It’s World Breastfeeding Week, so a lot of us doulas have boobs on the brain. Ha! And if you are the parent of a new baby that you are trying to breastfeed, you probably do too.
We’ve all heard that breastfeeding is natural and instinctual, but if this is true, then why is establishing breastfeeding so hard for many new mothers?
I heard from a wise person once, that breastfeeding is natural the way that walking is natural, not the way that breathing is natural. One of those things - breathing - we just do - without any thought, without any practice. The other thing - walking - we have to learn and it takes time and many stumbles before we get it right. So breastfeeding might be natural, but it takes a lot of practice and requires overcoming quite a few stumbling blocks to get there.
If you are in that stumbling phase right now, here are some of the challenges you might be dealing with:
Ouch! This is the part of breastfeeding that totally sucks (no pun intended). For many first-time breastfeeders, some nipple soreness is normal and to be expected. Your sensitive nipples are not used to this kind of treatment. And depending on your own tolerance for pain, this feeling can range from mild soreness to real pain.
However if the soreness persists, if your nipple appears crushed or pinched after a nursing session, or if you begin to develop cracked or bleeding nipples, you probably need to work on achieving a deeper latch with your baby. Remember to bring baby’s nose to your nipple, tickle it, wait for a nice wide open mouth and up-turned head, and then give baby a nice, firm assist on to the nipple. For some more tips on soothing sore nipples, check out this blog.
And if after all of your best efforts to achieve a nice, deep latch, the nipple pain and soreness persists, then it’s time to call a good International Board Certified Lactation Consultant (IBCLC) to figure out what’s going on.
Another one of the most common early breastfeeding challenges is engorgement. So why do your breasts get so engorged? This happens for a couple of reasons. First, it takes several days for your milk to transition from colostrum, that golden-colored pre-milk, to full, mature milk. But once that transition is complete, that mature milk really seems to come in with a vengeance.
Combine this increased flow with a sleepy newborn baby who is not very efficient at draining the breast and you get engorgement.
So how can you deal with engorgement? Our best advice is frequent AND efficient nursing sessions. Put baby to the breast as often as you can (or as often as you can stand it - I mean you’re not a breastfeeding robot) during these early days. And while your baby is at the breast, practice frequent breast compression or massage - with your thumb and index finger, gently press in and downwards, to move milk through the ducts and out of the nipple - in order to keep baby actively nursing. This is a great trick to keep those sleepy nursers eating.
It’s important to stay on top of engorgement and work through it as quickly as possible to avoid things like plugged ducts or even the dreaded mastitis.
And if the pain of engorgement becomes too much, alternate some warm (before nursing) and cold (after nursing) compresses for relief. And then nurse, nurse, nurse.
Stress and Worry
Believe it or not, we often find stress and worry to be some of the biggest challenges in early breastfeeding. An important hormone for breastfeeding is oxytocin - when oxytocin flows, milk lets down from the alveoli and flows through the ducts and out through the nipple. But if you are incredibly stressed, all that stress can block the oxytocin hormone and make it harder for milk to let down.
And we get it. Having a new baby is stressful so it’s not as easy as just saying don’t be stressed. But there are things we can do to try and reduce stress while breastfeeding. Find a calm, relaxed place in your house to feed your baby - a place where you are comfortable, have everything you need at your finger tips, and can just focus on your baby. Take some nice deep breaths as you raise and drop your shoulders. Practice some calming affirmations, such as “Breastfeeding is comfortable and relaxing and something that I can do.”
And in addition to stress, we also see worry - worry that baby is getting enough to eat - as one of the biggest challenges to early breastfeeding.
Sometimes this worry leads new breastfeeding parents to doubt their ability to bring in a full milk supply and fully feed their baby. So how do you know that your baby is getting enough to eat? Track the number of wet and soiled diapers your baby gives you in a 24-hour period. At four days and older, your baby should have 6-8 wet diapers and 1-3 soiled diapers in 24 hours (and often times you get a LOT more than that). Your baby should also have periods of alertness and wakefulness during the day as well as appearing well-hydrated.
If your baby checks all those boxes, your baby is getting enough to eat. But of course, if you just can’t shake that doubt or something just doesn’t seem right, never hesitate to reach out to an IBCLC for help.