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StorkNet's Breastfeeding Cubby
StorkNet > StorkNet Site Map > Breastfeeding > Breastfeeding Articles

Breastfeeding FAQ
compiled by Gaye E. Johnson

Why is breastfeeding so important? What is so wonderful about breast milk?

Breastfeeding gives your baby the best possible start in life! Breast milk is an amazing thing: it is a living, ever changing substance, full of everything a baby needs to grow and develop. Despite the efforts of scientists over the past few decades, no one has been able to exactly replicate what your body can produce so perfectly itself.

Breastfeeding ensures that your child has the lowest chance possible of developing a whole range of heath problems, such as allergies, asthma, eczema, gastroenteritis, ear infections, obesity and diabetes. The antibodies present in breast milk offer some protection against viruses such as the common cold. The fatty acids ensure optimal brain development, and studies have shown a statistically significant difference in IQ between groups of babies who were breastfed and those who weren't.

In addition to the benefits from the breast milk itself, the way of delivery has been found to influence jaw development, reduce the need for orthodontic work and improve speech. The closeness between mother and baby has numerous emotional benefits as well. Breastfeeding means that mother and baby experience skin to skin contact at least several times a day, which can assist in bonding.

To Breastfeed or Not: Why There Should Be No Question!

How does breastfeeding benefit me as a mother?

Breastfeeding has numerous benefits for the mother too! After birth, it helps contract the uterus back to non-pregnant size and thus helps prevent haemorrhage. Breastfeeding can also be helpful in losing weight after pregnancy. More importantly, it reduces your chance of developing breast and ovarian cancer.

Breastfeeding is easy on the family budget, both from the perspective of not needing to buy formula and from the reduced medical costs on average. Nursing babies are very portable, so mothers can get out and about easily. There are no bottles to sterilise and prepare, which also helps with nighttime feeds. Overall, it is often considered more convenient for the mother to breastfeed!

To Breastfeed or Not: Why There Should Be No Question!

Does breastfeeding hurt?

NO! Well, not when it is done correctly anyway! One of the main reasons why new mothers find breastfeeding painful is because their baby is incorrectly attached to the breast. This can be easily adjusted. Some women who have very sensitive nipples might find that it takes a few days for them to get used to the sensation of breastfeeding, and there might be some temporary discomfort even despite good latch; however, in almost all cases nursing with a good latch is not at all painful. Pain is a sign that there is something wrong and to seek help.

Some Breastfeeding Myths

Is breastfeeding inconvenient or confining?

On the contrary, as stated above, nursing mothers often find that they have more freedom than their bottle feeding friends. Breastfed babies are infinitely portable, so mothers can go practically anywhere without the need to worry about how much food to take for their baby, where to heat it up, whether they will be delayed, or so on. Even on the instances when mother and baby need to be separated, it is possible to express milk so that baby can still have all that wonderful breast milk in her mother's absence. Breastfeeding is probably the most convenient and liberating part of motherhood!

Some Breastfeeding Myths

Will I have to give up eating the foods I enjoy?

Almost certainly not! Nutritionists recommend that everyone eat a wide range of foods, including lots of fresh fruit and vegetables and grains. A nursing mother, for her own health, would be wise to follow these basic guidelines! However, from the perspective of milk production and reactions in the baby, very few women find that they need to adjust their diet. There are, unfortunately, so many myths about what you should and should not eat while breastfeeding. When a dietary change is necessary, usually it is dairy that is the culprit.

Interview With Jill Dalley
More Breastfeeding Myths
Colic in the Breastfed Baby

Can I breastfeed if I have small breasts?

You can breastfeed with small breasts, large breasts or breasts which are somewhere in between! The important thing is not the size of the breast but the ductal tissue inside it. It is possible to breastfeed even with only one breast, and often at least partial breastfeeding is possible after breast reduction or enlargement. Even women who have never been pregnant (such as adoptive mothers) can lactate successfully in many instances. The human body is an amazing thing!

More Breastfeeding Myths

What about the baby's father? I don't want him to feel left out if he can't feed the baby.

