You've finally done it. You've made it through nine months; the requisite paraphernalia is set up throughout the house: the swing, the bouncy chair, the co-sleeper. You are eager to meet this little one whose personality thus far has been defined by where he chooses to kick you (the ribs) and when (just after midnight).

Heather Kelly, IBCLC

You've been answering questions about the birth for everyone who spots your swollen belly: where are you delivering, what sort of birth are you going to have and, Oh, are you going to breastfeed? While your answer is "of course! I know the health benefits," secretly you're beginning to wonder how breastfeeding is going to work with your life. Many women are unsure if breastfeeding is compatible with living in today's modern world. These worries are compounded by the many misconceptions about breastfeeding. Let's debunk those myths and let you get back to worrying about fun stuff, like what to name your little kicker.

1. Breastfeeding hurts
If a baby is nursing properly, it should not hurt. Getting a baby on the breast correctly means ensuring that he is latched onto the nipple and the areola (the area around the nipple.) A baby should be breastfeeding, not nipple-feeding. A correct latch is an asymmetrical one, with more breast tissue in the mouth near the tongue. Some women make the mistake of centering the nipple in the baby's mouth, or allowing him to start off at the end of the nipple and pull it into his mouth. This can be painful. Since nursing is a learned behavior for both the mother and the baby, it is important to watch other women latch their babies on. Ask a relative or friend if you can sit with her while she breastfeeds, find a local support group, or get your hands on a childbirth or breastfeeding video that shows you what you need to know.

2. I won't have enough milk for my baby because I have small breasts
Relax mom-to-be, size does not matter! What matters is the amount of milk-producing tissue in your breasts, something which isn't determined by outside packaging. During pregnancy, you may have noticed that your breasts increased in size. You were seeing the proliferation and growth of milk-producing cells. When your mature milk "comes in" on day 3 or 4 postpartum, those small breasts may well be a thing of the past! Keep in mind that is very rare for women not to produce enough milk. As long as you don't limit the number or duration of feedings in the early weeks, odds are you will produce enough to satisfy baby. If baby is generating wet and dirty diapers, gaining weight adequately and seems content after feedings, your breasts are working well, no matter their size.

3. I can't "have a life" when I'm breastfeeding. I'll always be tied to the baby and I certainly can't breastfeed when I return to work.
With the development of high-quality breast pumps over the past decade, it is entirely possible to meet a friend for lunch, get a manicure, or just have a night out while maintaining breastfeeding. Keeping lactation going after returning to work, even if you work long hours, is also very doable. And while hand expression (the removal of milk from your breast via hand into a container) has existed for millennia, the advances in electric breastpumps have made working and maintaining your milk supply entirely feasible.

4. I used to take a medication for depression. My doctor says it is probably best not to breastfeed in case I need to go back on the medication once the baby is born.
Many, many medications are compatible with breastfeeding. Taking a medication while breastfeeding is vastly different from taking a medication while pregnant; the breast is a pretty good filter. Your doctor may prefer to proceed with caution if he or she does not know to what extent the medication is actually compatible with breastfeeding. Ask your doctor to consult Dr. Thomas Hale's book Medications and Mothers' Milk, a wonderful, comprehensive resource. Also, most over-the-counter medications are perfectly fine to take while breastfeeding, as are most antibiotics. You should always tell your doctor that you are breastfeeding and request that he or she take the time to put you on the most compatible and appropriate medication.

5. My husband and I like to sample different wines on the weekends, and I've been missing margaritas. I can't breastfeed and still indulge, can I?
Yes, you can. Remember, you are no longer sharing a blood system with the baby, and many midwives and OB/GYN's allow a glass or two of wine in the final trimester of pregnancy. It is fine to have the occasional drink or two. If you feel like you are unable to moderate your alcohol intake to the extent that it is driving your decision about whether or not to breastfeed, you may want to talk to a qualified professional or to your doctor. It is important to note that recreational drugs such as marijuana, cocaine, etc., while not only illegal, are completely contraindicated (i.e., prohibited) during breastfeeding.

So there you have it -- breastfeeding for today's mom. And as you think about beginning a breastfeeding relationship with your baby, remember the health and emotional benefits of breastfeeding will last a lifetime. Remember, too, that while breastfeeding is an instinct, it is also a learned behavior. Education is important; seek out other woman for support -- this is information that we have shared with each other for years. Finally, while its smart to prepare for what to expect, enjoy the unexpected. You may actually relish being a C cup for a while!

Tags: medications

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