Rebecca from Wisconsin says that her first two children latched on, but she did not produce enough milk.
Q: As we think about having a third child, I don't think I could do it again. Is it normal to not have the capability to produce enough milk, or is there something else I could have done to increase my milk?
A: About 1 percent to 2 percent of the population cannot make enough milk to meet their babies' needs. Other moms fail to produce a good milk supply because they don't get the right help after delivery. The baby's ability to latch properly is critical. Poor latch can cause pain and make the mother's nipples sore. Low thyroid, hormone levels or diabetes in the mother can also cause low milk supply. There are a variety of factors to consider. Sometimes you can figure out why there is a problem, and sometimes you might not. Every pregnancy and every baby are different. Sometimes it is easy with the first pregnancy, but more difficult the next time around. It's a complex process, and just because it is natural does not mean it is always easy. Feeding some colostrum in the first week would be better than the baby getting no breast milk at all. The baby can learn to latch better when the breasts are nice and soft after delivery. Babies who feed well right after delivery seem to do better than those who have a delay in the first feeding. After the first few days, the breasts may become much more firm, and it can be a little more challenging for the baby to latch on.

Kory from Hawaii, a mother of a 10-month-old daughter, writes:
Q: I was adamant about breastfeeding from the beginning and don't regret my decision. However, now that I would like to stop breastfeeding by her first birthday, I worry about the transition. Will she be able to let go of the emotional needs nursing gives her? What are the options for mothers who want to avoid the “crying it out” strategy for weaning?
A: Gradual weaning is easier for both mom and baby, instead of going cold turkey. Gradual weaning over a few months is ideal, if mom has the luxury of time. It probably works best to take out a feeding a week. Weaning quickly can be difficult for both. Slow and gradual is the way to go.

Kimberly from Oregon writes:
Q: I am currently nursing my four-and-a-half-month-old daughter. Sometimes during evening feedings she sucks me dry but still seems hungry. Should I be concerned when she wants to continue to eat but there is nothing left? Does this mean that I need to start supplementing with formula?
A: If the child is growing appropriately, it's not an indication for formula. Mother's supply is more plentiful in the morning. Frequent feeding in the evening, or cluster feeding, is pretty common, especially when mom is trying to fix dinner and the older kids are demanding attention. Frequent nursing will stimulate increased supply. It doesn't necessarily mean you need to supplement. Fortunately, the baby never completely empties all of the milk from the breast, so even if the baby is feeding often, she is still getting milk. Also, babies have periodic growth spurts. The breastfed baby will feed more vigorously and the mother's supply will be boosted.

Quick tips for the new mom
Be prepared ahead of time
Attend breastfeeding classes, read books, or rent videos/DVDs. Talk to your breastfeeding friends. If you have never actually seen a baby breastfeed, go to a La Leche League Meeting. If you have had breast surgery or have nipples that point inward instead of outward, consider seeing a lactation consultant before delivery. Choose an obstetrician and a pediatrician that are supportive of breastfeeding and will help you through any problems you encounter. Interview your prospective pediatrician or ask your friends which pediatricians support breastfeeding. Make sure your partner is educated about breastfeeding and will support your decision. Deliver at a hospital that supports breastfeeding and will provide you help after delivery.

Recognize it takes commitment
While breastfeeding is a natural process, it does not always come naturally. For some mothers and babies it takes awhile to become comfortable with the process. The first few weeks of breastfeeding require time and patience. It is normal for mothers to feel like they are spending most of the day and night breastfeeding. Once the milk supply is well established and the mom and baby have learned to breastfeed, it gets a lot easier and becomes a much more convenient way to feed the baby.

Ask for help and ask early
Get help in the hospital before you leave. If you are having problems with pain or are unsure if the baby is latched on properly, ask for help. Make sure the baby is latching on with a wide open mouth, which helps him to drink more milk while he is feeding. Ask your doctor or lactation specialist for help. Your pediatrician should see your baby within 2 to 3 days after hospital discharge to check their weight, their breastfeeding, and to look for signs of jaundice (yellow color of the skin). If mother is having any problems with breastfeeding, this needs immediate attention to establish and maintain a good milk supply.

Any breast milk is better than none
Breastfeeding is the gold standard for infant feeding. Formula feeding is an acceptable alternative, but it is not equivalent to breastfeeding in terms of health or optimal growth and development. The American Academy of Pediatrics recommends exclusive breastfeeding for about 6 months, continued breastfeeding with the introduction of solids for at least the baby's first year of life, and as long thereafter as the mother and baby desire to continue. This is the ideal, but may not work for every mother and baby. Providing colostrum to the baby in the first days after delivery is important to boost the baby's immune system. Delaying introduction of cow milk protein may help to prevent allergies. Breastfeeding for even 4 months helps to prevent ear infections for up to a year. Longer duration of breastfeeding provides the best developmental outcomes and protection from obesity or other chronic diseases. A combination of breast milk and infant formula may end up being the best choice for some families. Any breast milk the baby gets is better than none at all, and the longer the baby breastfeeds, the greater the potential benefits.

MORE FROM HEALTH

Health Section Front

Baby formula poses hidden risks Vermont named healthiest state, Louisiana last Top 20 medical breakthroughs for women 10 healthiest cities for women Veterinarian's ruff road to drop 155 lbs. Randy Jackson reveals his weight battle Randy Jackson on conquering diabetes Twix and pizza — are these really diet foods? Quiz: Surprising Thanksgiving calories! Gobble, gobble: Holiday meals can trigger gout Health Section Front   Add Health headlines to your news reader: