IBCLC explains TOP TIPS for BREASTFEEDING SUCCESS | Dr. Amna Husain
Dr. Amna Husain...: Hey, everybody. Welcome back. My name's Dr. Amna Husain, board-certified pediatrician, board-certified lactation consultant, and mom. So, today I'm actually going to put on my lactation consultant hat and talk to you guys about my top tips for breastfeeding success.
Now, a quick disclaimer. A lot of these breastfeeding videos, when they're being educational, they may also be tinted with a little underlining of shame or, perhaps, judgment. If a mother is unable to breastfeed or chooses not to breastfeed, that's not my decision to make. This video is not about that at all. It's just approaching breastfeeding from an educational perspective.
However, if you feel like this video could potentially cause you to have feelings of shame or feel judged about not being able to breastfeed, then feel free to skip it. I won't mind at all. Again, this is purely from an educational perspective, things that I wish that I had known personally, when I started on my breastfeeding journey with my first daughter. And now I'm actually pregnant with my second daughter, so these are a lot of the same tips that I'm going to be instituting again.
Now, first let's talk about the benefits of breastfeeding, and we'll hit on these very quickly. But from a maternal perspective, immediately after delivery, it can actually help decrease the risk of postpartum bleeding and hemorrhage. It can help increase uterine involution, or basically the uterus returning back to normal size. It can also help with things like decreased risks of postpartum depression, even things long-term, like a decreased risk of ovarian and breast cancer for mom.
But I'm not a mommy doctor per se. I'm a baby doctor, right? So, what about the benefits for baby? Well, there are a few. We've definitely talked about, from the preterm aspect, what benefits breast milk carries. If you haven't checked out my video yet on preterm babies and what to know if your baby's born premature, I highly recommend checking it out. But we do discuss that breast milk does carry benefits in regards to decreasing the risk of necrotizing enterocolitis, or NEC. There's also some evidence it can be helpful for retinopathy of prematurity, or ROP, and even chronic lung disease.
What about term babies? Everybody always talks about the fact that breast milk contains antibodies, and it also contains enzymes and other cytokines and important factors that can be helpful when it comes to fighting infections. So, breastfed babies may have a lower risk of ear infections. They might also have a lower risk of lower respiratory tract infections, like pneumonia, bronchiolitis. In general, you can also see that breastfed infants can have a lower risk of diarrheal diseases.
Now, I'll be really honest. I think this is more prevalent in developing nations, where perhaps the water source isn't as reliable to be safe to make formula with, for example. In that event, it's probably safer to breastfeed your infant. Here, in a developed nation like the US, I think it's probably less helpful or less prevalent from the diarrheal and GI disease standpoint. But, again, it's something important to know about.
Why do all these things happen? Well, it's actually through a type of antibody that's secreted in the breast milk called IgA. That's a different antibody than what's passed between mom and baby prenatally, which is called IgG. Now, in general, we do see that the antibodies do start to decrease in volume and quantity as breastfeeding goes on. So, perhaps for the nine to 10-month infant onward, we do see that the IgA volumes in breast milk can go down. But, again, breastfeeding has lots of benefits like we've already hit on.
So, we've discussed a lot of the benefits, but let's talk about what we started with. Right? My tips for success. So, speaking of, what's my first tip? Prep before birth. I know that sounds really presumptive. Right? To learn all about breastfeeding right before baby's born. You don't even have a baby to breastfeed. But this is really important because, especially depending on how your delivery goes, you might actually be recovering from surgery perhaps, or maybe something happened unexpectedly, and you're actually recovering perhaps away from your baby, whether that be you in the ICU or baby in the NICU.
And it's really hard when our breastfeeding journey doesn't start off the way we expected. So, make sure you educate yourself, whether it be reading websites, watching this video, sharing this video with your support partner, talking to friends who have breastfed, and especially somebody who's breastfed recently. I wouldn't say go to your mom who breastfed you 20 plus years ago, because you'll want to know and get an insight from somebody who's done this recently.
Spoiler alert. Breastfeeding isn't easy. And, while it might be a natural way to feed your baby, it doesn't come naturally to many women, and even babies. So, make sure you educate and prepare yourself before baby comes, so that you can set yourself up for success.
