Breastfeeding Basics: So That's What They're For! -- Janet Tamaro --10/9/2003

Last Editorial Review: 10/19/2004

By Janet Tamaro
WebMD Live Events Transcript

Congratulations! You've decided to breastfeed. The experts agree it's the best way to feed your baby. But that doesn't mean it's always easy, especially for first-time and working moms. As part of our "Baby Bootie Camp" university, we discussed breastfeeding basics with lactation educator Janet Tamaro, author of "So That's What They're For!" on Oct. 9, 2003.

The opinions expressed herein are the guest's 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 University: "Bootie Camp: A Four-Week Guide to Baby's First Year." Your instructor today is Janet Tamaro, author of, "So That's What They're For!"

Support for this WebMD University course provided by Blue Cross Blue Shield of Massachusetts.

Welcome to WebMD University, Janet.

Tamaro: Thanks for having me.

Moderator: How difficult is breastfeeding?

Tamaro: Breastfeeding can be very simple for some women. In my experience, breastfeeding two children, it was difficult both times. Breastfeeding takes some time to learn. The first month can be hard, but it's kind of like getting in shape: once you're in shape, it's a blast. That is not to say that breastfeeding is always a blast, but it's much easier and more satisfying for you once you get over the four-week hump.

Depending on the underlying issue, most problems can be resolved. Does anyone have some specifics to add?

Member: It was easy with my first child and difficult with the second.

Member: My son would not latch on.

Tamaro: Latch is key. Especially with a newborn, it is difficult to get the hang of it. You want to make sure the baby's mouth is wide open and you are essentially hooking them on to your breast. They are not sucking as though from a straw, but instead, they're compressing the milk sinuses.

If you know you have a problem getting your baby on, get an expert's hands-on help. In my experience, the biggest reason women give up is latch and positioning, which will almost always result in a frustrated mother and a wailing baby.

Member: He got dehydrated so badly even the lactation consultant recommended a bottle. He has ADD. I wonder if it affected his ability to nurse?

Tamaro: I suppose it's possible, though I have not seen a study connecting a future diagnosis of ADD with an inability to breastfeed successfully. That doesn't mean that it isn't out there. Your story underscores my point that if this is a problem, you absolutely want to address it as soon as you can. I'm so sorry your son got sick.

Moderator: Let's talk about positioning.

Tamaro: Start by reading some literature on positioning or check chapter 5 of my book. Initially you'll probably want to use both hands, because your newborn can't control his or her head. Use pillows so you can support the baby, and it's generally easier to use the same hand to hold the breast and your dominant hand to cradle the baby's head.

Member question: I've been told breastfeeding is best for baby. What are the benefits for baby? And does it have benefits for Mom?

Tamaro: Yikes! Aren't you sick of hearing breast is best? Good question, though: What the heck does that mean? I could bore you all silly with two years of research, but the most convincing reasons are pretty straightforward.

Breast milk makes your baby much less likely to get sick. Breastfeeding dramatically lowers rates of serious illness, like ear infection, diabetes, liver diseases, etc. Both my husband and I come from families with a history of both asthma and allergies. Of course, this is anecdotal, but neither of my children has asthma. Both of my nieces, who were formula fed, are asthmatic.

For me, the most convincing studies had to do with brain development. Though there is some controversy, there are a number of studies that seem to indicate breastfed babies are ahead developmentally, and even in the IQ department.

As for the benefits to the mother, I'm sorry to say I worked when my children were babies. The fact that I was the only one in their lives who could do this incredibly loving, essential task, made getting my butt out of bed and going to work doable.

Member question: How about latching on too well? Especially when those teeth start coming in. Ouch. Any tips?

Tamaro: Double ouch! Believe it or not, babies are very attuned to your reaction. Those teeth are new toys for them, but if the first time they bite you, you shriek, it is often the last time. Sounds like that isn't the case for you. I would suggest the next time it happens, you immediately stop breastfeeding, say gently but firmly, "That's not okay, that hurts mommy," and wait. My experience with babies is they are much smarter than we give them credit for, and if you tell them what you're doing and why you're doing it, number one, you really can stop the biting, and two, guess what? You're teaching them language skills.

Member question: I'm so tired. How do I keep track of which side to switch to?

