Category Archives: Breastfeeding

Breastfeeding: Why Is It So Hard To Breastfeed A Baby?

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:

Why Is It So Hard to Breastfeed a Baby?
 
One
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. 
 

Myth #1: It’s so much easier to learn about breastfeeding these days.
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.)
      
Myths #2 and #3: It won’t hurt if you’re doing it right vs.  Early breastfeeding is painful and you just have to suck it up.
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.

 
Myth #4: A lactation consultant is a lactation consultant.
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.
      
Perhaps most pernicious is myth #5: Breastfeeding has to get off to a good start or it won’t work out. A good start is a big help, but here’s what you do if you get a rocky start instead (courtesy of Linda Smith):

  1. 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.
  2. 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.
  3. Fix
    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.
One last note: many of the women who read and comment here are
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
luck!

Q&A: Nursing bras

Mimi writes:

"I’m expecting my first child very soon and am feeling very calm aboutnearly everything birthing and parenting related.  My anxiety is
completely centered around picking the right nursing bra.  Sizes,
styles, stores… I’m stymied!  Please opine at length."

"At length"? Ah, you know me too well.

Now, lingerie is such a personal thing. So what I’m going to recommend (with the exception of buying one or two Bravados ahead of time, which seems to be universally recommended) is just my opinion, based on the limited number of different nursing bras I’ve tried. My advice is coming from a woman who started out a C-cup before pregnancy, went up to a DD (and up one band size) by the end of pregnancy, was an E for a few days when my milk came in, and then was a DD for the first 9 months of nursing. I went down to a D (and back to my original band size) by 9 months post-partum and then back down to my original C by 18 months or so of nursing. I sincerely hope that others comment with their opinions so we can get some more data points from women with different sized breasts.

I would buy one or two Bravado bras right now to have when you deliver. Bravados are kind of a stretchy sports-bra style that fits a range of sizes, so you can order the size you are in your 8th month and know it’ll fit you when you deliver. I liked my Bravados because they were extremely comfy and gave me enough support for everyday activities. However, I did not find that I could open and close them with one hand–the band was too stretchy for that. What that meant was that I wore them a lot at home, but not out when I’d need to open and close smoothly in public or in front of my FIL. I wore them so much I ended up throwing one of them away last month after 40 or so months of use (with two different kids), when it finally gave up the ghost. Bravado’s not the perfect bra, but it’s a good one to have on hand to carry you through the first few weeks until your size settles down and you can think about ordering or buying another few.

An aside: I never could have managed with 2 bras. They tell you you should have one on and one in the wash, but come on. Who’s washing bras when you’ve got garments full of spit-up to wash first? I think 4 is probably a reasonable minimum number of bras for someone who nurses for more than 6 weeks.

I also have a few Playtex Expectant Moments bras, which win hands-down in the dumbest name category. They are very easy to open and close with one hand. I have the older style with woven cotton cups so they don’t stretch much. I got them on sale, so I’m fine with them, but they’re not the first bras I reach for. Maybe the stretch cup style is better, but this style was just kind of eh. I’d wear them when I knew I’d need to open and close smoothly with one hand, though.

My favorite nursing bras for every day are actually the cheap bras I bought at Target (I’m positive I used to be able to find them on the website, but I can find them now). They range in price from $12 to $17, and I’ve liked most of the styles I’ve tried. They don’t last forever, and if you wash them in the machine you risk losing an underwire, but I don’t think you can beat them for the intersection of price, comfort, and style.

I have two nursing tanks from Target, which are OK, but they’re way too short and run extremely small. I’ll probably buy a nursing tank or two from Motherwear to see if they run a little longer (the ones from Target ride up like crazy). Wearing a tank under another shirt turns that shrt into a nursing shirt, because you’ve got the tank layer covering your tummy. This is key for those of us who live in cold climates.

That’s all I’ve got. Anyone else? Smaller-breasted women? Other larger-breasted women? I’m due for some new bras myself and could use recommendations. Sign in with your size, favorites, and least favorites.

(Oh, and has anyone tried the new uber-sexy nursing bra?)