Breastfeeding can be a real pain. (Literally!) We asked a team of experts how to deal with aches and more.
Every couple of months, there's a new headline proclaiming the latest way in which nursing is a win for Mom and Baby. Decreased cancer risks, reduced rates of obesity, and increased immunity for Baby! Yet more decreased risks for cancer and diabetes for Mom! Trust me: No one is happier about all this than me. Between my two kids, I've been a milk machine for a combined five years and counting.
But for all those long-term benefits, sharing your body with another human being can take a real toll right now. "We live in a culture that often falsely equates natural with easy," says Meredith Fein Lichtenberg, owner of A Mother Is Born Pregnancy and Parenting Services, in New York City. "But breastfeeding is work, and you have to care for your own body while you're doing it." That means keeping your pantry stocked with healthy snacks, sipping plenty of water, resting whenever you can—and taking any discomfort you might think is an inevitable part of nursing as a signal to get help. We took top concerns to the pros and got their coping tricks.
The Bummer: Back, shoulder, and wrist pain
"I often see moms hunched over their newborn, wearing their shoulders like earrings," says Leigh Anne O'Connor, a lactation consultant in New York City. "And they're holding their babies with such force that their wrists are bent at a 90-degree angle." When you sit like that eight to 12 times a day to nurse, your body can start to feel as if it's been through a Navy SEALs obstacle course. And who can blame it?
Breast defense Never lean forward to nurse. Instead, let a chair or couch fully support your back. Then—and this is most crucial—imagine a magnetic strip across your belly that pulls Baby to you, O'Connor says. Put a small pillow under the crook of your arm that's nestling her head. When side-lying (on a firm mattress without any loose blankets nearby), use a pillow under your head, between your legs, and behind your back. And in any position, be sure to relax your grip. For new moms with a history of carpal tunnel, the tension can be enough to prompt a flair-up. Use your hands to loosely position your newborn, and be sure to pause for a few wrist circles before you bring her over to feed on the other side.
Finally, work on toning your abdominal muscles, which will help stabilize your midsection, and in turn, stave off back pain. Not that we're suggesting you do crunches right now! O'Connor's favorite do-anywhere exercise: "While sitting at a red light or standing at the changing table, imagine your belly button moving strongly and slowly toward your spine. Let it go, then repeat.
The Bummer: Bone loss
When you're nursing, calcium is taken directly from your bones to ensure your milk has enough of the stuff. And without the extra protection of surging estrogen that safeguarded your bones while you were pregnant, it's no wonder moms on average lose between 5 and 10 percent of their bone mass within six months of starting to breastfeed, says Mara Horwitz, M.D., associate professor of medicine at the University of Pittsburgh's division of endocrinology and metabolism. What's more, research shows that a lack of calcium at this time could increase your risk for gum disease.
Breast defense The good news is that, roughly six months after weaning, you'll probably gain back whatever bone you lost while breastfeeding, says Dr. Horwitz. And you may actually be at lower risk for long-term problems. A 2012 Osteoporosis International study found that women who had breastfed for more than 33 months total had stronger, larger bones than moms who had nursed for fewer than 12—as well as those who had never breastfed at all.
Still, it's critical to take in at least 1,000 milligrams of calcium daily to keep your bones in good health. That's roughly equal to a bowl of cereal and milk, a glass of calcium-fortified orange juice, a serving of yogurt, and a handful of almonds. Dark leafy greens are loaded with the mineral but in a less absorbable form. If you decide to take a supplement instead, know that calcium citrate is more easily digested (but also pricier) than calcium carbonate, which can cause constipation and nausea. Take a multivitamin or calcium supplement that also has 400 to 800 IUs of vitamin D to help improve bone density. Amp up your body's production of D by taking your baby for sunny strolls. Bonus points if you wear her in a carrier: "Weight-bearing exercise forces bones to turn over and strengthen," says Shelly Holmström, M.D., associate professor of obstetrics and gynecology at the University of South Florida, in Tampa.
The Bummer: Weaning blues
Trading your nursing bras for regular ones feels fantastically liberating for some moms and like postpartum depression 2.0 for others. For moms in the latter camp, "it can be hard to tease out what's hormonal and what's psychological," says Alice Domar, Ph.D., executive director of the Domar Center for Mind/Body Health in Boston. Depending on when and how abruptly you wean, prolactin and oxytocin, two feel-good hormones surging through your body when you nurse, may plummet quickly. And regardless of how long you nurse, deciding to stop can feel like a last snip to the umbilical cord.
Breast defense Babies who wean themselves typically won't do so until after age 1, says O'Connor, so if you're ending before that, it's key to taper off slowly. Plan for the process to take a month or longer as you gradually swap in a bottle—and lots of cuddles—for the breast, one feeding at a time. For instance, if your baby is 6 months old and nursing five to seven times a day, replace an afternoon feeding with a bottle for several days until he and your breasts adjust. Then move on to another. A steep drop in prolactin levels can leave some women weepy; weaning slowly can prevent that. Plus, if your baby isn't old enough to have started solids, your milk stores might still be very high to meet his nutrition demands—putting you at risk for engorgement and infection.
If your breasts begin to feel swollen and hard, express just enough milk to soften them—any more than that, and you'll ramp up your supply, even if your baby is nearly a year old. Remember that feeling teary post-wean is normal. But if you feel down for more than a few weeks—or your emotions start to interfere with your life—talk to your doctor, so you can enjoy your little one's newfound independence right along with him.
Just Started Nursing? Read This!
We asked our experts for help with three of the most common beginner hurdles. You'll be a pro in no time!
1. Your cups runneth over. Two to three days after birth, that yellowish colostrum is replaced by the real deal, and suddenly it's: What are these boulders bursting out of my bra? In a few weeks, your body will have calibrated its supply to your newborn's needs. Until then, ease the pain and discomfort with these steps: Apply anti-inflammatory cool compresses between feedings, pop a pain reliever as directed, and nurse on demand. Aim for a minimum of ten times every 24 hours, even if it means waking Baby up. Take a warm shower just before you nurse, and gently massage your breasts as she feeds to encourage milk flow. Let her drain one side before switching to the other.
2. Ouch! He just latched on. Nipple pain during those first weeks is so common that many moms assume it's part of the nursing package. It's not! You might feel some tugging, but if you're in agony, it's time to get help. Likewise if your nipples look red, scabby, or misshapen. A lactation consultant will probably first look at your baby's position to make sure his lips are flipped out, his chin pressed close, and his jaw and ear are moving slightly. To keep Baby from dragging your breast downward, hold him snuggly, leaning back so that gravity helps keep him in place, and align his nose to your nipple to encourage him to open wide. Finally, try positions that might be more comfy.
3. You're feeling lumpy. A painful, marble-like bump in your breast could be a plugged milk duct. You might be more prone to them during those first weeks if Baby's latch isn't emptying your breast, or later on if she's nursing less frequently—for example, when she starts sleeping longer at night. While pain is the most common side effect, untreated plugs can develop into an infection called mastitis. To get rid of them, keep nursing on that side while massaging the breast to help unplug the duct and get milk flowing freely again. If you experience fever, flu-like symptoms, or redness in one area of the affected breast, antibiotics and continuing to nurse should knock it out quickly.
Originally published in American Baby magazine in September 2014.