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Breastfeeding basics: Overcoming the hurdles

Nursing is natural, but learned. Lactation consultant Sheri Bayles offers tips to help first-time moms with some of the challenges.

Nursing seems to be a natural instinct, however many new moms know it's a learned skill. And with the help and support of breastfeeding experts, breastfeeding becomes something that gets better over time. Sheri Bayles is a board certified lactation consultant with New York Presbyterian Hospital and she was invited to appear on “Today” to offer some advice for first-time moms. Here are her tips:

Seventy-five percent of moms in the U.S. breastfeed their newborns, but only 30 percent are still breastfeeding at six months (which is the new recommendation from the American Academy of Pediatrics and World Health Organization). Most moms attempt to nurse after the baby is born, and some are successful immediately, others have to go through weeks and weeks (sometimes months) of pain, discomfort, frustration and sleep deprivation before they are successful, too. So what's a new mom to do? 

Where do you stand on breastfeeding? Is it something all moms have to do?I've been a lactation consultant for 23 years. And what I've been saying for that amount of time is that it has to work for the mother. I give every mom the guidelines to make it work. You have to go with each mother and see what works for her. And after working with each mom for a while, I know what works for them and what doesn't. 

What do you think about pumping?
I have no problem with pumping. I give permission for moms to stop breastfeeding and to pump exclusively. But don't forget that pumping is oftentimes hard. Pumping is good and bad. Women should see if pumping works for them. For some moms it is the only way their child will get breast milk. Some moms don't mind pumping and pumping. For others, they don't like the disconnect.   pumping doesn't help every woman. It works for me. A lot of people will tell you not to pump, but it helps. 

How do you start your sessions with moms?
One of the first things I tell every mother is to "give yourself small goals."  Forget about the lofty goals of breastfeeding for six months or one year. I tell every mom to just get through the first few weeks. After those two weeks pass, then add a few weeks on, and so on. Usually by the first six or eight weeks it gets easier. 

Is breastfeeding as hard as everyone says it is?Usually you'll hear the horror stories. Breastfeeding is a natural process, but it is a totally learned art. We don't have our mothers watching over us, telling us what we do right and wrong. 

Do you ever tell moms to stop their efforts to breastfeed?I give permission every day for women not to breastfeed. There are women doing it for peer pressure or the husband is convinced that mom needs to breastfeed. It is not for everyone. 

What kind of advice do you give breastfeeding moms?
The first piece of advice I give my mothers is to learn as much as you can about breastfeeding before you actually begin to do it.

The second piece of advice is: Make a commitment to stick with it, which is really tough for some women to do. The women that are most committed to pushing through the early obstacles succeed the best. 

Thirdly: As soon as possible, get the baby on the breast — at least two hours after the baby is born. Women who had a vaginal delivery will usually get a baby on quickly. If a woman has a c-section, then it might be more difficult. Either way, the success rate increases if you try to get your baby to latch within the first two hours.

Babies need to be fed a minimum of eight times a day. In order for them to thrive you need to feed them eight times a day. 

How do parents know how much the baby is getting?

  • diapers
  • mood
  • weight gain

you want to check for how many pees and poops are coming out of your baby every day. With those super absorbent diapers today, we tell moms to put a square of toilet paper in the diaper to figure out if the baby pees. Also, look at how they look like after they feed. If they are in that dreamlike state, then they are happy, satisfied and full. and lastly, weight gain is important for all babies.

What are the major challenges?
The number one challenge is sore nipples. Many women get pain right away from day one.  A ton of people will say it shouldn't hurt. They lie. When a baby latches on, if you see stars in your eyes and you're in a bit of pain, that is expected. But within two minutes if you can talk through it, and move on from it then nothing is wrong. If the pain continues, then there might be a problem with the latch.

The next challenge is sleepy baby. Most babies want to sleep for 48 hours when they are born, and parents are tense about waking a sleeping baby. A gentle wakeup is an important thing to do. Believe me, the head is not going to fall off and nothing will happen to them. Waking a baby up usually goes away by the third day. Try to wake the baby every three hours between the hours of 6 am to 12 midnight. After midnight, never wake a sleeping baby.  If you get five hours of sleep every night you've hit the lottery.

The last challenge is engorgement. Just that overwhelming feeling that you're going to burst. The milk gets so backed up sometimes. What we tend to tell moms to do is 15 minutes in the shower/15 minutes breastfeeding/15 minutes ice packs. This is what I tell all the dads. If dads can get cold hands on mom when she's nursing he can help her soothe her breasts. 

Sheri Bayles, RN, is a certified Lamaze instructor and board certified lactation consultant with 18 years of experience teaching at New York Presbyterian Hospital, and 23 years total as a lactation consultant. She's taught over 4,000 couples.