Doctor Mommy’s Guide to Breastfeeding

@silverpebblephotography

You guys, breastfeeding is HARD! My med school and residency training did nothing to prepare me for this! Now that I made it to my 6 month goal (my goal keeps changing by the day – the AAP recommends exclusively breastfeeding for a year and adding solids after 6 months), I would love to share some things I wish I knew ahead of time and hopefully help you mamas on your breastfeeding journeys.

Before I had Mason, I expected breastfeeding to be pretty easy. I knew it would hurt at first, because everyone says it does, but I didn’t know just how much it could hurt! I also didn’t think it would take any effort at all to get it right. After all, it’s the most natural thing in the world, right?! And everyone has seen that video of the newborn baby crawling up to mom’s boob right after delivery and start feeding like it’s no big thing. Well, that’s not how it always works out.

Mason’s first time breastfeeding. @silverpebblephotography

After my c-section, I had been pumped up with so many fluids I looked like an oompa loompa. My boobs were legitimate bowling balls. I don’t know how Mason’s little mouth latched onto them but somehow it did, with the help of the lactation consultant in the hospital.

            Tip #1 – ask for the minimum amount of IV fluids necessary while in the hospital – doctors sometimes go a little overboard or even forget that fluids are still running.

            Tip #2 – have the lactation consultant see you every day, even multiple times a day while you are in the hospital.

Even if you think things are going perfectly. Have her watch your baby latch. Ask whatever questions you have. This is the only time you will have someone there all day long who can help you and your baby get off to a good start.

            Tip #3 – bring your Boppy or Brest Friend (yes, it is spelled that way!) pillow to the hospital so the lactation consultant can help show you the best ways to use it.

Your baby won’t need much those first few days so don’t feel like you ‘aren’t giving him enough’. For reference, here is a picture of baby’s stomach size and what it can hold over time:

Your boobs also aren’t ever ‘empty’. The first few days. all your baby needs is a little colostrum. After your milk comes in, they might not always feel heavy and full, but they are continuously producing milk, so again, don’t worry that your baby isn’t getting anything. The most important thing for the first few days is to have your baby skin-to-skin as much as possible, and latching as often as they are interested. This will help regulate their body temperature, heart rate, breathing, allow you to bond and help establish your milk supply.

Here are some signs that your baby might be hungry:

• licking lips, sticking out tongue, opening mouth
• sucking on his hands (or anything else!)
• rooting (turning his head and opening his mouth)
• fidgeting
• crying (a late sign of hunger)

Many newborns are super sleepy over the first few days and you may have to wake them to eat. At first, they should be eating every 2-3 hours during the day and at least every 4 hours at night – from the start of one session to the start of the next – until they have established good weight gain. This also helps establish your milk supply. Each nursing session should take anywhere from 15 – 40 minutes. You might feel like you are nursing 24 hours a day, because you are!

@silverpebblephotography

            Tip #4 – Watch your baby and not the clock. You will learn his cues better this way.

When I first started breastfeeding, I used an App to track how long he was eating and from which side. If I could go back, I wouldn’t do this again because it made me so anxious looking at the numbers and making sure I always had my phone with me to track his feeds. Just let your baby do his thing.

Be prepared for cluster feedings. Babies go trough growth spurts at 1 week, 3 weeks, 6 weeks, and 3, 4, 6, and 9 months. They may go from feeding every few hours to feeding every few minutes with hardly any breaks! This is totally normal.

Tip #5 – Alternate which breast you start with every session. My little trick to remember which side to start with was to move a hair tie from one wrist to the other after every nursing session.

Breastmilk is composed of foremilk (more liquid) and hindmilk (more fat) and you want to make sure your baby is getting both. You should try to let your baby completely drain one breast at each meal. My lactation consultant said to think of the first breast they feed from as ‘dinner’ and then to offer them the second breast once they are done as ‘dessert’. They may take it or leave it and that is okay! I always burped Mason between sides as well.

When your baby is full, his hands and body will relax, he will unlatch on his own, and he may fall asleep. Cherish these snuggly moments! Everyone says it, but they grow up so so fast.

@silverpebblephotography

Tip #6 – A good way to know if he is getting enough milk is by counting the number of wet diapers.

