Informed is Best: Navigating Breastfeeding in Today’s Society

November 07, 2018

I always knew I wanted to breastfeed my children. It was something I was very sure of and passionate about. It’s what I felt was best for my children and my family. When I found out I was pregnant, like with most things, I jumped head first into research mode. I wanted to be prepared. The birthing center that I was going to for my prenatal care offered free breastfeeding classes with a wonderful lactation consultant for their patients, so we went to all of them (being the supportive husband he is, Burkley came with me so he could learn the ins and outs as well; this made a world of difference for us). Most people think breastfeeding just comes naturally to moms, it just happens, but there’s a surprising amount you actually have to learn about the process to be successful with it, especially in today’s society.


I have been very fortunate to have had a relatively easy time with breastfeeding from the beginning. It was a little bumpy at first, but because I had such easy access to proper breastfeeding education and was surrounded by so much support (family, informed doctors and nurses, lactation consultants, etc.), we were able to navigate those tough times and get to the other side without too much drama. We battled weight loss and jaundice, questionable diaper counts, worries about supply, pain, blisters, anxiety, and tears, but here we are, 10 months into it, and it’s second nature now. 

(For those wondering, yes, I plan on breastfeeding over a year old. I’m sure that’s not much of a surprise.)

Today’s society works against mothers from pretty much every angle. The biggest problem is the lack of access to proper education. Not everyone has free classes offered to them; often times when classes are offered, mothers can’t afford them, or if they can, the information they’re taught is outdated or just flat out wrong. Many women think they know what they need to, but because not many people actually talk about their struggles openly, these women don’t know what they don’t know, and are left to figure it out on their own when the time comes. We also live in the world of instant gratification, so often times if breastfeeding is tough at first, mothers are urged to just quit. Or they’re pressured by ill-informed doctors to supplement when it isn’t really needed, or when it is needed, they aren’t told how to maintain their supply in hopes of weaning off the supplementation. Furthermore, women who have to or want to go back to work aren’t always supported when it comes to maternity leave or their need to pump; the basic mechanisms of breastfeeding are not widely taught, so those not in the know make up policies that ultimately cost a mother her supply. And the second biggest issue I’ve seen comes down to how women are treated in almost every aspect of their lives; they’re taught not to trust their bodies. 

I want it to be clear, I am not against formula. I think it’s wonderful that an alternative exists because some women decide breastfeeding isn’t right for their family, and because there are times where supplementing is necessary or breastfeeding just can’t happen, but the way the system is in the US right now, people think that happens way more often than it actually does. I have seen far too many women forced to give up breastfeeding when they really wanted to because they weren’t supported, I have seen far too many women told they weren’t enough, and I have seen far too many women shoved into the deep end of guilt and post partum depression because of this, because they think it’s their fault, they did something wrong, their bodies didn’t work right, when in reality, they were the ones let down. By not being supported, the choice of how they wanted their child fed was taken from them. I have seen first hand the difference education and support can make, and I desperately hope that one day all women will be afforded the same experience I’ve had.  To do my part in changing this, I’d like to share the information I’ve learned that made a difference in my breastfeeding journey. 

Please note: While this list is long, it is not an exhaustive list; this is the information that has stood out to me as some of the most helpful. This is general information and does not take into account specifics of every case or individual, especially in the case of premature birth, disability, or other underlying medical issues, physical or mental/emotional. If you are having trouble breastfeeding, please consult an IBCLC for help with your situation. Again, I am not a medical professional, I am simply sharing what I have been taught through my breastfeeding journey.

