"Your body is designed to make healthy milk," says Laura Viehmann, M.D., clinical instructor in pediatrics at the Warren Alpert Medical School of Brown University, in Providence. Because your baby gets first dibs on the nutrients your system stores, eating well is not so much about producing quality milk as it is the key to maintaining your own health and energy. So don't agonize over eating an Oreo...or three. If your plate's not brimming with veggies, fill in nutritional gaps by taking a prenatal vitamin, which often has higher levels of calcium, vitamin D, and iron than a multi. Another who-knew: You can welcome a fair amount of caffeine, about two cups of coffee or one 12-ounce caffeinated soda, and even the occasional alcoholic beverage back into the fold, Dr. Viehmann says. "It's nice to know that I can have a glass of something because it makes me feel like an adult, not only a mom," says Amanda Mlinar, of Wayne, Pennsylvania, whose daughter, Halsey, is 13 months. Time your tipple for right after you breastfeed so your body metabolizes the booze (it takes about an hour per drink) before your next nursing session.
"It felt like bad menstrual cramps and got worse with each baby," says Rebecca Glassberg, of Teaneck, New Jersey, mom to 6-week-old Eli, 2-year-old Talia, and 4-year-old Jonah. "Luckily, it only lasted a few days." What's going on? "The same hormone responsible for triggering milk letdown, oxytocin, causes your uterus to shrink back to normal, which reduces the risk for uterine bleeding," says American Baby advisor Laura Jana, M.D., pediatrician and author of Heading Home With Your Newborn. "Although it's uncomfortable, cramping is a sign that your body is healing properly." Some experts believe the pain may increase with subsequent pregnancies because your uterus stretches more each time.
It won't look the same day to day, either. That's because breast milk's composition changes to meet your baby's nutritional needs, Dr. Jana says. At first, you'll produce a sticky, yellowish-white colostrum that's rich in protein. In a few days, when your milk supply comes in, it will contain two parts, which might separate in the fridge: Foremilk is thin, watery, and may appear pale blue; hindmilk, which has more fat, will be slightly thicker and creamier.
Blame it on those hormones again. "Anything that makes you think of your baby, like saying her name, talking about her, or even hearing another baby cry, causes your body to release oxytocin," says Dr. Viehmann. The hormone helps you bond with your baby, but it also turns on the sprinklers when you least expect it. "I remember being out with my girlfriends, and I soaked through my shirt. I was so embarrassed that I had to keep my jacket on the rest of the night," says Michelle Regoso, of Flushing, New York, mom to 2-year-old Zoe and 5-year-old Aiden. Wearing nursing pads can help sop up leakage. Or try Lilypadz, reusable silicone cups that rely on pressure to inhibit letdown ($23 per pair; SimplyLily.com).
When you're ready to do the deed again, you may discover that it's, well, different. "Estrogen levels tend to be lower in nursing moms, which can cause vaginal dryness," says Jessica Goldman, a certified nurse-midwife in Brooklyn. Keep a bottle of lube in your night table. Another potential sore spot: your breasts, which you may not want touched due to sensitivity or fear that you'll spray. "This is a time for your husband to focus on other areas," says Heidi Raykeil, coauthor of Love in the Time of Colic: The New Parents' Guide to Getting It On Again. "Take it slow and have fun exploring. Tell him what feels good and what doesn't." To declare your breasts a no-fly zone (or to control leaking), wear a bra during sex.
Feedings can last as long as an hour, and babies need to be fed every couple of hours at first. Repetitive? You bet. It's fine to interrupt the monotony by checking email or catching up on your DVR queue while you nurse, but resist the temptation to do so at night. "Change the baby, feed him, then put him down, but don't turn on any lights or TV," suggests Eileen Murphy, a registered lactation consultant in Chicago. You want to orient your baby to day and night. Too much stimulation in the wee hours can get him wired up.
"Your nipples may feel irritated at first because they've never had that degree of stimulation, but if you're writhing in pain, you might have a problem with the latch," Dr. Jana says. Talk to your OB, so she can rule out mastitis or blocked ducts and recommend a lactation consultant. "The first few days after my son's birth were agony," says Jen Geller, of Scarsdale, New York, mom to 3-month-old Will. "He'd clamp onto my nipple so hard that I could stand up and he'd probably still be attached. A lactation consultant showed me how to correct the latch and my nipples healed within days." Breast pumps can also leave you hurting if you use them incorrectly. "Some moms make the mistake of putting the pump on too high a setting, thinking it will save time," Dr. Jana says. You're pumping, not blow-drying your hair! "Start with the lowest setting and increase it to a comfortable level," she adds. Use a purified lanolin product, like Lansinoh HPA Lanolin, to soothe nipples after feeding or pumping.
You may feel like a dairy cow, but many men find their wife stepping into her new role as mother incredibly sexy--and what could be more maternal than feeding your baby? He won't hate the extra weight you're carrying up top either. "My boobs got so big while breastfeeding that all my husband wanted to do was touch them," says Dayana Martinez, of Miami, mom to 6-week-old Luca and 2-year-old Milos.
The very best thing you can do to set yourself up for a successful breastfeeding experience is take a prenatal nursing class at your community center or hospital. "Many parents take a birth class but, if they're lucky, spend no more than 24 hours giving birth," Murphy says. "You're going to spend much longer nursing, so investing your time in a course while you're pregnant will pay off hugely." Still, breastfeeding may not work out for you. Claire Fuzesi, of Old Greenwich, Connecticut, had every intention of nursing her now 15-month-old twin girls, Chloe and Hannah, but things didn't go according to plan. "My girls were six weeks premature so they had trouble latching, and I found myself bonding with a pump every few hours," she says. "Once they were able to breastfeed, I had blocked ducts. Within a few weeks, I gave up. I felt zero guilt. Instead, I was relieved that I could finally relax with my babies." Many moms who decide not to nurse experience backlash from friends and family, but try to tune them out. "It's best for anyone confronted with breastfeeding obstacles to get support before giving up, but those moms who do end up using formula shouldn't feel guilty!" Dr. Jana says.
"There was nothing like the feeling of my child relaxing into my arms while she nursed, says Katie Shur, of Queens, New York, whose daughter, Maya, is 21 months. "I felt absolute peace and quiet." The oxytocin surge ushers in a cascade of feel-good emotions, says Joan Younger Meek, M.D., a pediatrician and editor-in-chief of The American Academy of Pediatrics New Mother's Guide to Breastfeeding. And the release of prolactin, another hormone involved in milk production, makes you feel drowsy when you're done. Can you say naptime?
Originally published in the August 2011 issue of American Baby magazine.