The Basics of Breastfeeding by Atrium Health

April 17, 2019

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This is a shortened version of an article featured in Atrium Health’s “Your Guide to Pregnancy & Motherhood.” It includes 26 articles, plus frequently asked questions about breastfeeding. To read more, get your free copy of the guide

Breastfeeding is one of the most natural parts of being a new mom. So, why doesn’t it always come more naturally?

For as easy as it might look or seem, here’s the truth: Breastfeeding can be difficult for you and your baby. But just like everything else with motherhood, it’s something you’ll figure out together.

Why breastfeed?

Breastfeeding is supported by all medical organizations, and for good reason: From improving digestion to strengthening the respiratory system, the benefits of breastfeeding go far beyond just keeping your baby fed.

Breastfeeding also helps build your baby’s immune system, with many studies showing that it can keep your little one from getting sick. “We think the white blood cells in breast milk play a huge role in protecting your newborn,” says Ariel Haddad, DO, an OB/GYN at Atrium Health NorthEast Women’s Health & Obstetrics.

When you breastfeed, you pass on immune system properties that keep your baby healthy. So, while many moms think they need to stop breastfeeding when they’re sick, the opposite is true.

In fact, the Centers for Disease Control and Prevention (CDC) even encourages moms to breastfeed when they have the flu. This is advice that Jan Ellen Brown, IBCLC, RLC, a lactation consultant at Atrium Health Levine Children’s Charlotte Pediatric Clinic, gives her own clients. “Your breast milk makes antibodies for your baby that can protect them,” adds Brown, who has more than 29 years of experience helping new moms learn to breastfeed.

According to the CDC, flu vaccinations are a perfectly safe way for breastfeeding moms to fight off the flu. To see what else the CDC says about breastfeeding, visit cdc.gov/breastfeeding.

Breastfeeding is good for your baby, but Dr. Haddad says it can be good for you, too. Not only have studies shown it can reduce your risk for breast cancer, but it can also boost your mental health. “They haven’t really been able to study this long-term, but if you look at postpartum depression scores, a lot of them are better in breastfeeding moms than non-breastfeeding moms,” she adds.

From the fat to the carbohydrates to the lipid components, breastfeeding gives you peace of mind that your baby is getting exactly what they need to grow healthy and strong. Plus, unlike formula, you don’t have to worry about your breast milk getting recalled at the grocery store.

From latch to leakage: Here are some common challenges

Although breastfeeding can be a completely new experience, there are certain things you can learn now that will prepare you for later.

For one, there’s the latch. The latch refers to the moment your baby latches onto your nipple – and it’s perhaps the most important part of breastfeeding your baby comfortably.

When it comes to latching and positioning, here’s a rule of thumb: If it hurts, it’s time to reposition. “Breastfeeding has some level of discomfort, especially when the infant is first figuring things out,” says Dr. Haddad. “But immediate, sharp-shooting pain is a sign that they’re not latching properly.”

Like with anything else, practice makes perfect, so be sure to practice latching and positioning before you leave the hospital. “Get out of the hospital bed and into a chair,” advises Brown. “Simulate your positioning for when you get home.”

The latch isn’t the only breastfeeding challenge to prepare for. For the first month or so after giving birth, you might notice that your breasts are producing milk – even when you aren’t feeding your baby. This is normal, natural and varies from woman to woman. “Some mothers will leak when it’s time to feed their baby, and others will leak if they’ve gone too long between feeding and pumping,” says Brown.

Whether your leaking is profuse or just an annoyance, Brown says nursing pads can make breast milk leakage – which she fondly calls “Mother Nature’s escape valve” – a little more manageable. These pads go directly on your nipples and can help keep milk in your breasts while you’re out and about.  

Just as pregnancy can change your body, so can breastfeeding – but the changes aren’t the same for everyone. Breastfeeding can affect everything from your weight to your bone density, but any bone density loss is only temporary.

Breastfeeding can mean lots of changes to your body, and to your breasts in particular. “When you’re pregnant, your body prepares your breasts for breastfeeding,” says Brown. “Some mothers notice this early in pregnancy and will increase a few breast sizes. Others won’t notice any change. And changes to shape vary for everyone.”

You might also notice that your breasts are swollen and sore. This is called engorgement and can happen when your breasts continue producing milk between pumping and feeding your baby.

