What to expect when you're expecting (175 page)

Don’t try to feed a screaming baby. Ideally, you will feed your baby when he or she first shows signs of hunger or interest in sucking, which might include mouthing his or her hands or rooting around for the nipple, or just being particularly alert. Try not to wait until frantic crying—a late indication of hunger—begins. But if the frenzy has started, do some rocking and soothing before you put baby to breast. Or offer your finger to suck on until baby calms down. After all, it’s hard enough for an inexperienced suckler to find the nipple when calm; when your newborn has worked up to a full-fledged frenzy, it may be impossible.

Stay calm. Start out as relaxed as you can, and try to stay that way no matter how frustrating the nursing episode becomes. If you’ve allowed visitors, send them packing 15 minutes before a feeding, and use that time to chill out a little. Do some relaxation exercises before you begin (see
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) or tune in to some soft music. As you nurse, try to keep your cool. Tension not only hampers milk letdown (your breasts’ way of making your milk available for suckling), it can generate stress in your baby (infants are extremely sensitive to mom’s moods). An anxious baby can’t nurse effectively.

Keep track. Once your milk comes in and until breastfeeding is well established, keep a running written record of baby’s feedings (when they begin and end) as well as of wet and soiled diapers produced each day. While that may sound obsessive, it’ll really help give you a good sense of how breastfeeding is going—and also makes it possible for you to report progress to your baby’s doctor more accurately (you will be asked). Continue to strive for at least 8 to 12 feedings in each 24-hour period, but never force your baby to suckle. Though the length of feedings may vary considerably, once engorgement and nipple soreness have leveled off, they’ll average about half an hour each, usually divided between both breasts (though sometimes a baby will turn away or fall asleep before latching on to breast number two,
which is fine as long as number one has been drained well). Your baby’s weight gain and diaper record will give you an even clearer picture of baby’s intake. There should be at least six wet diapers (the urine should appear clear and not dark yellow) and at least three bowel movements over a 24-hour period. No matter how long baby is suckling, if weight gain and output are satisfactory, you can assume the intake is, too.

Just when you and your baby seem to be getting the hang of this whole nursing thing, milk gets in the way. Up until now, your baby has been easily extracting tiny amounts of colostrum (premilk), and your breasts have been easily handling the workload. Then it happens, suddenly and without warning: Your milk comes in. Within a few hours, your breasts become swollen, hard, and painful. Nursing from them can become frustrating for baby and seriously uncomfortable for you.

Fortunately, this miserable chapter in breastfeeding history is usually pretty brief, often lasting no more than 24 to 48 hours (though it can occasionally linger as long as a week). While it lasts, here are a variety of ways of relieving engorgement and the discomfort that comes with it:

Heat it. Use heat briefly to help soften the areola and encourage letdown at the beginning of a nursing session. To do this, place a washcloth dipped in warm, not hot, water on just the areola, or lean it into a bowl of warm water.

Massage it. You can also encourage milk flow by gently massaging the breast your baby is suckling.

Cool it. Use ice packs after nursing to reduce engorgement. And although it may sound a little strange and look even stranger, chilled cabbage leaves may also prove soothing (use large outer leaves and make an opening in the center of each for your nipple; rinse and pat dry before applying).

Dress for it. Wear a well-fitting nursing bra (with wide straps and no plastic lining) around the clock. Pressure against your sore and engorged breasts can hurt, however, so make sure the bra is not too tight. And wear loose clothing that doesn’t rub against your sensitive breasts.

Keep at it. Don’t be tempted to skip or skimp on a feeding because of pain. The less your baby sucks, the more engorged your breasts will become—and the more you’ll hurt.

Next Stop: Easy Street

Hit a breastfeeding bump or two? Stick with nursing and you’ll soon be cruising down Easy Street (as you’ll find out, once you get the hang of it, there’s no easier way to feed a baby). In the meantime, get the help you need to fix any rough spots you’ve been facing—either from the tips here or from a lactation consultant. Also, don’t let the bumps with a first baby discourage you from nursing your next. Thanks to mom’s previous experience (and that of her breasts), nursing is typically second nature with second (and subsequent) babies, making engorgement, nipple soreness, and other problems a lot less common.

The Breastfeeding Diet

It’s the couch potato’s dream—burning up the calories of a 5-mile run without leaving your lounge chair. And guess what? That dream is your reality now that you’re breastfeeding your little Tater Tot. It’s true. Milk production burns 500 calories a day, which means that you’ll get to eat an extra 500 calories a day (up from your prepregnancy numbers—not your pregnancy allotment) to meet that need.

Hello, potato chips? Not exactly. Quality matters as much as quantity (remember, you’re still—sort of—eating for two). The good news is that you’re probably an old pro at eating well, what with all the practice you’ve had for the past nine months. The even better news is that eating well while breastfeeding is very much like eating well while expecting, but with (best news of all) more relaxed recommendations. Plus, while calories definitely count, you still won’t need to count them. Just follow the Breastfeeding Diet as best you can:

What to eat.
As always, eating well is about getting the right balance of good—and good for you—food. Try to include the following each day while you’re breastfeeding:

Protein: 3 servings