I think it is rather strange, really, that I have been a La Leche League Leader for ten years (newly retired), I am a certified lactation consultant, and a mom of two who breastfed for a grand total of 7 1/2 years, and I honestly never blog about breastfeeding or babies. Well, since there really is no one who has to subject themselves to my vast resources of knowledge at meetings anymore, maybe it is time that I wrote about it here. I've lately found myself surrounded by babies at church...so hey, while it is on my mind, I'll write the things I've always meant to write:
1. Breastfeeding is awesome. It gives the baby the perfect food...changes not only depending on the time of life for the baby, but the TIME OF DAY. It provides nutrients exactly as needed (thorugh a biological feedback loop that they think occurs because the Montgomery glands are sensitive to certain enzymes in the baby's saliva), immunological protection (that again, through the Montgomery glands, the mammary glands can produce antibodies to germs the MOTHER HASN"T BEEN EXPOSED TO), and I could go on and on and on and on.
2. Just because breastfeeding is awesome, doesn't mean it is easy. Especially the first several weeks. Actually, in a couple of months it is so easy that you'll wonder why people ever mess with bottles or formula. However, in the first weeks, the baby has never had to eat before it was born, just as the new mom has never had to figure out how to feed a baby through her breasts. Positioning can be a big deal. When the baby is 3 months old, it can be doing backflips while nursing and it doesn't hurt. When the baby is little though, leaning over just a tad can cause pain. A lip could get tucked in, a tongue might be in the wrong place. But it shouldn't hurt and nipples should not crack and bleed. If it does hurt, find someone (a La Leche League Leader, a lactation consultant, or even an experienced mom). There are ways to make it better, and often better VERY quickly. 90% of all breastfeeding pain is positioning. It helps to have someone take a look.
Some people just expect it to come naturally. Occasionally it does. But not very often. I tell moms that it is like learning to drive. The first time I got behind a wheel, all of a sudden, 25 miles an hour felt FAST, and keeping track of the speed, the mirrors, the guy next to me, and everything else was dang hard. Now I do it without really thinking about it. New moms have never breastfed before and it is hard to get a stiff, flailing baby to your breast and get everything right. It takes loads of practice. And as I said before, the baby has never done this before, either. I find that most moms find it gets easier somewhere around 6 weeks.
Learning to nurse in public helps with feeling tied down. Most states have protected the right (and none have prohibited it). It is not indecent, even if skin shows. A blanket over the shoulder often advertises the fact that you are nursing rather than hides it, and my kids would not tolerate a blanket between me and them. However, it generally is possible to nurse discreetly by pulling up your shirt from the waist and letting it sit on the breast where the baby's head meets. It is very hard to even tell that the baby is nursing. With a button up blouse, unbutton from the bottom rather than from the top - that way the neck and breast isn't fully revealed, and again, let the shirt flap hide the top of the breast (lots of moms I know wear belly bands - knit bands around the belly that keep the breezes out and hide skin). Practice by sitting in front of a mirror. (though babies will at certain times grab the shirt and pull up). Baby slings can help, too. Nojo, Maya Wrap, and Over the Shoulder Baby Holder are the big brands -- but there are others...Google them. Slings take practice, and sometimes when a baby doesn't like it, he will like it in a couple of weeks. Or he will like a different position.
3. As I said, the baby has never had to eat before it was born. Out of any system, the baby's digestive system is the most immature. Nourishment went straight into the blood stream through the umbilical cord, and the stomach and intestines and such just sat there biding their time. So often, it takes a baby time to learn how to get that digestion thing down...and often it is the same time as they are kind of getting that breathing thing down...so it takes a while...and it is hard to do both at the same time. When it is extreme, we call it colic. Colic is loads of screaming from 3 weeks to 3 months, usually in the evening, for about 3 hours straight.
4. But even when it is not colic, babies are often very fussy in the evening, during the same phase of life. There are lots of reasons for that. "THEY" (the omniscient "they") seem to think that it is said immature digestive system. Also, it tends to be the busy time at night. The electric lights are on, which may bother the baby more than we know. Everyone is stressed after getting dinner done and dishes done (or if they aren't doing it, they are stressed that they aren't doing it).
5. Babies do sometimes show reactions to foods (more often than most parents know, really). Shadows under the eyes, stuffiness (newborns do not generally get colds), clicking while nursing, abdominal pain, a rash between the buttocks that is smooth and burnlike, green, mucusy stools -- can all be signs of a food sensitivity. Chances are, if you bring your baby to the doctor, he will look at you like you are full of it. Dairy is the most common. Cowsmilk (at least pasteurized cows milk) has huge proteins and passes through the milk and causes problem. It is the protein, not the lactose. A baby that is truly lactose intolerant is in serious trouble. Real lactose intolerance doesn't show up until 7 or 8 years old, because human milk has more lactose in it than any other milk, and lactose is VERY important for brain growth.
