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    Getting Past Breastfeeding Barriers

    How can mothers know whether they are producing enough milk? continued...

    Babies' elimination habits can vary, adds Andrea McCoy, MD, chief of pediatric care at Temple University Children's Hospital in Philadelphia. "So even though the baby may stool with every feeding," she says, "I caution mothers not to be overly concerned if the baby doesn't stool every day."

    A good medical follow-up is essential for babies, because assuring that they are gaining enough weight is the best way to be sure the mother has an adequate milk supply, McCoy tells WebMD.

    How can new mothers get past nipple problems?

    The baby's position while nursing is key, says Garrison. Mothers need to position them so that they can reach the area an inch to an inch-and-a-half around the nipple. Otherwise, the baby is feeding on the end of the nipple, which causes the mother pain.

    The ideal position, explains McCoy, "is the cradle hold, where they are on the side, level across your chest, with head slightly down ... but making sure the head is not hanging down and tugging at the nipple, and making sure that the head is adequately supported. Many moms initially feel uncomfortable, that they're suffocating the baby in the breast tissue, but the tip of the nose presses against the breast tissue and pushes the little airway open so the baby can continue to breathe."

    If nursing hurts, ask a healthcare provider for help, Garrison advises. "There are too many women who are told it's going to hurt in the early days," she says. "If they tough it out and they never look for ways to correct this ... they think they have to go through this pain. Different tolerances of pain mean some women won't continue."

    "The skin of nipples is tender, and it does need to get a little bit toughened up," says McCoy. "After mothers get past that, [the pain] usually subsides after the first few days. Persistent pain with nursing is unusual ... it could also indicate that the mom or baby has [an] ... infection that could be causing the pain -- because it normally shouldn't hurt, except for that tingly feeling that moms get when their milk lets down. That's very brief, right at the beginning of the feeding."

    "Cracked nipples are usually a sign the baby is not latched on properly, or the mother has not been instructed how to care for her nipples -- making sure she cleans them, air-dries her nipples, before she covers back up," says McCoy. "Using a lanolin cream is also very helpful in healing nipples."

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