  • Whether or not your breasts leak during pregnancy does not indicate your ability to breastfeed. Nor does the size of your breast.
  • You have milk from the beginning, in the form of thick, nutrient and calorie rich Colostrum. Colostrum is all babies need at the beginning, since at birth their stomachs are about the size of a cherry. It can take anywhere from 3-7 days for your body to begin producing mature milk (when most people say “your milk is in!”) because it’s not until the placenta detaches from the uterus after birth that the body is signaled to begin producing mature breastmilk. 
  • In the beginning, most babies will clusterfeed. There are a few reasons behind this: first, the more baby latches and nurses, the faster your nature milk will come in; second, colostrum/breastmilk is very easily digestible, combined with having tiny stomachs at the beginning, this means baby needs to eat often; and third, babies nurse for comfort (they’ve been in a dark and cozy womb for nearly 10 months, it’s been just you and baby. Now suddenly they’ve been through the tough ordeal of birth and are in this big, loud, bright and confusing world; that’s a lot for a little one to take in).
  • Pretty much every baby is going to lose weight in the beginning. For the last 9-10 months, baby has been taking in the nutrients you’ve provided, but not expelling the waste. For the first few days, baby poops out “Meconium,” all the waste that’s built up during that time, which can make up a significant potion of their birth weight. The general guideline for babies birthed vaginally is that they can safely lose up to ~11% of their birth weight. A recent study done has shown that for babies birthed through csections, a loss of around 15% of their birth weight can be safe and expected; this is due to the fluids and medications pumped into mother (and subsequently baby) during the procedure. It can often be more accurate to use babies weight at 24 hours old for calculations with csection babies. 
  • Many babies will experience jaundice early on. Jaundice is when a baby’s still-developing liver is slow to remove bilirubin, a yellow pigment produced during the normal breakdown of red blood cells. In most cases, jaundice is very easy to treat, through frequent feeding (to help flush baby’s system) and sunlight. In more severe cases, phototherapy is needed for more concentrated UV exposure. Many doctors, in an attempt to treat the jaundice faster, will suggest supplementing with formula to flush baby’s system. If the jaundice is that severe, you can achieve the same results with pumping and feeding breastmilk. Jaundice can last anywhere from 3-12 weeks after birth, and as long as bilirubin levels are monitored, complications are rare. (This is known as Breast Milk Jaundice, not to be confused with Breastfeeding Jaundice, which is jaundice resulting from insufficient milk intake, which is very rare.)
  • The best way to track your milk supply is by watching baby’s weight gain and diaper output. In the beginning, baby should have at least one wet diaper and one dirty diaper per days old, until 6 days old (meaning day 1: 1 pee, 1 poop; day 2: 2 pees, 2 poops; etc.). After day 6, baby should be having a minimum of 6-8 wet and 6-8 dirty diapers (no, that doesn’t necessarily mean 16 total diapers (though that is possible), as baby can poop and pee in the same diaper.) After 6 weeks, baby is expected to have a minimum of 4-6 wet diapers and anywhere from multiple poops in one day to pooping just once every few days. —-This where we had the most worry with Desi. He pooped 6 times on day 1, then only peed once on days 2 and 3. However, while I was freaking out about starving him, our pediatrician (thankfully well versed in breastfeeding) told us that because he “overachieved” on day 1, it averaged out and wasn’t too much of a worry, especially since by day 4, when my mature milk was in and ready to go, he caught back up on his diaper counts.
  • Latching should NOT be painful. For the first few weeks, the initial latch may be uncomfortable as your nipples are getting used to being used in this way, but pain throughout an entire feed indicates an issue. Baby may be latching too shallowly, or there may be tongue or lip ties that need to be evaluated. If you are experiencing pain, blisters, bleeding, or clogs, make an appointment with an IBCLC as soon as possible. 
  • In the beginning, while your mature milk is still coming in, your body is figuring out how much to make, and baby’s weight is under scrutiny, you should be feeding baby every 2-3 hours, minimum. This often requires waking baby, which for some takes a little more effort than others. For Desi, what worked best when we found out picking him up, tickling him, that sort of thing didn’t work, was undressing him down to his diaper and doing skin to skin with him. A few times he was sleepy enough to warrant a quick wipe down with a cold cloth. I also had to make sure I burped him sitting up rather than resting on my shoulder, otherwise he’d fall back asleep and not want to finish a full feed.
  • Because of clusterfeeding (which again, is a good and necessary thing), some babies will want to eat more often than the 2-3 hours. This is ok, and you should follow baby’s cues. The 2-3 hour recommendation is the longest you should go between feeds in the beginning.
