WebMD Live Events Transcript

Breast is best when it comes to feeding baby. But it may take a bit of effort from both you and baby to get started. As we observed National Breastfeeding Awareness Week,lactation expert Janet Tamaro, author of "So That's What They're For!" joined us on August 4, 2005 to answer your questions about breastfeeding.

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.

MODERATOR:
Welcome to WebMD Live, Janet. Thank you for joining us today.

TAMARO:
Thanks for having me.

MODERATOR:
It's National Breastfeeding Awareness Week.

TAMARO:
Why are we not aware of breasts?

MODERATOR:
Unfortunately, all too often, our breasts are thought of as toys rather than wonderful unique parts of ourselves that can enable us to feed and nurture our children.

TAMARO:
Let's be real -- if you're breastfeeding, they aren't toys. Making the transition from fashionable to functional is tricky in this culture. But once you have that cute little baby rockin' your world, in all senses of the phrase, that part of your body really does take on sacred new meaning.

MODERATOR:
For thousands of years women have breastfed their babies. Why does it seem to be presented as a challenge for modern American women?

TAMARO:
I think it is a challenge and I think it's always been a challenge. It's the first time you are doing it. People are born, and not to be morbid, die every day, but when it's you doing the birthing or the dying, it's a hell of a lot more challenging. We have so many other demands on our time that we rarely think about something like breastfeeding until we actually have to do it.

"Babies are truly brilliant. Listen to their cues. When they're hungry, feed 'em."

MODERATOR:
So what are your top ten tips for getting started when you want to breastfeed your new baby?

TAMARO:

Start before the baby's born. And I don't mean practice with your husband.
Don't make up a plan, i.e., I'm only going to do it for 24 hours to give the baby colostrum. Remember, it is a learning curve.
I hate these top ten things.
Line up some help. That means get somebody who's really knowledgeable, not your anxious mother-in-law.
It ain't fun until about week four. And if you don't make it through those first brutal weeks, you'll never get to the good part.
Go to the park and watch new mothers breastfeed. Tell them what you're doing so you don't get arrested.
Get yourself some fashionable new clothes with flaps. I promise you won't have to wear them after about week six.
Get your husband or partner on board. Tell him Michael Jordan was breastfed, Michael Jackson was not.
Pretend you have a hearing problem when people ask you, "How long are you going to do that for?"
Babies are truly brilliant. Listen to their cues. When they're hungry, feed 'em.

MODERATOR:
I'd like to add Number 11: Read Janet's best-selling book So That's What They're For!

MEMBER QUESTION:
I have been on bed rest most of my pregnancy (I'm 30+ weeks now) and am determined to BF (breastfeed). I'm concerned though that I can't take any of the classes? Any advice on how to prepare?

TAMARO:
Are you bored of reading and watching videos yet? Read my book. Do you have any friends that are breastfeeding?

MEMBER QUESTION:
I've been told that I may deliver at around 32 weeks. Any advice on how to BF successfully in that scenario?

TAMARO:
There's a section on preemies in my book. It will require more work on your part, but it is doable. You will absolutely need assistance from a good lactation specialist.

MEMBER QUESTION:
How does a mother initially prep the breast for the first time of baby feeding?

TAMARO:
She takes them for a walk. No, I'm kidding. There are no breast pushups which should be done. You might want to walk around the neighborhood flashing your neighbors if you have to do something.

It's best not to knead or pull on the nipple, and you shouldn't apply any kind of cream. There's one caveat. If you know you have inverted nipples, you may want to use breast shells, not shields. This gently coaxes the nipple by everting it through a hole.

MEMBER QUESTION:
I have had nipple piercings, although they've been out for five years now. This is my first pregnancy and some people say I will not be able to breastfeed because of the old piercings. Could you shed any light on this? Will I have a problem?

TAMARO:
I think it's so cool you had your nipples pierced. I have enough problems with the holes I already have. I don't think you will have problems because milk comes out of more than one hole. You may have scarred your nipples. You can tell by compressing your breasts and looking to see if any of the tiny holes suddenly spew a few drops of milk.

MEMBER QUESTION:
What makes it so hard the first four weeks, and what can we do to make them better?

TAMARO:
Hmmmmm. You are about to have your first child, aren't you? This answer could go on, and does go on for 337 pages in So That's What They're For! The simple answer is there are a lot of body parts to coordinate, and there is a learning curve. I think it's helpful to know going into it that you may have problems so that you're not lulled into a false sense of complacency as I was.

