1. Engorgement is normal on day three. Cut back on fluids to help it.

True          False

2. It’s a good idea to stay away from pacifiers and artificial nipples at first.

True          False

3. Going back to work?? The best thing you can do to get ready is to freeze plenty of milk.

True          False

4. Some women just cannot breastfeed.

True          False

5. Breast milk is a complete food, but you will need to give the baby vitamin D drops.

True          False

6. A baby is never allergic to its mom’s milk.

True          False

7. Breastfeeding ties you down.

True          False

8. The nurses in the hospital will get you off to a good start with breastfeeding.

True          False


1. False. Now, truth to tell, we’re so far away from “natural” on breastfeeding that we don’t even know how much engorgement is normal. We do know that in women of healthy weight who have had uncomplicated births, the milk usually starts to come in 24-36 hours after the placenta falls out. Babies get protein-rich colostrum in small sips at first, then colostrum-rich milk in the first week or so.

But engorgement is all about fluids. When we’re pregnant our body-fluid weight goes up by about 40%. After all we are nourishing a new life with our blood supply! And many moms find swelling of the feet and legs are part of even a very healthy pregnancy. Our bodies use all those extra fluids to help us make milk in the early days – and those extra fluids are where the engorgement/edema of the breast comes from. If you are induced with Pitocin via IV, or you have an epidural or a cesarean birth, you will have extra fluids on board postpartum –often with the troll feet to prove it. In that case getting your baby to breast as early and often as possible will help prevent engorgement.

Here in The Birthing Center, our Golden Hour will help you get breastfeeding off to a good start. Your baby is primed to find the breast and we will offer you the privacy you need to feel at ease about feeding your baby from the very beginning. There’s lots of great information about this at https://www.sciencenews.org/blog/growth-curve/timeline-baby%E2%80%99s-first-hour or https://www.youtube.com/watch?v=XtxRxTOoieY

2. True. What are the reasons to stay away from artificial nipples and pacifiers at the beginning if you’re planning on a happy breastfeeding career? First, breastfeeding works best when you and your baby figure out how you fit together. It is downright amazing how often the baby wants to practice at first – but having someone around to help, and doing lots of effective nursing, will help reduce engorgement, fend off jaundice in the baby, and give you a big boost of confidence when you take your new baby home. And most often an artificial nipple will be placed on a bottle. We live in such a bottlefeeding culture that it may feel really comfortable and normal to use it – which may make the breastfeeding that you’re learning feel uncomfortable and abnormal. The number one rule in any case though is Feed the Baby.

3. False. Although you would think a stash would be essential, truly the best thing you can do is fall so madly in love with your baby – and breastfeeding! Plan well for going back to work:

  • Make sure your baby will take a bottle – do not wait until three months to try one because three month old babies will act like you are trying to ruin their lives when you give them a non-you nipple.
  • Think carefully about what your schedule will look like at work, and how that syncs with your baby’s usual feeding schedule. Most moms have lots of milk in the morning….if you have quiet time when you are listening to phone calls and returning emails, you may find you have good luck pumping first thing in the morning. Practice enough with your (double) pump so you can be done pretty quickly not just with pumping but also with getting the paraphernalia put away and ready for the next feed.  www.workandpump.com has some really great info, and be sure you check out our post about Nancy Mohrbacher’s Magic Number and how it can help you figure out your future at https://www.bmhvt.org/babysteps/mohrbachers-magic-number

4. True! This is a really tough one – because for years our first thought was, “ every mother can make milk, you’re just not trying hard enough.” Wrong!! This topic – well, we could write a book. And in fact, take a look at Diana Cassar-Uhl’s article at http://kellymom.com/bf/got-milk/supply-worries/insufficient-glandular-tissue/ and her book : Finding Sufficiency: Breastfeeding with Insufficient Glandular Tissue.
The quick down and dirty is this: Most women can make enough milk for their babies – the number who can’t is probably somewhere under 5%. Here’s just some of the things I think about when wondering “Is this mom making enough milk and if not why?”