But taking foods out of the mothers diet (one at a time) can help. Eliminate one type for two weeks and see if there is a change. Dairy is the first (and you want to eliminate anything with casein, sodium caseinate, or whey is important. Look at all labels, you'll be amazed what it is in); followed by soy (and 1/2 of all babies that react to dairy will react to soy...same problem with that huge protein); followed by eggs (and look at labels for albumin; wheat (avoid all gluten); and citrus. Chances are, if you had a lot of it when you were pregnant...that is your culprit. But it might not be. That is the first place to look, though. If you notice an improvement, you probably are pretty sure you found your culprit. If you are not sure, reintroduce a bit to see if the baby reacts again. With dairy, some babies will tolerate cheese and yogurt (somewhat predigested) but won't tolerate milk, cream, or ice cream (sigh)
6. Moms in our culture are expected to do way too much too soon. In many cultures, mothers get breaks of several weeks before they are expected to be out in public, or even allowed to be. Jews have 40 days of uncleanness before the mother is expected to keep a kosher kitchen or participate in prayers and the lifestyle again. Muslims, the same thing. Even in Orthodox Christianity, it is common to treat the mother as a shut-in and bring communion to her until six weeks. The only time she comes out with the baby is for the baptism. This sabbatical is merciful....the most important thing at this time is the baby and the mom getting to know each other and figure each other out and only deal with the basics of life. When family is around, they are obligated to help...not be entertained.
Often, we expect the mom to be up and moving and have her act together within the first week or two. That's not right. She is recovering from the birth, her hormones are all over the place, and the baby is adjusting to life outside the womb. It is a stressful, life-changing time. Dad and mom need to do all they can to ensure a quiet adjustment and being as available to each other as possible, as well as support from outside the immediate family. If you are a friend, offer to clean something, do a load of laundry, or hold the baby while mom takes a shower or a nap. However, most of her instinct are going to be that she wants to stay close to the baby...so if she turns that down, just offer to help anyway possible. Some feel guilty for this...so sometimes saying "I AM bringing over some food and would like to help you while you relax" can help.
6. Family bed is a lifesaver when it comes to caring for a baby, especially a breastfeeding baby. But what I would've liked someone to tell me was that it is really hard during the first several weeks. The baby is just too small to latch on easily from that side, and latching on even in a regular position and nursing is still a skill being learned. However, getting past that first growth spurt at around 5 or 6 weeks makes a HUGE difference. That is also about the time that breastfeeding gets easier on the whole. Turning on the light to see what is going on also kind of defeats the purpose and wakes the baby up completely. A lot of moms recommend having a small flashlight by the bed or a booklight. But be careful of shining an LED right into the baby's eyes.
7. Oh yeah...that growth spurt that occurs around 5 or 6 weeks (sometimes 4). All of a sudden, the baby wants to nurse CONSTANTLY...when you put him down, he wakes back up again and is fussing and rooting....it gets scary. Often, when I've had a mom tell me "I just didn't make enough milk" I find that it happened at six weeks. What happened was the baby hit a growth spurt, the mom panicked that the baby was nursing all the time, gave the baby a bottle, and baby got full and went to sleep after downing a whole bunch of formula. But then baby didn't need to eat again for 3-4 hours, and when the baby went to the breast, the same thing ensued, until the baby was getting a lot of formula, and not nursing much, so the breasts slowed down on making milk.
The way it actually works is the mother gives up any hope of a sane day and surrenders to a day on the couch, nursing constantly. What goes in has to come out, so she watches the diapers to make sure that there are 5-7 wet disposables (bowel movements count) and at least one bowel movement). If that is happening the baby is getting enough. But what he is doing is stimulating the breasts to increase milk production, because the baby is growing. This goes on for one to two days, and then every body catches up. You stimulate milk production by frequency of nursing, that is why the baby gets back on soon after he gets off. And that is why also, if you are trying to increase your supply, you put the baby to the breast more often instead of longer, or pump halfway between feedings rather than right at the end of one.
But very few pieces of breastfeeding literature talk about growth spurts or frequency days. So I am.
8. Some babies nurse a lot or are just plain fussy. These are called "high need babies." And there is nothing wrong with them. They are just better at asking for what they need than some other babies are. All babies should be held most of the time, nursed frequently, and sleep close to their mom. It is how babies have been raised for most of history. By being close, they are safe. They crave contact, your breathing regulates theirs, and breastmilk digests quickly so they need to do it again soon (and sometimes they are just thirsty) -- not to mention it is soothing, and this big world is pretty overwhelming to a little baby.
But high need babies let you know they need it and they are not going to easily tolerate not getting it. From experience, high need babies tend to be very intelligent, very emotional, very in tune to others emotions, and very sensitive to their environment as they grow. Chances are, you can look at (at least) one of the parents and see that coming. Some babies seem to need time to adjust to life in this world. Others, kind of need ways of coping with it throughout the rest of their life -- but do pretty well all the same.
One thing that really helped me was something I read in The Discipline Book by Dr. William and Marth Sears (I recommend any book by the Sears'). They said something that really took the load off for me. They said that sometimes there is nothing you can do with a fussy baby but hold him and let him know that you love him even when he's fussy. And that is enough. You don't have to stop the fussiness (as much as you want to), but just love him through it. The fact that you are not leaving him to deal with it alone is exactly what he needs. That freed me from having to solve the fussy problem with my son and just love him through it. He did get through it - at least 90% of the time I think he did. But boy was it a huge relief when he smiled at me, because he was so fussy the first several weeks that I swore he thought I was an idiot. Oh wow did that smile make it better.
I'm sure I forgot a lot...but I'm sure some of you wise women out there can add to it. Warning: I delete Ezzo stuff (strict inflexible schedules, cry it out training). It's my blog. I don't like it.