One-Breast vs Two-Breast Feedings

I am often asked whether one breast or two breasts should be offered per feeding. This is a tricky question, and every mother/infant couplet should be considered individually. However, in the first couple of weeks after birth, a mother’s breasts may be somewhat engorged (normal fullness) as they begin to regulate milk production. Offering both breasts per feeding allows each breast some relief of pressure, and therefore comfort for mother. Later, after the initial couple of weeks, one-breast feedings may serve to balance the intake of fore-milk and hind-milk (a discussion all in its own).

Indicators of Adequate Infant Intake

New mothers often wonder how they can tell if their baby is getting enough milk. Fortunately there are several indicators that can be used to determine the adequacy of baby’s milk intake.

First and foremost is weight gain. Most babies lose some weight in the days following birth. However, once a mother’s transitional milk comes in, her baby should begin to gain. By two weeks of age, she should expect to see a return to birth weight. Breastfed infants typically gain between four and eight ounces per week thereafter.

Stool output and urination is another important means of gauging adequate intake. An infant who is receiving adequate amounts of milk (and therefore enough calories for growth) will stool at least three times in every 24-hour period by the time he is five or so days of age. Often the stool is yellow in color and has a pasty or watery consistency. Tiny white seeds or curds may often be seen. Wet diapers are important as well, but are only an indicator of hydration, not caloric intake. So, while at least five wet diapers in every 24-hour period is expected (and certainly encouraging), stool output is the most reassuring indicator of adequate intake by an infant under six weeks of age.

Your Breasts (and you) Need to Arrive Alive!

Please don’t pump and drive!!! Yes, we’ve all been warned about texting, talking on the phone, applying make-up, etc. while driving. Well, here’s another one for you!

Now that we have hands-free pumping options, it doesn’t mean we shouldn’t use good sense. Sure, those of us who are in a hurry to get to work would have loved to nurse before we left the house. But, unfortunately no one may have told the baby. Or perhaps you slept through the alarm. At any rate, imagine the look on the police officer’s face when you try to explain that the milk was overflowing the bottle and you let go of the wheel to turn off your breast pump. Or worse yet, that you aren’t drunk. Instead, the release of the hormone relaxin made you feel so relaxed and sleepy that you began swerving from lane to lane! Your breasts (and you) need to arrive alive.For your safety and the safety of others on the road, please don’t pump and drive! Pumping really can wait a few minutes until you reach your destination! :-)

Inverted Nipples

Today, an expectant mother asked me what she could do to prepare her breasts for breastfeeding. This is a common question, so I thought I might address it here with our group.

The most important thing a mother can do is to check to be sure she doesn’t have inverted nipples. Inverted nipples are those that retract (telescope in to the breast tissue) when the areola (brown area behind the nipple) is gently pinched together. The condition makes it difficult for a baby to latch correctly. If identified during pregnancy, treatment can be very effective in reducing the degree of retraction and facilitating an early attachment of infant to breast. So, if a mother thinks her nipples might be inverted, she can ask her doctor to check or call our lactation office for a recommendation.

Breasts: Small Versus Large

Breasts come in all shapes and sizes. Many women are led to believe that the size of one’s breasts will determine their ability to produce milk. Not true. Most of us are blessed with an ample amount of mammary (glandular) tissue that is responsible for making milk. Our mammary glands make up only a portion of our breast tissue. The rest is adipose (fat) tissue and is the greatest contributor to breast size. Women with large breasts will not necessarily make any more milk than those with small breasts. So, don’t let your breast size be your guide. Remember, breasts may be small…but they will be mighty!!!

Getting Started: The First Few Days

In many cases, the first few days of breastfeeding a newborn are quite different from what most of us have read or learned about breastfeeding. For example, we are told that a full-term baby will want to nurse about every two to three hours in the first few weeks. This is true. However, the first few days may throw us for a loop! Day one:Baby is often sleepy and may not awaken easily for feedings. This can be related to his tummy being filled with amniotic fluid (especially if born by cesarean) or by the store of fluids and nutrients transferred to baby in the days and hours just before birth. Day two:Baby is more awake and alert. His store of nutrients may now be depleting, and now he wants to nurse every hour! These are called “cluster feedings” and are baby’s way of letting mom’s breasts know that he will soon be ready for larger volumes. These frequent feedings not only help mom’s uterus to stay nicely contracted, but also allow baby to practice suckling before the voluminous transitional milk comes in. Days three to five: Mom’s transitional milk is coming in. Her breasts may change (blood and milk engorgement) and baby must re-learn how to latch to these “new” breasts. He must refine the way he suckles in order to handle the increased flow of milk. It is usually at this point that feedings begin to occur more consistently at two- to three-hour intervals. After the first few days, things begin to settle into more of a routine. Still there will be many more changes to adapt to. Life with a new baby can be challenging, yet wonderful. Just remember to eat, drink and sleep when baby sleeps, and let everything else go to pot!

I Think I Can, I Think I Can

Have you ever read the children’s book about the little engine that could? It is an inspiring story about the value of positive thinking and self-empowerment. When we are expecting our first baby, many of us feel worried about breastfeeding. This is completely normal, especially if we are going to be working mothers. In our culture of communication technology and information overload, expectant mothers often hear only about problems associated with breastfeeding. Unfortunately, that’s what people talk and write about. They may not hear the scores of wonderful, successful breastfeeding stories (yes, even for working mothers)! In most cases, especially when there are expert clinical resources, women and their babies do quite well with breastfeeding. One thing to remember is that, as women, our bodies are built for growing, birthing and breastfeeding babies. So let’s not forget that! Yes, indeed, I think you can, I think YOU can!