June 24, 2000 -- It's 4 in the afternoon, and her baby boy wants to nurse --
June 24, 2000 -- It's 4 in the afternoon, and her baby boy wants to nurse -- again. "You find out after they're born: You can't go anywhere. When he needs to eat, he needs to eat," says Robin, a New York mom who has been at home with her newborn for two weeks now.
Like many women, Robin felt pressured to at least try breast-feeding. "My husband was very adamant," she tells WebMD. But she worries: She's had difficulty getting the baby started nursing. And she has no idea whether he is getting enough milk.
"My husband and I never realized how difficult this would be," she says. "If you want to measure how much they're eating, you can't do that with the breast. You don't have an ounce meter on your nipple."
New mothers often hear that "breast is best." In fact, the American Academy of Pediatricians (AAP) recommends that mothers breast-feed for at least 12 months. In a policy statement, the AAP says breast-feeding is "primary in achieving optimal infant and child health, growth, and development."
But ask mothers and you'll find that breast-feeding is not as easy as it looks. "For some women, it's not a nice experience at all," pediatrician James Sargant, MD, tells WebMD. "I can say from my own experience that some mothers feel relief when I talk to them ... [and] make them feel OK about quitting." Sargant is an associate professor of pediatrics at Dartmouth Medical School in Lebanon, N.H.
A recent study involving 350 mothers in New Zealand showed that most new mothers stop breast-feeding when the baby is about 7 months old. In that study, only 30% of the mothers continued to breast-feed for a year.
"The most common reason for stopping, especially in the early months, was a belief that milk production was inadequate," writes A. Vogel, the study's author. "Later, many mothers simply felt that they had breast-fed their infants long enough." Vogel is with the department of pediatrics at the University of Auckland in New Zealand.
Other factors affecting a woman's decision to quit breast-feeding, pediatricians say, are problems with nipples as well as mastitis, an inflammation of the mammary glands. Also, giving babies pacifiers and formula in the early days seems to deter long-term breast-feeding.
The pressure of returning to work also is an issue, Vogel says: In the study, "younger women [under 25] and those returning to work full time in the first year were relatively likely to stop, as were those who originally planned to stop by age 6 months."
Doctors agree that any amount of breast-feeding -- even during just the first few weeks -- offers the baby a host of health and developmental benefits. To help new mothers get past the barriers to long-term nursing, WebMD turned to a lactation consultant and a pediatrician for advice.
How can mothers know whether they are producing enough milk?
Lactation consultant Cynthia Garrison, BS, IBCLC, of Magee-Womens Hospital in Pittsburgh, tells WebMD: "We often send mothers home with a "feeding log," a real simple chart where they can keep track of the numbers of feedings, wet diapers, and dirty diapers in a 24-hour period, so they see that it's falling within the ranges of normal.
"Because what goes in must come out, we instruct mothers that if baby is having 4-6 wet diapers within the first day, increasing [along with the baby's milk intake] to six to eight, and they're having at least two dirty diapers every day, then life is going quite well. They can be a little more relaxed and understand that as the baby matures, they will start spacing feedings out; they won't need to feed as often. The babies' stomachs are getting bigger."
Babies' elimination habits can vary, adds Andrea McCoy, MD, chief of pediatric care at Temple University Children's Hospital in Philadelphia. "So even though the baby may stool with every feeding, I caution mothers not to be overly concerned if the baby doesn't stool every day."
A good medical follow-up is essential for babies, because assuring that they are gaining enough weight is the best way to be sure the mother has an adequate milk supply, McCoy tells WebMD.
