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Best Tips for Breastfeeding
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If you don't start breastfeeding with the attitude that you are going to do it no matter what, the first few weeks will not make you want to. It is crazy painful, I had mastitis twice, and you are sleep deprived. But if you stick with it, it is so so worth it.
Enter the nursing coach, Linda Hanna. She is the most knowledgable and supportive woman you will ever meet. She arrives in what was once a van, now a living room on wheels, and helps moms with any and all nursing problems they are having.
Below you will find the most common questions new moms have and her best advice. I have added links to my favorite products.
 
Q: What will I really need to get started breastfeeding at home?
A: Getting started requires very little. You’ll need:
  1. comfortable bra that is soft and easy to open for nursing.
  2. A relaxing breastfeeding space at home. Find a comfy chair, a footstool to rest your feet on while nursing, a few pillows (preferably one nursing pillow and one or two pillows for your back and shoulders), and a small table to keep your nursing supplies, water bottle, and snacks within reach.
  3. A natural nipple cream or nipple butter to soothe your nipples after nursing.
  4. Soothing gel pads and washable or paper nursing pads.

Q: What does it mean if I am having a painful latch on with my baby, and what do I do to fix it? 
A: A painful latch is almost always due to either a shallow latch or an incorrect placement of the baby’s mouth around the nipple/areola area. If you feel pain with latch on, remove the baby gently and reposition him or her. Retry this until it feels right. A pain score of 4 or higher means something is not right, and generally requires a do-over. Keep in mind: some pain at the nipple may also be caused by previous irritation that has not fully healed. 

If there is a burning pain with nursing after the 2nd or 3rd week of life, see your lactation consultant or health care provider to check for a possible infection. Any pain associated with nursing should be treated as soon as possible. Nursing should not be painful.

Q: How often will the baby need to nurse?
A: Your baby will need to nurse 8-12 times in a 24-hour period. Some feedings will be close together (e.g. every 1.5 hours), and other feedings will be 3-4 hours apart. Watch for feeding cues: licking, tongue movements, hands at mouth, fussiness, crying, or whining. Some feedings will be short (e.g. 5-15 minutes) and other feedings will be longer (e.g. 45 minutes). Feeding for more than 60 minutes is considered unusual and it may be that the baby is comfort nursing, not transferring milk. If you are okay with this behavior, comfort nursing is fine. But, just know that not every feeding should have to be this long. 

Q: How will I know if my baby is getting enough to eat while nursing?
A: To determine effective milk transfer, you will want to count at least 4-6 wet diapers every 24 hours, and at least 1 – and as many as 10 – healthy bowel movements in the same 24 hour period. If your baby is meeting these numbers every day, this is a good sign. Your baby should be calm, content and restful after nursing, and having at least 2 or 3 2-hour sleep periods every 24 hours. Your baby should also be gaining weight after the 2nd or 3rd week of life at a rate of 0.5-1 oz. per day, or 1-2 lbs. per month, at minimum. 

Q: What should I do if my baby needs supplements?
A: If your baby requires supplementation, you would want to use your pumped milk first, if available. If you don’t have enough, then a formula will be the next option. Some parents will want to use donor mother’s breast milk – talk to your pediatrician and lactation consultant about this option. Formulas do differ, so talk to your pediatrician and lactation consultant about this option as well, before purchasing a formula. 

Use supplements after the baby nurses on you. Consider ways to offer the supplement without using a bottle/nipple (e.g. a supplemental nursing system), if you are concerned about the baby being able to nurse afterward. Good to know: most infants will switch back and forth between breast and bottle without any issues. 

Q: Is there anything I shouldn’t eat or drink while nursing?
A: There are no restrictions on the breastfeeding mom’s diet, unless you have your own dietary restrictions due to a health condition or allergy. There are certain foods that should be consumed with caution such as raw eggs, raw meats, raw fish, and cheeses, which may contain bacteria that can be harmful to you or your baby. Those foods should be eaten in moderation. If you have any unusual symptoms from foods, talk to your health care provider about restricting those foods for some time. 
 
