1. DO NOT let anyone tell you it is necessary to toughen up your nipples for breastfeeding.

2. DO some reading about breastfeeding. Good choices are:

~ The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from Birth Through Weaning
~ The Womanly Art of Breastfeeding: Seventh Revised Edition
~ The Nursing Mother’s Companion: Revised Edition
~ The Ultimate Breastfeeding Book of Answers: The Most Comprehensive Problem-Solving Guide to Breastfeeding from the Foremost Expert in North America, Revised & Updated Edition

3. DO NOT think you need to buy a lot of breastfeeding-related products. The great thing is all breastfeeding really requires is you and the baby!

4. DO, however, consider whether you might enjoy shopping for breastfeeding products and learn how to choose and use a breast pump safely if you will be returning to work.

5. DO NOT listen to people who pressure you to formula-feed.

6. DO attend a La Leche League meeting while you are pregnant (find a local group in the United States or other countries) and surround yourself with family, friends, and medical professionals who are supportive of breastfeeding. (If you are wondering, here’s how to pronounce “La Leche” League!)

7. DO NOT accept or keep any free formula samples “just in case.” (For thoughts on what to do with any samples you might receive, see this post).

8. DO have the phone number of a local La Leche League leader and/or lactation consultant with you at the birth.

9. DO NOT neglect to talk to your health care providers and birth attendants about your birth plan and your desire to breastfeed.

10. DO believe in yourself! Taking these 10 steps can give you the knowledge and confidence to have a good breastfeeding experience.

Enjoy these other entries in this month’s carnival (and watch for additions throughout the day):

~ Motherwear Breastfeeding Blog: A Breastfeeding-Friendly Birth Plan
~ BreastfeedingMums: Preparing for Breastfeeding
~ Natural Moms Talk Radio: Breastfeeding during Pregnancy and Tandem Nursing
~ Crunchy Domestic Goddess: Breastfeeding while Pregnant (Trying at Times but Ultimately Worthwhile)
~ Permission to Mother: Low Milk Supply in Pregnancy
~ API Speaks: On Breastfeeding while Pregnant
~ Milk Donor Mama: Her Experience of Preparing for Breastfeeding and the Advice She Offers Now

Post from: Breastfeeding 1-2-3

__ In the cradle or cross-cradle positions, the baby should be resting on his side, his tummy facing your tummy, shoulder and hips aligned, mouth level with the nipple

__ The baby’s mouth should be covering at least a half inch of the areola, the dark area of skin around the nipple

__ His nose is touching or nearly touching the breast

__ Both the top lip and bottom lip are flared out

__ Once your milk lets down (starts to flow freely), you can see the baby’s jaw moving all the way back by his ear

__ The baby’s temple may wiggle, too

__ You can hear the baby swallowing (you might notice a pattern, such as “suck, suck, pause for swallow.” The pattern will slow as the baby fills up and takes in less milk). Dr. Jack Newman describes an “open mouth wide – pause – close mouth” pattern that indicates whether the baby is swallowing big mouthfuls of milk.

__ Absence of pain (if breastfeeding doesn’t hurt, that’s a great sign that the latch is good. Some women may experience initial soreness, tenderness, and even pain in spite of a good latch, but it’s a good idea to work with a La Leche League leader and/or lactation consultant to rule out problems with latch, thrush, or other things that could cause pain).

__ The baby’s tongue is extended over his bottom gums and is cupping the breast (if you peeked, you could see a little triangle of tongue in the corner of his mouth, but there’s no reason to peek if everything feels right).

__ When the baby pops off (or the latch is gently broken), the nipple does not look unusually squished or angled like the tip of a new lipstick (a distinct line across the nipple might be a sign of tongue-tie).

One final way to gauge latch (and the baby’s consequent intake of milk) is to watch the baby’s output! Is the baby having enough wet and poopy diapers?

Post from: Breastfeeding 1-2-3

Breastfeeding is an instinctual and natural act, but it is also an art that is learned day by day. The reality is that almost all women can breastfeed, have enough milk for their babies and learn how to overcome problems both large and small. It is almost always simply a matter of practical knowledge and not a question of good luck.

From Why Is LLL Necessary?

Post from: Breastfeeding 1-2-3

Post from: Breastfeeding 1-2-3

If you’re in the market for some nursing clothes, there are several sources out there.

In Stores

If you want to try on nursing clothes before you buy, check out the few retailers who have actual stores. In the United States, two main ones are Motherhood and Mimi Maternity. Target offers a basic selection of nursing bras and tank tops, and many major department stores will also carry nursing bras.

