I’ve become intimately familiar with these fascinating milk-making things called breasts over the past seven months. I fancy myself the "milkies" expert in our home! Before baby S arrived, I took a breastfeeding class and knew from friends that breastfeeding would likely be difficult for about the first six weeks, but that was the extent of my knowledge. I faced an uphill battle with breastfeeding and these are some of the things I’ve learned that I wish I knew before baby S was born.


I was blessed with one flat and one inverted nipple. I always thought I had the weirdest breasts, but it’s really common. Who knew?! If you think you might have a flat or an inverted nipple, then research your hospital’s lactation support resources. I expected my nipples to cause problems so I had the LC come to my room as soon as baby S was born. Every time I nursed after then and during the LC’s hours, I would call down and ask someone to stop by to help with his latch.

I was able to get baby S to latch onto my inverted side without a nipple shield while we were in the hospital. But when we got home and my milk came in, I was engorged and he couldn’t latch. I used a nipple shield (against my lactation consultant's advice) and he was able to nurse again, but it caused all sorts of problems (see mastitis below) and turned out to be more of a hindrance than a help.

If you have latch issues after you get home, schedule an appointment with a lactation consultant as soon as you can. I went to see one when baby M was two weeks old and hadn't regained to his birth weight yet; she had him latched without the shield in one try! I just needed a little more help and one visit was all it took. I wish I had gone sooner.

In the meantime you can try pumping before your baby latches to draw out your nipple, or use a suction tool.


For the first few days your body will produce colostrum, which is calorie-dense and all the food your baby needs. Within a few days to a week your milk will come in and your baby will start to eat more.

Those days before your milk comes in can be very trying. You’re exhausted from the birth and being awake constantly with a new baby; your whole life has changed and your baby wants to eat. All. The. Time. Psych yourself up for this time period, which won't last long, because that’s just what it takes to get your milk to come in – your breasts need to be stimulated A LOT, which means constant nursing.

One tip that really helped me was to start pumping straight away. I pumped after each time baby S nursed in the hospital and my milk started to come in early, by the end of the second day (he was born at 8:30am.) I was so grateful for the hospital LC who made the suggestion when I asked the first day how long it would take my milk to come in. Plus, I saved a tiny amount of colostrum in small vials that Mr. S was able to finger-feed to baby S after I nursed during those first few days. We gave baby S every drop we could!


Mastitis is an infection in a milk duct that is more common early in the breastfeeding relationship, and plagues some women more than others.

I got mastitis when baby S was ten days old and spiked a fever so quickly and so high that I was hospitalized overnight… without my baby… on Christmas Eve. I got it because I was using a breast shield that compressed a duct, caused a plug that got infected. It happened within 24 hours of my first using the breast shield! It was not a good start, but I persevered and recovered.

The second time I got mastitis was when baby S was three weeks old and slept 7 hours straight one night. He did it again a second night and by noon, I again had spiked the highest fever of my life. This time it was caused by suddenly going a long time without emptying my breasts. My midwife advised that I not wake to pump in the middle of the night and assured me that my body would adjust. It did and, knock on wood, I’ve been infection free since then.

Signs of Mastitis

  • Redness in one area
  • Red streaks on the breast
  • Sudden fever (if you suddenly feel like you have the flu and you’re breastfeeding, it might be mastitis so call your OB asap)
  • Exhaustion and generally feeling like you’re about to get sick
  • Hard lump in the breast

Prevention

  • Check your breasts daily, if you feel any lumps, massage them out toward your nipple. They’re likely clogged ducts, which can lead to mastitis
  • Avoid using breast shields, or wean off them as soon as you can
  • Get fitted for breast pump flanges; make sure they’re not too tight and know that at different times of day you might need different sizes
  • If you think you have a clogged duct then nurse, nurse, nurse! Don’t let up because you’re not feeling well. In fact, if you have a clogged duct, nurse twice as much or pump between nursings
  • If you have a clogged duct or mastitis, try nursing on all fours – this one sounds funny but lay your baby on its back on your bed and nurse with your breast hanging over the baby. This allows gravity to help clear the clogged duct

If you do get mastitis, your supply may take a hit. Help your body get its supply back by pumping after each nursing session to "trick" it into thinking you need to produce more milk. Mother's Milk Tea, the herb mixture More Milk Plus by Motherlove and delicious lactation cookies helped me regain my supply.


Thrush is a yeast infection of the breast. It can be passed back and forth from mom to baby so if you think your baby has thrush, it’s important for you both to get treatment.

Moms or babies who undergo antibiotic treatment are more at risk for getting thrush. I had antibiotics at the hospital because I tested Group B Strep positive and got thrush within a few days of baby S’s birth. We were both being treated when I had more antibiotics for mastitis and got thrush again! It’s a constant battle in our house that I’ve definitely learned to manage. Thankfully, baby S has only had it twice; it's a lot easier to prevent thrush than to treat it.

Some Signs of Thrush in Mom

  • Itching on your breasts
  • Pain in the breast while nursing that is not resolved by improving the baby’s latch
  • Pain in the breasts after a period of pain-free nursing (and your baby has a good latch)
  • Shiny, flaky or red nipples
  • Pain when pumping and using the pump correctly

Prevention
An ounce of prevention is worth a pound of cure. Yeast loves a dark, moist environment, which breastfeeding breasts definitely provide. These are some tips to stay thrush-free:

  • Wash pump parts thoroughly with hot soapy water
  • Sterilize baby's pacis a few times a week (steam bags work very well)
  • Wash your breasts with a solution of 1:4 vinegar water twice a day - this is my #1 prevention tip!
  • Wear your bras and sleep tops only once between washings – this sounds extreme, but I found if I re-wear a bra, I’ll start having problems straight away
  • Don’t use disposable plastic-backed or reusable PUL lined nursing pads – they trap in moisture and provide a great home for yeast. Try simple pieces of flannel instead
  • Avoid the use of antibiotics unless absolutely necessary
  • Dry your clothing in the sunshine


The decision whether to breastfeed or formula feed is a very personal one, and there is no right or wrong way to feed your baby. If you choose to breastfeed, it’s important to have a support system lined up. Breastfeeding can be difficult in the beginning, but it gets much easier as time goes on. I felt like it was a big mental game in the beginning: I kept telling myself there was no other option and just powered through, reaching out for help everywhere I could. I feel like my determination was key for our breastfeeding success.

These are some of the resources I found helpful:

  • My hospital's breastfeeding support group – they meet weekly and even if I didn’t have any questions, I would go just to hear other people’s questions
  • Breastfeeding support groups help at the offices of local lactation consultants – these are often free and can be much smaller groups where you might be able to get some individual attention
  • Kellymom.com
  • Dr. Jack Newman’s website
  • Your baby's pediatrician's office may have a Lactation Consultant on-call you can consult
  • La Leche League
  • Independent, certified lactation consultant - google "lactation consultant" in your area or search here (I went to Northern Virginia Lactation Consultants)
  • Read up on breastfeeding - I like Ina May Gaskin's book
  • Friends who have successfully breastfed for a year or more

It's also important to be prepared for changes as your child gets older - breast milk or formula will be their primary source of nutrition for the first year of their life, and the breastfeeding relationship changes a lot during this time. Your baby will become a distracted nurser at some point, will start solids around six months and around month nine may become disinterested in nursing, but it's very unlikely they're ready to self-wean yet - wait it out and they'll probably show a renewed interest in a few weeks. It's all perfectly normal and having the support and resources to go to when you have questions makes all the difference in the world!

Did you face any challenges in your breastfeeding relationship? Please share your tips for successful breastfeeding!