This is the first in a multi-part series Ask Moxie is going to run on breastfeeding. My guest expert is Jamie. She’s a lactation consultant, mother of four, raconteur, and tireless supporter of all things boobular. She’s the person you want to talk to when your tits are in a vise (literally or not). In addition to writing these articles for Ask Moxie, she’s written an amazing series of posts on breastfeeding, breastfeeding support, and breastfeeding in U.S. culture on her own blog. You should check them out.
And now, on with the show:
thing that complicates breastfeeding for new mothers is the abundance
of myths steering her in the wrong direction (or at least in unhelpful
directions) as she’s getting started.
There is a ton of breastfeeding information floating around out there.
Unfortunately, a lot of it is bad. My copy of the Sears & Sears Baby Book
instructs mothers to center the nipple in baby’s mouth and RAM the baby
on. Some babies are fine with that. Others will respond with the same
indignation I would feel if someone shoved my face into my plate and
expected me to eat that way. So choose your sources carefully to find
current, research-based recommendations. (I am partial to kellymom.com and LLL myself.)
If breastfeeding hurts a lot, something isn’t right. It may be that a
tiny adjustment in the baby’s latch (usually helping him to latch more
asymmetrically, taking a deeper bite with his lower jaw — details on these pages)
will make a vast difference. The problem may be an anatomical varation
like a tongue-tied baby or a mother with larger-than-average nipples
(technically known as "oro-boobular disproportion"). Significant pain
should signal you to get help pronto, before your nipples turn into steak tartare.
On the other hand, a lot of women experience a little pain. Your
nipples have never been stretched so far; your ducts have never been
distended to such a degree. Sometimes, especially before the milk
starts flowing, it makes a person say ouch. According to The Breastfeeding Atlas, this
type of pain should last about 20-30 seconds per feeding and resolve
within a week. But if you hear that you shouldn’t be saying ouch, you
may worry that you’re doing it wrong. Motherhood presents many and
varied opportunities to worry that you’re doing it wrong. Whenever
possible (this is just such an instance), decline them.
As far as I know, no state in this country regulates lactation
consultants. You can get tired of your career in furnace repair one day
and hang out your shingle as a lactation consultant the next. This is
part of why lactation support in hospitals is so uneven. You can find
some wonderful nurses and LCs with a magic touch — and, more
importantly, the ability to transmit same to you. You can also
encounter nurses whose idea of evidence-based practice is "Good Enough
For My Baby In 1982 Is Good Enough for Yours in 2006." If you need
breastfeeding help, you can search here for an IBCLC. You might also call a local LLL Leader (start here). If you need more assistance than she can provide, ask her whom she would call if she had a stubborn breastfeeding problem.
- Feed the baby. If possible, your own expressed milk, given in whatever way works for your family. If you opt to use a bottle, this is a helpful article on using bottles to transition a baby back to the breast.
- Protect the milk supply. To bring in a milk supply, rent a hospital-grade pump. If your insurance company balks, an LC should
be able to drop them a letter explaining why it’s important.
the breastfeeding. If you can keep something relaxed happening at the
breast, offering the baby a chance to nurse when you’re both calm and
he’s not too hungry, many babies will catch on all on their own. Most
will figure it out in time, with assistance from an experienced LC.
infertility veterans. Lactation consultants report, anecdotally, a
higher rate of breastfeeding difficulties among women with a history of
infertility. Sometimes the cause is physical (PCOS can be related to
supply issues); sometimes the reason is unclear. I mention this not to
alarm anyone, but because forewarned is forearmed. The same tenacity
that brought you to motherhood can also help you, given good
information and support, to get past most breastfeeding hurdles. Good