On-Line

Two of the major on-line retailers are Motherwear (see affiliate link in the side bar) and Expressiva (not affiliated). There is also quite a selection of nursing clothing available on Amazon.com (affiliate).

Smaller retailers include:

www.breast-is-best.com
www.evalillian.com
www.milkface.com
www.onehotmama.com

Cost Saving Options

I have seen gently-used nursing clothing in the maternity section of thrift shops such as the Salvation Army. A quick search on eBay for “nursing” under “Clothing, Shoes and Accessories” finds a wide selection of offerings. The only caution I have about buying used nursing clothing is that thrush can be transmitted through clothing, and anything you buy should be washed in very hot water (with bleach if the fabric allows) if the item will be in direct contact with the breast and not worn with another nursing bra or pad or tank top underneath.

One other option is to sew your own nursing clothing.

Reader Feedback

What’s your favorite source for breastfeeding clothes? Leave a comment!

Post from: Breastfeeding 1-2-3

When I was talking to my mom last night, she asked me if anyone (namely my midwife) had suggested that I ‘toughen my nipples’ in preparation for breastfeeding. This is my first baby, so I’ve been reading all sorts of books and articles–mostly about pregnancy and labor, but some beyond–and I’ve never seen this mentioned anywhere. Is this still common practice, or at least a good idea? Or is it just an old school of thought? Thanks!

Good question! I am totally cringing at the thought of “toughening up my nipples” and I want to assure all prospective mothers that it’s completely unnecessary! The idea that a woman would need to toughen her nipples is outdated. The key to comfortable breastfeeding is a good latch. Breastfeeding shouldn’t hurt, and if it does it can generally be chalked up to latch (or thrush, especially if the mother or baby has had antibiotics). Of course there’s a learning period in the beginning as both mother and baby learn how to breastfeed — something that people think is supposed to come naturally actually requires a bit of knowledge and practice. There may be some tenderness in the beginning, and that can be helped both with pure lanolin (such as Lansinoh), and by expressing some breast milk onto the nipple and letting it air dry (breast milk has healing properties).

Consider taking a breastfeeding class, either before or right after the birth. Two good books to help you prepare for breastfeeding are The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from Birth Through Weaning by Dr. Sears and The Nursing Mother’s Companion: Revised Edition by Kathleen Huggins, RN. You can also attend a La Leche League meeting while you’re pregnant. Have a local lactation consultant or La Leche League leader’s phone number handy so you can call for advice right away if you have concerns. Best wishes!

Post from: Breastfeeding 1-2-3

A: Domperidone is an anti-nausea medication that also happens to increase serum prolactin in women. It’s used in combination with frequent nursing or pumping to induce lactation or increase milk supply.

Domperidone is readily available outside the United States but is not available through most pharmacies in the U.S. It’s not illegal though and women can order it with a doctor’s prescription through “compounding pharmacies” in the U.S. or without a prescription directly from pharmacies in other countries.

Dr. Jack Newman and lactation consultant (and adoptive mother) Lenore Goldfarb have developed three protocols for induced lactation: (1) the Regular Protocol for women who have six or more months before bringing a baby into the family, (2) the Accelerated Protocol for women with little time to prepare for arrival of the baby and for re-lactating women, and (3) the Menopause Protocol for women who are menopausal due to surgical removal of the reproductive organs or naturally occurring menopause. Each of these protocols involves taking domperidone.

In June 2004, the U.S. Food and Drug Administration issued a warning against the use or import of domperidone. A reading of the warning raises two concerns: (1) is domperidone safe, and (2) is it illegal to import it into the U.S.? The easy answer first–In spite of the harsh warning about importing the drug, Dr. Newman explains:

It is perfectly legal for a US doctor to prescribe domperidone even though it isn’t available in the US [see exception below]. Any Canadian pharmacy can send you domperidone if you get a prescription from your doctor. And it is legal for a US citizen to bring domperidone into the US for personal use provided it is accompanied by a doctor’s prescription, a letter stating that the medication is for the patient’s personal use, and the shipment does not exceed a 3 month supply.

Domperidone is also available from compounding pharmacies in the U.S. with a prescription, and countries other than the U.S. and Canada without a doctor’s prescription. According to Dr. Newman, a doctor’s prescription is not necessary to import the drug as long as the drug is not a controlled substance, it is for personal use, it does not exceed a three-month supply, and the patient lists the name and address of a doctor who will be overseeing the patient’s use of the medication.

As always, when a woman has questions about the safety of a particular medication, she should consult her doctor, do her homework and make an informed decision. The good news is that domperidone is approved by the American Academy of Pediatrics for use by breastfeeding mothers. Domperidone is listed as a medication “usually compatible with breastfeeding” and there are no reported signs or symptoms in the infant.

