A visit with a breastfeeding support group
New mothers have many questions and concerns about breastfeeding in the weeks leading up to and after birth. Breastfeeding support groups are a wonderful way to exchange information and experiences. Frankly, going to a group is a great reason to get out of the house and talk to other adults. Lactation consultant, Clare Karten, MS, IBCLC, was invited to sit in on a support group of new breastfeeding moms. The moms were 2 to 8 weeks postpartum, and most were first-time breastfeeders. Here's what Clare heard:
"I'm only getting 3 hours of sleep a night—and that started in the fifth month of my pregnancy."
"I have to write everything down—I seem to have five things on my mind at once."
One thing all the moms had in common was feeling tired and a little stressed. To help improve their energy levels and decrease stress, the moms recommended massage (for moms and babies both) and a weekly exercise class designed for new moms and babies. Two of the other moms met several times a week for a short walk, babies in tow.
Clare's note: Rest is really important in the postpartum period. In fact, in addition to breastfeeding your baby often, getting enough rest is key to building a good milk supply. The moms agreed that a daily nap was essential. They had all heard, "Nap when the baby naps," but it helped to remind each other to do it.
"I feel like I'm drinking water all the time. It doesn't seem to increase my milk supply, though."
Clare's note: Most of the moms were drinking plenty of liquids every day—at least six to eight glasses of water, low-fat milk and juice. But drinking beyond satisfying your thirst will not result in more milk. What will? Getting enough rest—and feeding the baby often and until the baby is satisfied.
"Can I eat chocolate?"
"Are there foods that will make my baby fussy or give her gas?"
Almost everyone was wondering if there were certain foods to avoid while breastfeeding. All agreed it was a good idea to make a note of what they had eaten if they noticed their baby seemed more gassy or fussy. If the same foods disturbed their babies again on other occasions, it would be best to avoid those foods until their babies are older or weaned.
Clare's note: There are no foods that all nursing mothers must avoid. Some babies will, however, be bothered by something his or her mom has eaten. Chocolate contains a caffeine-like chemical that can bother some babies. Most breastfeeding moms find they can include small amounts of caffeine in their foods (for example, one cup of coffee or a glass of iced tea). Some moms say they feel better about skipping it all together. It's a good idea for breastfeeding moms to avoid alcohol. They should also check with the doctor before taking any medications.
The food talk led to a discussion of weight. A good rule of thumb is to eat healthy foods and either maintain your weight or, if you are overweight, make sure you are not losing more than one pound per week.
"I thought sore nipples only last 1 to 2 weeks. Mine are still sore, and my baby is 3 weeks old."
"My nipples aren't exactly sore, but they are definitely sensitive."
The moms shared tips like air drying nipples before dressing, using a purified lanolin cream, making sure to position the baby correctly and supporting the baby well throughout the feeding. All agreed this was really important in the first few weeks.
Clare's note: Most of the moms were doing well in the "sore nipple department." These are good questions to ask yourself in the early weeks: Are you turning the baby in towards you? Are you bringing the baby to the breast? Are you letting your nipples air dry before you get dressed? Are you comfortable while the baby nurses? How do your nipples look right after the baby nurses? (They should look slightly extended and rounded, not flattened at the tip.) If you're not sure if you're getting it right, ask a lactation consultant for suggestions.
"Every night I wake up with a wet shirt."
"My breasts seem to be leaking all the time."
"Drip, drip, drip."
Many moms complained, and laughed, about leaking milk. A few mothers recommended nursing the baby just before bedtime. Others dealt with nighttime milk leaks by wearing a comfortable sleep bra, all-cotton nursing pads and an old T-shirt.
Clare's note: Leaking milk is common, especially at night. Make sure your bra can accommodate breast pads, and stock up on all-cotton washable or disposable pads (you can find them in baby stores or drug stores). Eventually, this becomes less and less of a problem.
"I love nursing my baby, but I'm always worrying that she's not getting enough."
"My husband and I really want our baby to get breast milk. But the rest of my family is giving us a hard time."
"It doesn't help that my family and friends think that breast milk alone is not enough for a growing baby."
Just about everyone in the group had at least one or more close family members or friends who did not share their enthusiasm about nursing. One of the moms, who is now nursing her second baby, said, "As your baby grows, so will your confidence in the process."
