A subscriber to wrote to ask:

“I was wondering when my milk will come in? I had my little girl on Tuesday and still no milk. I’ve had to supplement with formula now because she isn’t getting enough.”

Two things here.

First we need to establish whether the baby actually isn’t getting enough.

Sometimes mothers assume they don’t have milk, or don’t have enough milk, when the truth is their milk supply is just fine.

Second, we need to talk about what it means for the milk to “come in”.

My first question is, how do you know your milk hasn’t  “come in” and that your baby isn’t getting enough?

How old is she and is she producing wet and dirty diapers? What comes out must have gone in.

While we often use the phrase “come in” when we’re talking about a postpartum mother’s milk supply, that term is somewhat misleading and inaccurate.

Your breasts have milk even before you give birth.

Typically, sometime in the last trimester your breasts start producing colostrum (the early milk that is rich in immune factors), so the term “come in” really isn’t accurate.

What happens when someone refers to a mothers milk “coming in” is when the milk turns from colostrum to mature milk and changes in volume (it dramatically increases) and in color.  Colostrum is a clear to yellowish color and then turns to mature milk which is a milky white - typically around 3-8 days postpartum. It’s at this time that some mothers experience engorgement.

photo credit: jessicafm

It’s very important to not limit a newborn infant’s time at the breast. The more time the baby the baby spends nursing, the more quickly the colostrum is removed and typically the faster the mature milk comes in.

The second issue is figuring out whether the baby is getting enough milk.

If your baby is producing enough wet and dirty diapers then you don’t need to supplement. Supplementing with formula may not be necessary, and can actually decrease your existing milk supply.

My advice to this mom is to speak with a lactation consultant or a La Leche League leader who can observe her baby nursing to see if there are any obvious problems with positioning or latch. A baby who is not latched on well may not get enough milk at a feeding and also won’t sufficiently stimulate the mother’s milk supply.

I also suggested that she allow plenty of time for her baby to get her tummy filled. Some babies are quick eaters and some aren’t. Especially during the early weeks, it may take 20 minutes or longer for baby to get enough.

Make sure she isn’t sleeping at the breast and is actively nursing (sucking and swallowing) for the entire feeding before allowing her to nap. And don’t attempt to schedule a breastfeeding baby, especially while she is still learning how to feed.

More tips for increasing milk supply can be found here.

Four Ways to Ensure Breastfeeding Success

Step Four: Surround Yourself with Supportive People

Know those people in your life who aren’t so enamored with the act of breastfeeding? You know, those people who are offended by babies eating nature’s perfect food?

Well, push their presence aside for a few months.

Instead, surround yourself with people who support your decision to breastfeed. There will be times when nursing gets difficult and you’ll have many self-doubts. The last thing you need is negativity. Negative people can sabotage a breastfeeding relationship with their misguided “advice.”

Support yourself. Attend more La Leche League meetings and make sure your baby’s pediatrician is supportive of your decision to breastfeed. If your doctor gives you grief, go see someone else.

A supportive spouse can do wonders for your nursing relationship. If your partner isn’t thrilled about the idea of breastfeeding, hand out research on how beneficial it is (and how much money you’ll save by not buying formula).

Now is the time to live in a pro-breastfeeding bubble. Don’t let anyone pop it.

Four Ways to Ensure Breastfeeding Success — Step Three: Arm Yourself with Supplies

Baby? Check. Breasts? Check.

That’s all you need to breastfeed, right?

Right. But there are many products that, while not completely necessary, can make breastfeeding a whole lot easier.

Besides for having breastfeeding books, you may want to purchase a nursing pillow. These pillows come in all shapes and patterns and can be an invaluable tool in the early days of nursing. These pillows prop baby to the level of your breasts, with no strain on your end. Newborns love to fall asleep on these pillows while nursing to their hearts’ content.

Purified lanolin nipple ointment (or a botanical lanolin-free one) can be a lifesaver when you have cracked, sore or bleeding nipples.

A few nursing bras coupled with breast pads make for convenient and discreet nursing. Breast pads keep you from leaking milk all over your clothes, which is a common experience in the early days. It’s much easier to change a few soaked breast pads then to keep going through laundry.

You’ll probably want a breast-pump for times you may be away from baby. Decide how much time you’ll be apart when figuring out which type to buy.

Since nurslings like staying near their all-you-can-eat buffet (aka Mom), you may want to pick up a good sling so you can keep baby close while being able to walk around.

Four Ways to Ensure Breastfeeding Success

Step Two:  Ensure a Proper Latch

Know how your nipples are cracked and sore from nursing? That’s because you haven’t perfected your latch. The sooner you get the right latch, the less time you’ll be in pain.