But for any breastfeeding mom, the biggest concern isn’t the latch, the leaking or even the changes to her breasts: It’s whether her baby is getting enough to eat. “A lot of unexpected challenges stem from not knowing how much milk your infant is actually getting,” says Dr. Haddad. “And you might feel concerned because you don’t know if your infant is hungry or if they just want the comfort of your breast.”

We all think that newborns should know what to do when it’s time to breastfeed, says Dr. Haddad. But this isn’t always the case. And just like it can be hard to know what they want, it can be even harder to know when they’ve had enough. Wet, poopy diapers are certainly signs that your baby is fed – and so is weight gain, which is tracked by your pediatrician at every newborn wellness exam.

As Dr. Haddad says, breastfeeding can be a leap of faith at times – but it’s almost always a leap worth taking.

Whether formula or breast, fed is best

There are a number of reasons a mom might not be able to breastfeed – or simply might choose not to. Nipple abnormalities, for example, can pose a challenge and make breastfeeding painful.

One of the most common reasons moms choose not to breastfeed is because they aren’t producing enough milk. “Especially if failure to thrive or weight gain are issues for the baby, many women choose not to breastfeed due to inadequate milk supply, which can cause the infant to not grow as well,” says Dr. Haddad.

If you’re concerned your baby isn’t getting enough milk – or are worried that you might have a nipple abnormality – don’t hesitate to talk to your doctor, your baby’s doctor or a lactation consultant. They’ll help ease your fears and guide you to a solution that’s best for you and your baby.

Though your body might be a major factor in whether or not you choose to breastfeed, there’s one other thing many moms consider – and that’s convenience. “Especially if a woman has another child at home – and needs a little more sleep – she might choose formula,” says Dr. Haddad.

Because formula-fed infants aren’t fed as frequently as breastfed infants, they tend to sleep a little longer between meals. 

Although breastfeeding can help you bond with your baby, Dr. Haddad wants you to know: Formula feeding won’t stop you from bonding with your baby. “There are other ways you can bond with your infant,” she says. “You can feed your baby their bottle with formula and put them on your chest, so they know your warmth and contact are still there.”

If you’re still trying to decide between breastfeeding and formula feeding, Brown says it’s okay to make a decision – or even change your mind – after your baby is born. “Many mothers will partially breastfeed and offer formula bottles, too,” says Brown. “It’s not all or nothing.”

But do keep in mind that most doctors recommend that you exclusively breastfeed for the first 6 months, if possible.

Whatever the reason might be, if you find that breastfeeding just isn’t working for you and your baby, don’t worry – your baby will still be taken care of. “A fed baby is a happy baby, so whatever works best for you and your family is ultimately what we strive for,” says Dr. Haddad. “Surrounding yourself with a really good support system of positivity is really what allows you to best succeed in whatever you decide to do.”

And as the science community continues to analyze and understand what’s in breast milk, formula companies continue improving their products. Formulas are made to mimic breast milk as closely as possible, and there are plenty of high-quality formulas out there that will feed your baby healthfully. 

Ask for help when you need it

Dr. Haddad and Brown agree: Breastfeeding is a work in progress – and no two experiences are alike.

If you’re facing some breastfeeding challenges, don’t be afraid to ask for help. Your care team is there to assist you, but Dr. Haddad and Brown both suggest turning to a lactation consultant for expert support. Like Brown, these board-certified breastfeeding consultants can give you guidance on everything, from the first latch to any feeding issues your infant might be having.  

“As much as the internet is part of our society, it’s an added benefit to have someone there physically showing you what the correct placement is and guiding you to what’s normal and what’s not normal,” says Dr. Haddad.

And one last word of advice: The most natural thing about breastfeeding is that it doesn’t always come naturally. “Breastfeeding is challenging, despite how natural it is,” says Dr. Haddad.

So don’t be hard on yourself if breastfeeding is more difficult than you thought, or if you decide not to breastfeed at all. “Moms are very hard on themselves and impose guilt and ‘should haves’ as they figure out what’s best for them and their baby,” says Brown. “Relax and enjoy. As the saying goes, ‘The days are long, but the years are short.’”

This is a shortened version of an article featured in Atrium Health’s “Your Guide to Pregnancy & Motherhood.” It includes 26 articles, plus frequently asked questions about breastfeeding. To read more, get your free copy of the guide