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Breastfeeding

Your clinician, pediatrician, the World Health Organization and UNICEF all agree on one thing — breastfeeding is the best nutritional start for your newborn. The experience of breastfeeding is special for so many reasons, including the joyful bonding of mother and baby, and the health benefits for both of you.

Here are some of the most common topics related to breastfeeding.

  • Advantages of Breastfeeding

    Breastfeeding and breast milk have advantages for both mother and baby that can’t be found with formula feeding. Human milk is easier to digest and contains at least 100 ingredients not found in formula. It provides all the protein, sugar, fat and vitamins your baby needs, as well as helps to protect your baby against certain diseases and infections. Breastfed infants have lower rates of hospital admissions, ear infections, diarrhea, rashes, allergies and other medical problems than formula fed babies.

    Breastfeeding also helps mom because it uses up extra calories and stimulates the uterus to contract back to its original size. Breastfeeding research also has shown a reduction in the risk of ovarian cancer, and in pre-menopausal women, a reduction in the risk of breast cancer.

    Frequent nursing suppresses ovulation, making it less likely for a nursing mother to ovulate, menstruate, or get pregnant. There are no guarantees, however, so it is recommended that you use a convenient form of birth control when having intercourse.

    Other pros of breastfeeding include: no bottles to sterilize and no formula to buy, measure and mix. Nursing at night is easy as well — no one needs to stumble to the refrigerator for a bottle and warm it while the baby cries. Best of all it is free and convenient!

  • Formula Feeding

    If you plan on formula feeding, your pediatrician or health care provider will recommend a formula. Most infant formulas are made from a base of cow’s milk that is fortified with amino acids, vitamins and iron. If your baby does not tolerate a cow’s milk formula, your pediatrician may suggest using a soy-based formula. Formula comes in a variety of forms -- ready to use liquid, concentrated liquid, or powder. Read the preparation instructions carefully and do not add any additional water or fluid in a formula mix.

    It is important that you do not feed your baby “straight” cow’s milk for a full year after birth as it is difficult to digest and does not provide adequate nutrition for a developing baby.

    Bottle Feeding Basics

    Whether you bottle feeding exclusively or alternating breastfeeding with bottle feeding, here are some tips:

    • Bottles should be cleaned in a dishwasher or washed in soapy hot water, rinsed thoroughly and boiled. If you are using plastic liner inserts, use one for each feeding.
    • Nipples should not be boiled for more than a couple of minutes to prevent the latex or silicon from stretching and drying out.
    • Formula and breast milk can be fed to an infant at room temperature. If you need to warm them, run the bottle under hot water or place in a pan with warm, rather than boiling water to prevent burning. Test temperature by dropping a few drops of the fluid on your wrist.
    • Do not use a microwave to warm up formula or breast milk. Microwaves can cause hot spots in the liquid, which can cause internal burning.
  • Breastfeeding and Medications

    Since most medications have not been tested in nursing women, no one knows exactly how a given drug will affect a breastfed child. Very few problems have been reported so most over-the-counter and prescription drugs, when taken in moderation and only when necessary, are considered safe. Be sure to read the labels or ask your clinician or pharmacist if you’re in any doubt.

    Even mothers who must take daily medication for conditions such as epilepsy, diabetes, or high blood pressure usually can breastfeed. Always check first with the child's pediatrician. To minimize the baby's exposure, the mother can take the drug just after nursing.

    The following information is from the American Academy of Pediatrics:

    Drugs USUALLY compatible with breastfeeding:
    • Acetaminophen (like Tylenol)
    • Many antibiotics
    • Antiepileptics (although these should be given with caution)
    • Some antihistamines
    • Alcohol in moderation (large amounts of alcohol can cause drowsiness, weakness, and abnormal weight gain in an infant)
    • Some antihypertensives
    • Aspirin (should be used with caution)
    • Caffeine (moderate amounts in drinks or food)
    • Codeine
    • Decongestants
    • Ibuprofen (like Advil)
    • Insulin
    • Quinine
    • Thyroid medications
    Drugs that are NOT safe while nursing

    Some drugs can be taken by a nursing mother if she stops breastfeeding for a few days or weeks. She can pump her milk and discard it during this time to keep up her supply, while the baby drinks previously frozen milk or formula.

    Radioactive drugs used for some diagnostic tests like Gallium-69, Iodine-125, Iodine-131, or Technetium-99m can be taken if the woman stops nursing temporarily.

    Drugs that should never be taken while breastfeeding include:

    • Bromocriptine (Parlodel): drug for Parkinson's disease, it also decreases a woman's milk supply.
    • Most chemotherapy drugs for cancer: Since they kill cells in the mother's body, they may harm the baby as well.
    • Ergotamine (for migraine headaches): Causes vomiting, diarrhea, convulsions in infants.
    • Lithium (for manic-depressive illness): Excreted in human milk.
    • Methotrexate (for arthritis): Can suppress the baby's immune system.
    • Drugs of Abuse: All controlled drugs should be avoided – now is the time to think of your baby’s well being and not do drugs. Some drugs, such as cocaine and PCP, can intoxicate a baby. Others, such as amphetamines, heroin and marijuana cause a variety of symptoms, including irritability, poor sleeping patterns, tremors, and vomiting. Babies become addicted to these drugs.
    Tobacco Smoke

    Nursing mothers should avoid smoking. Nicotine can cause vomiting, diarrhea and restlessness for the baby, as well as decreased milk production. Maternal smoking or even passive smoke may increase the risk of sudden infant death syndrome (SIDS), as well as increase respiratory and ear infections.

