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Breastfeeding CONTINUED FROM PAGE 15A
time the baby is 6 months old, less than half of mothers are still breastfeeding. Although mothers who have just delivered their babies may receive some advice from hospital staff, the nature of today’s in-hospital childbirth experience is seldom conducive to establishing good breastfeeding practices. “In the hospital, every hospital has a breastfeeding coordinator and you should be able to get advice from them. Usually they have a group morning breastfeeding session,” said Robert Rosenberg, M.D., of Hartsdale Pediatrics. “The trouble with the hospitals is that with the two-day discharge, your breast milk is not going to come in for 96 hours.” Dr. Rosenberg recommends that new mothers visit the pediatrician within 24 to 48 hours of discharge. He also applauds the idea of calling a lactation consultant. “I think it’s a great idea,” he said. “Lactation consultants can help, since we don’t have a tradition of breastfeeding. Lactation consultants have a lot to offer.” He notes that mothers don’t have to wait until problems arise to call a consultant. “If you’re motivated to breastfeed and you have some anxieties, I think it would be helpful,” he said. Lactation consultants see clients before and after childbirth. Some of their
Kids!
services are purely educational and preventive, while others are aimed at solving problems that are interfering with nursing success. Getting help early “For the most part, women can create an excellent milk supply,” said Beth Shulman, an IBCLC in Hastings. But when mothers come home with a new baby — especially first-time mothers — they may not know when they should ask for help. That’s where private consultations and postnatal breastfeeding groups come in. For example, while breastfeeding is being established, “intermittent discomfort is something normal, but pain is an indication that something is not right and should be — and could be — improved by better positioning, or something going on with the baby’s suck,” Shulman said. “It’s an indication to call for help. I would say that getting help early in the breastfeeding experience is really valuable because as each day goes by, the difficulties can go unresolved, and it makes the experience more difficult in general.” When mothers have trouble establishing a good milk supply, “Most frequently it’s unrelated to her physiology, but more related to the way breastfeeding got started early on, in terms of the supply-demand situation,” Shulman said. “Also, the birth experience can influence milk supply.” She explained that medical intervention during childbirth, or having a Caesarean section, can interfere with the early establishment of a
good milk supply. “You can come back from that,” she said. “Every woman’s body is a little different. Some women’s milk supply responds more to various factors than others. It’s a very individual thing.” OK to seek help “Years ago, when I started working as a lactation consultant, moms were sometimes disappointed with themselves if they needed help because they felt this was a natural process,” Shulman said. “There has been a shift that I’m very happy with. Breastfeeding is a learned behavior. There are a lot of people who want to be helpful based on their experience. But there’s evidence-based information that can really inform people, in a very professional way. Moms are lucky now.” Shulman likes to have both parents come to the prenatal classes or consultations: “I feel if the mom has the support of her family, of her partner, she’s most likely to succeed if the partner is on board and part of the team. I think it’s a family thing. I also feel that when couples have a sense of what is coming in that first week or two after the baby is born, it helps people to cope with the early days.” Shulman noted that parents are often surprised at how frequently and how long babies have to nurse in the first weeks after birth. “The supply of milk depends on the baby’s demand,” she explained. “The time spent on the breast and the amount of milk removed from the breast goes to the brain and determines the amount of milk made. So the baby needs full access
MARCH 23, 2012
to the breast whenever desired.” Shulman runs a twice-monthly breastfeeding support group at Pediatrics on Hudson in Hastings. Breastfeeding groups help moms establish connections with other new nursing mothers. They also give mothers the peer support to continue breastfeeding longer. Breast milk continues to confer benefits to older babies and toddlers, even when the child has begun to eat solid food. The composition of breast milk changes according to the needs of the child, and continues to be superior to formula at any stage of the baby’s life. Yet the longer a mother breastfeeds, the more likely she is to encounter criticism, even from people who applauded her efforts to breastfeed when the baby was born. Your own decision A mother’s decision to breastfeed — whether to do it, and how long to do it — is a personal one. Lactation consultants do all they can to help mothers who want to breastfeed. But it may not be right for everyone. “I really try not to be dogmatic about breastfeeding,” said Shulman. “There are people who have problems with this, and I really feel my role as a lactation consultant is to offer proper, evidence-based information in a supportive way, so couples can make their own decisions about the best way to feed their baby. “I try really hard to be nonjudgmental about what people choose to do.”