  • Feeding every 2-3 hours (minimum) should be done until Baby is over their birth weight. Once over birth weight, follow baby’s cues and feed on demand. Again, it depends on baby if they want to eat more or less often than 2-3 hours; trust your baby to tell you what they need.
  • In the beginning, it is recommended to nurse off of both sides at each feed, for around 10-15 minutes per side, though the second side tends to be nursed for less time than the first side. Allow baby to nurse until they decide to unlatch. 
  • You should alternate which side you start on. So if you nurse left then right, at the next feed, nurse right then left. This ensures each breast is being drained equally and fully. Burp after each breast. 
  • It is generally advised to wait until 4-6 weeks post partum to begin pumping. This is because baby is much more efficient at getting milk out than pumps are. Breastfeeding works through supply and demand; it makes what it’s told is needed. While your supply is regulating (which can take up to 12 weeks), you want your body to know how much baby needs, not how much a pump is able to get out. Pumping too early can cause supply issues, clogs, and if done incorrectly, permanent damage to your nipple and breast tissue which may hinder breastfeeding. Make sure you read your pumps manual and get fitted for correct size flanges. Pumping is not necessary to maintain your supply unless you are not latching baby at every feed, like in the case of mothers who work outside the home.
  • If you decide to pump and bottle feed, whether it be exclusively or occasionally, make sure you are Pace Feeding baby. This means feeding baby no more than 1.5-2oz per hour between feeds (not to exceed 4oz in a single sitting), and using the slowest flow nipple available for your bottle. This ensures baby is working to pull the milk out, like they would at the breast, and not being overfed, which can cause their stomach to stretch, making their bodies think they need to eat more than they actually do. If babies stomach is unnecessaryily stretched, it can cause supply issues because the mothers breasts won’t have known to make more milk.
  • As I’ve mentioned above, the best way to tell if baby is getting enough milk is by watching their diaper counts and their weight gain. Doctors watch baby’s growth by using a growth chart and tracking the curve they follow on that chart. Ask your doctor whether they follow the WHO chart made for breastfed babies, or the Similac chart, which was made for formula fed babies. The way baby is fed affects how they grow, and at what rate, so if your child is being tracked based on a chart that does not fit their situation, they may be incorrectly labeled as not growing fast enough. 
  • If supplementing with formula or pumped milk becomes necessary, whether it’s because of a health issue or weight issue, again, be sure to Pace Feed baby to avoid stomach stretching and the supply issues that may follow. Also make sure you are pumping every time baby gets a bottle to keep up your supply. You can also request that the formula be fed to baby through an SNS tube feeding system, where a tube is attached to your breast (just tape, don’t worry) and dispenses the formula/pumped milk even while baby is latched to your breast, that way your breast is still being stimulated and signaled to make milk. This can help if there are latching issues and worry about possible bottle preference. 
  • A common misconception is that breastmilk is made from what the mother eats. It’s actually made from the mothers blood. This has two implications. First, this means that, with a few exceptions (like dairy, gluten, soy, other high allergen foods, alcohol, and foods with proteins that make it into your blood), what you eat is unlikely to cause stomach problems or fussiness in your baby. So eat that broccoli. Second, it also means that regardless of what you eat, your milk has all the nutrients in it that your baby needs. Unless your body is deficient in vitamins and nutrients (keep taking your prenatal vitamins while breastfeeding), it will prioritize putting those nutrients into your breastmilk for your baby. There is a feedback mechanism in your breasts that “reads” baby’s saliva to know exactly what baby needs, in terms of vitamins, fat and water content, and antibodies. 
  • I recommend here several times to seek help from an IBCLC if you’re experiencing issues. An IBCLC is a super specialized and certified Lactation Consultant. They are a step above a lactation consultant and can give you the most accurate and specific information to help you with whatever issue you may be having. 
  • While some pediatricians have taken the time to learn all about breastfeeding, it is not part of their regular education. Not all pediatricians understand or prioritize proper breastfeeding practices and bad advice can cost a mother her supply. I will never say don’t listen to your pediatrician, but it is a good idea to interview your pediatrician before deciding who will care for your child, and a second opinion from an IBCLC on breastfeeding matters is highly encouraged.
