Tuesday, August 2, 2011

Breastfeeding – What do I need to know before I deliver?

Well, there are many things to think about with breastfeeding before you deliver your little bundle of joy. Just the fact that you are asking the question, though, is the first step in the right direction.

Breastfeeding is the normal way to feed your baby. I’ve read several posts recently from bloggers talking about how the catch phrase “Breast is Best” is simply wrong. I have to say that I agree with them. Not because it’s not the best (we obviously know it is), but because it implies that while it’s the best thing for your baby, formula is ok too, and even if you can’t* nurse your baby or don’t want to, you don’t have to give your baby the best – "good enough" is good enough, right? And formula is a "good enough" alternative to the "best" breastmilk. The point is, that breastfeeding is normal. Just like we were made to give birth to our babies, and only about 12% or so of us should actually need a cesarean to deliver, we were also made to nurse them! Our breasts are not just something pretty that our husbands really enjoy looking at. They were made to nourish our babies. They do it so well, in fact, that the different types of milk that we produce is actually exactly what our baby needs, exactly when they need it. It is alive and perfect. How amazing is that? To actually visualize it, check out these pictures of breastmilk, cow milk, and formula under a microscope and see if you can tell the difference. Pretty amazing, huh?
Ok, so now that we’ve established that breastfeeding is normal, let’s dive into what you should know before you deliver.

Third Stage of Labor – Many providers tend to “manage” the third stage of labor, which is the delivery of the placenta. Basically what this means, is that they will push on the outside of your stomach (i.e. uterus) right after the baby is born, tug on the umbilical cord (that likely has been clamped immediately), and pull out your placenta, often also injecting you with Pitocin to clamp down the uterus. This can cause a multitude of problems, like detached cord, hemorrhage, retained placenta, etc. Alternatively, nursing your baby immediately after birth will help stimulate your uterus to clamp down (doing the same thing the Pitocin does, only naturally), thereby detaching the placenta all on its own. Once detached, you will be able to give a gentle push and it should deliver very easily within anywhere from 10 minutes to an hour or so (though I have heard of a placenta staying attached for much longer without an issue) – no tugging or pulling on the cord is necessary. If you would prefer your provider to not “manage” this stage and instead would like to nurse immediately, make sure they know that ahead of time and agree to your wishes.

When to begin – Like I stated in the above paragraph, nursing immediately after birth is the most optimum time to begin. Your baby will be very alert at this time, and the sucking instinct is strong. Your baby knows you, and your areolas release hormones and smells that he or she will recognize and react to. If your baby doesn’t want to latch on immediately, don’t fret! Just be patient and let it happen. There’s no need to force it. Nipple shields are rarely needed, so make sure to give it some time before using them. I would recommend consulting with a lactation consultant, trying different positions, etc, before even considering shields. Also, I would not advise the use of sugar water, either, because it covers up the hormones that your baby is naturally attracted to. And really, does your baby actually need sugar water to be enticed to eat the perfect nourishment that your body produces? I don’t think so.

After the first feeding – Right after delivery your baby is very alert, and will want to breastfeed relatively quickly. He or she may nurse for a long time that first nursing. After that first feeding, your baby will be super sleepy. He or she may sleep up to 12 hours. Yep – that’s right – 12 hours. After the hard work of being born (yes, your baby works hard too), they need the perfect nourishment that comes from your colostrum, then they need to get their rest to get on with exploring their new world. Our second baby, born at home, therefore free from interventions, slept the entire day (he was born at 10:30 a.m.) after his first nursing, woke and ate for a little while in the evening, and then proceeded to sleep the entire night except for one feeding. He was not only recovering from his entry into the world, but was gearing up for the next weeks and months of eating, growing, exploring, and learning that he was about to do.

Nursery Practices and Policies – Most nurseries now respect your right as a mother to keep your baby for as long as you want and need to. Rooming-in (baby staying with mama at night) is gaining popularity and the nursery staff will do what you, as the mama, wants. However, if you need the nursery to take your baby for awhile – no matter what the reason - you need to be very, very specific about your wishes so there aren’t any misunderstandings. For instance, you won’t want your baby to get a formula bottle to “supplement”, because your baby simply doesn’t need supplementation from a bottle. Babies have teeny, tiny tummies, and they don’t expand in the first day of their life. Colostrum is all they need! Check out this Breastfeeding Card put together by Ameda to learn more about baby tummy sizes. You likely won’t want your baby to get a pacifier, either – at least until breastfeeding is well established. Allowing your baby to have a bottle, pacifier, or even nipple shields can cause nipple confusion and make it more difficult for your baby to get a good latch. If you aren’t extremely clear about your wishes, assumptions can be made, and they may do things that you don’t want them to.

So, congratulations on choosing to breastfeed your baby when he or she arrives! Yes, it is definitely the best nourishment in the world, but it’s also normal. Be prepared – check out your local La Leche League for more information (you can go even before you deliver), or let me know and I can get you in touch with other local resources or at least give you ideas for potential resources in your area.

* I’m using the term “can’t” very loosely – there are very few mother’s that truly can’t because of a medical reason or otherwise…most mama’s that “can’t” actually are victims to “booby traps”…learn more about them here.

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