  • How many days old is the baby? What kind of birth did mom have? Did the baby have easy access to the breast from Day One? (In other words – did things get screwed up in the hospital or at home? We know that ad lib good feeds in the beginning leads to good stuff going on later.)
  • Does the baby have something going on that makes it hard to nurse effectively? Being sleepy from jaundice, having a tongue tie, an undetected birth injury (like a broken clavicle that makes it hard to get comfy at the breast), an undetected cleft palate.
  • Is baby actually eating fine but mom is thrown by the baby’s behavior at 2 AM or just the fact that the baby wants to eat “so much”? It’s incredible how often newborns want to eat. And if you come from a family or circle of friends that have formula fed, they are going to think something is wrong, when actually it’s fine. Even harder if your own mom was told she didn’t have enough milk but it was bad hospital practices that screwed up her supply.
  • What do mom’s breasts look like? Did she have breast changes during pregnancy? Does she have hormonal challenges going on like Polycystic Ovarian Syndrome (PCOS), or insulin resistance? (Back to Diana’s research there.)
  • Even when moms can’t bring in a full supply for their babies, we need to help them have the intensely intimate relationship with their babies that both mamas and babies crave – and that makes them thrive. (Do join us at New Moms Network on Wednesday mornings if you’ve been crying over this one. We will love you up and help all we can, and there are moms who can support you in your quest to make the most milk possible.)

5. I hate this question. Why did I put it on here? Well, because Vitamin D is important for moms and babies. We are making a real effort to make sure we’re all getting enough of it. Currently the American Academy of Pediatrics is suggesting that all babies be given a Vitamin D supplement of 400IU per day. They also have noted that most babies don’t have optimal circulating Vitamin D levels, no matter whether they are fed breastmilk or artificial formula.

The American Journal of Clinical Nutrition published a research article that states, A maternal intake of 4000 IU/d could achieve substantial progress toward improving both maternal and neonatal nutritional vitamin D status. You can read it at http://ajcn.nutrition.org/content/80/6/1752S.full
So do some reading, talk to your physician and your baby’s caregiver, and make a good decision for yourself and your baby. And if you know someone who is pregnant, by all means talk to your doctor or midwife about optimal Vitamin D levels. Because if you have good levels, so will your milk.

6. True. A baby is never allergic to mom’s milk – but s/he may react to things in the milk. This goes back to the whole “You should never eat (fill in the blank) while you are breastfeeding.” There are very few things that moms need to stay away from in terms of fussy babies. So don’t worry about eating apples or broccoli or cole slaw. Babies are not lactose intolerant either – human milk is just full of lactose, so it’s later on that the intolerance begins . Otherwise the human race wouldn’t be here any more! Some babies are very aware of flavors – and hot hot spicy food like Szechuan peppers can certainly make your baby miserable. But a classic study was done with garlic and babies actually ate more for a few days until they got used to the flavor. You can read the abstract of that study at http://pediatrics.aappublications.org/content/88/4/737.short

One thing moms find here in our area is that their babies may react to dairy. Again – it’s not the lactose, but rather the bovine immunoglobulins (!), and moms may need to stop beef as well. If you’re interested in more information on this one, you can start your reading at http://kellymom.com/health/baby-health/food-sensitivity/

7. False – unless you spend too much time looking at formula company ads. They would like you to think that moms who breastfeed only do so in the privacy of their bedrooms! Or you live in a place where people give you the evil eye for breastfeeding in public. I dream of a day when babies can happily eat anywhere they want.

If you haven’t breastfed yet when you’re out and about, I’d encourage you to come to Brattleboro New Moms Network some Wednesday morning. You’ll see lots of babies eating in various ways. And some moms even go out for lunch together afterwards (gasp!). Breastfed babies are easy to travel with, and their food and comfort is immediately available when mom is nearby. Yes, I know a dad with a bottle is very nice but this is The Best Feeding Breastfeeding Quiz! Don’t forget you can see our New Moms calendar on the Events tab at www.bmhvt.org

8. Hmmm – I hope so! But get yourself a good breastfeeding book. The first one I think of is The Womanly Art of Breastfeeding (8th edition) by Diana West and Diane Weissinger, and you may like Breastfeeding Made Simple too (Nancy Mohrbacher and Kathy Kendall-Tackett).
If breastfeeding isn’t going well at the hospital, remember that we have good help out in the community too. An International Board Certified Lactation Consultant can help – and so can a mother-to-mother support group. More about that soon!