Amy Newman, C.N.P.
Obstetrics & Gynecology (OB-GYN), Prenatal Care, Women's Health
As a lactation specialist, I see many new moms who are anxious about breastfeeding, but want to give their baby the best start. And breastfeeding is one of the best things mothers can do to give their infant a strong start in life.
Human milk is the perfect food for babies. It decreases their risk for asthma, ear infections, obesity, Type 1 diabetes, stomach infections and sudden infant death syndrome. It's good for moms, too, reducing their risk of breast and ovarian cancer, Type 2 diabetes and high blood pressure.
Breastfeeding is a learning experience for mother and baby. It's a natural activity, but it takes practice, which requires time and patience.
Feeding sessions can take 30 minutes or longer, especially in the beginning. New moms need to remember that the process will get easier and babies will get more efficient at nursing.
During pregnancy, a woman's health care provider will talk about breastfeeding, but at about 28 weeks, that conversation becomes more detailed, giving the mother-to-be an opportunity to ask questions and consider what she'd like to do. Prenatal breastfeeding classes also are available, which provide excellent resources for the expectant mother and her support person.
Pregnant women who opt for breastfeeding are now being given instruction and shown how to hand-express the first milk (colostrum) once a day, starting at 37 weeks, to jump-start flow and supply. Any colostrum that's collected can be frozen and brought to the hospital at delivery so the baby can start on their mother's milk right away, rather than formula, until the mom's milk comes in and supplementation is necessary. This has been exciting for new moms and seems to have really helped support their breastfeeding journey.
During consultations and classes, here are the questions new mothers most often ask and the answers:
When will I start producing milk?
A mother's milk doesn't come in immediately after delivery. It can take three to five days postpartum for this to happen. Those first few days, mothers produce colostrum, which provides protective antibodies and helps the baby's digestive system develop. By starting with this small amount of colostrum, the baby gets time to coordinate sucking, swallowing and breathing at the same time.
How do I know if I'm producing enough milk?
Most moms will make enough breast milk with no problems. To make sure, they should monitor baby's wet and soiled diapers. Babies who get enough to eat will go through five to six diapers a day once their mother's milk fully comes in. Also, their pediatrician will check the baby's weight regularly.
How do I know I'm doing it right?
I've found that moms just need reassurance. They can ask their health care provider or consult with a breastfeeding specialist or public health nurse. These specialists can check that mom and baby are positioned comfortably and assess the latch on the breast. They also can answer any questions. Learning to breastfeed can feel overwhelming in the beginning, but we're fortunate to have so many resources who are here to help you set and reach the goals best for you and your baby.
How will I know when my baby is hungry?
Newborns need to eat at least eight to 12 times during a 24-hour period. Watch your baby, not the clock. Babies give cues when they're hungry. These include rooting from side to side, putting their hands up to their mouth, and searching for a breast or nipple. You'll quickly learn to recognize these cues. Crying is the last sign of hunger, so it's important to try to feed before crying starts. It can be difficult to calm a crying baby and get them latched.
What if I need to go back to work?
Work is a reality for most women, but that doesn't mean once you go back that you have to stop breastfeeding. Workplaces are supportive of breastfeeding, and laws allow you to pump at work in an appropriate space ― not a bathroom. There are wonderful breast pumps available and most insurance covers them. We can help make sure you have a prescription for a breast pump when you leave the hospital. There are so many tools and support systems for moms to reach their breastfeeding goals.
Breastfeeding doesn't have to be all or nothing. You can determine what works best for you and your baby. You can choose to do a combination — just breastfeeding when you're at home and giving baby formula when you're not. It's also up to you how long you breastfeed, whether it's a few months or more than a year.
The most important goal is for baby to be fed. We want new moms to feel they have the tools and resources they need to feed their baby and enjoy the process. We're here to help make that happen.