- If it hurts, it's not right.
Pain indicates a problem, usually improper positioning or attachment. Mother and infant require a consultation with a knowledgeable breastfeeding counselor.
- Demand makes supply.
The more often an infant feeds correctly, the more milk the mother will make. Very few women are physically incapable of making enough milk.
- Insufficient milk supply is generally caused by infrequent or ineffective breast stimulation.
The infant who is feeding well is the most effective way of stimulating and maintaining a milk supply. A quality breastpump should be used when the infant is unable to breastfeed. Colostrum, the "first milk," is critical to the health of any infant, and especially for preterm infants. The anti-infective properties of colostrum offer protection against necrotising enterocolitis and other infections.
- Maternal use of nearly all prescription and over-the-counter medications is compatible with breastfeeding.
Generally speaking, if the prescription medication is safe for the infant, it is safe for the breastfeeding mother. Very few medications are contraindicated. Lactation consultants provide information and research on specific medications and their compatibility with breastfeeding.
- Early, unrestricted, and unscheduled breastfeeding is the best insurance for healthy, full-term neonates and their mothers to prevent many common difficulties, including engorgement in the mother and attachment problems for the infant.
Twenty-four-hour rooming-in makes unrestricted breastfeeding easier.
- Even if the mother and infant must be separated, she can still breastfeed, or feed breastmilk.
If health problems or hospital policy prevent mother and infant from close and continuous contact, the breastfeeding mother should be taught manual expression first to offer her infant colostrum, and then offered and encouraged to use a breastpump to supply her infant with breastmilk.
- Pacifiers can be a useful tool for calming preterm infants and encouraging sucking, but also can be detrimental to healthy infants in that they may be used to defer essential feedings.
Research conducted worldwide has found a correlation between pacifier use and shorter breastfeeding duration in healthy, full-term infants (see Aarts et al., 1999, in resource section in The ASHA Leader Online). However, in preterm infants, pacifiers have been demonstrated to assist the infant in development of feeding skills (Measel & Anderson, 1979). Each infant's case should be evaluated individually.
- Preterm infants can, in many cases, transition from nasogastric feeds directly to breastfeeding without interim bottlefeeding.
Such tools as nipple shields, tube feeding devices, or other aids may assist in the transition. Lactation consultants are trained in the evaluation of the infants and in the use of feeding devices and aids.
- No special dietary rules need be observed by breastfeeding mothers.
Women with food sensitivities or allergies, or a family history of food sensitivities or allergies may wish to avoid specific foods. However, "all things in moderation" is a fine rule of thumb regarding food and beverages.
- Maternal smoking and consumption of alcohol negatively affects all infants and should be avoided, or at least timed to have the least impact, whenever possible.
Maternal smoking has been identified as a cause of decreased milk supply. Alcohol (beer) consumption does not increase milk supply. Exposure to second-hand smoke has also been identified as a risk factor for SIDS, upper respiratory illnesses, and other health concerns in infants.
-Barbara Ash
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