New parents can be under a lot of stress, especially mothers who may face expectations and pressure around nursing their babies.

While lactation specialists say the evidence is overwhelming on the physical, mental and emotional long-term advantages of breastfeeding for both mom and baby, there is no “one-size-fits-all” when it comes to nursing.

“How that works and how that looks are different for every family,” said Liz Graham, a registered nurse and lactation consultant at UCHealth Yampa Valley Medical Center. “It’s not all or nothing. While we know there are extraordinary health and social benefits to exclusively breastfeeding, any amount of breast milk is good for baby and beneficial for mom, too.”

Whether a mom exclusively breastfeeds, supplements with formula or switches to formula, Graham wants to empower moms to pick what is best for their family and to do so without guilt.

She said there is a misconception that the goal of lactation consultants is to “make” people breastfeed. Rather, “our job is to help parents figure out what their goals are and support them in reaching those goals.”

Graham offered a number of breastfeeding tips for various stages, below.

Before baby comes

Graham said common questions include, “Will it hurt?” and “Will I produce enough milk?”

Lactation consultants are happy to talk with expectant parents before and after baby arrives to discuss any breastfeeding concerns.

YVMC offers a breastfeeding basics class that discusses the benefits of breastfeeding, how to establish and maintain good milk supply, feeding techniques, breast pumps, milk storage and how to avoid common problems.

Graham also recommends the American Academy of Pediatrics, firstdroplets.com and kellymom.com for additional information.

First few days and newborn stage

In the first days after birth, a mother produces colostrum, the first form of breast milk which is rich in nutrients, antibodies and antioxidants that helps build a newborn’s immune system.  A healthy baby born at full term has reserves that last about 24 hours, which is why they don’t immediately need large amounts of milk, allowing a mom’s body time to increase milk production.

“Nature designs a gentle ramp up as babies are learning how to suck and swallow, starting gradually with a smaller volume,” said Graham. “If there are no medical issues, this is a good way for them to gradually learn a new skill.”

Newborns typically lose a little weight in the few days after birth before getting back to birthweight at the two-week mark.

Parents who are worried about whether a newborn is getting enough milk should look for one wet diaper on Day 1, two wet diapers on day 2 and so on, until they are seeing six wet diapers by Day 5. Another sign baby is getting enough milk is a change in texture and color of baby’s stool to yellow and seedy. Many nursing moms will also notice their breasts feel less full or dense after nursing.

Prior to discharge from the hospital, if a mom is worried about their baby needing more milk than they can provide, they can participate in the hospital’s donor milk program while in the hospital with their newborn, Graham said. Donor milk is also available for purchase from YVMC’s outpatient pharmacy.

The Lactation Club, a weekly breastfeeding support group held in Steamboat Springs and Craig, offers an opportunity to meet other moms, ask questions, weigh your baby and address any questions with a lactation consultant.

As a baby grows

During the next few months, babies go through growth spurts and developmental jumps and may want to nurse more frequently.

“It can be exhausting, but keep in mind this too shall pass,” said Graham. “These cluster feedings are how babies get energy to do what they need to do. They are following their biology and even their personality. It’s not just about breastfeeding, but about security and having a place of stability being with mom.”

For moms feeling overwhelmed, depressed or anxious about nursing, Graham said it’s important to have a conversation with their OB/GYN, primary care physician or lactation specialist.

“We encourage parents to reach out to us by phone or come in and talk about concerns,” she said. “If what you’re doing is not working, we can see what can be done differently to protect mom’s time and energy.”

Teething

Teething can be an adjustment for both mom and baby, but it’s not a deal breaker.

“Just because a baby has teeth doesn’t mean they are going to bite,” Graham said.

There are techniques to make the transition more comfortable for baby and mom, including breaking the latch and having mom set baby safely away from her for a few moments so baby can learn cause and effect.

Weaning

While the American Academy of Pediatrics recommends breastfeeding for two years or beyond, Graham said lactation specialists can support mothers who are ready for the weaning process.

Quitting “cold turkey” is discouraged, as that is stressful for both mom and baby. Instead, a gentle wind down of breastfeeding is encouraged as baby transitions to formula or cow’s milk, for instance, which is not recommended before a child turns 1.

“When a mom is ready, we can talk about options, timing and techniques,” she said.

When to seek help with breastfeeding

There are many resources available to nursing mothers and their babies, such as doctors, certified nurse midwives, nurses and lactation consultants. Situations that might require additional assistance include:

• Breast or nipple pain. While it is normal for breasts and nipples to be tender during the early days of nursing, they should not hurt.
• Trouble latching. If a baby can’t achieve a deep latch during nursing, get help right away so both mom and baby don’t get too frustrated.
• Navigating a breast pump. Moms who need to pump can work with lactation consultants on how to use a pump, proper milk storage and other related issues. Hospital-grade breast pumps are available to rent from YVMC’s outpatient pharmacy.

Mary Gay Broderick writes for UCHealth. She can be reached at marygaybroderick@comcast.net.