Breastfeeding: How to Handle Common Concerns

When you continue breastfeeding at home in the weeks after your baby’s birth, you're giving your newborn a great health advantage. For maximum benefit, the American Academy of Pediatrics recommends nursing for a year. But many moms give up breastfeeding before their babies are six months old. Here are some suggestions for how to cope with common concerns and help you feel confident with breastfeeding.

Ask for help.

It is important that a breastfeeding mother is well-rested and relaxed in order to keep up her milk supply, so even if she isn't accustomed to asking for help, she will need to do that once baby arrives. Since no one can help a mom with the actual breastfeeding, family and friends can assist in other ways. They can lend a helping hand by bringing you the baby when it is time for a feeding. They can also help with cleanup and some household routines while mom is nursing the baby.

Reduce anxiety and stress.

Postpartum anxiety is as common as postpartum depression. It can be difficult to maintain a good milk supply or take proper care of yourself and your baby if you have anxiety or depression. The lack of sleep that occurs in those first weeks and months of motherhood before baby is sleeping through the night or on a set schedule can contribute to postpartum stress. Here are some tips to help you relax and get more rest:

  • Find ways to relax (e.g., soothing music, white noise, and getting into a nursing position that’s comfortable). Keep in mind that the American Academy of Pediatrics says you can’t sleep with your baby. However, nursing in a side-lying position can be relaxing. If a mother is very fatigued, it would likely be dangerous for her to nurse while sitting up.

  • If you nurse in a side-lying position and are concerned that you may doze off and roll onto baby while you sleep, you can bend the upper knee and raise it over your body, then place the bent knee onto the mattress—the bent knee is like a stopper that prevents you from rolling over.

  • Take a warm bath, which helps release oxytocin and encourage milk flow.

  • Massage your breasts gently during nursing or apply a heat pad on the breast before nursing your baby.

Tune into your baby's behavior.

You’ll know if your baby is getting enough breast milk by observing his/her behavior. After you nurse, burp and change your infant, check for these signs:

Quiet time is good – This occurs after your baby has been breastfeeding effectively (which happens when there is a good balance of your milk flow and your baby’s feeding skills). He or she comes off the breast after feeding and looks around, hiccups, or falls into a deep sleep—all signs of satisfaction.

Keep a close watch on baby’s weight.

Is your baby crying often—perhaps acting distressed despite frequent nursing? You can typically relieve distress by burping or rocking the baby to relieve gas, and checking for a dirty diaper.

Some weight loss after birth and the first weeks of breastfeeding is normal for a newborn. It is important to stay in touch with your doctor for follow-up to track your baby’s early growth and progress. Dramatic weight loss in a newborn or failure to gain weight after the first few weeks of breastfeeding can sometimes be a cause for concern, so communication with your doctor is important.

Adjust the feeding schedule, as needed.

The golden rule of breastfeeding, according to La Leche League is that the more a baby nurses effectively, the more milk there will be. Really understanding this rule will lead to a contented baby who is receiving enough nourishment from breast milk.

Of course, a breastfeeding mom needs to be diligent (feeding 8 times a day in a 24-hour period) in the crucial first few weeks. After the baby gets back to birth weight or gains weight at an appropriate pace, the eight feedings can be spread out accordingly.

Every new mother's schedule may be different—it all depends on how long the baby sleeps at night. If someone’s baby sleeps for a five-hour stretch, the nursing mom just has to fit in those eight feeds before she goes to bed at night.

By six weeks, the baby starts making the hormones melatonin and cortisol—this usually helps the child sleep better at night. Mom may not need to nurse as frequently at that point. However, if your infant is not feeding well (losing weight, not getting enough nourishment), then wake him or her up at regular intervals to nurse. Double-check that he/she is latching on properly, and consult with a lactation consultant if you need help.

Relieve/prevent breast engorgement.

Breast engorgement occurs when milk and blood build up, resulting in hard and painful breasts. (You likely experienced engorgement when your milk came in during those first days following your baby’s birth.) It could also happen for other reasons later on, such as:

  • If you leave your baby with a sitter or family member for an extended period of time, interrupting the usual breastfeeding schedule, then your breasts may get too full of milk.

  • If you're prone to anxiety or stress, this can interfere with the “let-down” reflex, resulting in a feeling of fullness and pain in the breast.

Here are ways to prevent and/or relieve engorgement:

  • Nurse often. (8 times a day)

  • Use a breast pump. A mom can pump any time she wants after breastfeeding. If your baby only wanted to nurse on one side, for example, you can pump the other side – not to empty it, but to soften it, and prevent engorgement.

  • Be prepared. If you know you’ll be away too long from your baby to nurse on schedule, be sure to pack a breast pump and empty bottles, and a portable case with an ice pack to store the pumped milk.

  • Get enough rest, good nutrition, and fluid intake.

  • Don’t stop breastfeeding abruptly!

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