9 tips to help make breastfeeding easier

Breastfeeding may have many benefits for baby and parent. According to the American Academy of Pediatrics, breastfeeding helps protect against asthma, ear infection, obesity, and sudden infant death syndrome (SIDS). The practice may also help reduce the chances of developing diseases like type 2 diabetes, childhood leukemia (a type of blood cancer), eczema (an condition that causes inflammation and rashes on the skin), and lower respiratory tract infections. Research also shows that the practice may benefit parents who breastfeed by lowering the risk of both breast and ovarian cancers.

At the same time, breastfeeding may pose some challenges. Here are some tips to make the process easier from Erin Young, MD, a primary care physician in Big Rapids, Michigan.

There are many myths about breastfeeding. The most common ones Dr. Young hears are:

• Because breastfeeding is natural, it should be easy.
• Breastfeeding is painless.
• You can’t breastfeed when you go back to work.
• Formula-fed babies sleep better.
• If a breastfeeding baby seems hungry or eats more often, then you aren’t making enough milk.

These myths can lead to self-doubt and can limit the opportunities new parents have to create their own experiences. Every parent and every baby is different, with a different set of experiences.

A parent who is considering breastfeeding should be prepared to feel overwhelmed at times. Breastfeeding places a lot of the responsibility for feeding the infant on the lactating parent, says Young. “This can be a heavy burden,” she says, “especially in the first few weeks and months.” When only the lactating parent feeds the infant, it can result in increased exhaustion as well as personal and relationship stress.

Prepare for these responsibilities by taking breaks and devising stress-reduction techniques beforehand. Having a partner or support person who can provide periods of rest is helpful, as well. Depending on your family arrangement, you might also consider pumping and storing milk so that your partner or other caregivers can feed the baby as needed.

The decision to breastfeed might also require adjustments at work and when you’re outside the home, including scheduling time to nurse and designating a private location. “Mothers require means to either feed their infant directly by latching [onto the breast] or expressing breastmilk,” Young says. "Expressing milk requires a pump, private location, refrigeration or ice to store the milk, and clothing which makes the breasts accessible." Before returning to work, discuss your feeding options and breaks with your employer to help set expectations and make the transition smoother.

Even experienced breastfeeders face challenges. You might have a first child who breastfed easily but have a harder time with the second. Expect things to change from child to child.

Risk factors for breastfeeding problems vary with each newborn and can even range for the parent based on different pregnancies. For example, a newborn may be tongue-tied, a condition where the tongue is anchored to the floor of the mouth and interferes with feeding. A parent may have an ordinary pregnancy and delivery with the first child but experience severe anemia (low red blood cells, which can cause extreme fatigue) with a subsequent delivery. "Both of these situations can affect breastfeeding," says Young.

In addition to your regular healthcare provider (HCP) and your OBGYN, hospital lactation consultants can be a valuable resource. These are medical professionals who provide expert help with breastfeeding. In the early days after birth, they can help establish one of the most important aspects of any breastfeeding experience: a good latch [when the baby attaches to the breast with its mouth].

"They are also a wealth of knowledge in regard to any breastfeeding concern, including pumping and returning to work,” says Young. "Insurance companies are mostly covering lactation consultation services."

Lactation consultants can provide feedback on where to find resources and supplies upon leaving the hospital, as well. Resources include Women, Infants, and Children (WIC) food assistance and breastfeeding support groups like La Leche League, an organization aimed at providing information and encouragement to enable new parents to breastfeed.

Nipple pain is natural for a few seconds at first, as you get the hang of breastfeeding. But if it persists, it may indicate breast pump issues, thrush (a yeast infection), a nipple blister or, most likely, a bad latch. Sometimes, changing your position is enough to fix the latch and alleviate some discomfort. For example, you might try leaning backward with your baby on top of you or lying on your side with your baby next to you. Pillows and footrests can help you stay in certain positions.

Other positions, like the “football” or the cross-cradle position [holding the baby beside you] might require more practice. Call your OBGYN or lactation consultant or visit the La Leche League website for more information on positions. A lactation consultant can also help you prepare and recommend potentially helpful aids, such as a nipple shield if your nipples are flat or inverted. In the meantime, nipple creams may alleviate pain by helping the skin retain moisture.

Breastmilk functions under a “demand and supply” system. In other words, the more you stimulate milk production, the more milk you will produce. But clogged milk ducts can interfere with supply.

Clogged ducts may occur for many reasons, including ineffective milk removal (which can be caused by a weak or poor latch), inconsistent feedings, or even oversupply. Although breastfeeding is less comfortable with a clogged duct, it is recommended that you keep nursing to avoid developing mastitis, or inflammation of the breast. Applying heat, gently massaging the breasts, feeding frequently, and wearing loose clothing can all help with clogged ducts, as can taking certain nonsteroidal anti-inflammatory drugs (NSAIDs). Remember to speak with your HCP before trying any new medication when you’re breastfeeding, as not all drugs are safe during lactation. For example, among NSAIDs, ibuprofen tends to be preferred over naproxen.

After you've expressed milk, medication and cold compacts can help reduce pain. Chills, high fever, and pus or blood in milk are all signs to call your HCP to discuss treatment.

“It is extremely important to have a support system with any newborn, but especially with breastfeeding," says Young. She believes surrounding yourself with dedicated people as much as possible can help you meet your breastfeeding goals. “I'm a firm believer that successful breastfeeding requires a team which includes medical professionals as well as a support system at home. The support system could include the new parent's mother, significant other, grandparent, friend, or coworker.”

If you know a nursing parent, try these tips to help support them:

• Ensure they have access to food. Even better, surprise them with meals.
• Offer to come by and help with things around the house so they can get adequate rest.
• Avoid shaming them or making jokes about breastfeeding.

If you would still like your child to experience the benefits of breastfeeding but are having trouble with milk production, there are options. One of these is donor milk. Many neonatal intensive care units (NICUs) have donor milk available for babies in need. It may also be available outside of the hospital from both for-profit and nonprofit organizations.

“Donor milk sources range from certified centers where the milk is screened for viruses, bacteria, or exposure to toxic substances, to friends and family who have an oversupply,” says Young. The American Academy of Pediatrics advises against sharing breast milk informally (without its being screened or pasteurized) and cautions parents not to buy it over the internet.

If your local hospital cannot direct you to milk resources, state and citywide milk banks are a great place to start. Those linked with the Human Milk Banking Association of North America have high standards for processing and screening.

Deciding not to breastfeed does not make someone a bad parent. If nursing becomes a problem, there is no shame in stopping.

“Reasons for discontinuing breastfeeding are person-dependent," Young says. "For example, working through poor latch may be enough for some women to give up, whereas others may have the resources available to work through it." Job issues and health problems are other perfectly reasonable reasons why some parents opt out.

And if you're undecided, not producing sufficient milk, or would like to begin tapering off breastfeeding, you may try supplementation. This involves using formula and breast milk at the same time. Speak to your OBGYN, pediatric HCP, or family practitioner for advice on how and when to begin.