there regarding baby's first solid foods.

Myth #1: My baby is hungry and breast milk isn't enough.

Evidence shows: Breast milk contains all nutrients baby needs up until 6 months.
The AAP states time and again that breast milk is the best source of nutrition for babies up until they are one year old. At around 6 months when baby's iron stores begin to dwindle, introducing solid foods rich in iron is a great way to supplement his nutritional needs. But a baby's need for iron may be impacted by factors like birth weight, gestational age at birth, etc. So if you have a healthy, typical baby who isn't a huge fan of solid foods at 6 months, keep offering those solids, but keep offering the breast as well. It's likely that she will come around when she is ready without her health suffering.

There are some periods of time early in baby's life when he may be going through growth spurts and doing lots of cluster feeding. Frequent feeding is not necessarily a sign that baby isn't getting enough. If you are concerned, see an IBCLC to do a weighed feed (do not rely on pump output to tell you how many ounces baby is consuming!) and ask for advice. This timeline of a breastfed baby has some excellent guidance to help you know what is "normal" as baby grows and develops.

Myth #2: My baby needs solid food to sleep through the night.

Evidence shows: There isn't a link between feeding baby solids and longer stretches of sleep at night.

One study specifically found that rice cereal feedings before bedtime had no discernible impact on infant sleep duration at night. In fact, research has shown that introducing solids too early may make your baby sleep less! Dr. Gold, a pediatrician in Brooklyn, told the New York Times that infant sleep often has less to do with hunger and more to do with learning how to sleep. If you're a haggard mommy zombie who's desperate for some infant sleep guidance, try reading this or this.

Myth #3: My baby can only eat bland purees at 6 months.

Evidence shows: Different babies prefer different kinds of food.

Age-old solids introduction probably looked like a mix of purees and finger foods. Baby-led weaning (BLW) is on the rise today with more parents introducing their baby to solid finger foods before first using purees. Skeptics of BLW are often leery of choking episodes. Whether you choose to do BLW or not, be sure to look up procedures for infant choking. I keep the picture below on my phone, desktop, and have a printout close by for ease of mind. The point is, babies love exploring new foods and textures. It can take  up to 10-15 tries before a baby will accept a new food, so if she refuses, offer again a few days later, and repeat!

Both images courtesy of American Heart Association

Myth #4: Delaying solids can lead to [insert malady here].

Evidence shows: Evidence shows: Delaying solids until at least 6 months benefits mom and baby.  Not all babies are ready to eat solid food at 6 months.

More moms today are realizing that delaying the introduction of solids until at least 6 months has many benefits. What confuses many parents in US black-and-white culture is that guidelines are not intended to be hard and fast rules because every baby is the same, but at the same time marvelously different. We introduced solids to my daughter at 6 months, but she did not really become interested in eating any of them until closer to 10 months. During this time I had moments when I worried, but I tried to remind myself that she was developing at her own pace. Now she is 13 months old and healthy as she's ever been. She attacks broccoli, enchiladas, and blueberries with great gusto and it's rare that she refuses a particular food.

Some are concerned that a baby's delayed interest in solids could lead to speech and fine motor delays. This speech and language pathologist shares her take on BLW and how it has some overlap with an SLP's perspective on feeding.



Like I said before, do some research. If you find some method or philosophy that resonates with you, keep reading! Don't limit your explorations to only reading studies, blogs, and articles that agree with you. As you widen your search and learn about feeding (or parenting in general!) you will learn to differentiate between people who are experts and those who are blowing smoke, and you will ultimately learn to trust yourself.

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!