Babies should have one wet diaper for every day of life…one on day 1, two on day 2 etc. Once your milk comes in, expect 5-6+ wet diapers a day. Or 10-20 in Mason’s case! He hated being in a wet diaper and let us know even if there was just a little sprinkle!! After day 4, your baby’s poop should have changed from black and sticky to yellow and seedy as well.

I saw a lactation consultant twice over the first three weeks I was home with Mason. I recommend this to EVERYONE and even wish I had scheduled this ahead of time and didn’t wait to feel like I wanted to give up.

            Tip #7 – Think about where you will go for help ahead of time.

Schedule a visit to a lactation consultant for your first and third weeks home from the hospital before your baby is even born. Or at least have a lactation consultant in mind and have your partner call to schedule as soon as your baby is born. You aren’t going to want to spend time asking people for recommendations or searching Google when you have a newborn at home and are struggling with cracked nipples and cleaning spit up!

La Leche League meetings are also a great resource. Most groups have weekly meetings you can bring your baby to, meet other mamas, and ask any questions you may have.

Seeing a lactation consultant was so helpful because she not only watched Mason’s latch and gave us good pointers, but she did weighted feeds, which allowed us to see exactly how much milk Mason was getting. This was super reassuring to me. They can also help you figure out if your baby has tongue or lip tie.

Check out these videos of what a good ‘chin first’ latch looks like:

https://www.youtube.com/watch?v=Zln0LTkejIs

            Tip # 8 – Set up a breastfeeding ‘station’.

In our early days of breastfeeding, I took Mason into a spare bedroom next to ours to nurse at nighttime. Tyler was back at school and I didn’t want to keep him up. Mason and I were also still figuring things out. In return, Tyler took Mason for two hours in the early morning so I could get some uninterrupted sleep.

I liked to turn the lights partially on (we had a dimmer) so I could make sure Mason was latching well and it also helped keep me awake. On the bedside table I kept a huge water bottle, chapstick, snack bars, my iPad, the TV remote, and my favorite nipple cream.

I always had a couple of muslin swaddles nearby which I used for burp cloths. I nursed him on the bed and I had a fuzzy blanket in case we were chilly and a bunch of pillows including my Boppy to make sure we were comfortable. Yep! We pretty much moved in!

Try using a Milkies Milk-Saver or Haakaa pump on the opposite breast to catch extra milk from your letdown. Some moms are even able to store enough for their first days back at work just using this method!

Make sure your partner and your families know how important breastfeeding is to you. I can’t tell you how many times someone said to me, ‘Oh, just give him some formula. It’ll be fine.’ And it is fine, especially when it is necessary for the health of your baby. But for me, when Mason was growing well, not hypoglycemic, jaundiced, dehydrated, or any other condition necessitating supplementation, supplementing with formula at that point would have affected my milk supply and made it easier for me to give up. And I just needed some encouragement.

@silverpebblephotography

Tip #9 – Never quit breastfeeding on a hard day.

I heard time and time again that the first three weeks of breastfeeding were the hardest and if you can make it past that, it gets so much easier. I wanted to give up so many times but I trusted all the mamas that have done this before me and kept pushing ahead waiting for the day it felt natural and didn’t hurt. And I promise you mamas, that day comes!

Let your partner and family know what they can do to help. Sometimes they just don’t know what you need and we have to remember that they aren’t mind readers. When you are exhausted, have your partner change the diapers, bring you the baby so you can nurse, and then hand him back so they can rock him back to sleep afterwards. Don’t worry about keeping the house clean, ask people to bring you meals when they ask what they can do, laundry and dishes can wait. Nursing takes a lot of time and energy – literally 300-700 calories a day! Don’t be afraid to ask for help!

There were so many days that I thought I couldn’t make it through another feeding session, let alone another week or month. At the beginning, I cried even just thinking about how soon he would want to nurse again because it hurt so much. But now, these quiet snuggly moments together are the best part of my day.

@silverpebblephotography

You should check out the website KellyMom for literally anything breastfeeding related. I spent lots of time reading these articles on my iPad when Mason was nursing for 40 minutes at a time in the early days.

I especially recommend this article on how to bottle feed the breastfed baby and this video on paced bottle-feeding which is critical to teach to any potential caregivers, including daddy!

Whether you breastfeed for a week, a month or a year, just know you are doing the best you can for your baby. #fedisbest always. You’ve got this mama!

Any tips that you would like to add? Comment below!