Feed Me! Breasts, Bottles, & Beyond

WebMD Live Events Transcript

Breastfeeding is best, but what can working moms do? What if you aren't able to nurse? We looked at bottle babies and which formula is right for your baby. When do you start feeding solids and what do you start feeding? Make it yourself or buy it? We asked these feeding questions and more when our baby expert Ann Douglas joined us on June 22, 2004.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MEMBER QUESTION:
I was breastfeeding for the first week. My baby had latch problems so my lactation consultant told me to bottle feed her till my nipples healed. I did that for three days now the baby refuses to breastfeed and I cannot get milk to pump out of my breast? I fear my supply is going to dry up. She was two weeks old 6/20/04. What should I do?

DOUGLAS:
Wow. That is a very challenging situation. I'm not quite sure what to recommend, because you have been working with a lactation consultant; however, I am surprised that a total interruption in breastfeedings was recommended during that all-important first week of breastfeeding.

I think you may want to consider consulting with a second breastfeeding expert, perhaps another lactation consultant or a pediatrician who has a lot of experience with troubleshooting breastfeeding problems, because it's important to get breastfeeding back on track as soon as possible. I wish you all the best, because you are clearly committed to breastfeeding your baby.

MODERATOR:
What tips do you have for new moms who want to breastfeed?

DOUGLAS:
The big thing is to try to find out as much as you can about breastfeeding ahead of time. Ideally, if you take prenatal classes there should be at least one session devoted to breastfeeding. You may also want to think about taking some separate breastfeeding classes ahead of time or visit a La Leche League meeting so you can get hooked up with breastfeeding support before your baby is born.

Another thing to do is find out where you can find answers to your breastfeeding questions. Before your baby arrives you may want to:

• Jot down the number of the local La Leche league leader.
• Check the yellow pages to see if there are any lactation consultants in practice in your community.
• Contact your public health department to find out what kinds of breastfeeding support services are available locally.
• Think about which friends you have who have successfully breastfed their own babies, because they may prove to be the best resource of all.

Of course it's always a good idea to read. In the back of my book, The Mother of All Baby Books, I include a number of recommendations of excellent books on breastfeeding. Fortunately, there is a wealth of breastfeeding information available today, so you can do a great job of researching ahead of time.

That's not to say there won't be a bit of a learning curve after your baby is born. There's a world of difference between looking at the mechanics of breastfeeding on the page and figuring them out in real life. Most of us find that there is a little bit of fumbling around, but that over time breastfeeding becomes a whole lot easier.

"There's a world of difference between looking at the mechanics of breastfeeding on the page and figuring them out in real life. "

MEMBER QUESTION:
Do you have any information about pumps? I have to go back to work and want my baby to have breast milk. Which pumps work the best? And is this a realistic plan -- pump for the day and breastfeed at night?

DOUGLAS:
When you're shopping around for a pump you may want to consider renting one of the top quality electric pumps as opposed to settling one of the poorer quality pumps. The reason is I rented one of the hospital quality electric pumps after my youngest child and I couldn't believe how much more milk I was able to pump as compared with some of the less expensive consumer-type products that I had used with my previous babies. Some of the truly creme de la creme hospital grade breast pumps even allow you to simultaneously pump from both breasts at once. If you are trying to extract milk quickly during your break or during your lunch hour, this can be a huge time saver. I can't speak highly enough of the Medela brand of breast pumps; they are simply fantastic in my opinion. So that's my two cents on breast pumps.

Obviously, you'll have to consider work wardrobe issues as well if you're going to be pumping breast milk on the job. You'll need to choose clothes that are easy to either lift up or open at the front to accommodate pumping at work. And it's also a good idea to choose garments that won't show staining too easily, should you leak a little milk before or after a feeding. Hey, it happens!

Another thing you might want to think about ahead of time is where you are going to pump at work. Ideally you will work for an progressive employer who understands that breastfeeding is a natural function and is good for babies, and therefore that the company should be supporting your efforts to breastfeed. Such forward thinking companies often provide comfortable rooms where mums can use a breast pump.

At the other end of the spectrum are employers who discourage mums from pumping in their offices and shame them into having to pump in the washroom stall. I personally think this is appalling, because I wouldn't dream of making my husband a steak dinner in the company washroom stall, so why should I have to collect breast milk for my baby's next feeding in the company washroom stall? I really think employers have to be much more supportive of the needs of breastfeeding families. Yes, I'm back on my soapbox again!

MEMBER QUESTION:
My wife breastfeeds our daughter. She works in the day (my wife; not our baby!) and pumps throughout. This gives me bottles to feed the baby during the daytime. We started her on solids -- mostly pears, apples, and rice cereal. Not sure what is the right amount to feed her. We mix in about 1 ounce of milk in each solid feeding. But, to be honest, our baby girl eats like a cow and always wants more. Can you overstuff a baby?

DOUGLAS:
It sounds to me like your baby is positively thriving, so I would just keep doing what you're doing, offering her food and letting her appetite be your guide. I think that feeding babies is one of those challenging areas of parenting, because every baby's appetite varies widely and we all have to figure out for ourselves how much food our baby really needs.

The best approach to take with babies, and older children, is to offer the food and watch for the cues they offer when they've had enough to eat. If, for example, she turns her mouth away when the spoon starts coming towards her, she's saying, thanks, dad, but I've already had enough. Instead of trying to convince her to have just one more bite, put down the spoon and let mealtime be done, because she is clearly full at that point. Young children haven't learned to disregard the message that tells them when they are full, and we don't want to train them to disregard this all-important message.

MEMBER QUESTION:
Can you mix formula and breast milk in the same bottle?

DOUGLAS:
Yes, you can. I'm assuming that you are topping up breast milk with formula because you don't have enough breast milk to make for a full feedings.

MEMBER QUESTION:
What's the frequency of breastfeeding the baby after first month?

DOUGLAS:
I am a strong advocate of demand feeding, so simply continue to offer the baby the breast when it appears the baby is hungry. This will ensure the baby receives the appropriate quantity of food. You probably will find your baby no longer needs to eat at the two to two and a half hour intervals that he or she did as a newborn, and the number of feedings decreases slightly now your baby is a little older.