Loma Linda University Children’s Hospital’s physicians, nurses and staff are passionate about taking care of mothers and babies. One of the ways they support them is through empowering moms to exclusively breastfeed their babies.
Elaine Hart, MD, obstetrician and gynecologist at Loma Linda University Children’s Hospital is an expert in breastfeeding, passionately educating students, staff and new mothers about the importance of breastfeeding. She says that many mothers will face challenges when first starting to breastfeed.
“Motivation is key to successful breastfeeding,” Hart says. “But also, it's so important to understand the challenges and be prepared to deal with those — knowing what to do moving forward helps significantly.”
Five common challenges she says a mom might face while trying to breastfeed include:
1. New mother anxiety.
“A mom wants to do the best for her baby, but there’s often a fear she may not adequately feed the baby since she can’t see how much the infant is eating,” Hart says. “This is one of the most common mental challenges a mom might face.”
Hart explains there’s a misperception that babies need a big bottle — 30 ccs of milk — every day, but in actuality, they need very little.
“The day after birth, the infant only needs 5 ccs — a teaspoon — of milk,” Hart says. “By day three, approximately 15 ccs — a tablespoon — of breastmilk is perfect. They don’t need very much starting out.”
If the baby is sucking and swallowing, the baby is getting something, says Hart.
“Wet diapers are also a good way of knowing if your baby is feeding properly,” she says. “What you should be seeing are a couple of wet diapers within the first few days, and by day six of life, they should be having six or more wet diapers.”
2. Feelings of deficiency.
If a mother’s milk isn’t coming-in right away, many moms may feel their bodies are deficient and not working properly to produce milk for their baby. Hart says it takes two to six days for mature breastmilk to begin to flow. Until then, colostrum — a nutrition concentrated pre-milk filled with antibodies, growth factors, protein, fat and white blood cells — provides perfect nutrients for the baby, she says.
Hart advises that milk flow can also be affected by the type of birth. “With vaginal birth for a first-time mom, it takes three to four days on average for milk to begin producing,” Hart says. “With cesarean section, it may take five to six days.”
She tells new mothers to put their baby to their breast or to pump their breast 10 times in a 24-hour period after delivery. “This should help the mature milk come in faster,” Hart says.
3. Sore nipples.
While unfortunately uncomfortable, sometimes painful and frustrating, many women get sore nipples from breastfeeding, says Hart.
“Be assured that this soreness is transient,” she says. “It comes with almost every baby, but it only last about five days on average. It is, however, important to make sure the baby is latching properly. If the latch is correct, the discomfort will pass.”
New moms may have to learn to juggle work and the need to breastfeed. By law, work environments are required to have a space where mothers can pump their breasts. Hart says moms must remember that they are protected and have rights when it comes to breastfeeding.
“Your employer legally cannot discriminate against your need to pump,” she says. “And pumping won’t be an overly time consuming thing once a new mother becomes familiar with the process.”
5. Desire to use formula.
While it’s a common perception that women can breastfeed and use formula to bottle feed their babies, Hart says this may not be the best route if a mother wishes to continue breastfeeding for a full year or more.
“When you’re bottle feeding with formula, you’re not removing out as much milk from your breasts,” she says. “Over time, this will decrease and may ultimately stop your production of milk. You have to take milk from your breasts to continue producing it. As the body reacts by not making as much, mother’s will think they’re just drying up and may give up on breastfeeding all together.”
Hart says this is one of the biggest challenges new mothers bring to her. “Formula often times sabotages breastfeeding,” she says.
However, Hart still emphasizes the importance of listening to your pediatrician. “If the child’s pediatrician is telling you to add formula to your routine, listen to them,” she says. “Sometimes pediatricians will suggest formula in the first few days after birth, if the baby has lost more than 7 to 10% of their birth weight.
Hart says that putting the baby to the breast or pumping 10 times in a 24 hour period in the hospital can often times prevent the pediatrician’s recommendation of supplementary formula.
For expecting mothers who choose to deliver at Children’s Hospital, there are certified lactation specialists who visit every new mom and walk her through the breastfeeding process. For any other new or expecting moms, the Birth and Beyond Education Center hosts a breastfeeding basics class taught by a certified lactation educator. This class will answer any questions from babies hunger cues, positioning and latching, to ways a dad can be an active participant.