Personally, I didn't do this. I was a resident when I had my baby. I went to newborn and breastfeeding classes, and I went to labor and delivery classes. And I certainly knew a lot about breastfeeding. I knew the physiology of breastfeeding. I knew the benefits of breastfeeding that we just recently hit on. But did I really know that much about how a baby latches and how important a latch is and how to troubleshoot common concerns that arise in the newborn period, as a new mother, who's trying to breastfeed? I didn't, and I wish that I could go back in time and actually change that. So, again, I think this is a super important tip when thinking about how to set yourself up for success.
Tip number two. Try to breastfeed as soon as possible. Now, again, we've already discussed that sometimes birth is unpredictable, and we might not be able to breastfeed within that first hour of life that we call the golden hour because, perhaps, maybe mom's health or baby's health comes first, and they may need to be separated for a short period of time.
But if you are able to bond with your baby and breastfeed within that first hour of life, it can be really beneficial. So, we call it the golden hour, and we actually recommend that moms and babies stay skin-to-skin for that time. Skin-to-skin can have lots of benefits. It not only regulates baby's temperature and their heart rate and their breathing, but it also helps babies become accustomed to mother's smell. It helps induce mom's milk to come in. So, I'd highly recommend it.
Speaking of what can you expect your breast to produce? You should know and prepare yourself that your milk won't be flowing initially, especially if you're a first-time mom. You will have colostrum within your breasts though. That has actually been made during pregnancy, which is really amazing. So, colostrum is readily available. And it's a thicker, yellow substance, and it's very high in antibodies, carbohydrates, and protein.
Again, baby's not going to need a lot in the first few weeks of life. Honestly, their belly is like the size of a cherry or a grape. So, don't be surprised if you only produce a few drops initially. This is totally normal.
All right. Tip three. Make sure you get help early. Please don't be worried that breastfeeding's not going well, and that it's your fault, and that it should come naturally. I've already discussed this, but breastfeeding might be a natural way to feed your baby, but it really doesn't come naturally. Especially if this is your first time feeding your baby, you kind of don't even know what issues to troubleshoot. So, make sure you get help early. Don't be afraid to use your hands. Don't be afraid to ask your partner for help. Get help early from a lactation consultant as well. They're always in the hospital just to help for this reason on the mother-baby ward.
Speaking of, let's talk about signs of a good latch. Baby's mouth should be actually open very wide. And it's not abnormal. It's not painful for their jaw at all to do this. This is super normal. Their mouth actually has to be open very wide, and their lips, especially their bottom lip, flanged or turned outward. That's really important to make sure that you're getting enough of the breast tissue in the mouth. Also, make sure that they're latching onto more than just the nipple area. They should actually be latching onto the whole dark circle around your nipple area, called the areola.
Now, to feel if baby's actually swallowing, you should actually hear suck and swallowing sounds from the baby. Sometimes, they can sound like clicking. You might even see the ear and the jaw moving because, as they're swallowing, you see that coordinated motion. You might feel a strong tug, but it shouldn't feel painful.
Again, there's a lot of troubleshooting to work through in the beginning. It would be completely naive to pretend that there's no issues whatsoever. So, it can be a little uncomfortable initially, but not acutely painful. And if it is painful, make sure you get help early.
On that note, be familiar with different holds. Your lactation consultant can talk you through it, but there's tons of different holds that you can use for your baby. Cradle, cross-cradle, football hold, side-lying, and even laid-back nursing, are great options for moms.
So, why do I discuss so much about pain and being familiar with seeking help if you are having pain with breastfeeding? Well, because if you're feeling pain and discomfort, your baby's likely not transferring milk very well. You might even want to end the session prematurely while you still have milk in your breasts. And that's getting me to tip number four for success.
Make sure you breastfeed and empty your breasts frequently. That's why a latch is so important. Let me explain. So, our breasts and breast milk actually work on a supply-and-demand sort of philosophy. So, for example, the more demand that your body senses or that your breasts actually sense for needing milk, the more our brains send out signals to create more breast milk. So, get it? Demand, supply.
Now, let's say that you're making too much milk, and you leave some milk in your breasts after baby's done doing a feed. Well, then our breasts send the signal up to the brain saying, "Nope. You're doing a great job. You actually may not even need to produce that much more milk." And slowly, after a few days, we might actually down-regulate to meet baby's needs.
