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Breastfeeding Bootcamp – A First Time Mom & Pediatrician’s Experience by Dr. Hillary S. Lewis

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Wow! What an introduction to motherhood! I felt like I had survived boot camp by the time my daughter was 6 weeks old. Breastfeeding may be the single best gift you can give your child, but it is also one of your first big challenges. If you take anything from this post, I urge you not to get discouraged. If you are still reading this, you obviously have dedicated yourself to learning about breastfeeding. For that, you should be congratulated!

Almost immediately after I found out I was pregnant, I grew nervous about breastfeeding. I had spent years of medical training encouraging mothers to breastfeed, proclaiming, "breast is best." Although I had spent time during my training with lactation specialists, I quickly realized that I still had a lot to learn. I struggled with so many questions about breastfeeding, introducing the bottle, pumping, storing breastmilk and returning to work.

I remember finally feeling like I had "gotten the hang of it" by ~8 weeks. I feel blessed to have a baby who had a great latch and who transitioned from breast to bottle without difficulty. That being said, many of my friends (including several pediatrician friends) were not so lucky. They struggled with babies who would not latch, painful and cracked nipples or an inadequate supply. It is important to recognize that these struggles are not uncommon. I encourage all mothers to seek the advice of both a lactation specialist and a pediatrician. Many of these difficulties can be worked through with proper advice. However, sometimes the difficulties of an inadequate supply or painful nursing are simply too much. Despite all of the power pumping, fenugreek and oatmeal, some moms have difficulty keeping up with the needs of their growing babies. New moms are exhausted physically and emotionally. The feelings of disappointment, inadequacy or failure can burden an already emotional and fragile mother. I believe it is critical to care for these mothers. Ensuring that mom is happy and healthy is the best way to help care for her child. Sometimes, that means no breastfeeding, sometimes that means exclusive pumping, and sometimes that means partial supplementation with formula. This does not mean mom is a failure! Remember to encourage and praise all mothers for their breastfeeding efforts.

I have included some important facts about breastfeeding in addition to some practical tips that helped me. I found that was an amazing resource. It is a website founded by a woman who is a mother of three children and who is also an International Board Certified Lactation Consultant.

Practical Tips

  • Your milk will "come in" around 3 or 4 days after delivery. Those first few days, your child will nurse constantly. This is exactly what he/she should be doing, as it will stimulate milk production. Your nipples will likely be the most sore during this time. Apply lanolin cream liberally and be assured that breastfeeding will become less painful! Do not be discouraged!
  • Initially, your baby will be getting colostrum. Colostrum is thick and yellow. It contains proteins including important immunoglobulins for your baby. Mature milk will follow after a few days. It is thinner, less yellow (more white) and much greater in volume. It also has a greater fat content for your baby.
  • Supplementing with formula may be medically necessary for some babies. Those infants with jaundice in the first few days of life are the ones most likely to need supplementation if mom's milk has not come in. You may use a syringe to help supplement—this enables your child to get formula while latched to the breast. Talk with your pediatrician or lactation consultant about this!

Important Facts About Breastfeeding (AAP Policy Statement – March 2012)

  • The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.
  • Medical contraindications to breastfeeding are rare. Contraindications to breastfeeding:
    • Mothers of infants with classic galactosemia should not breastfeed.
    • Mothers who are positive for human T-cell lymphotrophic virus type I or II should not breastfeed nor provide expressed milk to their infants.
    • Mothers with untreated brucellosis should not breastfeed nor provide expressed milk to their infants.
    • Breastfeeding should not occur if the mother has active (infectious) untreated tuberculosis or has active herpes simplex lesions on her breast. However, expressed milk can be used because there is no concern about these infectious organisms passing through the milk.
    • Refer to the CDC website for a complete list of medications that are approved/not approved for breastfeeding.
  • The benefits for your child's health are incredible.
    • The risk of hospitalization for lower respiratory tract infections in the first year is reduced 72% if infants breastfed exclusively for more than 4 months.
    • The severity (duration of hospitalization and oxygen requirements) of respiratory syncytial virus bronchiolitis is reduced by 74% in infants who breastfed exclusively for 4 months compared with infants who never or only partially breastfed.
    • Any breastfeeding compared with exclusive commercial infant formula feeding will reduce the incidence of otitis media (OM) by 23%.
    • Exclusive breastfeeding for more than 3 months reduces the risk of otitis media by 50%.
    • Serious colds and ear and throat infections were reduced by 63% in infants who exclusively breastfed for 6 months.
    • Any breastfeeding is associated with a 64% reduction in the incidence of nonspecific gastrointestinal tract infections, and this effect lasts for 2 months after cessation of breastfeeding.
    • Breastfeeding is associated with a 36% reduced risk of SIDS.
    • There is a protective effect of exclusive breastfeeding for 3 to 4 months in reducing the incidence of clinical asthma, atopic dermatitis, and eczema by 27% in a low-risk population and up to 42% in infants with positive family history.
    • There is a 15% to 30% reduction in adolescent and adult obesity rates if any breastfeeding occurred in infancy compared with no breastfeeding.

It does get better and easier! Focus on one day at a time.



"Breastfeeding and the Use of Human Breast Milk." Pediatrics. Vol. 129 No. 3 March 1, 2012.