Beginning to Breastfeed

If you're planning to breastfeed for the first time, you might be worried that you won't be able to produce enough milk or that your milk won't be nourishing enough. Don't be anxious-you're not likely to have any problems. All women are equipped to feed a baby. No breast is too small, and in most cases, your supply of milk will automatically adjust to meet your baby's needs.

Feeding on demand

A baby can digest a full feeding of breast milk in an hour and a half to two hours (half the time it takes for a bottlefed baby to digest a full feeding of formula). So breastfeeding on demand means frequent feeding, but this doesn't mean your milk supplies will run out. Research shows that mothers who breastfeed their babies on demand produce more milk than mothers who feed their babies at regular but less frequent intervals.

One study compared babies breastfed on demand with those fed only every three or four hours. The babies fed on demand got an average of nearly 10 feedings a day, compared to an average for the others of just over seven. The more frequent feeding didn't mean that a daily amount of milk was being divided into more but smaller feedings-in fact, it was the opposite.

Better fed The fed-on-demand babies got an average of just over 73 milliliters at each feeding (725 milliliters a day), while those fed at fixed intervals got only 68.8 milliliters at each feeding (502 milliliters a day). As a result, after two weeks, the fed-on­demand babies had gained more weight than the others-an average of 561 grams compared to 347 grams.

Keeping up Your Milk Supply

Milk production can be affected by many things, including how you're feeling, how healthy you are, and what you eat.

Producing milk - The change from colostrum to breast milk is triggered by changes in your hormones after the birth, but continuing supplies of milk depend on the sucking action of your baby. When he sucks, nerve endings in your areolae are stimulated, sending signals to a part of your brain called the hypothalamus. The hypothalamus in turn sends signals to your pituitary gland telling it to release prolactin, the hormone that stimulates milk production-this response to your baby's sucking is known as the prolactin reflex. Your pituitary gland also releases oxytocin, a hormone that causes the muscle fibers around the milk glands to contract, squeezing the milk from the glands into your milk ducts. This is called the milk ejection or "letdown" reflex. When your breasts are full, it can be triggered not only by sucking but also by your baby's hunger cries or even simply when he's near to you.

A good milk supply - The best way to keep up your milk supply is to feed your baby often, so that the prolactin reflex and the milk ejection reflex are triggered frequently. This will also prevent engorgement-swelling of your milk-producing glands with milk.

If the glands do swell, they won't be able to make milk efficiently. And you won't feel like nursing because it'll be painful. For these reasons, the reflex that promotes the release of prolactin diminishes and so your milk production slows down. If this does happen, you can relieve engorged breasts by expressing milk, and keep it from happening again by nursing your baby often.

It's also important to wait until your baby empties the first breast you give him before switching him to the other. This way he'll be sure to get not only the thirst-quenching, low-fat foremilk that comes from your breast first, but also the highly nourishing, fat-rich hindmilk that follows.

You'll need to eat well at this time, since your body has an even greater need for good nourishment than during pregnancy. You don't need to eat any special foods for breastfeeding, but it's best to have a balanced diet with plenty of protein, iron, and calcium, and lots of fluids, fresh fruit, and vegetables. Three good meals, with light snacks of fruit, cheese, or milky drinks in between, will give you energy and keep you from getting too tired. It's a good idea to keep taking an iron supplement daily. Caring for a baby can be exhausting, so relax or nap during the day whenever you get the chance. If you're diabetic, your doctor will keep a close eye on your diet, and your glucose and insulin levels. When you start making love again, don't use oral contraceptives until you stop breastfeeding.

Refusal To Take a Feeding

Occasionally, your baby won't want to breastfeed. This is most likely to happen during the early days, when he may be too sleepy to be interested in nursing. If your baby refuses the breast, don't give up-express the milk your baby would have suckled and wait for him to want food. Babies take the breast much more enthusiastically when they're hungry.

If you find that your baby tends to fall asleep soon after you've started nursing, try lying on your side, with him lying beside you. This way he'll find breastfeeding less tiring.

Your baby may also refuse to nurse because he has difficulty latching on. Your breasts may become engorged, as a consequence-and the swelling makes it almost impossible for your baby to latch on. If you express some milk from your swollen breasts before nursing, he'll be able to latch on more easily.