  • There are many different positions for nursing, and different ways to hold your breast to support it for baby. I recommend looking at pictures and watching YouTube videos prior to baby’s arrival to become aquatinted to the different options. What works for each mother and baby will be slightly different as it ultimately comes down to preference, breast size, baby size, and comfort. Since I had a csection, I found Football Hold to be most comfortable for in the beginning while my belly was tender and sore, and it made it easier to support my breast and keep baby’s airway clear, as I am a good bit larger in that area. I absolutely loved the MyBreastFriend nursing pillow, as well. If something about your positioning doesn’t feel right, or feels like it’s affecting baby’s latch, request that the hospital or birthing center’s LC come check you out and give you pointers. 
  • While breastfeeding, your body needs anywhere from 500-800 extra calories per day, and lots of water, in order to make milk. Dieting and weight loss supplements should be avoided until after you’ve weaned. 
  • Spitting up is normal. Lots of spitting up can be normal. Baby’s digestive system is still maturing and developing. However, some babies do have acid reflux. The best way to tell if your baby needs medicine for acid reflux (besides speaking with your pediatrician or IBCLC), is to pay attention to baby’s weight and whether or not they seem to be in distress while spitting up. Desi was a very spitty baby for a while, often spitting up what seemed like an entire feed, but because his weight gain was good and he seemed to barely notice the spit up, our pediatrician was not concerned, and he eventually grew out of it. The peak age for spit up is 3-6 months. 
  • The same goes for gas. Gas is normal. Sometimes your baby may need help with some trapped gas by burping, doing bicycle legs, gentle tummy massage, being held with their tummy against your forearm for a bit of pressure, or getting a warm bath. However, if baby seems to be in pain or the gas issue seems to be constant, speak with your pediatrician. There may be a food allergy that needs to be tested. 
  • At some point or another, you may face clogs, mastitis (infected clogs), or thrush (yeast infection either in baby’s mouth or on your nipple). Clogs can be treated at home with heat, massage, dangle feeding, pumping, and increased nursing to get the clog out. Mastitis and thrush, however, need immediate medical attention. Mastitis symptoms include pain in the breast, redness or streaking on the breast, fever and flu like symptoms. Thrush usually presents as pain with latching and white spots in baby’s mouth that are not easily wiped away (milk and fat on the tongue can look white, but is usually easily to wipe away with a wet cloth). 
  • Not all medications are breastfeeding safe. Double check all medications with your pharmacist and/or IBCLC. You can also call the Infant Risk Hotline (US) to ask. 
  • If you are facing supply issues, of course you should speak with an IBCLC. You should also check that you’re eating and drinking enough. Also check that you haven’t ingested large amounts of peppermint, or taken any medications that are not nursing friendly (antihistamines for example can dry you up). A few things that can help increase your supply: increased nursing sessions, pumping after nursing, power pumping, and in some cases certain foods or supplements can help, but generally only if you’re not eating or drinking enough. Some women have found that Fenugreek helps their supply, however, it has also been shown to dry some women up, and to cause increased gas in baby, so take with caution. Oatmeal, flax, coconut, and brewers yeast are favorites for trying to increase supply. They are not guaranteed, however, and the best thing to do is to increase how much milk is being demanded from your breasts. Again, breastfeeding is supply and demand. It makes what you tell it is needed, within reason. 
  • In the US, public and uncovered breastfeeding is legal and allowed anywhere you are legally allowed to be. No store policy is above this law. If you need to feed your baby and are comfortable being uncovered, you are allowed to do so whenever and wherever you need.
  • If you are a working mother who needs to pump, federal laws are in your favor. Any company with 50+ employees must allow you to pump as you need, and must provide a safe, private, lockable, and hygienic area for you to do so, until your baby has reached 1 year of age. They cannot make you pump in the bathroom. Some states may have stricter policy in your favor. If you are being denied these rights, print out your states laws as well as the federal laws, and speak with HR. 
  • Besides speaking with your Lactation Consultant/IBCLC or Doctor, you can get more help and information at KellyMom.com or visiting your local La Leche League chapter (they also have online Support Groups on Facebook). 
With the right support and education, you can feed your child the way you want. You can be successful at breastfeeding. I hope something here will have helped made things a little easier for you. 

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