In societies where breastfeeding is the norm, fathers would probably not even consider wanting to feed their infants themselves. As we live in a predominantly bottle feeding society, many breastfeeding dads will have friends who are able to feed their children bottles. We need to be sensitive to their feelings and let them know how very important their support of breastfeeding is. A father's support is one of the most important issues which affects breastfeeding success, so having his full support is vital.

Discussing how he is feeling can be a good start. In some families, a decision is made that the mother will express some milk so that the father can feed it to their baby. If everyone concerned is happy with that arrangement then it can work very well. It is important to realise though that many, many dads manage to bond with their children beautifully without ever giving a bottle of EBM (expressed breast milk). It is an option which works well for some, but it is certainly not a "must do". There are so many ways in which a father can be involved with his baby's care: bathing, cuddling, wearing in a snuggly or sling, rocking, singing, the list goes on and on. A father can also show a keen interest in the breastfeeding, show support (especially if relatives are giving his partner a hard time about it), and stay close by when mother and infant are nursing. There is something incredibly special about a father snuggling with a mother and nursing baby. It doesn't get much better than that!

Dads and Breastfeeding

How can I breastfeed in front of friends or in public?

In a society which has sexualised the breast so much, it is probably normal to approach breastfeeding in public with some degree of trepidation! However, with a bit of practise and some handy tips, everyone can accomplish it. Every baby has a right to be fed and nurtured wherever he is and whenever it is! There are laws to protect nursing infants and their mothers, and you are well within your right to nurse your child anywhere that you have a legal entitlement to be. Being able to nurse in public and/or around friends can be an important step towards liberation as a nursing mother. Once you can do this, any fears of being confined will drift away!

One thing which can really help is to practise at home, in front of a mirror or your partner. Being able to latch your baby on relatively quickly and with confidence can really help when nursing in public. Learning how to do this without stripping to the waist is a bonus too! Some women find special nursing clothes to be of great benefit, especially for special occasions or church. Other women manage just fine with their normal clothing by being a bit selective about what they wear when going out. Separates, especially with a loose fitting top, can be great as the top can be lifted easily to latch baby on and then it can fall to cover the top part of the breast. Baby covers the lower part of the breast and anything below. It can also help to "work yourself up" to breastfeeding in public, by choosing a relatively "easy" situation to start with. Probably sitting in the front row at Easter Mass is probably not a good idea for your first endeavour unless you are feeling very confident!

With time and a bit of practise, this is a skill which can be mastered and is well worth it.

Breastfeeding in Public

I am having my baby via C-section and am wondering how this will affect the breastfeeding.

If having a C-section or a difficult vaginal birth, you might find that you face some challenges in the early days. However, these can be overcome with help and motivation. It is helpful to talk with your doctor beforehand about your desire to breastfeed. It is a good idea to have a first nurse as soon as you and your baby are up to it - for this you will probably need some help in attaching your baby, as you might be either numb, sore or feeling a bit "out of it". Your baby might also be feeling the effects of the drugs which were administered to you, so don't panic if she is a bit sleepy at first.

It will help if you have your baby with you as much as possible, with help of your partner of course. If your baby is in the nursery, requesting that she be given no artificial nipples is a good idea to avoid the risk of nipple confusion and so that she will nurse from you to stimulate your supply. Your incision is likely to be sore for at least a few days, so finding a nursing position which is as comfortable as possible might take some trial and error. Lying down on your side is one suggestion. If nursing sitting up, a pillow over your cut can help with pain.

Breastfeeding After a C-Section

How can I get a good start at breastfeeding?

Probably before you even start breastfeeding, you can be setting the foundation for success! The more prepared you are, the better your chances of knowing what to do to get a good start! Reading a good book, such as The Womanly Art of Breastfeeding, joining a breastfeeding support group such as La Leche League, and perhaps attending a breastfeeding class are great starts! StorkNet has a wealth of information in this cubby as well, and joining in at our forum is helpful to many women as well. EDUCATION and SUPPORT are all-important!

