Replies to '10/07 The Latest Debates'

I would love to help you with your supply issue. Did you see a lactation consultant with the other 3? Sometimes doctors are quick to encourage formula because they are worried about babies not thriving, but formula interferes with supply. If you want you can email me at amyphilo@yahoo.com and I can talk about it in private, otherwise here is some general advice: 

1) Initiate breastfeeding within the first hour of birth, preferably the first half hour. During this time the baby is receptive to nursing. 

2) Keep baby with you in room during hospital stay at all times, or go with baby for testing if necessary. Feed on-cue. This can mean almost round the clock nursing for some babies. If you don't feed often enough in the beginning, it takes longer for milk to come in, and to build up supply. Do not give glucose water or formula supplements during this crucial time, unless a doctor orders it. Do not trust the nurse, insist on talking to the doctor and finding out what is the medical reason for doing so. Babies lose weight in the beginning, and the weight standards are based on formula babies, not breastfed babies. If jaundice or other condition sets in, follow the supplement orders but do so with a cup or a dropper, not an artificial nipple.  

3) Do not stop after 10 or 15 minutes on each side unless baby is totally finished. Feed on as long per side as baby wishes so the breast can be nearly emptied, stimulating more milk production. This also gets the baby the hind milk, which is more like cream and less like skim milk, baby will be less fussy and less hungry in between feedings. Then if baby is still hungry, switch breasts once the baby stops for good on the first breast  or starts to act fussy on it, as this may mean it's almost empty. 

4) Don't forget to empty both breasts by alternating which breast you start with at each feeding. 

5) Do not use pacifiers to soothe a baby. Comfort nursing helps build supply, and a pacifier for a nursing infant could be undermining the infant's sense of getting food when he is hungry. Since you don't know if the baby is hungry or wants to nurse for comfort, go ahead and offer the breast. Better to soothe where there was no hunger than starve because you think baby is not hungry and just wants to be soothed. Breastfed babies do not overeat, they take exactly what they need. If you are not offering bottles or pacifiers, they will get plenty of milk. 

6) Feed at least every 2-3 hours, but 1-2 hours in the beginning. Breast milk is digested very quickly. 

7) Do not introduce a bottle or a pacifier at all unless breastfeeding is well established. If you have to introduce a bottle, do so by 2 weeks of age, but it should be pumped milk so as not to interfere with demand and supply. 

8)Nursing works on demand - supply therefore if you go a long time between feedings your supply will go down because there is no demand. That is why it's better not to give supplemental bottles of formula, with each bottle of formula you deprive your body of stimulation to make more milk. 

9) Night nursing helps keep up supply, as prolactin is at different levels at night than during the day. If you go a full 8 hours without nursing, eventually you will dry up. Easiest way to do this is to cosleep. 

Common things that interfere with supply if no formula supplementation or nipple confusion is involved are: hormones from birth control, not nursing  often enough, or not drinking enough water, and pregnancy. 

If you have problems again you might need to see a lactation consultant or IBCLC. Also, you can check out some real expert advice on: 

www.lalecheleague.org (Local La Leche League leaders can also help you solve these problems in person but if you have major problems they will recommend an IBCLC) 

www.askdrsears.com 

http://www.thebirthden.com/Newman.html (lots of how tos) 

www.promom.org (info on benefits as well, and discussion boards for support) 

I would love to help you with your supply issue. Did you see a lactation consultant with the other 3? Sometimes doctors are quick to encourage formula because they are worried about babies not thriving, but formula interferes with supply. If you want you can email me at amyphilo@yahoo.com and I can talk about it in private, otherwise here is some general advice: 

1) Initiate breastfeeding within the first hour of birth, preferably the first half hour. During this time the baby is receptive to nursing. 

2) Keep baby with you in room during hospital stay at all times, or go with baby for testing if necessary. Feed on-cue. This can mean almost round the clock nursing for some babies. If you don't feed often enough in the beginning, it takes longer for milk to come in, and to build up supply. Do not give glucose water or formula supplements during this crucial time, unless a doctor orders it. Do not trust the nurse, insist on talking to the doctor and finding out what is the medical reason for doing so. Babies lose weight in the beginning, and the weight standards are based on formula babies, not breastfed babies. If jaundice or other condition sets in, follow the supplement orders but do so with a cup or a dropper, not an artificial nipple.  

3) Do not stop after 10 or 15 minutes on each side unless baby is totally finished. Feed on as long per side as baby wishes so the breast can be nearly emptied, stimulating more milk production. This also gets the baby the hind milk, which is more like cream and less like skim milk, baby will be less fussy and less hungry in between feedings. Then if baby is still hungry, switch breasts once the baby stops for good on the first breast  or starts to act fussy on it, as this may mean it's almost empty. 

4) Don't forget to empty both breasts by alternating which breast you start with at each feeding. 

5) Do not use pacifiers to soothe a baby. Comfort nursing helps build supply, and a pacifier for a nursing infant could be undermining the infant's sense of getting food when he is hungry. Since you don't know if the baby is hungry or wants to nurse for comfort, go ahead and offer the breast. Better to soothe where there was no hunger than starve because you think baby is not hungry and just wants to be soothed. Breastfed babies do not overeat, they take exactly what they need. If you are not offering bottles or pacifiers, they will get plenty of milk. 

6) Feed at least every 2-3 hours, but 1-2 hours in the beginning. Breast milk is digested very quickly. 

7) Do not introduce a bottle or a pacifier at all unless breastfeeding is well established. If you have to introduce a bottle, do so by 2 weeks of age, but it should be pumped milk so as not to interfere with demand and supply. 

8)Nursing works on demand - supply therefore if you go a long time between feedings your supply will go down because there is no demand. That is why it's better not to give supplemental bottles of formula, with each bottle of formula you deprive your body of stimulation to make more milk. 

9) Night nursing helps keep up supply, as prolactin is at different levels at night than during the day. If you go a full 8 hours without nursing, eventually you will dry up. Easiest way to do this is to cosleep. 

Common things that interfere with supply if no formula supplementation or nipple confusion is involved are: hormones from birth control, not nursing  often enough, or not drinking enough water, and pregnancy. 

If you have problems again you might need to see a lactation consultant or IBCLC. Also, you can check out some real expert advice on: 

www.lalecheleague.org (Local La Leche League leaders can also help you solve these problems in person but if you have major problems they will recommend an IBCLC) 

www.askdrsears.com 

http://www.thebirthden.com/Newman.html (lots of how tos) 

www.promom.org (info on benefits as well, and discussion boards for support)