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Expert Q&A: Tips for Successful Breastfeeding

An interview with Laurel Schultz, MD.
By Constance Matthiessen
WebMD Feature

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.

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