Breastfeeding 101
by Sharon Morioka

If you heard about a product that could enhance your baby’s development and help prevent illness while it also helped you to lose weight, you’d probably be skeptical. You’d be even more suspicious if this miracle product was easily available and free. But it does exist and those are only a few of the many benefits of breast milk.

Since the early 1970s, breastfeeding has become increasingly popular among American mothers. According to a recent study by Ross Products, 70.1 percent of American babies were initially breastfed and 33.6 percent were breastfed at 6 months. While more and more new mothers look forward to the experience, they are often surprised to discover that the process isn’t as simple as unbuttoning their shirt and positioning the baby next to their breast. There is a learning curve and some mothers experience difficulties in their attempts to breastfeed. But many difficulties can be overcome for mothers who persevere. For those who do, the rewards more than make up for the problems.

Why Breastfeed?

“Everything I read said it’s so much better for them,” says Debra Kennedy of Sandy Springs, who has been nursing her son, Thomas, since his birth last September. She says the bond she has created with her son is even stronger due to breastfeeding. “If I weren’t breastfeeding, it would be easy to give other people the bottle and to have other people feed him. It’s made me continually realize how dependent he is on me and that I need to be there for him.”

In addition to the health and emotional benefits of breastfeeding are the benefits of saving money (no formula to buy) and time (no bottles to warm or wash). And mothers take comfort in knowing they are providing the perfect food for their baby.

Gigi Harper of Cumming says that breastfeeding also helped in her transition from a career to motherhood by making her slow her pace. “I had to force myself to sit down and take the time,” she says of breastfeeding daughters Catherine and Victoria. Her experience was so positive that she now serves as a leader in the La Leche League, a nursing mothers support group.

La Leche was vital to Jennifer Manisco of Alpharetta as she struggled with breastfeeding after the birth of her daughter, Lily. “My saving grace was the La Leche League because they provided so much support.” Her need for support was something she didn’t anticipate when she first was pregnant with Lily. “I was looking forward to it, thinking it would be really easy.” But her difficulties spanned the first four months of Lily’s life.

A Learning Process

The very natural act of breastfeeding can seem very unnatural to a mother experiencing difficulties or just learning how to do it. In fact, mothers are often surprised that they have to learn the technique, says Linda Horovitz, a registered nurse and lactation consultant at Northside Hospital. “They think the baby will know how. I usually say that they’re teammates learning together. Starting to breastfeed is like starting a new job and there are adjustments.”

She adds that fear of failure is common among the mothers with whom she works. “We tend to work with mothers who have been very successful in their professional careers,” she says. They sometimes have unrealistic expectations in this totally new endeavor. They’re also worried about discomfort and the change in their lifestyle. But help is available and mothers can often overcome their fears and problems. “The more you do it,” says Horovitz, “the easier it gets.”

Manisco is one mother who experienced more than the usual difficulties. She had cracked and bleeding nipples, thrush (a yeast infection) and mastitis (a breast inflammation caused by an infection). She considered switching to formula but ultimately kept breastfeeding until she and her baby were comfortable with it. “Knowing all of the benefits, I thought I could ride this out,” she says. “And I knew women had gotten through it.”

Some of the other breastfeeding problems that can occur include the following:

Breast refusal. A baby who refuses the breast in the hospital could still be very sleepy from the labor-birth experience, says Horovitz. Also, there’s a proper way to suckle, and some babies are coordinated while others are more disorganized. It’s not refusal, she says, the baby’s just learning.

Engorgement. This swelling of the breasts occurs from the pressure of new milk. The best way to prevent engorgement is to breastfeed often.

Sore nipples or sensitive breasts. Horovitz says mothers can help ease this problem by making sure they are in a comfortable position and that the baby is latched properly. “After the feeding, we suggest that the mother express her milk, apply it to the nipple, and leave it open to the air for a few moments.” That takes advantage of the healing and moisturizing properties of breast milk. She also says that applying a small amount of 100 percent pure lanolin can be soothing to the nipple.

Low milk supply. This problem is usually related to stimulation, says Horovitz. “If the baby’s not latched to the breast properly, the mother’s not going to have the correct amount of stimulation.” She says mothers also need to breastfeed eight to 12 times during a 24 hour period. “We recommend every two hours during the day and every four hours at night. Usually 15 to 20 minutes on each breast.” She says mothers can use a breast pump for added stimulation if the baby is sleepy or reluctant to nurse.

In cases where mothers experience problems, a lactation consultant can assess the situation and offer techniques for overcoming the problem. “If mothers have concerns after they go home, we encourage them to call our hotline [404-681-6342],” says Horovitz. “We also encourage mothers to return for an outpatient consult.”

In some cases, women decide that breastfeeding isn’t working and switch to formula. Horovitz says this decision depends on the goals and desires of the mother. “Some persevere and go on, and others decide it’s not the best thing for the family. The lactation consultant can help the mother, give her options, and let her make her decision. Some mothers choose to pump and give their breast milk in a bottle. Some choose to breastfeed and give formula.” She adds that any amount of breastfeeding is good, even if it’s only for a few days.

Kennedy agrees that breastfeeding is something everyone should try because it’s a special experience. “But I don’t think anyone should get stressed out if it doesn’t work.”

Support from Dad

While they lack the physical attributes required for breastfeeding, fathers also have a role in the process. “The father is really a great influence on the breastfeeding family,” says Horovitz. “That’s why we talk about the ‘team’: the father, the mother and the baby.” The father can wake the baby, bring the baby to the mother, help make sure the baby is latched properly, make sure mother is comfortable and has food and water if wanted. He can also show support with kinds words and a positive attitude.

Manisco says her problems sometimes kept her in bed, which meant her husband had to care for both her and the baby. “I knew it was inconveniencing him when I was sick,” she says. “But he told me, ‘Whatever you choose to do, I will ride this out with you. If it’s too stressful, we’ll go to a bottle.’”

Harper says her husband initially felt out of the loop with their children but now bonds by bathing them, dancing with them, and interacting in other ways. “The lull of his deep voice and his strong arms and chest are comforting in a different way.”

When Do We Wean?

The American Academy of Pediatrics recommends that babies be exclusively breastfed for the first year of life. At 6 months, most pediatricians recommend giving solid foods in addition to breast milk.

Manisco is still breastfeeding Noah, who’s 1 year old, and will do so until he’s ready to move on. She adds that, despite her initial problems, “I nursed Lily until her third birthday. After we overcame the hurdles in the beginning, she just loved it.”