You’ll know when your baby has a proper latch. It’ll feel comfortable and you’ll feel relieved of milk. A proper latch is crucial to successful breastfeeding. Without it, your baby won’t take in enough milk, and since breastfeeding is based on supply-and-demand, you’ll make less of it.

Have a lactation consultant (LC) or doula help with the initial latch-on. Baby should have a wide open mouth when put on the breast. If her mouth is only slightly open, touch her top lip against the nipple until she opens wide. Then pop her on. Baby should take in most of the areola—not just the nipple. You should see the pink of baby’s lips and see her ears wiggling, an indication of a good suck. Listen to hear your baby swallow.

During these early weeks, it’s a good idea to frequently have your baby weighed to assess progress. New moms often worry if their baby is eating enough, but if she’s gaining weight and you’re feeding her on demand (without letting her sleep too long without nursing), then you’re doing fine.

Keep your LC close by if you need a helping hand. Breastfeeding will get much easier. Never underestimate the importance of a good latch.

Four Ways to Ensure Breastfeeding Success

Step One: Prepare Yourself Before the Birth

While there’s nothing you can do to physically prepare yourself for breastfeeding (harshly rub those nipples all you want—it won’t help!), you’ll want to learn all you can about nursing before you try it. You don’t have to become an expert, but it will help to know a few things.

Attend a La Leche League (LLL) meeting to learn breastfeeding tips from moms who’ve been there, done that. LLL meetings are fantastic ways to network with other nursing moms and learn about breastfeeding resources in your area.

Read about ways to ensure breastfeeding success and watch videos of how to properly latch your baby. Popular books include LLL’s “The Woman Art of Breastfeeding,” and “The Nursing Mother’s Companion.” Keep many of these how-to reference books on hand because they contain invaluable advice you can access any time.

Bookmark a few Internet websites like Kellymom.com and read over tips for a successful start. Be a sponge—learn all you can.

Find out the number of a certified lactation consultant near you. Whether you give birth at a hospital or your home, you’ll want to have easy access to professional breastfeeding help.

Even though breastfeeding is natural, it’s a learned process. You’ll want to have an idea of what a proper latch looks like before you have a hungry baby in your arms. Trust me, this research will pay off.

This post is the third in a series. To see the others, click on the “bad breastfeeding advice” tag.

Three Pieces of Breastfeeding Advice to Ignore — Bad Advice #3:

“Babies shouldn’t breastfeed beyond [six months, one year, etc]. Mothers who nurse their toddlers are doing it more for themselves than for their babies.”

There is nothing wrong with breastfeeding toddlers—literally.

The American Academy of Pediatrics (AAP) claim there’s no evidence of psychological or developmental harm in babies who breastfeed beyond age one.

Extended nursing has benefits. Research shows that babies over a year old still receive substantial amounts of nutrients from breastmilk. Even though toddlers need nutrition from solid foods, breastmilk is still a valuable part of their diet, providing high amounts of vitamin B12, vitamin A, folate, vitamin C and protein. The composition of milk even changes to fit baby’s growing needs.

Even though the sight of nursing toddlers isn’t at the forefront of society, extended breastfeeding isn’t extreme. The AAP recommends breastfeeding for at least a year and longer as mutually desired by mama and child and the World Health Organization urges moms to nurse for at least two years.

Extended nursing isn’t a selfish act. Sure breastfeeding is relieving for mom but, really, is there a mom who’d force her toddler to nurse just so she can “baby” him? Would that even be possible?

(This is second in a series of posts. To see the others, click on the “bad breastfeeding advice” tag.)

Three Pieces of Breastfeeding Advice to Ignore — Bad Advice #2:

“Whatever you do, don’t let baby sleep in your bed.”

While co-sleeping may not be the answer for all families, it can make nighttime breastfeeding (and sleeping) less of an ordeal for parents and babies. Most families throughout the world sleep next to their babies. The US is one of a few countries where this act is considered taboo. But why?

According to the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, babies and mothers who co-sleep receive more sleep than those who sleep separately.

But what about long-term negative effects of co-sleeping?

Research shows there aren’t any.

Actually, babies who co-sleep tend to have something in common—they’re thriving—both physically, mentally and intellectually. And they’re nursing well. Babies who co-sleep tend to eat more at night, maintaining mom’s milk supply and promoting natural child-spacing.

Co-sleeping makes nighttime nursing much easier and is safe, provided you take some safety precautions and are nonsmokers. If baby wakes during the night, all you have to do is roll on your side and let the nursing begin. Then you can continue getting your snooze on while baby nurses back to sleep.

Ignore those people who say you might roll on your baby (highly unlikely if you’re sober) or are being a sap. People talk like sleeping next to your baby is a slippery slope—do it once and you’ll never have a child-free bed until the teenage years roll around. But this isn’t necessarily true.

