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You are here: Home > Baby > Breastfeeding

Tips for Breastfeeding Success

by Rebecca D. Williams |
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It's helpful for a woman who wants to breastfeed to learn as much about it as possible before delivery, while she is not exhausted from caring for an infant around-the-clock. The following tips can help foster successful nursing: Get an early start: Nursing should begin within an hour after delivery if possible, when the infant is awake and the sucking instinct is strong. Even though the mother won't be producing milk yet, her breasts contain colostrum, a thin fluid that contains antibodies to disease. Proper positioning: The baby's mouth should be wide open, with the nipple as far back into his or her mouth as possible. This minimizes soreness for the mother. A nurse, midwife, or other knowledgeable person can help her find a comfortable nursing position. Nurse on demand: Newborns need to nurse frequently, about every two hours, and not on any strict schedule. This will stimulate the mother's breasts to produce plenty of milk. Later, the baby can settle into a more predictable routine. But, because breast milk is more easily digested than formula, breast-fed babies often eat more frequently than bottle-fed babies. No supplements: Nursing babies don't need sugar water or formula supplements. These may interfere with their appetite for nursing, and that can lead to a diminished milk supply. The more the baby nurses, the more milk the mother will produce. Delay artificial nipples: It's best to wait a week or two before introducing a pacifier, so that the baby doesn't get confused. Artificial nipples require a different sucking action than real ones. Sucking at a bottle could also confuse some babies in the early days. They, too, are learning how to breastfeed. Air dry: In the early postpartum period, or until her nipples toughen, the mother should air dry them after each nursing to prevent them from cracking, which can lead to infection. If her nipples do crack, the mother can coat them with breast milk or other natural moisturizers to help them heal. Vitamin E oil and lanolin are commonly used, although some babies may have allergic reactions to them. Proper positioning at the breast can help prevent sore nipples. If the mother's very sore, the baby may not have the nipple far enough back in his or her mouth. Watch for infection: Symptoms of breast infection include fever and painful lumps and redness in the breast. These require immediate medical attention. Expect engorgement: A new mother usually produces lots of milk, making her breasts big, hard and painful for a few days. To relieve this engorgement, she should feed the baby frequently, and on demand, until her body adjusts and produces only what the baby needs. In the meantime, the mother can take over-the-counter pain relievers, apply warm, wet compresses to her breasts, and take warm baths to relieve the pain. Eat right, get rest: To produce plenty of good milk, the nursing mother needs a balanced diet that includes 500 extra calories a day, and six to eight glasses of fluid. She should also rest as much as possible, to prevent breast infections, which are aggravated by fatigue. --R.D.W.

Medicines and Nursing Mothers Most medications have not been tested in nursing women, so no one knows exactly how a given drug will affect a breast-fed child. Since very few problems have been reported, however, most over-the-counter and prescription drugs, taken in moderation and only when necessary, are considered safe.

Even mothers who must take daily medication for conditions such as epilepsy, diabetes, or high blood pressure can usually breast-feed. They should first check with the child's pediatrician, however. To minimize the baby's exposure, the mother can take the drug just after nursing or before the child sleeps. In the January 1994 issue of Pediatrics, the American Academy of Pediatrics included the following in a list of drugs that are usually compatible with breast-feeding: acetaminophen many antibiotics anti-epileptics (although one, Primidone, should be given with caution) most antihistamines alcohol in moderation (large amounts of alcohol can cause drowsiness, weakness, and abnormal weight gain in an infant) most antihypertensives aspirin (should be used with caution) caffeine (moderate amounts in drinks or food) codeine decongestants ibuprofen insulin quinine thyroid medications Drugs That Are NOT Safe While Nursing Some drugs can be taken by a nursing mother if she stops breast-feeding for a few days or weeks. She can pump her milk and discard it during this time to keep up her supply, while the baby drinks previously frozen milk or formula.

Radioactive drugs used for some diagnostic tests like Gallium-69, Iodine-125, Iodine-131, or Technetium-99m can be taken if the woman stops nursing temporarily.

Drugs that should never be taken while breast-feeding include:

Bromocriptine (Parlodel): A drug for Parkinson's disease, it also decreases a woman's milk supply.

Most Chemotherapy Drugs for Cancer: Since they kill cells in the mother's body, they may harm the baby as well.

Ergotamine (for migraine headaches): Causes vomiting, diarrhea, convulsions in infants.

Lithium (for manic-depressive illness): Excreted in human milk.

Methotrexate (for arthritis): Can suppress the baby's immune system.

Drugs of Abuse: Some drugs, such as cocaine and PCP, can intoxicate the baby. Others, such as amphetamines, heroin and marijuana, can cause a variety of symptoms, including irritability, poor sleeping patterns, tremors, and vomiting. Babies become addicted to these drugs.

Tobacco Smoke: Nursing mothers should avoid smoking. Nicotine can cause vomiting, diarrhea and restlessness for the baby, as well as decreased milk production for the mother. Maternal smoking or passive smoke may increase the risk of sudden infant death syndrome and may increase respiratory and ear infections.

Rebecca D. Williams is a writer in Oak Ridge, Tenn. Isadora Stehlin is a member of FDA's public affairs staff.

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