So, if you reverse that philosophy and try to up-regulate to meet baby's needs, the only way our brain is going to send that signal to our breasts is if we get the signal that our breasts are empty. We'll then tell our brain, "Hey. Hey. You need to make more prolactin, the hormone that actually induces milk production." By that, we'll actually start regulating and creating more breast milk for our baby.
That's why it's so important, especially in the beginning, to not necessarily watch the clock, but watch your baby and your baby's feeding cues. And even if your baby's sleeping, sometimes wake them up from sleep, so that you can actually feed them on demand and make sure your breasts continue to get that signal that they're emptying, so that we can actually induce and regulate good milk production for the baby.
Does that mean that initially you will not have a schedule? Yeah. And, trust me, I love a good schedule. I love my planner. I love my calendar. I love planning out what I'm doing hour by hour, but in the first few weeks of life, it's really important to watch your baby and not the clock. Trust me. It's going to be really helpful, in general, for your long-term breastfeeding journey, if you can actually try to regulate to your baby's needs, rather than just watching the clock.
And then, certainly, I think as time goes on, once a good breastfeeding relationship has been established, we can definitely set ideas and times around when baby can nap, when baby should be awake, and things we can do to help promote that sort of good eat-sleep rhythm. But, for now, especially in the first, I would say four to six weeks of life, it's totally recommended and actually normal, to just regulate to your baby and your baby's needs.
All right. Tip five. Make sure you set up your space for nursing, physically, mentally, and emotionally. I'll explain. So, physically, I recommend that if you're going to be nursing baby, let's say whether it be in your bedroom, on your couch, in your living room, your rocking chair, the nursery, wherever it be, you have a mommy survival station. And I'll explain what that is.
You should at least have a water bottle with a straw, which will be super helpful for you to drink out of. Sometimes, those postpartum jugs of water that they give out on the mommy-baby unit are really great to just take home. They can hold two liters of water, which is really helpful, but that's an option.
Second thing to keep in mind, something that you can eat, that's healthy, with one hand. So, that could be granola bars, nuts, protein bars, cheese sticks, high-protein snack filled with healthy fats, something that's good for you, makes you feel good, so that when you're sitting there nursing and it's 45 minutes in, all you can think about is how thirsty you are or how hungry you are, you have easy access to get some good snacks and sustenance.
On that note, your nursing station physically should also be equipped with a good chair that makes you feel good. Now, if after a day or two, you're finding that you're having a lot of back pain, make sure you're reassessing your station, in addition to how you're positioning your baby, to make sure that you can make it as comfortable for yourself as possible. Maybe you need to actually get a nursing stool, so you can pop up your feet while you're nursing as well. That can be really helpful for some moms, especially postpartum, if they're having some discomfort from potentially stitches or hemorrhoids.
Now, what about mentally setting up your space? Well, maybe you need to actually be in a calmer frame of mind. So, perhaps that's the nursery. And if it's the nursery, or it's your bedroom, maybe you want to have a place where you can look outside the window, not just a blank wall. Or perhaps you want to listen to an audiobook or a podcast while you're nursing or calming music. That can be really helpful, and actually it can help milk let-down as well.
So, I would really start to think about these things ahead of time, and especially try and prepare yourself emotionally. Right? So, I said set up your space physically, mentally, and emotionally. What do I mean? Well, again, I think a lot of moms, and I've hit this point home a few times, might not be prepared with how intense and rigorous nursing can be. It can take a lot of your time, even if you're not nursing at the breast and you're exclusively pumping, it can take a lot of time, and it can be emotionally draining. So, make sure you set yourself up for success.
If you need to have a friend to talk to at that time, make sure you pop on the phone, so you can talk to somebody, distract yourself appropriately so, and that you're able to make the time go by in a more enjoyable way, potentially if you are feeling down while nursing.
On that note, I want to tell you all that it's okay to feel down. Especially after having a new baby, there can be some guilt. You have this beautiful baby in front of you. You're home. You're comfortable. You're healthy. Why do you feel sad? Well, there's a couple of different reasons why. We've discussed postpartum depression being decreased with mothers who breastfeed, but that doesn't mean that it doesn't happen at all. Postpartum blues can be very normal. Postpartum anxiety is also something that we're seeing a rise in.