Tamaro: We all get obsessed with switching breasts. While it's important to switch off, if your baby and you are falling asleep during a feeding, sleep. During the day if you really can't remember, you can put a piece of tape or a safety pin on the on the bra strap of the last breast used. I know mothers of twins do this. Since you said you're tired, let me just say, do not pin the safety pin to your breast.

Member question: My mom says that a glass of beer every day helps with the breast milk. Is she right?

Tamaro: Good God! I would not look for too many tips from your mother. Don't tell your mother I said that. There are a lot of other ways to facilitate letdown and increase milk production. That doesn't mean you can't have any alcohol while you're breastfeeding, but if you do drink, you should probably try to put time between the baby's feeding and the drink, or pump and dump.

I am the paranoid type, so I worried that when my child couldn't learn to ride a two-wheeler, it was probably because of that beer I had. I'm kidding! I didn't do this too often, because it killed me to throw away liquid gold, but when I say pump and dump, I mean if you've been to a wedding, for example, and tied one on, and your baby is crying to be fed, my advice is to use stored breast milk and to pump and throw away the alcohol-laced milk in your body

Member: I found that using a pump from time to time actually helped me to produce better.

Tamaro: If you want to increase your milk supply, say, if you're working, it definitely helps to pump more frequently. On the other hand, most women produce more milk when they're physically feeding their babies. If you're not getting a lot when you pump, but your baby is healthy, that means you're producing more when your baby is nursing.

Think of it this way: Would you be more turned on kissing a plastic replica of your husband or your actual husband? Wait, I forgot how tired you are, probably not a great analogy. But you get my point.

Member question: What should I be doing with regard to my diet while breastfeeding? Are there certain things I should or should not be eating?

Tamaro: I know this is a bummer, because you've been on a nine-month nutritional binge, but it's important to continue eating well. No matter what you eat, unless you're doing drugs, or subsisting on a diet of potato chips and diet soda, your breast milk is much better for your baby than artificial baby milk.

I noticed in the early months if I had caffeine, I had a cranky baby. Things that bother you, like beans, broccoli, cauliflower, or anything else that you notice could potentially irritate your baby.

Member question: Aren't there some things you are supposed to avoid so your baby doesn't develop food allergies? Like peanuts?

Tamaro: Good question. Once again, consider both family's histories, yours and your baby's father. Generally speaking, even highly allergenic foods shouldn't trigger allergies in your baby, but you might want to avoid foods known to be culprits.

More importantly, studies show if your baby is breastfed exclusively for six full months before introducing anything, even though I know how much fun it is to watch them spitting out cereal, you are far less likely to trigger food allergies in your baby later.

Member question: My sister stopped breastfeeding because she saw some story on the news about a baby that died from malnutrition when it wasn't breastfeeding properly. Please tell me this was just a sensational story and not a common event. I'm trying to convince her that going to the bottle wasn't necessary. As long as they are wetting their diapers, they are receiving your milk in adequate amounts, correct?

Tamaro: Correct. This is a sensational story. I was a television correspondent for ten years for, among others, ABC News. You can find anecdotal news to support anything. There was another story recently dissecting the ingredients of breast milk that scared nursing mothers. But here's the thing: Your baby was essentially made in your body with whatever toxins were already there. Not only that, I would much rather feed my newborn my breast milk than canned processed artificial baby milk. But that's me.

You probably cannot change your sister's mind. I know it's painful, but try not to let it get to you.

Member question: Do you have any advice for breastfeeding when out and about? I hate going to a restroom to feed my baby! That's not what bathrooms are for!

Tamaro: I don't blame you. I like to go out and with my first baby I spent more time in public bathrooms than I did in restaurants or stores. But then I learned some tricks. If I was with my husband, we would always take a table in a corner and he would create a distraction when I needed to latch the baby on. I felt uncomfortable throwing a blanket over the baby, because it was like wearing a sign: breastfeeding at 3 o'clock! Instead, I got really good at "wearing" my baby with a Baby Bjorn. If the baby faces you and is old enough to hold his or her head up, you can actually sneak them on your breast and walk around.

I think I only flashed one old lady one time, when she patted my baby's head and she, my baby, came off my breast and gave the old lady a winning smile and a nice view of my nipple.

Member question: I'm going to breastfeed, but want a way for my husband to be involved. Any suggestions?