With respect to the FDA warning, the Breastfeeding Answer Book says:

Note: In June 2004, the US Food and Drug Administration (FDA) advised that domperidone should not be used by breastfeeding mothers. Members of the La Leche League International Health Advisory Council are questioning this.

In Thomas Hale Ph.D.’s Medications and Mothers’ Milk he has this to say about the FDA caution:

Recently the US FDA issued a warning on this product stating that it could induce arrhythmias in patients. These claims were derived from data many years old where domperidone was used intravenously as an antiemetic during cancer chemotherapy…. Many of these patients were undergoing extensive chemotherapy and were extremely ill, and hypokalemic to begin with. Further, intravenous domperidone produces plasma levels many times higher than oral use. Thus far, we do not have any recently published date suggesting that domperidone used orally in breastfeeding mothers is arrhythmogenic.

p. 278. Domperidone is also discussed on Dr. Hale’s medications forum.

Further drug information can be found by searching for “domperidone” in the LactMed database I wrote about here.

Post from: Breastfeeding 1-2-3

Post from: Breastfeeding 1-2-3

When I was pregnant, I did a lot of reading about breastfeeding. I made a commitment to breastfeed as it clearly was the best thing for my baby. What I didn’t expect was that breastfeeding would become so much more than my baby’s source of nutrition. It served as:

~ pacifier
~ sleep inducer
~ pain reliever
~ immunity booster (I knew about this one, but I didn’t know I’d be so extremely grateful for this when the entire family had stomach flu and my daughter was the least sick of all of us.)

It took a while for both me and my baby to get the hang of breastfeeding, but once we did, breastfeeding became:

~ a quiet and restful time for both of us.
~ easier than bottle-feeding, by far! I didn’t have to prepare bottles in the night or pack a diaper bag full of ice and artificial milk when I went out during the day.
~ a good transition to solid foods. The flavors in the breast milk made my baby more receptive to solids when she was ready. At the same time, breast milk remained a significant source of my child’s nutrition.
~ something that would make my baby smile and giggle in anticipation!

I didn’t expect that I would ever want to nurse beyond one year. I didn’t realize that there would be huge advantages to toddler nursing. Breastfeeding became:

~ the key to taming tantrums instantly.
~ the only means to get my toddler to nap when even a car ride wouldn’t get her to nod off.
~ my toddler’s favorite way of reconnecting after a separation.
~ a big part of my mothering style.

I realize that not all mothers come to feel that way about breastfeeding, and that’s okay. It’s okay to take breastfeeding one day at a time. It’s okay to see what breastfeeding becomes for you and your baby!

Stay tuned for more contributions (see the underlined links) as they come in from:

~ Tanya at the Motherwear Breastfeeding Blog recalls the big changes that breastfeeding brought in her life
~ Sinead at BreastfeedingMums looks back over her seven years as a mother and shares what she wishes she’d known
~ Andi at Mama Knows Breast lists her top 10 things she didn’t expect
~ Jennifer at The Lactivist shares what she wishes someone would have told her

and our special guest contributors this month (blogs in alphabetical order):

~ Shelly at Adventures of a Breastfeeding Mother tells us what she didn’t expect about breastfeeding
~ Down with the Kids reflects back on breastfeeding as she weans her son in her post “Goodbye Booby”
~ Ashlee at New Mama’s Nest shares what she didn’t expect when breastfeeding her “early bird”
~ Heather at The Spice Choir talks about how breastfeeding changed her social interactions and connectivity
~ Melanie from Spit-Up on My Shoulder is a postpartum doula who has written a book entitled Why Didn’t Anyone Tell Me? True Stories of New Motherhood. She tells us why education is key
~ Rixa at The True Face of Birth shares how doing her homework helped her have a pleasurable breastfeeding experience

Photo credit: Johan Cloete

Post from: Breastfeeding 1-2-3

I realize that different slings/pouches/carriers might work better for different ages of babies and toddlers so please do leave a comment to share your opinions! Personally I liked the NoJo Sling when my baby was an infant but it got uncomfortable when my baby got older. My husband liked the NoJo as well but also enjoyed using the Baby Bjorn Baby Carrier once my daughter met the weight requirement and could hold her head up well enough. In honor of my second child my husband sewed a Maya Wrap sling from the free pattern and I liked that as well but still never felt comfortable using it once my baby became a toddler. I’d love to hear your recommendations! Feel free to “Add an answer” if you don’t see a particular style or brand mentioned and leave a comment as well!

For all prior poll results click here.

Post from: Breastfeeding 1-2-3