It takes a leap of faith to breast-feed. Most new moms plan to breast-feed their babies because of the multiple benefits of exclusive breast-feeding. But by two days of age, many breast-fed babies have already received formula. What happens? Why do new moms struggle with breast-feeding?
One theory is that new moms can't see exactly what the baby is getting from the breast. I am asked multiple times a day, "Is the baby getting anything?" We are a "see-it-to-believe-it" society, and breast-feeding doesn't work like that, in the beginning at least.
The breast starts making colostrum, baby's first milk, around 20 weeks of pregnancy. At birth and for the first few days after birth, the baby receives small amounts of colostrum — 1 teaspoon to 1 tablespoon — from the breast at each feeding session. This amount is perfect for a newborn during the first days of life.
New moms might not see the colostrum. Some, but not all, moms might leak or can express it by hand. Moms who pump their breasts in these early days might get only a few drops to 1 teaspoon. But most healthy newborns get more from the breast than a mom can hand-express or pump.
To determine whether a baby is getting colostrum, we monitor diapers and weight. If a baby is having an adequate number of wet and dirty diapers and his or her weight loss is less than 8 percent of birth weight, mom should continue to nurse the baby.
The breast knows how much milk to make based on stimulation that the baby is giving the breast. Since a mother's milk production is driven by a nursing baby, here are some things to avoid.
Formula: Don't be tempted to use even one bottle. This takes away the demand at the breast. If the baby is hungry or showing "feeding cues," nurse the baby. The breast is never empty. Ultimately the breast will make more colostrum or milk because the baby is stimulating it.
Pacifiers: Avoided during the first few weeks of breast-feeding because it leads to decreased stimulation to the breast.
Skipping a feeding: Don't let a sleeping baby skip a feeding. Some newborns would rather sleep than eat, but babies need to nurse eight to 12 times in 24 hours to get adequate nutrition and to stimulate the breast to make a good milk supply.
If new moms have faith and know what to monitor, breast-feeding can be successful.
Diana Howard, a lactation consultant at Baptist Health Lexington, assists nursing moms while they are patients and afterward in the hospital's Outpatient Breast-feeding Clinic.