Our Bodies, Ourselves (94 page)

© Judith E. Halek

Many of us find great pleasure and pride in our body's ability to nourish new life. In addition, breastfeeding offers many benefits to both mothers and babies. Breast milk provides exactly the right balance of nutrients, adapting to your baby's changing requirements as she or he grows in the first months of life. It has unique nutritional properties that benefit infant health and that are not available in formula. Babies who are formula-fed are more likely than babies who are breastfed to develop ear infections, diarrhea, asthma, diabetes, lower respiratory tract infections, and eczema. Both sudden infant death syndrome (SIDS) and childhood leukemia, though rare, are more common in babies who are formula-fed.
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Mother's health is also affected by breastfeeding. Women who do not breastfeed are more
likely to develop breast cancer, ovarian cancer, and type 2 diabetes.
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Women who do not breastfeed or breastfeed for only a short period of time are also more likely to experience postpartum depression.
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In addition to being good for our babies' and our own health, breastfeeding has practical advantages: When you breastfeed, you don't have to spend money on formula or deal with bottles (except when you're separated from your baby). Breastfeeding means that your baby's food is always available—at the right temperature and with the right nutrients for growth and development.

In several specific circumstances, breastfeeding is not recommended (see sidebar, above). In addition, some of us prefer not to or are unable to breastfeed. In these circumstances, formula is a
vital alternative
.

I remember at age 5 watching my mother breastfeed my youngest brother. He was born by forceps, and he had a scrape on his cheek by his ear from the forceps blade. My mom told me that she would take extra vitamin C that would go through her breast milk to help Scott heal and grow. I remember her saying, “Even though a lot of women don't breastfeed, in this family, we breastfeed all our babies!” Every time she nursed him, I would climb on the sofa next to her and watch his cheek heal. And years later, when I was handed my own newborn, I felt my mother and my grandmother's love through that memory of “in this family, we breastfeed all our babies!”

The attitudes and assistance of the people who surround you play a significant role in supporting breastfeeding. Many of us make the decision to breastfeed before our babies are born, although many women don't plan in advance and are still able to breastfeed just fine. Planning ahead can be helpful, though. We may sign up for a breastfeeding class, purchase nursing bras and nursing pillows, and choose birth settings and pain relief options that will maximize our chances of successfully breastfeeding. Having the phone numbers of local lactation consultants and your local La Leche League (LLL) can also be useful.

Some of us hesitate to breastfeed, for a variety of reasons. We may feel concerned about exposing our breasts in public, we may not know other women who nurse, or we may never have witnessed anyone breastfeeding before. If you are trying to decide whether to breastfeed your baby, learn more about breastfeeding. Ask nursing
mothers, female friends, or relatives to share their stories with you and answer questions and concerns you might have. You may also want to consider attending a La Leche League meeting to meet other nursing mothers and ask any questions you might have.

If your hospital doesn't provide sufficient breastfeeding support, or if you must return to work in a matter of weeks, you may feel as if the decision not to breastfeed—or not to continue an extended period of time—has been made for you. But breastfeeding for any length of time is better than none, because of the health benefits to both you and your baby. You may also find that you are able to overcome some of the physical or emotional inhibitions and obstacles that initially discouraged you from trying.

Breastfeeding is about building a relationship with your infant, and, like any long-term relationship, establishing it requires patience, give-and-take, and sometimes hard work. Most healthy newborns will be ready to nurse within the first hour after birth. Right after your baby is born, hold her or his belly skin to skin with yours. Most babies held in this position can locate the nipple and begin feeding on their own. Babies who have the opportunity to initiate the feeding process themselves are more likely to feed well as they grow.
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Your colostrum (sometimes called the “first milk”) is the best fuel for your baby during this learning phase. Frequent
skin-to-skin contact in the early days and keeping your baby in your room at night can make breastfeeding easier and help you get more rest.

I was lucky. My kids latched on right away after they were born. It's like they were showing me how to do it
.

Establishing a good “latch” or seal for breast-feeding is the single most important thing you can do to prevent sore nipples and other breast-feeding problems. A healthy latch is not painful and allows the baby to draw an adequate amount of milk from the breast. For most mother-baby teams, patience and practice are the keys to establishing a pain-free latch. To begin, it is important for you to know what a good latch looks like. Ask someone knowledgeable about breastfeeding, such as a nurse, midwife, or lactation specialist, to look at your baby's latch and give you feedback. You can also consult books and online resources that show images of correct latch.

Watch your baby and follow her or his signals. Learn to respond to the more subtle signs of hunger before your baby becomes agitated and starts to cry. Among the newborn's first signs of interest in food are little movements of the body, especially the hands moving near the head, smacking the lips, mouthing movements, seeking with the lips, rooting (turning the head in response to anything that touches the cheek), and bobbing the head. Babies who are awake and somewhat hungry will respond to the smell of their mother's milk and the closeness of her nipple by opening their mouths widely and sealing onto the breast and nipple. During the early days, breast-feeding frequently helps increase your chance of breastfeeding success. Put your baby to the breast at any sign of hunger. Rooming in with your baby at the hospital will help you learn to recognize and respond to these hunger signs.

Babies draw both nipple and breast tissue into their mouths when breastfeeding. To help your baby do this, line the baby up so that you are belly to belly and her or his neck is not turned to the side. When your baby's mouth is open wide, gently bring your baby to your breast, and insert your entire nipple and as much of the areola (the darker skin around the nipple) as possible into her or his mouth (flattening your breast with your thumb and index finger makes this easier). It is important to bring the baby to the nipple rather than leaning forward and pushing your breast toward the baby. The baby's lower jaw should be on the breast as far as possible from the nipple, so that the lower jaw and the tongue can draw
milk from the breast
.

Once the baby has established a seal, pause to look and listen. Your baby's cheeks should touch your breast, hiding her or his mouth. Your baby's lips, if you can see them, should be rolled slightly outward, away from your breast. If your baby's lips are curled in or under, gently break the suction by putting your pinkie between the nipple and the baby's mouth, and then try again (if just the bottom lip is turned in, you can pull down slightly on the jaw rather than relatching). Your baby's chin should be firmly planted on the breast. A good latch position will allow you to have good eye-to-eye contact with your baby. Listen for the sounds of swallowing and a shift in breathing between sucks. Watch to see if the baby's ears move, a sign that she or he is swallowing. If your baby is correctly positioned, you should not feel any pain. If feeding is painful, ask a nurse or lactation specialist for help.

She took right to the breast. Ahhhh, such a glorious feeling! Nothing in the world can match it. Such relief physically and mentally
.