A Division of Atlanta Women’s Health Group
Riverbend ObGyn and Counseling
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Breast Feeding

Human breast milk is warm, portable, sterile, always on tap, free and, most important of all, conveys the mothers immunity to may common diseases to the baby. This keeps the baby out of the pediatrician’s office and reduces illnesses in the first year of life.

Mothers who come from a tradition of breast feeding are usually successful. Moms who do not may have problems because of:

  1. Lack of positive role models
  2. Misinformation and ignorance
  3. The presence of destructive people and other elements in our culture (such as misinformation on the Internet) which shatter the self confidence of the new mother.

Preparation for Breast Feeding

Around 24 weeks, check your nipples. When they are touched, do they stand out or retract into the body of your breast? If they do not stand out, discuss this with your obstetrician. The most common problem that first-time nursing mothers have is pain. This may be caused by:

  1. Sensitivity of the nipple to touch
  2. Improper latch
  3. Chafing the nipples (i.e.: blisters)

Nipple Sensitivity

Every pregnant woman knows how sensitive the nipples are to touch. When you take off your shoes and walk barefooted after a winter in socks, you know how sensitive the soles of your feet are. However, with a week of two with stimulation, the sensitivity disappears. The nipple, which is a form of skin, is no different. A lot of the problem is caused by bras, a 20th century invention, since the bra is like a sock. So, starting around 24 weeks, try not to wear a bra all the time or use a nursing bra, flaps down, so that fabric of your blouse ( slightly coarser fabric is better) rubs over your nipples. Gentle massage your nipples, when showering with a washcloth. Massage your nipples with a breast cream which is commonly available in all pharmacies. Within several weeks, your nipple sensitivity should be reduced. Improper latch

When a baby latches onto the breast, the entire nipple should be deep in its mouth so that it cannot bite down in the nipple. The baby’s lips should form a seal with the areola (the flat pigmented area around the nipple), not the nipple.

Chafed Nipples

Like any other skin, if the nipple is abused, it will form blisters. As the skin toughens up, it is protected. The way you protect your hands from blisters is a gradual process of use. Nipples are no different. After the infant is born, let the baby nurse for short periods of time on each breast (5 minutes on each side hourly) for the first 2-3 days of life. When the milk comes in on day 2-5, the skin of the nipple will be in much better condition. Do not clean the nipples with harsh soaps or rubbing alcohol. This removes natural oils which protects the skin. Breast creams, such as lanolin, help replenish and protect the skin. Expelling a little breast milk and rubbing it on the nipple after breastfeeding will also help protect the skin.

How is breast milk produced?

When a infants cheek is stroked, it instinctively turns in the direction of touch and begins to “root”. “Rooting” means the infant’s mouth tried to latch onto the teat of the breast. As the baby latches, it creates a vacuum with its mouth and begins to lick the nipple (suckling). This sucking triggers a number of reflexes within the brain which

  1. Stimulates the production of a hormone caused prolactin which causes new milk to be formed
  2. Causes the mother to feel relaxed and somewhat sedated similar the effect of drugs such as morphine
  3. Produces oxytocin which causes smooth muscles in the breast to tighten. This ejects milk from the breasts. This is called the “let down reflex.”
  4. The same oxytocin causes uterine contractions like labor which lessens the loss of bleeding after childbirth and helps the uterus contract back to its pre-birth size

During the first two days of life, the baby receives colostrum from the breast. Think of this as a concentrated pellet of immunity to many common diseases. There is no milk for 2-3 days. All babies lose weight after birth. This is normal. Do not panic. If the baby experiences weight loss more than 10% of its birth weight (ie: 12oz for a 7 ½ pound baby), this is not normal. Babies stabilized the weight loss at about 5 days and pass their birth weight within 14 days. The normal nutritive requirement for newborns is about 1-1 ½ oz of milk every two hours. This is remarkably little—only 1-2 tablespoons of milk from each breast. You do not have to produce milk to fill an 8 oz bottle to be a successful milk producer!!

Bottle feeding vs. Breast Feeding

From the infant’s perspective feeding from the breast and bottle are two totally different acts:

Bottle Feeding

  1. The newborn sucks milk from a bottle.
  2. The baby gets the milk immediately

Breast Feeding

  1. The newborn licks milk which is ejected from the breast.
  2. There is a slight delay because of letdown

A newborn functions by reflex and simple learning. It does what it does by instinct and simple leaning. It cannot master both breast and bottle feeding simultaneously. If the newborn learns one (especially bottle feeding with instant gratification), it will move away from the other. This is common sense. Nothing is sadder than to see a newborn, accustomed to bottle feeding, attempt to suck milk from the mother’s breast— there is a delay of letdown and, the child rejects the breast. Do not allow nursery personnel to give the baby a bottle in the first few days of life. Suckle the baby hourly and allow the suckling to stimulate production.

Be patient, the milk will come on the second or third day. Request the assistance of the Lactation Consultant at Northside as soon as your baby is born.

Destructive People

Your prime task, after childbirth, is to enjoy your baby. While you and your baby are getting to know each other, it is very important to eliminate chaos from your life. Stress and chaos will shut down the essential brain reflexes which lead to milk production and let down. You will be tired and sleep deprived. Your bottom or surgical incision will be sore. You will instinctively feel very territorial and not want people messing with your baby. Your hormones will be all over the place and you may feels “blue” for all of the reasons above. It is totally OK to

  1. Disconnect the telephone
  2. Keep visitors away or restrict their access to you and the baby
  3. Turn off the TV
  4. Set boundaries
  5. This is not significant post-partum depression unless you lose the joy of life and motherhoods or become unable to function. If you are not clear if you have significant post partum depression or are simply “blue”, call your doctor.

If you are fortunate enough to have a mother, sister, mother-in-law, friend who is truly supportive, let them help you. An experienced mother who has nursed successfully is even better. Do not allow people who offer unsolicited advice. Do not read all the negative junk on the Internet.

Nursing is the most special relationship in the world and I hope you enjoy it.