How To Succeed In Breastfeeding

By Jeff Cersonsky, MD, FAAP

“I want to try breastfeeding my baby. Any suggestions?”

This question (or variations) frequently comes up at a prenatal visit when I meet expectant parents who are looking for their future pediatrician. I am encouraged by all the new mothers who want to breastfeed. Breastfeeding is one of the most important things you can do for your new baby. It provides protection against infection, a complete natural nutrition for the first six to nine months, is inexpensive, delays allergy development, and fosters a closeness between baby and mother.

I usually point out to parents that there are essentially only two reasons why a mother would not succeed in breastfeeding. One is that they did not really want to breastfeed to begin with and felt “pushed” into it. Breastfeeding is a commitment that requires dedication and persistence and a mother whose heart is not behind it could have a more difficult time. That said, many mothers in this situation find they love breastfeeding after all and are successful.

The second reason that mothers might not succeed in breastfeeding is they do not seek the proper advice. When a problem is encountered, frustration can too easily set in if the mother does not ask the right people. Humans have been breastfeeding for thousands of years! Most of the time, breastfeeding goes smoothly and no advice is necessary. Who are the right people when there is a problem? There are several resources that a mother might find helpful. Many hospitals now have a lactation consultant on staff and she can be an indispensable asset to assist the mother with breastfeeding. There are independent lactation consultants in most communities as well. Other sources are La Leche League, the mother's obstetrician or nurse midwife, the baby’s pediatrician or pediatric nurse practitioner, or simply another mother who has successfully nursed her baby.

There is no way in a short article such as this to go over all the nuances of successful breastfeeding, but following are some common situations and solutions:

“My nipples are too sore.” Most lactation experts believe that, aside from a little discomfort, any soreness is related to technique. If the baby puts a lot of traction on the nipple, the nipples will become very sore. The baby should be placed close enough to the breast so that she does not pull too much on the nipple while nursing. Of course, always make sure the baby’s nose is uncovered. Contact a lactation consultant if you are having this problem. If you see redness or have swelling or thick discharge, contact your physician or midwife in case an infection has developed.

“The baby is starving, yet my milk is in.” Babies have a tremendous need to suck. In addition, crying is one of the few ways a baby can communicate effectively. Put these two facts together and what happens is that a baby who is crying a lot is interpreted as being hungry when that may not be the problem at all. The mother puts a pacifier or bottle in the baby’s mouth, and she sucks and calms down. The natural interpretation is the baby is not getting enough from the mother. That is usually not true. The baby is exercising her need to suck and the cry could mean anything from a wet diaper, feeling cold, or a basic need to cry. The pediatrician or lactation consultant can make sure that the baby is getting enough nutrition (sometimes by weighing her) and nursing can continue.

“The baby does not want to suck on the breast and prefers a bottle.” Learning to suck on a bottle nipple is much easier than sucking on a mother’s nipple. Therefore, I recommend that mothers not even try a bottle until the baby is at least 3 weeks old and an old pro at nursing. However, if a bottle is introduced and the baby prefers it, it might be necessary, again with the proper advice, to discontinue the bottle and let the baby learn how to nurse. Once breastfeeding is established, a bottle might be introduced later for convenience.

Countless books have been written giving advise on breastfeeding, but another human who has experience or training can often be more helpful than any book. I have copies of a helpful booklet put out by the American Academy of Pediatrics about breastfeeding that I would be happy to send to you. Email me at jmcsdii@erols.com or call my office in Southbury at 203-264-2212.