  • Breastfeeding Difficulties

    For all its health benefits, breastfeeding does have some disadvantages. In the early weeks, it can be painful. A woman's nipples may become sore or cracked. She may experience engorgement more than a bottle-feeding mother, when the breasts become so full of milk, they're hard and painful. Some nursing women also develop clogged milk ducts, which can lead to mastitis, a painful infection of the breast. While most nursing problems can be solved with home remedies, mastitis requires prompt medical care.

    Nursing affects a woman's lifestyle. A nursing mother with baby-in-tow must wear clothes that enable her to nurse anywhere. She should eat a balanced diet and she might need to avoid foods that irritate the baby. She shouldn't smoke, it can cause vomiting, diarrhea and restlessness in the baby, as well as decreased milk production. Breastfeeding moms don’t “get a break,” dads, other family members and friends can’t participate in the feedings.

    Women who plan to breastfeed and return to work soon after birth should plan ahead. If her job allows, a new mother can pump her breast milk during the day and refrigerate or freeze it for the baby to take in a bottle later. Or, some women alternate nursing at night and on weekends with daytime bottles of formula. It’s important to introduce a bottle by 3 – 4 weeks so that the baby can adjust to eat from either the breast or a bottle.

    Although not very common, a few women have nipples that are drawn inward, or inverted. When nipples are inverted, a baby may not be able to grasp the areola (the darkened area of and around the nipple) properly to get milk. The problem of inverted nipples often clears up on its own during pregnancy as breasts enlarge. If this does not happen, inverted nipples can be treated late in pregnancy or soon after the baby is born.

    While breastfeeding has many advantages, some women who cannot breastfeed because they take chronic medications, have viral infections like hepatitis, or their breast and nipple anatomy makes breastfeeding impractical or impossible. We have formulas that approximate breast milk as closely as possible to provide adequate infant nutrition. If you cannot breastfeed, your child will grow and thrive, like all healthy babies.

  • Getting Started Breastfeeding

    According to the FDA, the following advice should help make breastfeeding a pleasant experience for a mother and her baby.

    1. Get an early start

    Nursing should begin within an hour after delivery if possible, when an infant is awake and the sucking instinct is strong. Even though you are not producing milk yet, your breasts contain colostrum, a thin fluid containing antibodies to disease. It is not uncommon to feel uterine cramping when you start to breastfeed. This cramping lessens with time.

    2. Proper positioning

    The baby's mouth should be wide open with the nipple as far back into his or her mouth as possible. The newborn’s mouth needs to surround as much of the dark area around your nipple as he/she can. This minimizes breast soreness. There are many resources such as nurses, lactation consultants and clinical specialists, to help you find a comfortable nursing position.

    3. Nurse on demand

    Newborns need to nurse frequently, at least every two hours, and not on any strict schedule. This will stimulate your breasts to produce plenty of milk. Later, the baby will settle into a more predictable routine. Because breast milk is more easily digested than formula, breastfed babies often eat more frequently than bottle fed babies.

    4. No supplements

    Nursing babies don't need sugar water or formula supplements. These may interfere with their appetite for nursing, which can lead to a diminished milk supply. The more the baby nurses, the more milk the mother will produce.

    5. Delay artificial nipples

    It's best to wait a week or two before introducing a pacifier, so that the baby doesn't get confused. Artificial nipples require a different sucking action than real ones. Sucking a bottle could also confuse some babies in the early days. They, too, are learning how to breast feed.

    6. Air dry

    In the early postpartum period or until your nipples toughen, you should air dry them after nursing to prevent cracking, which can lead to infection. If your nipples do crack, you can coat them with breast milk or other natural moisturizers to help them heal; vitamin E oil and lanolin are commonly used, although some babies may have allergic reactions to them. Proper positioning at the breast can help prevent sore nipples. The baby may not have the nipple far enough back in his or her mouth if the mother's nipples become very sore.

    7. Watch for infection

    Symptoms of breast infection include fever, painful lumps and redness in the breast. These require immediate medical attention.

    8. Expect engorgement

    A new mother usually produces lots of milk, making her breasts big, hard and painful for a few days. To relieve this engorgement, you should feed the baby frequently and on demand until your body adjusts and produces only what the baby needs. In the meantime, you can take over-the-counter pain relievers, and apply ice or cold compresses to your breasts to relieve the discomfort.

    9. Eat right, get rest

    To produce plenty of good milk, the nursing mother needs a balanced diet that includes 500 extra calories a day and six to eight glasses of water in addition to other fluids. You should rest as much as possible to prevent breast infections, which are aggravated by fatigue.

    10. Take proper care of your breasts

    During pregnancy, you can toughen your nipples for breastfeeding by rubbing a towel briskly over your nipples for a few seconds following your shower or bath. Also, be sure to wear a bra that provides support. Your breasts will get larger with breastfeeding so before delivery, buy a couple of nursing bras that allow room for growth.

    Wash your breasts with warm water only. Soaps, lotions, and alcohol are not necessary, may be drying and irritating, and should not be used. The American Academy of Pediatrics recommends that babies be breastfed for 6-12 months. The only acceptable alternative to breast milk is infant formula. Solid foods can be introduced when the baby is 4-6 months old, but a baby should drink breast milk or formula, not cow's milk, for a full year (difficult to digest and does not provide adequate nutrition for a developing baby).

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