MEMBER QUESTION:
I am breastfeeding my 3-week-old and a couple of times while feeding in a side-lying position at night, we have both fallen asleep. I'll wake up several hours later and the nipple is still in her mouth. Is this OK? I've heard of bottle rot for bottle-fed babies, is there something similar for breastfed babies?

"Somewhere between week four and week six the "Oh-my-god I'm going to scream!" pain should be long gone."

TAMARO:
When the first teeth start erupting you probably will want to stop this, unless your six-week-old already has chompers. At 3 weeks old you should be fine -- for a few more months.

MEMBER QUESTION:
I want to make sure my baby is getting enough "hind milk." Approximately how long does he need to nurse at each breast to guarantee he is getting enough?

TAMARO:
Stop timing your breasts! He will let you know when he wants to come off. If he only makes it through one breast before falling asleep, just offer him the full one when he's hungry again, because he will be, trust me.

MEMBER QUESTION:
I had breast reduction surgery 13 years ago. How can I tell in advance if breastfeeding is an option? I do not know if the milk ducts were cut or not. It seems as if there might be duct openings on at least my right breast -- they look like regularly spaced pimples and are occasionally sore. Is this wishful thinking, or are these developing milk ducts?

TAMARO:
Could be developing milk ducts. Take a warm shower when you're close to your due date, compress each breast and see if any droplets of milk get ejected. Good luck.

MEMBER QUESTION:
My baby is 4 weeks old. My breasts are still sore and tender after a feeding. I believe he is latched on correctly. When should the tenderness subside?

TAMARO:
Somewhere between week four and week six the "Oh-my-god I'm going to scream!" pain should be long gone. It could be he is latching on to your nipple instead of the tissue behind your nipple or it could be a positioning problem. My guess is it's something pretty simple that one visit to a lactation expert should solve.

MEMBER QUESTION:
My son is 3 weeks old and nursing very well. I would like to pump so my husband can give him a bottle, but when I do pump, I only get about 2-3 ounces total -- not enough to satisfy my son. Is it possible to pump enough in one sitting to provide enough (about 4 ounces) for my son?

TAMARO:
The baby is too young to be taking a bottle. I'm sorry to be telling you this. You can pump your milk to store for the future, but if you're trying to shift bottle feeding at such a young age, you may find your husband feeding the baby the whole time.

MEMBER QUESTION:
What is a baby's best age for introducing a bottle of expressed breast milk?

TAMARO:
Good question. No earlier than six weeks. And make sure you use the NUK or orthodontic nipple.

MEMBER QUESTION:
Is it possible to do a combination of breast feeding and formula feeding? And if so, do I have to pump to keep my milk up?

TAMARO:
You'll hate me for saying this, but it is not a good idea. Most women who do this end up exclusively formula feeding. It is not a good idea. The most compelling reason for me not to use formula with either daughter is the changes formula renders in an infant's gut.

"You are not a bad mommy if this feels hard, overwhelming, or even no fun. All those feelings are normal."

MEMBER QUESTION:
How long do you recommend breastfeeding to provide the best for your baby?

TAMARO:
Are you sitting down? Six months exclusively breastfed, and then supplement with food, and I don't mean Coke and barbecued potato chips, for the first year.

MEMBER QUESTION:
What is the best way to pump milk so that my husband can help with night feedings on occasion? In other words, should I wait an hour after I feed my son, then pump, then my husband will give him that bottle later that night? I don't want to add a pumping in addition to a feeding for fear of engorgement.

TAMARO:
Here are some basics for pumping:

You will get the most milk in the morning.
You will get the least amount of milk after a stressful day.
You may want to try feeding your baby in the morning and then pumping immediately after. By the third day, you should see a slight increase in the amount of milk you are producing.

MODERATOR:
Unfortunately Janet has to leave us early, but perhaps she'll come back again. Janet, before you go, do you have any final comments for us?

TAMARO:
As trying and as difficult as it sometimes was to feed small babies from my body, it was so worth the effort. You are not a bad mommy if this feels hard, overwhelming, or even no fun. All those feelings are normal. Happy breastfeeding!

MODERATOR:
Our thanks to Janet Tamaro for joining us today.

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