Breast is Best

By Brandy Gheesling, CLC, IBCLC, MD, FAAP

World Breastfeeding Week is celebrated every year from August 1-7.  The theme of this year’s week is “Breastfeeding: Foundation for Life”, a recognition of importance to a baby’s future.  According to the most recent 2016 CDC Breastfeeding Report Card for the state of Georgia, the rate of infants who ever breastfed was 69%.  The rate at 6 months of life was 48% and 29% at 12 months.  Exclusive breastfeeding at 6 months of life was only 25%.  The American Academy of Pediatrics (AAP) currently recommends exclusive breastfeeding for the first 6 months of life.  After the first 6 months the AAP recommends that the mother continue breastfeeding while gradually introducing solids into the infant’s diet.  They recommend that breastfeeding be continued for at least 12 months, and thereafter, for as long as mother and baby desire.  

In honor of World Breastfeeding Week which is August 1-7 and as I prepare for the arrival of my third bundle of joy, I thought I would share with you some things I frequently discuss with my new moms in the office.

First and foremost, when your baby is born, insist on skin to skin after delivery for at a minimum of two hours. Simply put your naked baby on your bare chest.  This helps regulate blood sugar, temperature and most importantly helps to establish breastfeeding.  I recommend that you continue skin to skin once you go home.  You can purchase shirts for both mom and dad that are designed to help facilitate skin to skin.  And yes, skin to skin can also be done by Dad. 

 

The biggest piece of advice I can give is be patient.  It takes practice to establish breastfeeding.  Try different positions to see what works best for you and your baby.  I highly recommend side lying nursing.  But just because it worked for me, doesn’t mean it will work for you.  I breastfed my first child for two years so I thought when my second baby was born, it would be super easy from the start.  However, it still took a few days for me to establish a good comfortable latch. 

Watch the baby, not the clock.  When you see your baby rooting or sticking its tongue out, offer your breast.  Don’t wait for your baby to start crying, as this is a late sign of hunger.  Afternoon cluster feeding is very common and is to be expected. Lower volume in the afternoon is also common.  Please don’t think you have a low milk supply because of the these two things.  In the first few weeks, a baby will feed for shorter periods of time more frequently than for fewer longer periods of time and they usually like to do this in the late afternoon hours.  Monitor your baby’s output closely.  Make sure they have at least one wet diaper for days old they are.  So if they are 3 days old, they should have 3 wet diapers in a 24 hour period.  Six wet diapers per day is generally sufficient once they reach 6 days of life.     

The best way to increase your supply is removal of milk.  Unfortunately, studies have failed to show much, if any, benefit from the many things on the market that are promoted as increasing your milk supply such as Fenugreek, metoclopromide, and domperidone.  And these medications and supplements can have dangerous side effects.  The best way is to feed very often, aim for 10-12 feeds in a 24 hour period.  If your baby has started sleeping for extended periods of time at night, try getting up and dream feeding or pumping.    

Feed your baby not the freezer.  You don’t need to have an entire freezer full of pumped breastmilk before you go back to work.  Fresh breast milk is best so you actually only need a few days supply.  For example, the milk you pump while working on Monday will be fed to your baby on Tuesday.  Invest in a good pump.  Try to pump every 3 hours while you are away from your baby.  Pumping while commuting back and forth from work can add an additional two pumps to your day and help to maintain your supply. 

When not breastfeeding, use a preemie slow flow nipple or cup feed.  Cup feeding can be done using a shot glass.  Breastfed babies have normal intake of around 1-1.5 oz per hour.  Most breastfed babies are more likely to take a bottle from a caregiver other than the mom.  They can smell mom’s milk so sometimes it is best if mom goes outside.  Spilled breast milk can cause lots of tears so discuss with your caregivers that they should be careful when handling your milk. 

Breastfeeding is truly a wonderful experience for both mom and baby.  The benefits of breastfeeding for both mom and baby are huge.  Breastfed babies have a lower risk of ear infections, gastroenteritis, severe lower respiratory tract infections, eczema, obesity, type 1 & 2 diabetes, childhood leukemia, asthma, allergies and NEC (severe infection of the intestine).  If a baby is breastfed exclusively for the first month of life, their risk of dying due to SIDS (Sudden Infant Death Syndrome) is halved.  Women who breastfeed have a lower risk of breast and ovarian cancer, type 2 diabetes, heart attack and postpartum depression.  Breastfeeding is also cost effective with 2013 estimates to formula feed a baby at $1,733.  The effects are long reaching.  A Brazilian study found that babies who were breastfed had higher IQs, more years of education and a higher income at age 30.  Breastfeeding also helps to promote bonding between mom and baby with the release of oxytocin, which is the “love hormone”.  As summed up by Amy Spangler, “while breastfeeding may not seem like the right choice for every parent, it is the best choice for every baby.”


For more insight from Dr. Gheesling, sign up to attend one of her baby basics classes.

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