Q: Can I drink alcohol when I am still breastfeeding?
A: It is recommended that you wait to consume alcoholic beverages until your baby is at least 4-6 weeks old. To reintroduce alcohol to your diet, start by having half of a glass of wine or beer and plan to continue nursing at your next scheduled feeding time. Observe your baby's behavior to see if there are any effects such as sleepiness, irritability, or disinterested nursing. If you notice any of these causes for concern, wait until your baby is a little older to consume alcoholic beverages again. However, since the majority of breastfeeding moms who consume an occasional glass of wine or beer notice no effect in the baby, you should be able to continue having a drink with dinner once a week after your baby has passed 6-8 weeks of age. 

Alcohol will remain in the breast tissue for 2-6 hours after consumption, but it is not harmful to the baby in small quantities. Therefore, you should not have to wait to breastfeed after consuming just one drink. However, when you've consumed more than 2-3 alcoholic beverages in a 2-hour period, you have the option to either "pump and dump" (tossing the milk out and giving your child milk from your previously pumped supply, not pumping and dumping and then immediately feeding on the boob), or you can "pump and pool," which means storing pumping milk and mixing it with milk from other pumping sessions which effectively dilutes the alcoholic content. Use alcohol with caution, as you would with any prescription medication, and don't hesitate to contact your lactation consultant or health care provider with any additional questions.  

Q: Are there any things I can do to help increase my milk supply?
A: There are many things a mom can do to increase her supply. Milk removal promotes increased milk production; so, first try extra minutes of nursing or pumping. You must remember to eat and drink well. Replace fluids with each feeding/pumping session. Consume foods high in galactagogue quality such nuts (except peanuts), dark leafy greens, chickpeas (e.g. hummus), sesame seeds, oats, barley, wheat, fennel, dill, and fruits. Herbal supplements such as goat’s rue, fenugreek, thistle, and nettle, also encourage lactation. Find additional information online in the My Nursing Coach Learning Center.  

Q: When is the best time to pump my milk?
A: Ideal times to pump are shortly after a feeding session, and early in the morning. Each pumping session will yield a different quality of milk, so be sure to combine the milk produced various sessions throughout the day. Pumping time should be 15-18 minutes (slightly less or more is okay too). And remember, pumping should not be painful!

Q: Is there a best time to introduce a bottle of pumped milk?
A: Although introducing a bottle of pumped milk may need to occur early on for some infants, if you can, wait until breastfeeding feels like a positive experience for both you and the baby before introducing a bottle.  You want to establish a strong breastfeeding relationship between you and your baby so the baby does not completely reject the nursing experience once the bottle is introduced. For some moms, that is two weeks post-delivery, and for others it can be as much as 6 weeks post-delivery. Having a positive attitude and confidence in your breastfeeding ability will help establish that positive relationship. 

Q: Will I be able to continue to nurse when I return to work?
A: Many moms breastfeed and pump for months after returning to work. Make every effort to establish a routine for home, daycare and work that allows for you to be as comfortable and relaxed as possible. Transitioning back to work can be stressful and may cause your milk supply to drop if you are not staying in a day-to-day routine that keeps you calm and relaxed. It is possible, but it takes planning and practice.
 
Linda M. Hanna, RNC, MSN/Ed., IBCLC, is a pioneer in maternity healthcare and breastfeeding education with over thirty years of clinical care experience. She has developed breastfeeding and baby care programs for several Los Angeles hospitals, including Kaiser Permanente and Cedars-Sinai. In 2010, Linda embarked on a new adventure and launched My Nursing Coach, the nation’s first mobile breastfeeding center. Today, Linda and her growing team of expert lactation consultants provide the highest quality at-home breastfeeding support and education to new mothers across Los Angeles. 
 
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