Having some basic breastfeeding knowledge, such as how to latch a baby, how to know whether baby is getting enough milk, and how to recognise if there is a problem and knowing some of the common pitfalls, such as introducing a bottle or pacifier too early, feeding by the clock, and accepting breastfeeding pain as normal can make the difference between a nightmare first few weeks or a pleasant experience.

If you are having your baby in a hospital, then trying to pick a hospital which is breastfeeding-friendly can make a big difference. If no such hospital exists near you then don't despair! You have every right as your baby's mother to request that no bottles be given and that your baby be with you ("rooming in"). Rooming in greatly assists nursing on demand and gives you a chance to get to know your baby and get some practise at breastfeeding before you go home.

Breastfeeding - Starting Out Right
Hindsight is 20/20 and other Getting Started Tips!

How should I latch my baby to the breast?

First, get into a comfortable position, as you are likely to be there for awhile! Having a glass of water next to you is a good idea, as many women get thirsty during a feed. You might choose to lie down, or you could sit in a comfortable chair. Baby's body and head should be aligned. He needs to be held close to you, so that his chin is in line with your breast and he doesn't need to turn his head to nurse. You can tempt your baby with the breast by tickling his lips with your nipple.

When his mouth is WIDE open, bring him in quickly to the breast by holding behind the neck. Don't push on his head, as he is likely to fling himself back away from the breast! Make sure you bring the baby to the breast, not the other way around, or you will be uncomfortable. Your baby should have a good mouthful of breast, and not just be "chewing" on the nipple. Depending on the size of your areola, he might have the entire areola in his mouth or just a portion of it. As long as he has a decent mouthful of breast he can suckle to get the milk he needs and stimulate more milk to be made. His lips should be flanged (like a "Special K" shape). It should not be necessary to hold a finger down on the breast. When attached correctly, his nose should be free enough so that he can breathe and pressing down on the breast can increase the risk of developing clogged ducts in some women.

Good latch-on should NOT be painful, although the first few times it might feel a bit unusual.

When Latching
Positioning and Latch-On

How often should I feed my baby?

The simple answer to this question is "As often as he wants it!". These days, demand nursing, perhaps more "nicely" termed "cue nursing" is what is advised. Newborns should be nursing at least 8-12 times in a 24-hour period, but many will request it more often than that (some babies MUCH more often than that!) Cue feeding allows the wonderful system of supply and demand to work the way it should. Feeding less often than baby demands can result in dehydration, failure to thrive and poor milk supply.

Generally speaking, the only time it is advised to break from feeding on cue is when the baby is not asking often enough (not the other way around, trying to make the baby go for longer periods than he would naturally want). Some babies, especially those born prematurely, might be undemanding and sleepy early on. In order for them to get what they need, the mother might need to take the initiative and offer the breast so that the baby is getting at least the recommended minimum number of feeds.

So I nursed Him Every 45 Minutes ~ Demand Nursing

How do I know if my baby is getting enough milk?

This is a very common concern! One worry that many women have is that they will not be able to produce enough milk for their babies. As they cannot actually SEE how many ounces they are ingesting (like you can when feeding from a bottle), the insecurity is compounded.

Firstly, it is VERY RARE for a mother who is nursing on demand to not be able to produce enough milk for her baby. Many women who are led to believe that they have insufficient milk probably had perfectly adequate supplies but were taken in by such poor advice as "If you need to nurse that often then obviously you have a supply problem" or "If your breasts go soft that means you have lost your milk."

Secondly, it is not necessary to know how much goes in, just to know that whatever the amount is, it is "enough". Counting wet (at least 6-8 cloth or 5-6 disposable) and dirty (in the early weeks probably several per day but it can vary) nappies is a good way to know that your baby is well hydrated and getting the nutrition she needs. Regular weighing is also helpful. Babies should usually have at least returned to their birth weight by two to three weeks of age. After that, a gain of about 4-8 ounces a week is considered acceptable, although babies can deviate from this and still be perfectly healthy.

Is My Baby Getting Enough Milk?

My baby is six weeks old and is exclusively breastfed. He used to have a bowel movement at every feed but now hasn't had one for three days. Is this normal?

