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How to Avoid the Top 10 Nursing Pitfalls

Posted on January 25th, 2013 by | 8 views
BY DIANA WEST, IBCLC, and LISA MARASCO, MA, IBCLC

As a pregnant or new mother, you might be concerned about making enough milk for your babe. The following 10 nursing pitfalls are among the most common reasons for milk supply difficulties. Knowing what they are and how to avoid them will help you lay a strong foundation for a successful breastfeeding experience.

Pitfall #1: Latch Problems

One of the most common causes of low milk production in the early weeks is poor attachment to the breast. When baby latches too shallowly, he doesn't have enough breast in his mouth to effectively draw out milk. Less milk is removed, and the breast responds by cutting back on production. The good news is that correcting the problem is often relatively easy. If you aren't able to fix it on your own, the problem could be related to baby's ability to suck effectively and may require the help of a lactation consultant.

 Pitfall #2: Hormonal Birth Control

"Combination" birth control pills containing forms of both estrogen and progesterone can significantly decrease milk production. Newer "minipills" are estrogen-free and better for nursing mothers, but a small number of women still experience a drop in supply. Similar problems have happened with patch and subdermal implant birth control, and a case of low supply related to a hormonal intrauterine device (IUD) has been reported. Depo-Provera, a long-acting injectable hormonal birth control, poses more serious problems because it lasts for three months and cannot be reversed; the best option is to try milk-increasing herbs to counter the effect. Waiting three months or longer after birth to use hormonal birth control will reduce the risk of problems. 

Pitfall #3: Herbs

Just as there are herbs that may help increase milk production, others seem to decrease it. Parsley is considered to have lactation-suppressing properties in large amounts, such as in a dish like tabbouleh. Peppermint and sage are reputed to decrease production when consumed in large or concentrated amounts. Frequent brushing with toothpaste containing real mint oil or even eating potent mint candies has caused trouble for some mothers. Fortunately, most of these herbs don't cause problems unless they are consumed regularly or in large amounts

Pitfall #4: Alcohol

Alcohol inhibits both the milk ejection reflex and milk production, especially when taken in large amounts. Even a single beer or glass of wine can disrupt the balance of lactation hormones. While the immediate effects of alcohol on milk production and delivery last only as long as the alcohol is in your system, chronic alcohol use has the potential to lower your milk supply overall.

Pitfall #5: Outside Interferences

Some mothers facing a medical procedure, drugs, or hospitalization are told that they can't nurse for a period of time. To make matters worse, little or no guidance is provided on how to maintain production, and by the time breastfeeding is "allowed" again, milk supply is damaged. Educating yourself on the facts is your best defense, and regular pumping is your backup. Dr. Thomas Hale's book, Medications and Mothers' Milk (updated biannually), is an excellent safety reference.

Pitfall #6: The Sleepy Newborn

Excessive sleepiness has several possible causes. A newborn may be drowsy after delivery because of medications given to you during labor. The effects may be brief, or they can linger for several days. During this time, lots of skin-to-skin contact can help stimulate your baby and trigger his nursing instincts.

Simply not getting enough milk can also cause a baby to sleep too much. He may eventually rouse and show signs of hunger but fall asleep again within minutes at the breast. This in turn leads to needing longer periods of sleep to conserve precious energy. This can happen as a result of low milk supply, a problem with baby's suck, or baby's medical complications. Supplementation may be needed until milk production can be increased or baby is able to take more milk.

Another cause of infant drowsiness is jaundice, a temporary yellowing of the skin that often looks like a suntan and can make babies lethargic. Wake baby at least every two to three hours until he begins to rouse more on his own. Gentle methods such as holding him upright, massaging his body, talking to him, undressing him, or changing his diaper are most likely to result in willingness to feed.

Pitfall #7: Unnecessary Supplementation

There are certainly times when baby isn't getting enough milk and must be supplemented. But there are also times when unnecessary supplements sabotage milk production by reducing milk removal and stretching out feeding intervals. Problems usually start with "just one bottle a day" or "just a few bottles a week," but the more supplements given, the more are needed because milk isn't made when it isn't removed. It becomes a slippery slope where bottle-feeding eventually seems more convenient or baby appears to like it better.

Pitfall #8: Pacifiers

Pacifiers can mask the hunger cues of babies who are easily soothed by them. They are often given in the belief that baby is supposed to be full after so many minutes at breast. An assertive baby will spit it out and insist on more milk, but an easygoing baby may not be as persistent. This can disrupt the baby-driven milk-making process by forcing inappropriately long feeding intervals that ultimately reduce milk supply.

Pitfall #9: Busyness

Juggling a baby and the conflicting demands of a busy household is challenging. Feedings can be unconsciously postponed when you're preoccupied by other tasks, trying to get "just one more thing" done. It's especially difficult if you have older children and are always on the run driving them around, and the temptation to put off feedings instead of taking time to nurse right now may be strong. Though this may sound difficult, it is crucial to slow down and remember that this baby will only be young once, and his needs are immediate and important. Keeping him close in a soft baby carrier can help you respond to early feeding cues while on the go.

Pitfall #10: Clock-Driven Feeding Durations and Feeding Schedules

Mothers are often urged to get baby on a schedule as quickly as possible to instill early discipline, fit him conveniently into family life, make life more predictable, or for "sleep training." Whatever a parent's fear or motivation, schedules are often regarded as an important parenting goal.

Schedules may seem helpful to parents, but they don't always meet the needs of breastfeeding mothers andbabies. Rather than allowing milk production to be driven by baby as nature designed, schedules artificially determine when feedings will take place. Mothers with abundant production and vigorously nursing babies may do well, but mothers with marginal supplies or babies with difficulties often do not. Even if all looks well in the beginning, a sudden drop-off in production can happen after a few months if an insufficient number of hormone receptors were established in the early weeks. Bottom line: advice that supersedes your instincts on when to feed your baby can undermine your milk supply.

Diana West, IBCLC and LIsa Marasco, M.A., IBCLC are the authors of The Breastfeeding Mother’s Guide to Making More Milk (Mc-Graw Hill, 2009), and board certified lactation consultants in private practice.

Reposted with permission from mindful-mama.com.

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