Aug 29, 2019

Interview Transcript

Dr. Jones: For something that is as common, normal, and naturally engineered as breastfeeding, most first-time moms are a little nervous.

Announcer: Covering all aspects of women's health, this is "The Seven Domains of Women's Health" with Dr. Kirtly Jones on The Scope.

Dr. Jones: Okay. Here are some dos and don'ts about breastfeeding for new moms. If you've done this before, it's usually like riding a bicycle. You don't forget. If you're not a first-time mom and your breastfeeding didn't work out so well for you last time, it doesn't mean in all cases that you won't be able to be a happy, successful breastfeeding mom this time.

So here we go. Do plan to breastfeed. The vast majority of women are biologically equipped to do it. There are very few women who physically cannot or are recommended not to breastfeed. The default decision these days, not in our mothers' days, is to breastfeed.

Don't beat yourself up if you cannot or choose not to breastfeed. For many women who are the main source or the only source of income for a family, they must go back to work immediately. Family leave only assures that your job will be there if you take a certain amount of time off. It doesn't guarantee that you'll get paid, at least not in the U.S. If there are medical reasons that you cannot breastfeed or you live near a big city, it is possible that you can access donated breast milk from a breast milk bank.

Do talk to a knowledgeable medical professional about any medications you may be taking after your pregnancy. Do not expect that all doctors and nurses know all of the science behind medications and breastfeeding. And many automatically default to, "Just don't breastfeed if you're taking that medication."

The Centers for Disease Control, cdc.gov, has a section on breastfeeding with a section on medications. The National Institutes of Health and the U.S. Library of Medicine has a website called LactMed that has a site with specifics on different medications and interactions with breastfeeding. You or your healthcare provider can plug in the name of the medication and find out the facts. It's updated monthly.

The InfantRisk Center at Texas Tech University Health Sciences website has done lots of good information, and a link to MommyMeds, a mobile app for meds and breastfeeding.

Don't just get information from your friends and family about drugs and breastfeeding because they probably don't know.

Do get some helpful advice from the lactation specialist in the hospital where you delivered. Most hospitals have nurses who are specially trained to help new moms get comfortable with breastfeeding, how to help the baby latch on to the nipple, how to troubleshoot if you're having difficulty for the first couple of days.

But remember, most women who have an uncomplicated vaginal delivery go home in 24 to 48 hours, and that's before their milk comes in. For new moms, that can be a little scary if they're planning to exclusively breastfeed because the milk hasn't come in yet. It may take even longer after a cesarean section. Lactation specialists know this and can give you a contact number and a handout on what to expect while you're waiting for the milk to come in.

Don't freak out when your milk comes in. It often comes in like a train and the breasts can be very distended and uncomfortable. Think of this as an insurance policy that nature has put in place in case you had twins. You may make more at the beginning than your newborn can use. If the breast is too tense for the baby to latch on, hand express some milk or use a breast pump. This is a great time to pump out the extra after the baby is full and put it in the freezer.

Do keep very well hydrated. Water is a good source. Milk, if you drink it, has all the calories and protein and calcium that you need for breastfeeding if you drink three glasses a day.

Don't expect to do it all. The first several weeks of nursing and recovering from delivery is tiresome. If you're breastfeeding, you'll be nursing every couple of hours. You will be sleepless. Think ahead about what your friends and family can do for you and have a list all ready so that when people say, "What can I do for you?" you can look at your list because you're going to be too tired to think of a new list. So you've got your list and you can tell them what's on your list.

Do think carefully about drinking alcohol and smoking marijuana. The amount of alcohol in your blood after a drink is transferred to the breast milk and is equal in your blood and your breast milk. Babies' livers don't metabolize alcohol very well, so their alcohol stays up longer. That doesn't mean that one glass of wine or one beer will knock your baby out. But remember, if you're making breast milk, you're doing it while you're drinking and alcohol will be in your breast milk for hours after you drink.

THC, the active ingredient in marijuana, and there are many but this is the one that gets you high, is excreted in breast milk and we don't know what it does to the developing brain.

Don't, just don't smoke cigarettes while you're breastfeeding. Just don't smoke cigarettes. If you gave it up because you knew it was bad for pregnancy, it's bad for your newborn.

Do get your vaccinations, especially influenza and measles and Tdap. If they find that you aren't immune during your pregnancy, the only vaccinations that are contraindicated in breastfeeding are smallpox and yellow fever. And most of you aren't going to be looking out to get those. You can check with the CDC's website on vaccination and breastfeeding.

Don't ignore your partner. Breastfeeding creates a highly intimate relationship with you and your baby. If you have some milk frozen and you use a bottle sometimes for breast milk or formula, let your partner in on it if they're willing and interested. It creates a good backup for you and your baby and lets them become close to the baby in their lives.

Do try to be flexible. A newborn and breastfeeding don't always fit into your pre-baby life. At the end of the day, if you have to stop breastfeeding, there are good alternatives and you are not a failure or a bad mother.

Don't quit breastfeeding because you get sick, unless you are too sick to breastfeed. If you have to stop because of some temporary medications to treat your illness, keep pumping. You can discard the milk, but keep the breast used to producing so you can go back to breastfeeding when you're better. If you stop breastfeeding or pumping for some days, it can be difficult to get the mechanism going again.

This is just a very short list of things women might wonder about. There's lots of information from the American Academy of Pediatrics and the CDC on other topics. If you're having trouble, get help from your local lactation specialist. You can do it.

Thanks for joining us on The Scope.

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