As with everything, do what works in your family’s situation. After all, those naysayers may only be jealous that you’re getting so much sleep while, at the same time, being able to cuddle with a sweet baby.

This is the first in a series of posts on breastfeeding advice you can feel free to ignore.  Click on the tag “bad breastfeeding advice” to see the others!

Bad Breastfeeding Advice #1:

“Don’t nurse your baby all the time or she’ll become too dependent. You must wait and feed your baby every few hours.”

This is possibly the most damaging piece of breastfeeding advice you’ll ever hear. Not only can following this advice lead to clogged milk ducts and breast infection (or low milk supply and poor weight gain in your infant), it can sabotage your entire breastfeeding relationship.

In short, don’t do it.

This advice was designed for formula fed babies, to prevent overfeeding. Don’t breastfeed your baby like a bottle-feeder.

Scheduled feedings apply to formula fed babies, not breastfed babies.

Unlike formula, breastmilk is quickly digested and since babies have small stomachs, expect your little one to “cluster feed” through most of the day—and night—in the early weeks. It’s normal for newborns to appear hungry every hour or so for part of the day.

According to the American Academy of Pediatrics, newborns should be nursed whenever they exhibit hunger cues: rooting, putting hands to mouth, mouthing, fussing, or crying, which is a late sign. Listen to them.

Unlike formula, breastmilk works on the law of supply-and-demand. The more baby nurses, the more milk you’ll make and vice versa. Babies on scheduled feedings may not nurse enough to build up an adequate milk supply.

And as for the line about babies becoming dependent? Babies are supposed to be dependent on you. After all, there isn’t much a baby can do for himself.

Throw those schedules in the diaper pail.

Fellow blogging mom Diaper Diaries is giving away an Evenflo Comfort Select Breast Pump this week.

Go to her blog to get more details and enter to win!

Click here: Evenflo Comfort Select Breast Pump Giveaway

6 Tips For Breastfeeding Success

You’ve talked about breastfeeding your child since you first found out you were expecting. The time is drawing near and you’re concerned about actually starting to breastfeed. Consider these six tips on early breastfeeding success to help allay any fears you may have and get breastfeeding off to a great start.
photo credit: moppet65535

Quick Note:  Many women are intimidated by the thought of breastfeeding but there’s really no need. Breastfeeding is the healthiest and most natural way to feed your babies.

1. Before your child even arrives, learn as much as you can about breastfeeding. Talk with a lactation consultant if there is one at the hospital where you’ll deliver. If not, find a La Leche League chapter near you. They’ll be glad to help you before and after the baby arrives to ensure you have the best start at breastfeeding and that it’s a positive experience for both of you.

2. Nurse as soon as possible after delivery. In fact - if you can, begin to nurse within an hour of delivery. Your infant will be wide awake from being prodded and checked over. Their sucking instinct is also very strong soon after making their entrance into the world. It’s also important that the baby gets the colostrum that is present prior to breast milk coming in, as it’s full of necessary antibodies to fight off disease.

3. Be picky about latch on. Be sure that the baby’s mouth is wide open so you can place the nipple as far back into the baby’s mouth as possible. This position is best for avoiding breast soreness and will enable the infant to get to the ducts that release the milk.

4. Listen to the baby. Nursing “on cue” or on demand will ensure your newborn is receiving enough milk to grow healthy and strong. This may mean that your infant is nursing every two hours, but you’ll soon be in a routine that will stimulate you to produce enough milk to meet your baby’s needs and give them the nutrients they need.

5. Avoid triple nipple syndrome. Nursing babies don’t need supplements of water or formula unless Mom has to be away from them during feeding time. And even if this is the case, Mom can express milk using a breast pump and give that to their infant instead of a supplement.

6. Be sure to get plenty of rest and to eat healthily. Nap when the baby naps to counteract the times you’ll be up during the night breastfeeding. Avoid excessive caffeine as it can cause agitation in infants and keep them from sleeping. Eat a well-balanced diet that allows for an extra 500 calories a day for milk production. Be sure to get plenty of high quality fats. Studies have shown that women who eat trans fats (processed fats, hydrogenated oils) have lower quality fats in their milk. Eat high quality butter, olive oil and coconut oil instead of margarine and cheap vegetable oils, and avoid processed foods.

Remember that although breastfeeding is the most natural way to feed a newborn it doesn’t come naturally to every woman. If you get discouraged, don’t hesitate to contact other mothers that have breastfed or other sources such as La Leche League. You don’t have to get by alone if you’re breastfeeding. There are moms all around that will be glad to help you succeed – for your sake and that of your newborn.