 The answer depends on whom you ask, so let’s ask the experts.
The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend breast milk only for baby’s first 6 months of life, and continued breastfeeding with the addition of solid foods from 6 months to at least one year. Many studies worldwide have shown that the health benefits of breastfeeding to mom and baby are dose-dependant, meaning, more is better. For example, the longer a woman breastfeeds, the lower her lifetime risk of breast cancer, ovarian cancer, type 2 diabetes, and other illnesses. This longevity affect is cumulative, so breastfeeding multiple babies increases the protective power of breast milk on mom’s health. Furthermore, the health benefits to the baby are increased the longer the baby breastfeeds. The longer the baby breastfeeds, the less likely he will experience health risks such as childhood cancer, diabetes, obesity, and certain infections. Older babies and toddlers still need immunity protection from breast milk because their immune systems are not mature yet. There is great nutritional value for a toddler in his mom’s breast milk. Studies have also demonstrated that children who were held often and for long duration as babies, and who received comfort from breastfeeding as toddlers, grow to develop confidence and independence. When toddlers learn that they are safe and nurtured, they grow into confident children. The American culture has decided that breastfeeding older babies or toddlers is weird, and that cultural norm hurts our babies and families. Worldwide, and throughout history, babies have been breastfed well into childhood, and this practice has been perfectly normal and healthy for children and communities. It is important for you to decide how long to breastfeed your baby based on the scientific facts of the health and emotional benefits to you and your baby from extended breastfeeding as well as the impact that breastfeeding has on your family. If you decide to continue breastfeeding beyond your baby’s first birthday, you are perfectly normal! You and your baby will benefit, and there is nothing harmful about this practice. Feed on, mama! Click here for the AAP policy statement on breastfeeding.
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Can I breastfeed if I have had a breast reduction?
There are many reasons women have breast surgery, and cosmetic concerns are by far the most common. However, there are some risk factors, such as obesity, diabetes, hypothyroidism, or PCOS, which need to be considered when a woman has had breast reduction surgery and later wants to breastfeed. Make sure you discuss your health history with your lactation consultant so that she can help you make a feeding plan that will best meet the needs of you and your baby. The likelihood of you being able to exclusively breastfeed depends on the surgical technique used, the amount of glandular tissue removed, and the resultant integrity of blood supply and nerve pathways. The pedicle technique leaves the nipple and areola attached to the breast gland on a stalk of tissue. A wedge is removed from the undersides of the breast; for the most part, the breast tissue, blood supply, and some nerves remain intact, and breastfeeding will have varying degrees of success. The free nipple technique removes the nipple areola entirely. The blood supply to the nipple areola is severed and nerve damage occurs. The amount of breast tissue removed does not appear to affect breastfeeding. The most important factors that do affect breastfeeding are the integrity of the nerves and of the milk ducts. Incisions around the areola are more likely to cause nerve damage and severed milk ducts than incisions in the fold under the breast or in the armpit. If your breast surgery involved removing some of the milk making glands, this will likely affect the volume of milk you can produce. Milk ducts are more likely to be cut when surgical incisions are made around the areola or into the body of the breast, rather than incisions made in the fold under the breast or in armpit. Milk ducts do regrow, and the rate of regrowth is faster during pregnancy and breastfeeding. This means that you can possibly produce more milk with subsequent pregnancies. Nerves can regenerate over time, at about 1 mm per month. The more time has passed since your surgery, the more sensitive your breasts and nipples are likely to become, which increases your likelihood of producing enough breast milk. The amount of sensation in your breast will be an important indicator of the amount of nerve damage sustained. If you can feel both touch and temperature on your areola and nipple, you are more likely to experience normal milk ejection during breastfeeding. Tips for breastfeeding after breast reduction surgery:
One of the most common concerns I hear from moms is, "I don't know if I have enough milk." There are a few easy ways to know, so that you don't have to guess if your exclusively breastfed infant is getting enough to eat. First of all, if you are feeding your baby on demand (not scheduling feeds, but feeding whenever he is hungry), and your baby is eating 8 times (or more) per day, that is a good sign. Secondly, by the time your baby is 5 days old, if he is having at least 5 wet diapers a day and at least 1 yellow poopie diaper per day, this indicates adequate milk intake. A third sign that your baby is getting enough is that breastfeeding is comfortable to you and your breasts are not hurting. This is a sign that your baby has a good, effective latch. It is important that you can hear your baby swallowing when he is feeding. Your baby should be visibly more relaxed at the breast after he feeds than he was before the meal. The most obvious way to monitor if your baby is getting enough is to check his weight. Obviously this is only helpful on days that your baby gets a weight check, and is not helpful on a day to day basis. Make sure you keep your baby's appointments with his doctor so that any possible problems can be identified early. If you are experiencing all of these things, that is a very good sign that breast-feeding is going well and that your baby is getting enough milk:
These are NOT signs that you aren't making enough milk for your baby:
These are signs that your baby might not be getting enough:
If you have any concerns, call your baby's doctor or an IBCLC right away. Greensboro Lactation Consultants can perform a "weighed feeding", meaning your baby will be weighed before and after a feeding. This will help us determine how much milk your baby is taking. I can be reached by phone here and by email here. In-home consultations are available usually within 24 hours of your request, so if you're worried about it, don't wait!  Your new baby has a very tiny little stomach. Very small amounts of colostrum in the early days is plenty for him to grow healthy and strong. Your colostrum is perfect for him, and it’s unlikely that he will need anything else! Let’s take a look at the amount of colostrum that your baby needs in the first 4 days.  On baby’s first day of life, he needs about 2 to 10 ml per feeding, which is about the size of a cherry! In his first day of life, he will take about one ounce total.  On your baby’s second day of life, he needs about 5-15 ml per feeding – that’s about a teaspoon to about half an ounce per feeding, or about the size of a walnut. He will eat 8 to 12 times (or more) on day 2.
