Breastfeeding - What No One Tells You

Sitting near the top of my "Things No One Ever Told Me About Parenthood List" is that dirty little secret about breastfeeding. I had heard that breastfeeding is best for babies, and that it helps us lose our baby weight, but no one had bothered to tell me that it's so hard. I'm telling you, It's damn hard!

As mothers-to-be, we begin our journey not giving much thought to breastfeeding. How hard could it be? After all, it's the most natural thing in the world. This is the way mammals have fed their young throughout history. Then, we give birth to a beautiful baby and we soon learn that breastfeeding is a biggie, and it's much more difficult than we ever expected. It's a biggie because the health and nourishment of our baby becomes the number one priority once the baby is born. In fact, the Center for Disease Control 2010 Objectives call for 75% of mothers to initiate breastfeeding immediately after childbirth and continue it throughout the first few months postpartum. That means, if you get caught bottle feeding your baby with formula while in the hospital, you can expect a visit from the Lactation Nazi. As for the difficulty, here's the thing. A new mom is just as inexperienced as a new baby, so it's a case of the blind leading the blind. And, if you've ever tried it, you know that when you're first learning, it feels like you need 8 arms just to get the baby and the breast in the proper position. Latching on correctly is another challenge, along with a host of other complications that may come about. But this is just the tip of the iceberg.

As soon as I give birth, my body will start producing milk, right?

Wrong. Normally, it takes 2 to 5 days for a new mom's breast milk supply to come in. Prior to that, the newborn is sustained by a protein-rich substance called colostrum. The body produces around 7 teaspoons of colostrum per day during those first few days after the baby is born.

In some cases, milk production is delayed and doesn't come in until 7 to 14 days after the baby is born. The University of Virginia Health System lists the following potential causes for milk delay:

• Stress
• Cesarean delivery
• Postpartum hemorrhage
• Retained placenta fragments
• Illness or infection with fever
• Diabetes
• Thyroid issues
• Extended bed rest during pregnancy

When milk is delayed, it's bad news for baby. The nurses will notice the baby's weight dropping quickly, or that the baby isn't producing enough bowel movements. Next, they'll try to determine the cause. Is the baby being fed every three hours? Is the baby on the breast long enough during each feeding? Is there a problem with the technique? This also spells trouble for the new mom. In addition to breast feeding a grumpy infant who is working hard to get milk, and is leaving the breast hungry and unsatisfied, Mom will also spend equal amounts of time using the breast pump. Doubling up this way is supposed to stimulate milk production. Unfortunately, breast feeding every three hours, followed by pumping 8 times a day leaves little time for rest, or anything else for that matter. The disillusionment really sinks in when you put in the hard work with nothing to show for it but a hungry baby and some condensation inside the milk collection bottle. After all, your milk is delayed, so you won't see a measurable amount of milk for several more days. It's difficult not to feel defeated.

Supplementing

At this point, all you want is to feed your baby and soothe her hunger. The lactation specialists will come in to assist you at feeding times and work with you on technique. They'll also tape a small feeding tube to your nipple in order to supplement with formula while your baby is breast feeding. Hopefully, someone will invent a better device for this purpose, because a gravity fed tube leading up to a bottle of formula balanced ever so carefully on your shoulder adds a whole new level of difficulty to the act of breastfeeding. Hopefully this will help the baby to learn that there is a reward for all that sucking. The doctors may also insist that you refrain from using pacifiers to soothe the baby. The goal is for the baby to want the breast, not the pacifier. So, get used to the sound of your baby crying.

When supplementing with formula or with pumped breast milk, you may find that bottle-feeding is a slippery slope. One one hand, your baby will be getting proper nourishment and will thus be a happier baby. On the other hand, the baby may start to prefer the bottle over the breast since the bottle allows the baby to receive milk more easily. Down the road, it can become much more difficult to get the baby to take the breast.

Sore nipples can be another challenge. When nipples become sore, it's usually a sign that the baby is not latching on correctly. Make sure the baby has the areola in his mouth, not just the nipple, the tongue is in the proper position, and the lips are curled outward.

If nipple soreness continues for more than a few days and is accompanied by redness, see your doctor. You may have mastitis (a plugged milk duct) which can lead to infection. Your doctor will prescribe antibiotics to treat this condition.

Inverted or flat nipples will also increase the difficulty of breastfeeding. There are several massaging techniques that can help alleviate this condition. The use of breast shells (worn inside the bra) can also help coax out the nipple by putting gentle even pressure on the area surrounding the nipple.

Hyperlactation is another problem. It's basically an overabundance of milk that shoots out fast and forcefully when the baby tries to breast feed. Unfortunately, this condition makes breast feeding unpleasant for the baby as it causes her to gag and choke when she is not able to swallow fast enough. This problem can be alleviated by expressing a small amount of milk before feeding to relieve the pressure, or by taking measures to slow down the milk supply. Slowing milk production is done by reducing the number of feedings each day, reducing the length of time for each feeding, or by using only one breast for two to four feedings.

Now that you've reached the end of this article, you know that breast feeding isn't as simple as putting the baby up to your breast and letting her go at it. It can be a much more complicated endeavor. The point of this article is not to discourage breast feeding, or to scare you. It is to educate. Knowledge is power, and if you have the right information, you can prepare to face any breast feeding challenge. The days following your baby's birth can be a fragile time for you. The trauma that occurs to your body during childbirth is substantial. You will be exhausted from the labor and delivery process. Sleep will be interrupted by feedings. Hormones may cause you to be overly emotional. You will be dealing with a lot, not to mention the added pressure of breast feeding your new baby correctly. By all means, give it your best shot. But if it gets to be too much, don't be hard on yourself. Formula is not the end of the world. It does not mean you have failed. What's important is that your baby is getting enough of the proper nutrition to sustain her growth and development. It that's the case, it's all good.