What’s more confusing than childbirth? Breastfeeding, of course!
Anusha*, 24, had just had her first child and was very determined to follow through with breast feeding for as long as possible. Like many, she had considered breastfeeding a natural extension of childbirth. It followed that neither she nor her doctor had discussed the potential pitfalls of breastfeeding and how to handle them. When she finally did try breastfeeding, her very sleepy infant just refused to latch on for hours. By the time the baby was hungry and ready to be fed, Anusha’s breasts were engorged with milk, making latching quite impossible.
The realities of breast feeding can drive the best intentions out the window. The romantic image of a baby cradled in the mother’s arms, gently sucking breast milk, can feel like a distant dream to a frazzled new mom.
Let’s look at a few things you must be aware of before you actually begin breastfeeding.
- Medication or no medication during breastfeeding?
Only if your doctor says so.
In general, breast-feeding moms are advised to stay away from potent antibiotics, painkillers and any other medication whose side effects on an infant are unknown. Hormonal birth control pills are a strict no, so stop them after delivery until your doctor advises otherwise. The general rule of thumb for prescribing medication while breastfeeding is if the potential benefits of the medicine outweigh its potential harm: a call that only doctors are qualified to take. 
In short, if you have the habit of popping a pill for every ailment, stop. Only use medication that your doctor prescribes, knowing that you are actively producing breast milk.
The same applies to alternative and herbal supplements. Inform the practitioner that you are breast feeding. Ayurveda has some potent prescriptions for increasing breastmilk production; use them at the right dosage and frequency. Lactation tablets are also available to increase breast milk production, although their benefits are yet to be studied further.
- What breastfeeding props do I need?
A pillow would help.
Let’s face it, holding a tiny baby and doing anything with them is scary. This is where breastfeeding props such as pillows can help. A feeding pillow gives your back some much-needed support, especially if you are breastfeeding after a Caesarian section and also gives you a place to lay the baby as opposed to holding them in your arms. One or two such support props are often enough. 
You may also choose to use a nipple shield if you have inverted nipples or if the breast engorgement makes latching on harder for the baby. Be warned, nipple shields can be quite painful and may not be ideal for everyday use.
Two must-haves that we recommend are breast pads for when you step out, and a good nipple cream. The former can help prevent accidental leaks (such as when your body listens to a baby cry and decides you need to make more milk) and the latter helps treat cracks and painful blisters that may form.
- Why does my baby prefer one breast to another?
It’s not what you think.
Several reasons may lie behind this seemingly strange situation. Your baby wants one breast only, while the other lies engorged and painful. An older child can choose a breast that has more flow than one that doesn’t. In very young infants, the reason could just be a preference or an earache or a nose block that makes feeding on one side painful. Also, never underestimate vaccination. Babies who have been vaccinated may choose not to feed for a few hours, or be in pain on one side of their bodies prompting them to seek out another breast instead. The baby is choosing a comfortable position for itself and not necessarily the breast side.
- Am I holding the baby correctly?
Simply put, are you and the baby comfortable?
If so, it is most likely a good position. However, if the baby disengages before emptying one breast, seems listless or isn’t gaining weight as much as they should, you may meet a lactation consultant. Sometimes, a position that is wrong for both of you could be prompting the baby to disengage too soon with a tummy that is just half-full.
What other breastfeeding questions bother you? Write to us at firstname.lastname@example.org.
- Briggs, Gerald G., Roger K. Freeman, and Sumner J. Yaffe. Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. Lippincott Williams & Wilkins, 2012.
- Stacey H. RUBIN, The ABCs of Breastfeeding: Everything a Mom Needs to Know for a Happy Nursing Experience.