It is not uncommon for mothers to notice that their babies' bowel habits change as they grow. Constipation is VERY RARE in an exclusively breastfed infant! Some babies can go for 10 days between bowel motions with no ill effect. When babies do go infrequently, parents might find that no nappy is up to the task though! As long as baby is not distressed, seems well, and when the movement does come it looks normal and is not hard pellets, all is probably well. A check with your doctor will put your mind at ease if you are concerned.

My breasts leak a lot! When will this settle down?

Leaking is pretty normal in the first weeks and perhaps months of breastfeeding. It is not uncommon for mothers to find their breasts start to leak at the very thought of their baby, or even when they hear another baby cry. One breast might leak while the other is being nursed from. It DOES settle down in time, but exactly when depends from woman to woman. Many women find that they need to wear breast pads day and night (and a bra to keep them in) for some time.

Leaking Milk

My breasts don't feel so full anymore and I am so worried that I am losing my milk. How can I tell if everything is okay?

This is a common misconception! It is actually very normal for your breasts to "settle down" once your supply is well established, somewhere around the six week mark in many cases. It does NOT mean that you have lost your milk - losing milk suddenly out of the blue is extremely rare! You can rest assured that if all the normal things are okay (nappy count, weight gain etc) then you still have plenty of milk for your baby.

When I was in the hospital, the nurses gave my baby a few bottles. Now I am having a lot of trouble getting him attached to the breast. Why is this and what can I do about it?

What a shame that the nurses were not following breastfeeding friendly hospital practices! Probably what has happened is something often termed "nipple confusion". The sucking technique to get milk from a bottle is totally different from the suckling technique at the breast. When a baby is still a "learner", it can be hard to go from one to the other without some degree of confusion. Sometimes a baby will even refuse to go back to the breast if given bottles for an extended period of time.

Probably the best thing you can do at this point (it is too late to avoid the problem this time) is to contact a lactation consultant or LLL leader to help you out. With some patience and expert help, your baby will be back on the breast very soon.

What can I do about sore nipples?

Prevention is, of course, better than needing a cure and the best prevention for sore nipples is correct attachment. Once the nipples are already sore, attention to correct attachment is even more important so that further damage and pain do not occur.

For minor nipple pain, gently expressing some hindmilk onto the nipple area at the end of a feed and then allowing the breasts to dry naturally can really help. If this is not successful, then lanolin cream, such as Lansinoh, can work wonders. If pain persists, as they say, please see your doctor!

Sore Nipples

My nipples are so sore, even though I am sure I have correct latch-on. What is going on?

It is possible that you are experiencing a problem with nipple thrush. When nipple pain occurs despite good latch, especially if it occurs "out of the blue" or after treatment with antibiotics, thrush is something often considered as the culprit. Thrush is a fungal infection, which thrives in moist, warm places on the body.

If thrush is suspected then a natural remedy to try is gentian violet. If this does not work, then a trip to the doctor is advised. Both mother and baby need treatment, even if only one is showing symptoms, as reinfection can easily occur. Treatment should continue until at least four days have passed after the last symptoms.

Using Gentian Violet
Flucanazole

One of my breasts is SO sore, with a red, hard area. I have a fever and feel really sick. What is wrong with me?

What you have described are the classic symptoms of mastitis. Sometimes a duct gets clogged and if it isn't cleared quickly, it can become infected. You should see your doctor as soon as possible for a diagnosis and treatment.

Blocked Ducts and Mastitis

What is let-down?

Let-down, otherwise known as the milk-ejection reflex, occurs after a short time of baby's vigorous suckling at the breast. It is when the hindmilk is ejected from the ducts. Many women experience a tingling or burning sensation as let-down begins. Even though some women never actually feel a let-down, they can know that it is happening by watching their baby's sucking patterns: at the beginning of a feed, baby's pattern will be suck, suck, suck, suck, quite quickly, but after let-down has started, the sucking becomes a more rhythmical suck, swallow, suck, swallow, suck, swallow. A thriving baby is also good evidence of effective let-down!

What exactly is Let-Down?

I have heard people talk about foremilk/hindmilk imbalance. Can you please explain this to me?

