Milk (no cookies) take 2

So when we left off, I'd told you that breastfeeding takes stamina, determination, frequent nursing sessions, and maybe a LOT of Lanolin.

Onward and forward we go. What about formula? What happens if supplementation is necessary? First off, formula is a totally acceptable form of nutrition and there are many circumstances where supplementing with formula is needed. Prematurity (this includes late-pretermers too), low blood sugar, excessive weight loss, significant jaundice, or maternal reasons (illness or complications from delivery) are all valid reasons for formula supplementation. It doesn't mean you're a failure. It also doesn't have to ruin your desire to breastfeed. Don't forget, you gotta be stubborn!

Resist the urge to supplement with formula in the few days between birth and when the breast milk comes in. Remember when I said it can take several days for mature milk to arrive? Healthy, full-term babies are born with a little extra chub-chub to burn off during those first few days. In fact, it's not uncommon for babies to lose up to 10% of their initial body weight. If your bundle of joy weighs 9 and a half pounds at birth like mine did, losing 10% can look like a LOT of weight. Just keep going back to the breast regularly, and watch your baby's output. The number of wet and dirty diapers is your clue as to whether or not he is getting enough.

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Prematurity can certainly lead to the longest period of supplementation, depending on how early your baby arrives. In this case, a good breast pump will be your greatest asset - because it may be your only means of stimulating a milk supply. This girl has written a great blog post with tons of great info about exclusively pumping. Keep in mind that most premature babies not only lack a strong suck reflex, but also don't have the energy required to nurse. For extended periods of separation, as in long NICU stays, you'll want to pump as often as your baby would nurse (10-12x per day). Maintain close contact with your NICU nurses and a lactation consultant to ensure the greatest chance for success in getting breast milk to your little peanut. Breast milk is FAR superior nutrition for premature babies, and although some supplementation will likely be necessary, any amount of breast milk will be ideal. Be diligent to pump, be protective of your milk supply, and be openly flexible in regards to feeding your baby expressed milk from a bottle.

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Low blood sugar, excessive weight loss, jaundice, and maternal reasons are typically short-lived instances of supplementation. We're talking as little as one bottle and as much as a week or so. When possible, always offer both breasts as a feeding prior to finishing a feeding with formula. This is ideal, as it still provides stimulation for milk production. In the absence of this option, pumping each feeding is needed to prevent a decrease in milk supply. If you're worried about "nipple confusion," ask your nursery nurse if it's possible to either gavage feed or use a supplemental nurser.

Maybe you're as stubborn as a mule and yet things just aren't working out like you'd hoped. There are certainly speed bumps that can pop up, which can make navigating around breastfeeding a lot more difficult. Low production, flat or inverted nipples, issues with latch, tongue tie, mastitis, engorgement, and nipple breakdown are some of the most common problems encountered while breastfeeding. My advice? Call a Lactation consultant. Certified lactation consultants can be a wealth of knowledge. Establishing contact with an LC prior to hospital discharge is a great foundation for future success.

Finally, with increased education comes increased chances of success. I can think of about a dozen more talking points regarding nursing, there is still so much to say! If you are serious about breastfeeding, look into taking a class. There are also tons of books, websites and blogs that are WAY more informative.

I know I've already said "finally," but I have one more thing to say about breastfeeding. There's this turning point that happens one day and suddenly things start getting easier. You see, despite it being exhausting, anxiety-inducing, and grit-my-teeth painful (lanolin, cold gel soothies, and nipple shells were my go-to comfort for nipple soreness), breastfeeding is also kinda magical. For the first 6 months of my son's life, my body provided every drop of nourishment his little body needed. I also protected him from disease (including one particularly nasty stomach bug that everyone in the house got except him). I've read to him, sang to him, prayed over him, studied his perfect little features and kissed his chubby cheeks. For a few minutes each day, he is once again a part of me.

And that makes it all worth it.