From month one to month 6, your baby needs 3 to 5 ounces per feeding, or a total of 25-35 ounces per day. Breastfed babies do not need as much milk as formula fed babies do, and they do not require more and more as they get older. If you have any concerns about how much milk you are producing, or if you are unsure that your baby is getting enough, please talk about your concerns with a certified lactation consultant.
I am available for in-home consultations usually within 24 hours of your request. Call or email me if you have any concerns.  You have heard that breastfeeding is good for your baby. You may have heard that breastfeeding is good for mom's health as well, and that breastfeeding helps new moms bond with their baby. However, if you are reading this, then you have either heard some scary things about breastfeeding, or you are experiencing difficulty, and you are seeking answers or help.
Breastfeeding is the normal way for human moms to feed human babies. Breastfeeding is natural. Just like walking. Walking is normal and natural. However, few people learn to walk on their first try, and very few learn without someone helping them. It is normal to get help with breastfeeding, even though it is natural to breastfeed. In many cultures, breastfeeding is so normal that new moms have been exposed to breastfeeding, literally, their entire lives, and they are surrounded by experienced moms as soon as their baby is born. In our culture, more often than not, a mom's first experience with breastfeeding is the moment she tries to breastfeed her own infant for the first time. Moms are trying to master a brand new skill that they have rarely, if ever, even seen done well. Experienced moms have challenges as well, as every baby is different. If you've done this before, but this time is just different, that's normal too. I am here to help answer your questions and to help you have a breastfeeding experience that is healthy and fulfilling for you and your baby. I will customize a plan for you, based on your goals, and provide coaching and counseling to meet your individual needs. I am available for in-home consultations, usually within 24 hours of your request. Call or email me, help is on the way!  What is a certified lactation consultant?
The Surgeon General of the United States says, “International Board Certified Lactation Consultants (IBCLCs) is an excellent source of assistance for breastfeeding mothers. IBCLCs are health care professionals certified in lactation management. They work with mothers to solve breastfeeding problems and educate families and health care professionals about the benefits of breastfeeding.” Indeed, IBCLCs are the foremost experts in lactation management. The IBCLC brings unmatched expertise and education in breastfeeding. It takes many years to acquire the education and the hands-on experience to be eligible to take the IBCLC exam. The IBCLC is required to have extensive education in health care, including college level courses in biology, human anatomy and physiology, infant growth and development, clinical research, nutrition, psychology, and sociology. The candidate is also required to take courses in basic life support, medical documentation, medical terminology, professional ethics, and more. Many IBCLCs have a degree in a health care field, but a degree is not required. The IBCLC is also required to have 90 hours of education in human lactation and breastfeeding, which have been accredited and approved by the board. Finally, the IBCLC is required to have a minimum of 300 lactation specific clinical experience under the direct supervision of a certified IBCLC. Click here if you want more information about the training and education required to become an IBCLC. Why should you work with an IBCLC? When you work with an IBCLC, you can be confident that you will receive expert care in breastfeeding management. All IBCLCs have successfully completed rigorous education and clinical hours and have passed a comprehensive certification exam. IBCLCs are required to maintain their skills and education through continuing education hours, and the exam is taken every 10 years to maintain certification. Why should you work with Greensboro Lactation Consultants? Greensboro Lactation brings the expertise and experience of an IBCLC to you in the comfort of your home in Greensboro. If you live outside of Greensboro, we will work with you to determine a meeting location if a local IBCLC is not available to you where you live. Why does it cost so much? Most parents will pay as much as they can for the safest baby furniture, car seat, toys, even laundry detergent. When you work with an IBCLC, you are working with a highly trained, experienced expert in human lactation. IBCLCs are the gold standard experts in breastfeeding. The fees for an IBCLC may seem like a lot at first glance, but the investment is well worth it. Breastfeeding will save you $1,000 or more in your baby’s first year just in formula costs. More significantly, the families of breastfed infants save thousands in health care costs. Mothers who do not breastfeed miss work 3 times more often than mothers who breastfeed. Mothers who breastfeed their babies spend about 1/3 less on health care expenses for their babies. The expense might seem like a lot at first, but it will likely cost you less than it would cost you to give up early and switch to formula. And it's possible that your insurance will reimburse you for the cost! The economic power of breastfeeding goes far beyond your own family. According to a 2010 study by Bartick and Reinhold, “if 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants.” (Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics. 2010;125(5):e1048-56.) Does my health insurance cover lactation support? The cost of lactation support should be covered by your insurance company. I advise you to call your insurance client services and discuss your coverage. I will provide you with a Lactation Visit Receipt and relevant visit notes for you to file with your insurance company for possible reimbursement. I will also provide you with information to guide you in filing your claim. Information about what your insurer is required to cover for lactation support can be found at http://www.dol.gov/ebsa/faqs/faq-aca29.html More information about the recommendations and benefits of breastfeeding: http://www.surgeongeneral.gov/library/calls/breastfeeding/executivesummary.pdf |
AuthorBeth Sanders, BSN, RN, IBCLC Categories
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