The milk at the start of a feed, before let-down occurs, is called the foremilk. It is high in volume and lactose (sugar). When let-down occurs, the hindmilk is ejected, and this is higher in fat and lower in water content.

In days gone by, the common feeding advice was to nurse your baby for 10 minutes each side (every four hours! ) The problem with this, is that the baby often ended up getting a "double dose" of the foremilk (getting over full and lots of the lactose) and hardly any of the hindmilk. Babies only have tiny tummies so filling the little space there with the less satisfying foremilk meant that they could get hungry more quickly again AND it could give gassy pains. Sugar can irritate the bowel (I believe that is why current advice is not to give lemonade when children suffer from diarrhea), but fat can help soothe the digestion and keep baby's hunger at bay that little bit longer.

Current advice is for women to nurse their babies on one side until baby comes off on his own accord and then to offer the second side IF baby seems interested. In mothers with an "oversupply", babies with a high need to suck and who tend to be gassy, it is often suggested to keep the baby to the one side for a two or so hour period, no matter how often the baby wants to nurse in that period. That way, he can suck as much as he wants without continuing to fill up on all that foremilk, getting little bits of the hindmilk which comforts him and helps with the gas.

My baby is six weeks old and has gone from nursing approximately every two hours to wanting to be attached almost constantly. Does this mean I need to supplement?

It is likely that your baby is going through a growth spurt. These are common at around three weeks, six weeks, three months and six months, but this can vary from baby to baby of course. The best way to deal with a growth spurt is to let your baby nurse as often as she wishes, and by doing this, your supply will increase to meet the new demand in a matter of days. By introducing formula during a growth spurt, you are in effect telling your body not to make more milk (and maybe even to make less), so once supplementation is started it can be a very hard cycle to break. Keeping an eye on the wet and dirty nappy count can reassure you that your baby is coping just fine.

Another reason why a baby might suddenly start nursing more frequently could be illness or teething (teething is unlikely in a six-week-old though). If in doubt, a check up at the doctor's is a good idea.

My baby is eight months old and still wants to nurse during the night. It seems that everyone is telling me that she doesn't need it.

It is actually very common for babies to still be nursing during the night at this age, and even into their second year of life. She might not technically NEED it (in that she could probably SURVIVE without it), but frequent nursing, both day and night, is of great benefit, both physically and emotionally. Especially in cases where baby and mother are separated during the day, such as when mother is working outside the home, babies often need to "catch up" on both nursing and the wonderful closeness it provides. One way of helping to cope with the nighttime demand on you is to consider co-sleeping: many women find that they can nurse their babies or toddlers several times during the night and still wake up reasonably refreshed in the morning.

Why bother breastfeeding when I know I'll be returning to work (or school)?

This is a common question! The answer is this: you CAN combine breastfeeding with returning to work or school, and even if you do decide to wean when you return, every breastfeed is worthwhile. Even breastfeeding for a few days, so that your baby can get the benefit of the colostrum, is very worthwhile!

There are various ways in which breastfeeding and work or study outside the home can be successfully combined. Some women are fortunate enough to be able to either have their babies with them or at a daycare facility on site so that they can continue to breastfeed pretty much as normal. Others are able to have their baby's caregiver bring her to the workplace for a nurse, or to travel home or to the daycare facility during breaks to breastfeed.

When this is not possible, then many, many women have great success at nursing when they can be with their babies and pumping their milk when they are apart, so that this can be used for the baby the next day. Some women, who are unable to pump, find that they can successfully combine breast and formula. There are no rules here, and the important thing to remember is that every bit of breast milk is precious!

Breastfeeding and Working Outside the Home

I am about to return to work outside the home and am wondering approximately how much EBM I will need to pump for my baby each day.

One way of getting a rough idea as to how much EBM you will need is to take your baby's weight in pounds and multiply by 2.5. This will give the number of ounces over a 24 hour period. For example, if your baby is 12 pounds, you would calculate 12 x 2.5 = 30 ounces in 24 hours. If you are going to be away from her for say 8 hours per day then she will need ROUGHLY one third of that (10 ounces) during the time you are apart, split up into say four bottles of 2.5 ounces each.

