Expert Q&A: Tips for Successful Breastfeeding
An interview with Laurel Schultz, MD.
Even new mothers who seem to sail through the first days of breastfeeding
have questions: How do I know if my milk supply is enough for my baby? How long
should the baby nurse? What can I do about sore nipples?
WebMD talked to Laurel Schultz, MD, a San Francisco-area pediatrician and
mother of two boys, about some of the most common breastfeeding questions and
concerns new parents have and how to deal with them.
What are some of the common breastfeeding problems you see among the new mothers in your practice?
I visit mothers in the hospital right after their babies are born, and I see
them regularly after that, so I see a variety of problems: nipple soreness,
improper latch (that is, the baby latches onto the breast in a way that causes
trauma to the nipple), engorgement, breast infection, babies who won't wake up
to nurse, and women with insufficient milk supply. I'd say that sore nipples
are the most common breastfeeding problem I see.
The first time you see a new mother, what do you tell her about how long and how often to breastfeed?
I advise new moms to pace themselves in the beginning and not to nurse for
long stretches, so their nipples can build up to it. I tell them, "These
are your first steps in a marathon: You don't want to get exhausted at the
beginning of the race." I cringe when a new mom tells me that she just
nursed for 45 minutes because I know she is going to feel it the next day.
In terms of how often and how long to nurse, I advise new moms to do 10- to
15-minute sessions on each breast. At the same time, I encourage them to nurse
frequently -- every three to four hours or so -- to build up milk supply. Also,
colostrum, the early milk, is very nourishing, so I like to see the baby get
plenty of that.
Some doctors recommend a schedule, but I think it's going to depend on the
baby: Some will nurse every two hours; others will nurse every four.
Sometimes people become concerned if they're told their baby has lost weight
in the first few days, so I remind them that it's normal for newborns to lose
10% of their body weight in the first few days of life.
What do you tell new parents about the first few weeks after they bring their newborn home?
New parents tend to overdo it. I advise people to keep the number of
visitors down. If your husband's brother comes to visit and you're chitchatting
with him, it may be hard to ask him to leave the room so you can nurse. When
you're not nursing your baby, you should be resting.
I urge people to keep their expectations down in terms of what they need to
do in those early weeks. I hear people bragging about walking to Starbucks two
days after their baby is born. But I advise new moms to rest at home with their
baby -- not just for infection control, but for their own well-being.
I tell women, "This is your chance to be a princess. Let people fill
your water glass, let people bring you meals." We aren't used to letting
people take care of us, but that's what you need to do in the beginning.