Tamaro: Another great question. I hate to always use research, however your partner has been shown to be the most important influence on whether you breastfeed and for how long. If you've read my book, then you know my husband, Steve, had to finger feed baby Julia for the first two days. Hopefully this is not how you'll get your husband involved. Steve liked to feed our girls and when they got older, at about six weeks, if I wasn't home he would feed the baby pumped milk.

But as I'm sure you know, feeding is not the only necessary and important part of taking care of a baby. You will probably diaper your baby about 7,000 times. Yup, that's right, seven, zero, zero, zero. If you use that time talking, cuddling, teaching and bonding with your baby while you're changing him, it can become a favorite time. I know this sounds crazy, but you know what I mean when I say even their poop is cute.

Member: My husband brings the baby to me to breastfeed and stays with us. I never have to get up at night to get the baby. That is how he plays a role in feeding the baby while I nurse.

Tamaro: That's so sweet! Can I have his name and address? I'm kidding. The best night of my life was the first time my daughter woke up crying and screamed, "Daddy!" Men love to fix things. Give them something to do. Like, "Honey, can you get up and get the baby?" You can pay them back in golf trips and cash prizes.

Member question: Is it worth starting out breastfeeding even if it's only for a couple of months until going back to work?

Tamaro: Absolutely. Try not to lock yourself into how long you'll go. Take it day by day. It's kind of like saying, "Is it worth sending my child to school if he's not going to college?" Whatever time you spend breastfeeding is worth it.

Member question: I'm going to have to go back to work. Does pumping work? Will my baby still benefit, even if the breast milk is in a bottle?

Tamaro: Yes. OK, we're going back to studies. They found with cows that passive immunities get passed from mommy cow to baby cow when the baby is nursing. That's the biggest benefit, aside from the physical comfort of breastfeeding versus feeding bottled milk. What that means is, let's say your husband comes home with a cold and exposes his germs to your baby. When your baby nurses, your body will be busy working to fight the germs and passing that back to the baby in your breast milk. Pretty cool, huh? So pumped milk is far better than ... you know where

I'm going, artificial baby milk.

Member question: How will the baby respond to my breast after having bottles of pumped milk during the day? I've heard that it is easier for the baby to take the milk from the bottle, but I want to continue to nurse in addition to pumping. Will she still nurse?

Tamaro: Feeding from a bottle is a little like watching an aerobics class instead of doing it yourself. Breastfeeding is much more work, which is why breastfed babies need less orthodontia. If you introduce a bottle too early or too often and the baby isn't a skilled breastfeeding baby yet, he may not want to do the work to get fed. So try to hold off of bottle feeding until at least six weeks.

Member question: What do you say to (mostly older) family members who think breastfeeding is nearly barbaric?

Tamaro: You can't say this, but usually they're saying that because they're jealous. This is actually a common problem, because you feel vulnerable and someone close to you is turning up her nose. But guess what? This will happen more if you don't shut them down tactfully.

The tactful response is something like, "Yes, I know it's barbaric, but I'm doing things differently." OK, I'm kidding. Change the subject and don't do it in their presence. That means do what we did: Guest-proof your house. My in-laws did not stay with us when I was breastfeeding. Gee, I sure hope my mother-in-law isn't in this chat room.

Member question: Are you a fan of La Leche League? I've heard good things, but don't know if they charge for their services or if it's volunteer. And is it worth it for even successful nursing moms to contact them?

Tamaro: Yes. Find a leader and a group that you like. Some people will tell you La Leche League is militant, but in my experience they're mostly mothers like us. If you find yourself turned off by a group, there are usually a number of leaders even in smaller towns. It's a great place to pick up tips on what to say to your nosy mother-in-law.

Moderator: Before we wrap up for today, do you have any final comments for us, Janet?

Tamaro: I have a 10 year old and a 6 year old, and whenever I feel I've made mistakes as a mother, I feel comforted by the knowledge that I worked hard at breastfeeding and that both of my children are wonderful and healthy, and most of that is due to the benefits of breastfeeding.

Moderator: Thanks for joining us, members, and thanks to Janet Tamaro for sharing her expertise and experience with us. For more information, please read her book, "So That's What They're For!" and "The Mother of All Baby Books," by our course leader, Ann Douglas.

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