baby, it’s going to be hard to make it work. What you need is SERIOUS determination. We are talking “girl is going after your boyfriend” type of determination. It won't be easy, but it will be worth it! You will be doing what your body was designed to do and provide the perfect food for your baby. What could be better than that?
You will need to learn how to handle unwanted advice.
Make it a game with your husband, partner, or best friend. Every time someone tells you to do something that goes against what the research shows, you can have a phrase ready to say like, “WOW, I had no idea! I’m definitely going to do that right away.” Get ready to say that phrase a lot!
For example, your mother-in-law tells you to stop eating broccoli because it's making the baby gassy, or that babies should be sleeping through the night at three weeks, or you have to drink milk in order to make milk (these are all breastfeeding myths, by the way). Just smile and say, “WOW, I had no idea!”
Chapter 4: Preparation While You Are Pregnant
There are lots of things that we can do while you are still pregnant. We can prepare for boosting milk supply based on your medical history or put a tool or two in your hospital bag just in case. Breastfeeding is physical and hormonal, so there is a checklist you can go through while you’re pregnant to see if you have any precursors for low milk supply.
1 Did you have trouble getting pregnant?
2 Do you have thyroid issues?
3 Do you have diabetes?
4 Do you have polycystic ovarian syndrome?
5 Did your breasts change size during pregnancy?
6 Have you had a breast surgery?
#5 is an important question: Did you experience breast changes during pregnancy. Sometimes you need to ask her significant other to answer that one. I’m not talking Dolly Parton changes, just slight changes in your bra cup size. About 1.5% of women do not have enough mammary tissue to make milk, so we must consider this as a possibility.
If you have any history of thyroid issues, diabetes, polycystic ovarian syndrome, or you had problems getting pregnant, these are all precursors for low milk supply. Don’t worry, we can work on synthetically boosting your prolactin after the baby is born, but just knowing this information will help. You can refer to the section titled “Increasing Your Milk Supply.”
Look at Your Nipples
When I work with a pregnant mom, I do a breast exam to see if I can find any potential issues with the latch. If the nipples are flat or retract upon compression, we can plan for the use of a nipple shield. We go into detail about nipple shields in a later chapter. To see if your nipples retract upon compression, simply squeeze your areola from both sides and see what your nipple does. If it stays in place, you are in good shape. If it retracts back into the boob, you will want to be prepared for a possible latch issue. Don’t worry, you found out before any issues began, so that is an excellent start!
Chapter 5: The Crucial First 2 Weeks
Why are the first 2 weeks so important when it comes to breastfeeding? In the first 2 weeks a lot is going to happen. Your baby’s going to lose weight, gain weight, you’ll go from having practically no milk, to having a lot of milk, and this is when you establish the prolactin receptor sites in your breasts.
Just picture if 10 of us have cell phones and there are only four plugs, six of those cell phones are going to die. That’s exactly what happens with prolactin receptor sites; if they don’t get set up in the first 2 weeks they die. Your brain controls how much milk you make, so moms who do not put the baby on the breasts in the first 2 weeks, and do lots of formula supplementation without pumping, have a real hard time down the line boosting their milk supply.
If you can give me (and your baby) 2 weeks of your life to establish your milk supply, get through the hardest stage, regain your baby’s birth weight, and push through any issues, you have a very good chance to be successful at breastfeeding for as long as you want to.
Chapter 6: Establishing A Milk Supply
Remember, the first 2 weeks of breastfeeding are the most important in establishing your milk supply, and insufficient milk removal is the number one cause of low milk production. Here are a few rules to live by if you want to have a great milk supply:
Rule #1: Empty Out That Milk 8 Times a Day!
Breastfeeding is demand and supply, so you have to get the milk out, in order to make more milk. If there are ANY problems in the beginning, including latch issues or engorgement, you should add in some pumping sessions so that a good supply can be established. Simply pump directly after a breastfeeding session.
Rule #2: You will need to breastfeed or pump a minimum of 8 times every 24 hours for the first 6 months.
Typically, a breastfed baby eats about 10 times a day, but 8 is the absolute minimum. I know this sounds overwhelming, but your baby will become very efficient at the breast and you will be breastfeeding about 30 – 45 minutes every 24 hours when your baby is 3 months old. A lot of babies will sleep long periods, but you will need to fit in those 8 pumping or breastfeeding sessions if you want your baby to thrive.
Rule #3: Prolactin Regulates Your Milk Supply.
If you have any of the listed precursors for low milk supply, you will want to consider boosting your prolactin before your prolactin goes back down to pre-pregnancy levels at 2 to 3 weeks postpartum.
A lot of people will NOT tell you these breastfeeding rules because they are afraid you will get scared and not even try. I find if I tell my patients the truth, they are better prepared. Don’t worry, you won’t be breastfeeding 8 hours a day for the first 6 months, each day your baby gets bigger and stronger they also get more efficient. A 3-month-old baby could drink 5oz of breastmilk from the boob in 5 minutes. Trust me, I used to see it every day.
Chapter 7: The First Stage of Lactation (Colostrum)
Here some fun facts for you! The reason your breasts changed size during pregnancy is because you already have milk in your breasts, ready to go!
Right now, you are currently in a phase called Lactogenesis Stage I. During this stage, you are making a highly concentrated breast milk called colostrum. The colostrum is full of antioxidants, antibodies, and white blood cells (to start the process of repairing your baby’s leaky gut). All babies are born with a leaky gut, like a porous rock, so that these important components of the milk can pass through the digestive system and get right into their bloodstream. Your baby is born from a very sterile environment into very non-sterile environment, especially if they’re born vaginally. The colostrum
