Keeping Breastfeeding Going

The American Academy of Pediatrics (AAP) and the World Health Organization recommend that babies be breastfed exclusively until solid foods are introduced around six months of age. Continued breastfeeding is recommended throughout a baby’s first year of life, and longer if possible. Yet, fewer than 25% of babies in the U.S. are still receiving breastmilk by 12 months of age. Two of the most common reasons that women give for discontinuing breastfeeding before their baby is a year old are:  “I didn’t have enough milk” and “Breastmilk alone did not satisfy my baby.” Concerns about producing enough milk prevent many women from reaching their breastfeeding goals.

Regularly draining your breasts by nursing (or pumping) will help you maintain an abundant milk supply throughout your breastfeeding experience. This is because your rate of milk production increases when your breasts are well-drained, and milk production slows down when your breasts remain full. Some women’s breasts can store a larger volume of milk before the fullness in their breasts signals their milk glands to produce less milk. Other women’s breasts can store far less milk before they begin to feel overly full and their rate of milk production slows down.

To prepare for an optimum breastfeeding experience, you should attend a prenatal breastfeeding class and learn as much about breastfeeding as possible before your give birth. The following strategies can help keep your milk supply plentiful throughout your baby’s first year, and make continued breastfeeding mutually enjoyable:

 

  • Use your hospital stay to get the best possible start with breastfeeding.  Ideally, you will be able to hold your baby skin-to-skin immediately after birth, begin nursing right away, and room-in with your baby. Request hands-on help learning correct breastfeeding technique, feed your baby as often as she gives feeding cues – including through the night – and avoid giving supplemental milk unless she has a valid medical need. If you want to use a pacifier, wait until breastfeeding is going well to introduce it.  Schedule an early follow-up visit with your baby’s doctor and seek help from a lactation consultant if you encounter any breastfeeding difficulties.

 

  • Keep your baby with you as much as possible and allow her to nurse whenever she wants.  Wearing your baby in a safe carrier or sling is a convenient way to keep her cozy and content in your presence. Avoid long separations that cause you to skip feedings, or supplementing your baby with formula (unless there is a medical reason). Practicing unrestricted, exclusive breastfeeding will help ensure that you continue to produce a plentiful milk supply.

 

  • Avoid going a long interval at night without draining your breasts.  When your baby starts sleeping for long stretches – five or more hours at night – your breasts may become overly full, and this will slow your rate of milk production. Many women soon notice a reduction in their previously ample milk supply once their baby starts sleeping a long stretch at night. To shorten the nighttime interval that your breasts go without being drained, you can express milk just before you retire. It’s also a good idea to express milk remaining after your first morning feeding to ensure that both breasts get well drained after a long night interval. Women who claim they can “train their breasts” to go all night without feeding or pumping without affecting their milk supply probably have a larger than average breast storage capacity. For many breastfeeding women, going too long at night without draining your breasts can decrease your milk supply, trigger the return of your menstrual periods, and lead to a permanent decline in your blood prolactin level, the main hormone responsible for milk production. 

 

  • Do not offer your baby a pacifier until breastfeeding is well established and she is gaining weight steadily.  As much as possible, all of your baby’s sucking should provide her with the milk she needs and should stimulate your breasts to produce an abundant milk supply. After the first month, offering a pacifier when placing your baby for sleep will help reduce the risk of SIDS. Use one only sparingly at other times, as frequently sucking on a pacifier may cause your baby to nurse less often, which can decrease your milk supply. Don’t use a pacifier to postpone feeding your baby when she is giving hunger cues.

Removing extra milk not only will keep your supply plentiful, it will allow you to accumulate frozen stores of milk to use later.

  •  Avoid hormonal contraceptive methods that contain both estrogen and progestin (synthetic progesterone), because estrogen may decrease your milk supply. If you do use a combination hormonal contraceptive, take the lowest dose possible and wait at least 6 weeks—preferably longer—after the birth of your baby. Although progestin-only contraceptives are less likely to affect breastfeeding, some women who use progestin-only methods notice a decrease in their milk supply. Before using one of the more permanent progestin contraceptives (injection, implant, or IUD), you would be wise to try the mini-pill first for a month or two to see whether it affects your milk production.

 

  • When starting solid foods, remember that solids should complement, not displace, breastmilk in your baby’s diet.  Most breastfeeding mothers produce more milk in the mornings and less in the late afternoon and evenings. Thus, it makes sense to begin offering solids after a nursing later in the day, when your baby may be less full after breastfeeding. Avoid feeding solids just prior to nursing your baby, as she may not drink as much milk after filling up on solid foods.

 

  • Do not feed your baby fruit juice before six months of age, and restrict your baby’s daily juice intake to four to six ounces.  Offer juice only by cup to limit the amount she drinks. Consuming excessive quantities of juice may cause your baby to breastfeed less often and reduce your milk supply.
  • Surround yourself with breastfeeding role models, including women whose babies are older than yours, who can provide advice, support, and encouragement that will keep you motivated to continue nursing your baby. Don’t let judgmental barbs (“Are you still doing that?”) from less-informed friends and relatives derail your efforts to continue breastfeeding. Join a breastfeeding support group, such as a hospital-based mothers’ group or La Leche League, so you can learn from the experience and example of other moms who have successfully breastfed long-term.
    If you plan to return to work, begin as early as possible to express extra milk after several feedings each day, especially in the morning when your milk production is higher. Many mothers begin as soon as their milk comes in to express some of their surplus milk and relieve uncomfortable breast fullness. Removing extra milk not only will keep your supply plentiful, it will allow you to accumulate frozen stores of milk to use later, if needed.  Copyright ©  2011  Marianne Neifert, MD, MTS     May be duplicated if authorship is cited.     www.dr-mom.com