Key points to consider if you're breastfeeding your baby during her first year of life.
Mother's milk is the ideal food
Nature has provided you with the perfect way to nourish your child during her first year of life: Your breast milk contains just the right blend of fat, protein, and antibodies to help your infant develop and to protect her against disease. That's why an increasing number of moms choose to nurse. In fact, 77 percent of babies are now breastfed, at least briefly, according to the latest data from the Centers for Disease Control and Prevention, up from just 60 percent more than a decade ago.
Nursing is natural, but not always easy
Many new moms expect breastfeeding to be a breeze and become frustrated when they don't get the hang of it right away. You may worry that your baby's not drinking enough milk. However, you can significantly increase your milk production if you use your hands to express early milk, called colostrum, from your breasts (in addition to breastfeeding) in the first three days, according to new research from Parents advisor Jane Morton, MD, clinical professor of pediatrics at Stanford University School of Medicine. While you're still in the hospital, take advantage of the nurses and lactation consultants, who will show you how to get your baby to "latch on" to your breast, not just the nipple, and will demonstrate comfortable nursing positions.
It's based on supply and demand
The more your baby nurses, the more milk you produce. So for the first six weeks after birth, you should let your baby nurse whenever she wants. Typically, that's every couple of hours -- or about 10 to 12 feedings a day. But don't fret if it's actually less, or more, than that. Your infant has her own needs, and your milk supply will adjust to meet them. As your baby gets bigger, she'll go a longer time between feedings. "You'll be able to recognize her patterns and develop some type of schedule," says pediatrician Laura Wilwerding, MD, breastfeeding coordinator for the American Academy of Pediatrics, Nebraska chapter.
You'll know if your baby is getting enough
Though it's normal for a newborn to lose a bit of weight in his first few days of life, he should start gaining about an ounce a day after the first week. But there's no need to put him on a scale: Your pediatrician will weigh and measure him at his monthly checkups. "If your baby is growing and gaining weight, he's getting enough to eat," says Dr. Wilwerding. In between visits, you can assess his milk intake by how often you have to change him. You should see about five to six wet diapers a day and, until he's 6 months old, usually a dirty diaper after every feeding or, if not that often, then at least three times a day. That pattern will change once your baby starts eating solid foods.
Pumping takes practice and patience
If you're planning to go back to work (or to leave your baby for an extended period), you'll need to master your breast-pump technique ahead of time. Initially, some women find they can pump only a scant amount of milk, but like nursing, pumping does get easier after a while. So choose one or two times each day to pump right after you finish nursing and stockpile your supply in your freezer for your caregiver to use later. You can also use this stash if you aren't able to pump during the day after you go back to work.
Nursing benefits moms too
Once you get the hang of it, breastfeeding is convenient, since there's no formula to mix or bottles to wash, and you have a ready supply wherever you go. But that's not all: Some moms find that breastfeeding helps them lose weight, says Pamela Berens, MD, an ob-gyn and lactation consultant at the University of Texas Medical School at Houston. And research shows that mothers gain health benefits as well. Nursing has been associated with a lower risk for breast and ovarian cancers.
You're still eating for two
Sometimes your baby can suffer gastrointestinal discomfort from something you've eaten. It takes between two and six hours for food to find its way into your breast milk, so if your little one seems uncomfortable, think about what you ate that day. Eliminate the suspected culprit from your diet to see if that does the trick. You can reintroduce that food a few days later to gauge his response and to confirm your suspicion.
You don't need to swear off booze
Although when you're pregnant you need to steer clear of any alcohol, it's fine to have a glass of wine or beer a few hours before nursing, says Dr. Wilwerding. "If you drink more than that, 'pump and dump,'" she says. Still, be careful not to overindulge: Two or more drinks per day may harm your baby's motor development and may interfere with your "let-down," the reflex that allows milk to move from your glands to your nipples. (You'll be in a lot of pain if milk builds up in your glands.)
Be careful about medication
Some drugs are considered safe (antibiotics, ibuprofen, and acetaminophen, for example), while others are not (certain cancer, migraine, and psoriasis medications). Talk to your pediatrician about any prescription or over-the-counter medications you want to take.
It's not an all-or-nothing proposition
If you're a working mom who isn't able -- or doesn't want -- to pump during the day, you can still maintain a healthy milk supply for morning and evening feedings. And regardless of your work status, it's fine to supplement with formula whenever you decide to give your breasts a break. During that vital first year, your goal should be to continue breastfeeding in a way that works for you, Dr. Wilwerding says.
Breastfeeding isn't for everyone: The choice is yours -- and you shouldn't feel guilty if you opt for formula. "Your baby will pick up on your stress," says Charles Shubin, MD, director of the Family Health Centers at the Mercy Medical Center in Baltimore. "It's important that feeding time is a relaxed experience for both of you." If you choose to bottle-feed, remember these essentials.
- Formula comes in three kinds: ready-to-feed liquid (the most expensive); concentrated liquid (less pricey); and powder (the cheapest).
- Most formula container linings are made with bisphenol A (BPA), a chemical that may cause neurological and behavioral problems in children. There's more potential for it to leach into ready-to-feed liquid in metal cans than into other formula types. The safest choice is powdered because it absorbs the least amount of BPA. Ask your doctor to recommend a brand.
- If you're mixing powder or liquid concentrate, use the exact amount of water the label says to use: Too little water can upset your baby's stomach or hurt the kidneys, while too much will keep her from getting enough nutrients.
- Always cover and refrigerate opened cans of liquid formula, and use them within 48 hours.
- To determine how much formula to prepare, divide your baby's weight in half: An 8-pound baby needs about 4 ounces, for example. You'll be feeding him every 2 1/2 to 3 hours at first, but as he grows he'll eat less often.
How to Hold Baby While Breastfeeding
Originally published in the December 2008 issue of Parents magazine.
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