When Breastfeeding Seems Impossible
In some cases, a mother may be advised to vary the medication schedule -- with her doctor's approval -- so that she is not pumping or breastfeeding at the medicine's peak time. "You can individualize the process to maximize her ability to breastfeed," Downey tells WebMD.
Also, when babies are latching on well but they're still not gaining enough weight, it may be that the mother just isn't producing enough milk, says McCoy. Solutions to increase milk supply? Pumping between feedings -- or putting baby to breast much more often than mothers think the baby should need to nurse.
One volume-building prescription medication -- Reglan -- has been used by mothers in Downey's neonatal intensive care unit to help them maintain volume when they are exhausted and under stress. "It's been very effective in 5- to 10-day treatment periods," she says.
As far as dietary supplements sold through health food stores, "I just can't endorse them," says McCoy. "The American Academy of Pediatrics still has some skepticism about them."
Supplementing with formula is certainly appropriate when things just aren't working, says McCoy. "There is nothing like breast milk, but we have to look out for the baby's overall nutrition and weight gain," she says. "I'm always amused by formula manufacturers who say that theirs is more like breast milk. You can change the proteins and fat to be more like breast milk, but you can't give formula the antibodies and white blood cells and other proteins that have protective factors that keep viruses from binding to the lining of the intestine."
Breastfeeding troubles can be disappointing for some moms, says McCoy. "But if a mom says, 'I can't' or 'I don't want to,' we have to be really supportive of them. It's important to be positive about her experience, to let her know she's given her baby the best possible start she can," she says.
McCoy reassures every mom that a formula-fed baby is well-nourished. "And the baby has the benefit of all that bonding," she tells WebMD. "Bonding has just as many positive effects on her baby's health."