The hard, the good and the unexpected of breastfeeding

Some mothers choose to exclusively breastfeed their newborns. Others prefer a combination of breastfeeding and bottles, and some may want to supplement with formula.

“I want moms to do what’s best for them and their household,” says Paula Judah, LPN, RLC, an International Board-certified lactation consultant at the MultiCare Deaconess Hospital breastfeeding clinic. “It doesn’t have to be one or the other. We as women can be very cruel and mean to other women and judge what others do. We don’t know their life, though.”

Whether it’s hesitancy of the unknown with a first child, financial burdens or a busy work/life schedule, the decision of how to feed your baby is personal.

So, while breastfeeding is the best source of nutrition for most infants and can reduce the risk of certain health conditions in both mothers and babies, it isn’t always easy.

The hard

Learning the ‘dance’

“Breastfeeding is very difficult, especially in the beginning. They call it a dance,” Judah says. “Everyone says it’s natural, but in the beginning it’s not something you’ve done before … moms and babies have to learn together.”

The first week is always the hardest, but by the second week, most moms have rebounded from their engorgement phase and things fall into place, she says.

Engorgement typically happens when milk production ramps up within the first few days of giving birth. The increased milk and blood supply in the breasts causes pain, swelling or tenderness.

“Everyone says it’s natural, but in the beginning it’s not something you’ve done before … moms and babies have to learn together.”

Sore/damaged nipples

Even the most experienced moms run the risk of sore or damaged nipples. These conditions are often a result of improper or poor latching, especially during the first few days, Judah says.

Your baby may still be learning, have oral tethering or need to be repositioned.

When in the womb, babies tuck their chin tight into their chest, which can weaken their neck and back muscles, Judah explains. As newborns, they may have a hard time relaxing those muscles into a correct feeding position.

Risk of infection

With damaged nipples, bacteria can enter the body and cause infection, she adds.

The other most common way to contract an infection of the breasts — known as mastitis — is by not emptying the breast sufficiently. When milk sits and becomes stagnant, it can cause infection.

Most infections can be treated for their physical symptoms, but more severe cases require antibiotics. The most important thing is getting the milk out and moving as much as possible, Judah says, which may mean pumping.

The good

Health benefits

Most moms naturally produce the amount of breast milk their baby needs. It also reaches baby at the right temperature to promote proper digestion and avoid shocking their taste buds.

Some of the health benefits of breastfeeding for babies include reduced risk of asthma, obesity, Type 1 diabetes, severe lower respiratory disease, ear infection, SIDS and diarrhea/vomiting.

Breastfeeding also lowers the risk of high blood pressure, Type 2 diabetes and ovarian and breast cancer for moms, and can promote weight loss and emotional well-being.

Bonding

As hormones fluctuate post-delivery, the risk of postpartum depression heightens.

“Breastfeeding can help stabilize some of these things and allow us to bond with our kids,” Judah says. “If we can get moms to feel comfortable in their skin and with baby, it’s such a nice thing to see them relax into their bed, feel that love and bond with their baby.”

Psychologically, breastfeeding can increase affection and decrease physiological and social stress. But Judah cautions that the “breast is best” motto can add extra pressure during an already emotional time.

Cost

One thing Judah can’t stress enough is that breast milk is free.

As a lactation consultant for 14 years, Judah says recent formula shortages and rising costs prompt her to remind her patients that — if they’re able to produce enough — breast milk is the easiest way to ensure their child is getting what they need.

The unexpected

Each baby is different

“Some moms just want to be perfect right away,” Judah says. “But every kid is different.”

Your first child could pick up breastfeeding right away, but your second may have trouble latching for months. It’s also not uncommon for boys to be more challenging than girls, she adds.

When babies are born can also play a role in how quickly they latch or learn to self-regulate their schedule, Judah says. For example, late- or near-term babies may need to be woken up when it’s time to eat, as their bodies naturally want more sleep.

Finding your flow and schedule

Getting into a groove that works for both you and baby can take some trial and error. You may plan to exclusively breastfeed and find that your baby only latches to one breast, meaning you have to pump from the other. Or maybe you want to return to work sooner, or have a partner who wants to bottle-feed at times.

Start by consulting with your doctor or other health care provider about how much your baby is eating and their weight changes. Also track how much you’re producing and how much you may need to supplement with.

Judah cautions that over-pumping early on can trigger an oversupply of milk, which can be hard to stabilize. If you choose pumping, mimic your baby’s natural feeding schedule as close as possible.

“Most moms only need to pump enough to stockpile a few days’ worth as they get back to work or as babies grow and need a little more each day,” she says.

Keep your support close

Like any big life change, it’s important to have a close support network and lean into them as needed. Whether that’s your partner, family, friends or a support group, Judah says it’s important to find a network that works for you.

“Sometimes we have women that have to stop breastfeeding because they don’t have that support,” she says. “Especially make sure you talk with your partner about how you want to feed your baby as a team before anything.”

Lastly, don’t forget to research what options and support systems are in place at your work, such as private pumping rooms, and know your state’s laws that protect you as a mother.

Breastfeeding resources

It’s never too early to prepare yourself for breastfeeding.

Classes (in-person/virtual)

• MultiCare breastfeeding support services
• Milkology
• Lactation Link

Online resources

• La Leche League International
• Kelly Mom
• American Academy of Pediatrics

Books

• “The Nursing Mother’s Companion”
• “The Womanly Art of Breastfeeding”
• “Breastfeeding: Getting Breastfeeding Right for You”
• “What to Expect When You’re Expecting”
• “What to Expect the First Year”

Laws

• Federal — Fair Labor Act
• Washington state — RCW 43.70.640, RCW 49.60.030(1)(g) and RCW 49.60.215(1)