The problem with this method is that every baby is different! Once you get in the swing of working outside the home, you will get to know how much to leave for your baby each day. Some babies really take to the bottle and especially those with high sucking needs might take more than you might imagine when you are apart. Others only take the bare minimum they need during the day and then nurse more frequently during the night to "make up for it".

I have started pumping in preparation for returning to work. I am finding it really hard to get more than an ounce or two. What are some pumping tips?

When you first start pumping, especially if you are trying to do so in between your baby's usual feeds, it is not at all uncommon to get small amounts. Don't despair! Once you return to work and you are not nursing during the work day, you will find that you naturally get more milk.

In the meantime, there are some things you can do to help you pump. Trying to relax is important. There more you worry that you won't pump very much, unfortunately the more likely it is that you WON'T pump much! Let-down is affected by your anxiety level. Making sure that you are physically comfortable can help, as can such things as holding your baby, having a favourite magazine to read, or listening to music.

Many women find that the best time to pump is early in the day, when they are better rested (in theory anyway!) and supply is best. It works beautifully for many women to pump from one side while their baby is nursing from the other. That way, you tend to be more relaxed and get the full benefit of let-down.

What are the storage guidelines for EBM?

According to La Leche League, freshly expressed breast milk can be safely kept at room temperature (66 to 72 degrees F) for up to ten hours, or in the refrigerator for up to eight days. Frozen EBM can be kept for three to four months in the freezer (separate door to fridge) or six months in a deep freeze.

How do I thaw frozen EBM?

To thaw frozen milk, hold the container under cool running water and gradually add warmer water until the milk is thawed and warmed to room temperature. If hot running water is not available, then the frozen milk can be thawed by immersing in a container of warm water. It is NOT advisable to microwave EBM, as it could scald the baby and it changes the composition of the milk.

Can I add freshly expressed breast milk to EBM which is already frozen?

As milk which has just been expressed is likely to be warm, it is not considered a good idea to add it directly to frozen breast milk, as it could cause partial thawing. If you wish to add milk to that which is frozen, it is suggested that you refrigerate the fresh milk first. It is worthwhile bearing in mind too, that EBM is probably the most useful when it is stored in small amounts (to minimise wastage), so often simply freezing each batch separately is sufficient anyway.

When should I introduce solids to my breastfed baby?

Breast milk is all a baby needs to grow and develop to his full potential for about the first six months (unless medically indicated to the contrary). Starting solids too early can adversely affect milk supply and can increase the risk of the baby developing allergies.

It is better to follow your baby's lead rather than starting solids at a particular age. Signs of readiness include: increasing demand for nursing at around the six month mark, which does not diminish after four to five days in spite of more frequent nursings, taking an interest in what is on your plate, having lost the tongue thrust reflex and being able to sit well.

Starting Solid Foods

Does my breastfed baby need vitamins?

If the breastfeeding mother is getting an adequate diet herself then her milk will contain everything it needs in just the right amounts. The AAP does not routinely advise vitamin, mineral or fluoride supplements for the full-term breastfed infant.

One issue which often arises is the question as to iron supplements. Breast milk DOES contain much less iron than baby formulas. However, the kind of iron found in breast milk is so readily absorbed that it is rare for a breastfed baby to need iron supplements. Unless there is some medical indication that your baby is deficient in iron (or anything else) then you can safely conclude that he needs nothing extra!

Breastfeeding and Other Foods

ADVERTISEMENT
I have just been diagnosed with PPD and my doctor wants me to take an anti-depressant. I don't want to stop breastfeeding.

Whether it be anti-depressants or some other type of medication, there is almost always a way that you can safely continue to breastfeed AND get the treatment you need! It is important to realise that the information which is supplied in the leaflets which comes with your tablets is distributed by the company which manufactures the drug: this information is almost always overly conservative. Almost every medication you can purchase says that it should not be taken whilst pregnant or breastfeeding, even drugs which are classified group A for use during pregnancy.