I really highly recommend you talk to your support network and loop your OB-GYN or your family doctor in early, even your pediatrician, so we can support you in a way that helps. You don't have to feel guilty about having feelings of anxiety or feeling down while nursing your baby. Certainly, some of it can be very normal and expect... That doesn't mean they're not validated. I think it's really important to set up a support network early.
And that's my tip number six. Make sure you seek support in all types of avenues. Sometimes, it might be your Mommy group. Sometimes, it might be a friend from church or from your workplace. Sometimes, it might be your doctor. Sometimes, it might be a lactation consultant. And it's totally okay to acknowledge what you're feeling. It can actually be more helpful, rather than sort of trying to bury those emotions.
It's also really important to bring it up because, as a lactation consultant, I'll tell you, there is something D-MER, or Dysphoric Milk Ejection Reflex, which can make mothers have intense feelings of depression, anxiety, or feeling overwhelmed while their milk is releasing, and you're having a milk ejection reflex.
It's not abnormal, and it does happen to a small subset of women. If you're able to bring it up to your doctor or even your lactation consultant, we can help you through that. But, again, it's not something for you to just think to yourself, "Well, this is normal, and I have to get through this."
So, there are certain conditions that can be associated with negative, adverse feelings and feeling down while you're nursing. Make sure you talk to somebody and seek help early.
My last tip for success is actually about mom's diet. Now, my background is actually Pakistani. There are a lot of cultural beliefs about what a mom should be eating to support her while she's breastfeeding. A lot of them are recipes for semolina toasted in butter, with lots of crushed nuts in it, something that's high fat, high calories. And then, of course, whole-fat milk, all types of different Old Wives' tales.
At the end of the day, let's talk about what really does help mom's diet. So, in general, bone mineral content can decrease during lactation, but compensatory remineralization does occur after moms get their periods back and choose to wean their baby. So, while lactation is associated with bone resorption, it's very transient, and all of its effects are basically reversed when you do end up deciding to wean your child.
That being said, a breastfeeding mother should be getting adequate amounts of calcium and vitamin D. That's really important. Again, no fractures are going to occur long term if you choose to breastfeed. That's not really the case, actually. But you should be supporting your bone turnover at that time. So, a good way to do that is actually just resume your prenatal vitamin that you were taking during pregnancy. You'll also get good stores of iron and folate from that as well.
When it comes to vitamin D, you will hear from your pediatrician that it's very important for your child, your infant, to also have vitamin D. Typically, even if mom's going to be taking vitamin D, I still recommend breastfed babies also be supplemented with vitamin D, to help decrease the risk of rickets.
Fish is a really good source of vitamin D. It's also a good source of protein, which a lactating mother will need, for example, for building, repairing, and maintaining tissues. In general, a lactating woman could need 71 grams of protein a day. That's 20 to 25 grams, more than what the typical woman might need, and there's a few reasons for that. You go based off of milk production, how much protein is needed to actually create the milk.
This recommended daily allowance is actually based off the average volume of milk that a breastfeeding woman would make, the average protein content of breast milk, and efficiency of dietary protein for utilization of milk synthesis. Fish is also a good source of DHA, which is an omega-3 fatty acid that can be helpful in the development of baby's brain and eyesight.
So, a lot of things that we talked about here, we can definitely recap through all the different tips for success. So, first of all, make sure you prep early. Second of all, try to breastfeed within the first hour of life, if you can. Tip number three, make sure you seek help early. That could be from the mother-baby unit, a lactation consultant, the follow-up clinic at your hospital, your healthcare provider, a local breastfeeding information hotline, your local chapter of your La Leche League, or even a local health department or WIC center.
Tip four, make sure you're emptying your breasts frequently, so our brain is getting the signal to produce adequate amounts of milk for your baby. Tip five, make sure you're setting up your space physically, mentally, and emotionally. Tip six, create a good support network. Tip seven, make sure you're getting enough nutrients in your diet.
I hope those were all helpful. Make sure you comment below if you have any specific questions. Let me know if you'd be interested in a video on breastfeeding myths. If this video was helpful, make sure you give it a thumbs-up. Follow me on Instagram or TikTok for more breastfeeding advice. Make sure you subscribe below. See you next Monday.