If Breast Is Best, Why Do Many New Mothers Give Up?
How can mothers know whether they are producing enough milk?
Lactation consultant Cynthia Garrison, BS, IBCLC, of Magee-Womens Hospital
in Pittsburgh, tells WebMD: "We often send mothers home with a "feeding
log," a real simple chart where they can keep track of the numbers of
feedings, wet diapers, and dirty diapers in a 24-hour period, so they see that
it's falling within the ranges of normal.
"Because what goes in must come out, we instruct mothers that if baby is
having 4-6 wet diapers within the first day, increasing [along with the baby's
milk intake] to six to eight, and they're having at least two dirty diapers
every day, then life is going quite well. They can be a little more relaxed and
understand that as the baby matures, they will start spacing feedings out; they
won't need to feed as often. The babies' stomachs are getting bigger."
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, 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, Garrison says. Mothers need to put
them in a position in which 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 health care provider for help, Garrison says.
"There are too many women told it's going to hurt in the early days. 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," McCoy adds. "After mothers get past that, it 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,"
McCoy advises. "Using a lanolin cream is also very helpful in healing