Better guides to drug safety are available! Dr. Tom Hale has done extensive research into the effect of medications whilst breastfeeding. Most lactation consultants should have access to the latest edition of his book (it is updated each year). Your baby's pediatrician is another good source of information about drugs passing through breast milk. Be aware that the fact that a small amount of medication might pass into the breast milk and therefore be ingested by your child does not necessarily mean that the drug is dangerous to your child! There is also the issue to consider that the alternative to breastfeeding (ie. giving formula) carries some risks itself.

Medication whilst breastfeeding is an issue which you should discuss carefully with your doctor, after considering the latest and most accurate information available, as well as alternative medicines which might be safer whilst breastfeeding. As mentioned before, there is almost always a way of managing to work around the confines of needing medication.

The three drugs favoured by Dr. Tom Hale for the treatment of depression are: Paxil, Zoloft and Cipramil. You can read more about them at his website.

You Can Still Breastfeed
Study Results Show Paxil Safe for Use by Breastfeeding Mothers
Dr. Tom Hale's Website

Now that my baby has her first tooth, people are warning me that I will have to wean. I admit that I am pretty worried about biting!

It is normal to be worried about biting, but there is no need to wean the second you see a bit of tooth peeking through those little gums! Many, many women around the world continue to breastfeed well into their child's toddlerhood, and manage to find ways of dealing with the "teeth issue".

It is natural for a teething child to want to chew. When you are a nursing mother, it is important that you teach your baby that your breasts are out of bounds for this activity AND to provide an alternative. Providing something cool for your baby to chew on, such as those teething rings which can be refrigerated, or in an older baby a frozen banana or other cold food, can really help soothe those gums.

If your baby does bite you, which he just might at some point, it is important that he knows that this is not acceptable. Do not allow it to continue or you will be very sore! Many women find it helpful to firmly but calmly say "No! That hurts Mummy!" and then take their baby off the breast for a short time, whenever their baby bites (EVERY time it happens). Shouting or screaming (even though it does hurt and it is normal to WANT to scream) can either have the effect of scaring your baby and perhaps causing a nursing strike, or causing your baby to come back for more because he finds it amusing! Calm but firm is usually the way to go. Biting or hitting your baby is not recommended. With a bit of patience and persistence, babies can be taught not to bite the breast that feeds them!

I am wanting to choose some form of contraception which is compatible with breastfeeding. What is available?

There are methods of contraception which are suitable for the breastfeeding mother, even though the choices are somewhat reduced. The most popular form of contraception used these days is the combined pill - this is NOT advised for use during breastfeeding, as it can adversely affect supply. The progesterone only (or "mini") pill is a better choice, although SOME women do feel some effect on their supply on this medication as well (less common than with the combined pill though). Barrier methods, such as the condom, are safe and suitable during breastfeeding, as is natural family planning.

Breastfeeding and Contraceptives

My baby is due any day now and I am looking forward to nursing him. I am a bit concerned about how I will manage caring for his older sister though. Are there any tips for caring for a two-year-old and a nursing newborn? What if my two-year-old wants to nurse again herself?

Caring for a toddler and a newborn, you are likely to have your hands full, no matter how you feed your baby! Breastfeeding is actually likely to be more convenient for you, as you won't have to worry about preparing bottles, sterilising, warming and so on.

Many nursing mothers with older children find a sling a very valuable item: if you get one in which your baby can nurse, then you are able to nurse your little one as often as he needs and still have your arms free to play with and attend to his big sister. Having a "nursing corner" set up is another great idea. You could have a box of special toys, story books, videos perhaps too, that you can entertain your toddler with while you sit and nurse your baby.

If you are comfortable with the idea of your toddler nursing again, then go for it! She might simply be curious as to whether you would let her, and then find that she is not actually interested in it or has forgotten how. She might go back to full-on nursing though, so it would not be advisable to let her nurse unless you are happy about this possibility. Tandem nursing can be a very special time for mother and siblings, so if you are willing to give it a try, you will probably be very happy with your decision.