Clare's note: You'll know your baby is getting enough to eat if, by the time your baby is a week old, he has:
- At least six or more wet diapers each day (urine should be pale yellow)
- Three or more bowel movements each day (stool will be soft, yellow and seedy-looking)
Steady weight gain (Most babies are back to their birthweight in about a week and gain 4 to 8 ounces per week for the next few months.)
- Periods of contentment for 1 or 2 hours after most feedings
- If you think your baby is not getting enough to eat, call your health care provider right away.
"My baby is 4 weeks today. I thought everything was starting to fall into place, but last week my baby just wanted to nurse all the time."
As soon as this mom was finished speaking, many women in the group looked at each other, grinned and said, "Growth spurt!"
Clare's note: New moms often notice that their baby wants to nurse more at about 2 to 3 weeks, at 6 weeks and from time to time thereafter. These periods of intense feedings usually correspond to a growth spurt. Your baby is getting bigger and needs more food. In a few days your breasts will adapt to the increase in demand and make just the right amount of milk for your baby. Frequent nursing is normal and necessary to stimulate increased milk production.
"My baby doesn't always burp—am I doing something wrong?"
"You're lucky—my baby has so much gas. I thought breastfed babies didn't have much gas."
Whether too much or too little—gas is something new moms worry about.
Clare's note: Breastfed babies do have gas; some more than others. Burp your baby after each feeding. If he doesn't burp but seems comfortable and content, don't worry. If your baby is more gassy, burping a few times during the feeding may help. You can also try placing your baby in a more upright position if he seems to be gulping milk.
Most breastfeeding support groups are free or low-cost. To find one in your area:
- Ask at the hospital where you gave birth or call other local hospitals.
- Call La Leche League at 1-800-LALECHE.
- Ask your pediatrician or obstetrician.
- Contact a lactation consultant.
Most common questions
How much vitamin D should my baby get?
Vitamin D is important to help avoid a bone-weakening disease called rickets. All babies should receive 400 IU of vitamin D per day, starting in the first few days of life. This includes breastfed babies and babies who drink less than 1L of infant formula per day.
Our skin makes vitamin D when it gets sunlight. But too much sunlight can be harmful, too. In fact, babies 6 months and older and young kids should stay away from direct sunlight and wear sunscreen at all times when out in the sun. However, sunscreen stops the skin from making vitamin D. The best way to get enough vitamin D is by giving your baby liquid multivitamin drops with vitamin D. They can be found in many pharmacies, and you won't need a prescription for it. Just be sure you've filled the dropper to no more than 400 international units (IU).
How often should I nurse my baby?
All babies are different and have different feeding patterns. In general, breastfed newborns need to eat 8 to 12 times in 24 hours (about once every 2 to 3 hours), for about 30 minutes each time. Breast milk is easily digested so it may be difficult to time when you should nurse your baby.
Newborns may need to feed more frequently than older babies. They may need to be fed on demand. As your milk supply is established and the baby grows, the baby's feeding patterns may change and she may go longer between feedings. Remember, breastfeeding is a natural skill, but it’s also a learned skilled. Be patient and give yourself (and your baby) time to master this new ability.
What solids foods should I start my baby on?
Begin with a single-grain iron-fortified cereal such as rice, barley or oatmeal. Mix it with breast milk or infant formula. Start with a small amount once a day. It's hard to tell how much your baby will eat. At first, most of her food will probably end on her bib or face. Be patient and help your baby learn this new skill. It's important that meal time is a pleasant time. This will build the foundation of healthy eating habits. If your baby cries, shows no interest in feeding or turns her head away from the spoon, stop feeding her. She is trying to tell you that she's full or she doesn’t want anymore. You should never force her to eat more than what she wants.
When should I give my baby solid foods?
Breast milk is the best food for most babies. It's best to give only breast milk for the first 6 months of life. Some babies might be ready to start solid foods between 4 to 6 months of age. When your baby is between 4 to 6 months, she may begin to show signs that she's ready to try some solid foods alongside her breast milk or formula. Watch for her developmental cues (signs) and she'll let you know when she's ready. Some signs that show your baby might be ready to start solid foods are:
- She can sit with support.
- She shows a good head neck control when seated.
- She shows a desire for food by opening her mouth, drooling and leaning forward.
- She begins to chew and brings her hands to her mouth.
- She begins to handle objects with the palm of her hand.
- She swallows pureed food and the extrusion reflex starts to go away (tongue-thrust reflex).