Well-Being//

Ask the Expert: The 5 Important Things You Need to Know for Successful Breastfeeding

Dr. Nick Papaevagelou shares expert tips, tools and support a mom needs when deciding to breastfeed

Getty Images
Getty Images

There are countless worries when you become a new mom—and one that causes many of my patients anxiety is breastfeeding.  If you look back 12 years, the most common breastfeeding question I got was, “Dr Nick, how can I slow down my milk supply?” At that time, most patients were choosing formula.  Fast forward to 2014, there was a cultural shift and more women were choosing to breastfeed. Now, the biggest issue is milk production, or lack-there-of. Be it the anxiety of becoming a parent or bodies not producing milk for a multitude of reasons —mothers are overwhelmed and are feeling inept if they start having trouble with producing milk. Wanting to help mothers who would like to breastfeed, I make sure to spend the first few initial visits with new and old parents talking about breastfeeding and all that comes with it.  

This goes beyond my experience as a doctor. Seeing my wife going through the same troubles with breastfeeding when our daughter came. Whatever discussion a parent makes about feeding their child, it’s a doctor’s job to help alleviate some of the pressure and stress that comes along with it. 

If you do choose to breastfeed, consider five important factors:

MILK TAKES TIME TO COME IN 

In a day and age where we want and expect to see results immediately, moms need to be patient with breastfeeding. For almost all, milk will come in if you give it time. There is a lot of unknown with it. Patients will ask: “How much is actually coming out? How do I know if there are eating enough? Why is my baby hungry all the time?”  Your body knows a baby doesn’t need a lot of milk to fill up in the first few days, even in the first few weeks of life, so it just produces enough to keep your little one full enough for an hour or two until hunger strikes again. 

The example I give my parents is simple: Imagine your child’s stomach as your car’s gas tank. If you fill the tank to the top, your car will run for 500 miles, but if you just fill it above the empty line it will run for a lot less. Same goes for your child’s stomach. If you fill up the stomach to the top, either with formula or pumped breastmilk, your baby won’t be hungry for 3-4 hours, small feedings will get them to eat again a lot sooner, usually within an hour. Again, there’s a reason for that. Your body needs that increase in frequency of feeds. The more feedings your baby initially has, the more milk your body will produce to meet those demands.  

Every baby is different, but  a general rule-of-thumb is a breastfed baby will take 8-12 feeds per day, roughly every 2 hours.  In the beginning, if you try to bunch a couple of feeds before the 2 hour mark during the day, you might get lucky enough to go through a 3-4 hour stretch of sleep at night. Trust that your body will be producing what your baby needs. Also, your baby will stop eating if they are full.  

PRO TIP: Your milk should start coming in within 5 days after a vaginal delivery and up to a week after a c-section. As your body adjusts to the demands of your baby it might take up to 3-4 weeks to get a schedule going. In the meantime, try to feed at least every 2 hours or sooner according to their demand.

STRESS IS A MILK KILLER

This is a bit of a controversial one that is debated in the medical community, but I see it in my practice time-after-time. As I mentioned milk will take time to increase, but with the waiting for some, stress levels increase.  As challenging as it may be, try your best not to get stressed out —there’s a reason for taking it’s time. Your body knows in the beginning your baby will be ok with frequent small meals. By the 3rd week, your body should start adjusting and start producing the amount your newborn needs to last a little longer before the next meal. Many mom’s start overthinking and their brain focuses on everything other than producing milk. There’s no parent that has no stress, but if you keep overanalyzing your milk production it will make it impossible to reach your goals.

PRO TIP: To stimulate milk production and capture more milk to build up your reserve, you can also pump in between feeding sessions. Experts say since your prolactin levels (a hormone that makes your body produce milk) are high while you’re breastfeeding try to pump 10-20 minutes after a feeding session. It might not work for everyone, but it will not hurt to try. You can stash the milk in your freezer and use for a date night, when you go back to work, or if you need it on another date.

SUPPORT IS NEEDED

When my baby girl was born, I was lucky enough to have a couple of weeks off to help out my wife. She was ecstatic.  Her stress level was lower since I was in the house and I was her “water boy.” I got her water as soon as her cup was empty, while she kept breastfeeding throughout the day. Staying hydrated is a huge factor in keeping your supply up.  I tried to be as understanding as possible and help with positioning the baby for feedings, stay with the baby while she took short naps, as well as offer kind words of encouragement. 

The support of course could come from anywhere whether it’s your spouse, significant other, parent or a friend —don’t be afraid to speak up and ask for help.  Another breastfeeding mom friend is a great option —things will happen that you may not understand and they are going through it too. Speak up and reach out. Your support could also come from your pediatrician. I always try to encourage my mom’s with every visit and make sure to let them know to call me for anything they feel is important to them. Overnight your body and life changes. Please do not try to be brave and carry all that by yourself, seek support —you deserve it. 

DRINK LOTS OF WATER

This is a simple one. I mentioned it before, but bears repeating. You can’t produce fluids if you don’t drink fluids. My rule of thumb, whatever it took you to hydrate yourself prior to pregnancy, double or even triple it. If you’re not drinking enough liquids, your body will never reach its potential and your milk supply will never rise. Go fill that glass up right now! 

DON’T BE SHY TO ASK HELP FROM A PROFESSIONAL EARLY

Starting at hospital. When you are there, ask to see the lactation specialist on staff. Have them show you how to get your baby to latch, give pointers, tips on how to increase milk supply, teach you to self express. They are there to help you feel confident before you leave. If there’s issues with the baby’s latch, they will see it and give guidance to next steps. After the hospital, if you are having issues with latching or sore breasts / mastitis, you could also find lactation specialists around your neighborhood that will come to your house. A great place to look for certified lactation consultants is www.lalecheleague.com. 

You should also talk to your pediatrician if there’s latch issues. In certain instances,  there might be an organic cause for the lack of latch such as a tongue tie or a lip tie that will need to be released with a very simple surgical procedure by an ENT. Sometimes a high arched palate can produce a difficulty in achieving great suction and a good latch that can also be evaluated by your pediatrician. Use the professionals  to your advantage. Both a lactation consultant and a pediatrician should work together for you to achieve the best latch possible to get the breastfeeding right immediately. 

The most important thing to remember is that this is a new skill and you are both learning.  You are doing your best and your baby knows that. Be patient with yourself —you’ve got this! 

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