We are so excited to have Naya Weber, certified lactation consultant on Love Child today. An expert in her field and self-described, boob nerd, she settles nerves and clarifies so many misconceptions surrounding breastfeeding. Naya’s own difficult journey with breastfeeding is what eventually led her to becoming a lactation consultant. She stopped by to share tips, frequently asked questions and remind us all that, “breastfeeding may be the most natural thing in the world, but it doesn’t come naturally for some.” May we all breathe a sigh of relief now! Photo by Heather Gallagher 

By Naya Weber

Prior to having my first child, I vividly remember thinking, “how hard can breastfeeding be? Baby goes on the breast, and that’s it. It’s very natural!” Oh naive, sweet, inexperienced me! How I wish it had been that simple! My first experience with lactation was a tough one: a late preterm baby, low milk supply, and significant weight loss made for a perfect storm. There were lots of tears initially, but eventually there was also a lot of breastmilk! My own difficult journey led to learning more about lactation, a passion for supporting families and breastfeeding advocacy, and eventually a career switch to becoming a lactation consultant. I thought I would put together a list of the most frequently asked questions I get from expectant and new moms about lactation.

1. How can I prepare for breastfeeding my baby?

Despite many old wives tales, you don’t have to “toughen up” your nipples with a rough washcloth – OUCH! The best way to prepare for baby is to learn what to expect. Take a prenatal breastfeeding class, attend a lactation support group meeting, and get the contact info of some great lactation consultants in your area. It can also be helpful to reach out to your insurance company ahead of time and find out what they cover for lactation support.

2. Should breastfeeding hurt?

This is a question that will get you many different answers depending on who you speak with. The short answer is no, breastfeeding should not hurt. That being said, it’s possible that there will be an adjustment period where your breasts and nipples feel tender or more sensitive. This is very common for new mothers to experience. Many new mamas report feeling a little bit uncomfortable for the first few seconds after initial latch, but that fades very quickly. However, you do not want to be in toe curling pain during the entire feed, and cracks or scabs are signs that you may need some assistance.

3. How do I know my baby is getting enough?

The best way to gauge baby’s input is through their output, especially in the early days of breastfeeding. A newborn should have one wet and one soiled diaper per day of life – 3 wet diapers and 3 soiled diapers on day 3, 4 wet diapers and 4 soiled diapers on day 4, and so on. This maxes out at about a week, where a baby will have 6-7 wet diapers and 4-5 soiled diapers in a 24-hour period. You will likely be visiting with your pediatrician a few times during the first few weeks of life. If there are any concerns about intake or weight loss, contact a lactation consultant or other breastfeeding support person to assess a feed.

4. When should I introduce a bottle?

The best time to introduce a bottle to baby is between four and six weeks. By that point, breastfeeding should be well established and it would be a great time to have your partner offer baby a bottle of your expressed breastmilk. