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It seems like breastfeeding should be instinctive -- women have been nursing babies for ages, after all. But for many new mothers (and their babies), breastfeeding can be awkward, uncomfortable, and unproductive in the beginning. With the right advice and support, though, you can avoid the frustration.
Women tend to have questions or need support mainly in four areas of breastfeeding.
Plenty of support is available, though -- from nursing hotlines to in-home consultations with lactation specialists. Here are the most common sources for help with your questions about best breastfeeding positions, breast pumps, breastfeeding and bottle-feeding, breast tenderness or pain, and more.
To get a sense of breastfeeding before your baby arrives, consider taking a breastfeeding class. These classes provide basic information on what to expect, basic breastfeeding positions, and how to handle breastfeeding problems. Many hospitals and pregnancy resource centers offer them. Ask your obstetrician or midwife about resources in your area.
"A lot of expectant parents have never seen anyone breastfeed," says Cara Vidano, owner of Natural Resources, a parenting resource center in San Francisco. "Taking a class helps demystify the process, and gives you tips about what to do if you run into problems."
Whether you have a home or hospital birth, you'll receive free nursing advice from your obstetrician, midwife, doula, and/or nurses at the hospital immediately after your baby is born. Your newborn's pediatrician will also be able to offer guidance. Laila Weir, who lives in Portland, Ore., says she found nursing challenging at first -- but the nurses at the hospital where her son Luca was born gave her lots of support and reassurance.
"I asked every nurse who came into the room, 'Am I doing it right?' and they really helped me," she says. After she brought Luca home, a nurse from the hospital called to see how she and the baby were doing and asked specifically about breastfeeding.
Too much breastfeeding advice can become another problem. Some new mothers find a barrage of birth team advice confusing. After San Francisco mother Jessica Kitchingham's baby, Sydney, was delivered on Christmas Eve last year, she began breastfeeding almost immediately. They stayed in the hospital for a few days because Jessica had had a Cesarean delivery, and one morning a nurse congratulated her on her nursing progress.
"She said we were doing better than anyone else on the maternity ward," Kitchingham recalls. "But later that same day, a different nurse told us Sydney was losing weight and instructed us to supplement with formula."
Looking back, Kitchingham thinks Sydney's weight loss was nothing to worry about -- it's normal for babies to lose weight right after they're born. But the incident shook the new mom's confidence.
"Once my milk came in, she began gaining just fine, but I still felt really incompetent," she says. "She'd sometimes get fussy when she was nursing, and I was sure I was doing something wrong." For Kitchingham, the solution was a breastfeeding consultant.
If you have trouble nursing your newborn or just want a few tips and a dose of comfort, consider hiring a lactation consultant. They provide breastfeeding information and training; a consultant will observe you as you nurse your baby and offer suggestions. Lactation consultations can be pricey: $100 per hour or more, depending on where you live. But often one or two visits are enough, and are well worth it to many mothers for the support they provide right in your own home.
When Kitchingham brought Sydney home from the hospital, the baby's weight was fine, but she'd still occasionally pull away from the breast and cry during nursing for no apparent reason.
Kitchingham contacted lactation consultant Michele Mason, and a single visit helped restore her confidence and allowed her to relax. "I think we were all kind of stressed out," Kitchingham says. "The hospital had us worried about her weight, and my mother thought we should be waking her up to feed her -- I felt like I was doing everything wrong.
"When Michele came over, she alleviated my worries. She demonstrated different nursing positions and showed us how to hold the baby to relieve gas. She told us that during the first few weeks, all we needed to do was bond with our baby and not to worry about anything else."
Mason, a mother of three, has worked as a lactation coach in the San Francisco Bay Area for 13 years. Like many lactation consultants, she also offers information on infant care, how to calm a fussy baby, and basic newborn behavior and development.
"I strongly believe that a new mom should stay at home with her baby and that help should come to her, so I do home visits," Mason says. "I come when the baby is awake and I can make a good assessment and observe the baby nursing. I stay for about 1 and a half hours. During this time, I gather information from Mom, observe the baby nursing and latching on, and then provide Mom with a plan of action to address her breastfeeding questions and concerns."
It helps to get the names of a few lactation consultants before your baby arrives, whether you end up using them or not, so you won't have to scramble right after the birth. Your doctor, pediatrician, hospital, or midwife should be able to refer you to one, and many hospitals now offer lactation consultant services.
You can also find names in your area at the International Lactation Consultant Association web site, which features an international directory.
For 40 years, this international organization has been providing education and community support for breastfeeding mothers. La Leche League International (LLLI) operates through local meetings, where women can ask questions and share information.
Weir says she referred to LLLI's book, The Womanly Art of Breast-feeding, often in the days after she came home from the hospital with her son, Luca, and it helped her resolve several nursing issues.
To find out more about La Leche League or to find a local chapter in your area or country, check out its web site.
It may not be very personal, but calling a breastfeeding hotline is fast and convenient. They may be able to answer some general questions if that is all you need. The U.S. Department of Health and Human Services runs the free National Breastfeeding Helpline, which is staffed by peer counselors trained by La Leche League. They can answer your basic breastfeeding questions. To reach the helpline, call 1-800-994-9662.