Breastfeeding Effectively

According to the guidelines of the American Academy of Pediatrics, infants who are discharged from the hospital early should be evaluated by their Pediatrician or other health care professional by 2-4 days of age, even if your newborn doesn't have any risk factors.

There are also risk factors in the mother that can put her at higher risk of having difficulty breastfeeding, including:

• chronic illnesses, such as diabetes or cystic fibrosis or having complications around the time of delivery.
• a history of difficulty breastfeeding a previous infant.
• previous breast surgery, including breast reductions, breast augmentation and excisional biopsies, especially if a periareolar incision was used, and breast radiation.
• having minimal or no breast enlargement during pregnancy.
• flat or inverted nipples.
• breastfeeding for the first time, especially if the mother has no breastfeeding experience, such as observing another family member or friend breastfeed.

Mothers with these risk factors may benefit from a prenatal breastfeeding class or an evaluation with a lactation consultant once she begins breastfeeding. The better prepared you are for breastfeeding once your baby is born, the more likely that you will have a successful breastfeeding experience.

The risk factors above, either in the mother or infant, can contribute to breastfeeding problems by causing a poor milk supply, either because the mother isn't able to produce breast milk (primary lactation failure) or because the infant isn't removing the milk and stimulating further breast milk production (secondary lactation failure).

Other factors that can contribute to breastfeeding failure include some of the things that mothers think they should do or are instructed to do. This includes giving supplemental bottles of formula because of the belief that the baby isn't getting enough. There are some situations where supplemental feedings are medically necessary, especially if the baby is dehydrated or has excessive weight loss. If medically necessary, giving supplements, in addition to ensuring the health of the baby, should include a goal of fixing whatever is going wrong with breastfeeding, so that you will ultimately be able to exclusively breastfeed. This can include increasing the mother's supply of breastmilk and/or helping the baby latch on or suck properly. Instead of substituting breastfeedings with a bottle, if it is really thought that a supplement is medically necessary, it is usually better to allow your baby to breastfeed for about 10 minutes, supplement him until he is satisfied and then pump for an additional 10 minutes. By emptying your breasts, you will stimulate your body to produce more milk.

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