If you are not comfortable with the idea, then you have every right to refuse! You could make a big deal about her being a "big girl now" and make a point about getting her a "big girl drink" each time you nurse your new baby. As long as she can snuggle with you whenever she wants, she will probably accept that quite happily.

Siblings and Breastfeeding

My child is almost 12 months old and I feel that it is time to wean her. How do I go about doing this?

GRADUALLY is the key. The more gradual the weaning, the more readily your body will adjust and the better your child will accept it. It is usually a good idea to start with dropping the least favoured nursing session first (say the middle of the day). Dropping one daily feed every week or two (or longer if you are amenable) is usually recommended. The last feed before bed at night is usually the last one to go.

If your child is getting very upset at any stage of the weaning process then it is a good idea to slow down. There is no set age at which a child must be weaned and in fact, you can nurse as long as both you and your child are happy to do so. You might even decide on partial weaning, where you still nurse once or twice a day for many more months. There are no rules here - it is up to you and your child!

I heard of a woman who is still nursing her four-year-old child! I didn't realise that was even possible - can you tell me about this?

It is pretty rare in Western society for children to be nursing past several months, let alone still be nursing as pre-schoolers! However, in many parts of the world a nursing four-year-old would be the norm.

Many women in our society who are currently nursing toddlers and pre-schoolers probably didn't envisage doing so at the start of their breastfeeding "careers". In many cases, women who nurse for an extended period of time start out with an initial goal such as twelve months and then decide that they and their baby are enjoying it too much to give it up. The benefits of breast milk and breastfeeding do not stop once a child reaches a certain age, and in fact, those who have nursed toddlers will attest to the wonders of being able to nurse during those tumultuous toddler years. The emotional aspect of breastfeeding probably plays more of a role the older a child gets. The security that the child feels, the closeness of the bond, can be amazing!

Dr. Katherine Dettwyler did extensive research into weaning ages around the world, in humans and in different mammals. She concluded that a natural age of weaning for humans would be somewhere between 2.5 and 7 years. In societies where children are allowed to wean when they feel ready, without any parental or other pressure to do so, she found that most children weaned at around the age of three or four, which is within the "natural age of weaning".

Breastfeeding a Toddler
Breastfeed a Toddler - Why on Earth?

I had so much trouble when I tried to breastfeed my first child and really want things to go better this time. What can I do to prepare myself better?

Good on you for deciding to give it a second try! Probably the best thing you can do is to set up a support system (get the number of a local lactation consultant, get in touch with LLL near you, start joining in at the Breastfeeding Support Forum here at StorkNet) and to learn as much as you can about breastfeeding before your new baby arrives. If you know what went wrong last time, it might help to talk this through with someone so that you can work out ways of coping if a similar situation presents itself this time.

I stopped breastfeeding a week ago but now would like to give it another try. Is that possible?

Relactation is possible! The less time in between weaning and attempts to relactate, the easier it will be in general. It is even possible for adoptive mothers to establish at least partial lactation!

The important thing when attempting to relactate is to get nipple stimulation so that the supply demand system is set back in swing. The best form of nipple stimulation is from your baby, so if she is amenable to going back to the breast, do this as often as possible. If she won't nurse at all, or only rarely, then it might be necessary to get a good quality pump (you can rent hospital grade ones) and pump at least every two hours. Don't worry if you are not getting much milk out; the aim at this point is to get the stimulation (demand) going - the milk (supply) comes later.

Many women who are relactating or trying to start up a milk supply find a supplemental nursing system (SNS) really useful. These consist of thin tubes which run from a bottle (holding formula or EBM) hung between the breasts. The tubes are taped so that the end is at the nipple. A SNS enables a baby to get any necessary supplementation whilst suckling at the breast and thereby stimulating supply. Over time, the amount of supplementation can be decreased (with careful attention to wet and dirty nappies, and weight gain of course), to the point where it is no longer necessary at all. Exactly how long this takes can vary from woman to woman, but it is wise to be prepared to be patient and determined.

If attempting to relactate, ongoing contact with a lactation consultant or LLL Leader, as well as your baby's pediatrician, is a good idea. This is definitely a situation where expert help is warranted.

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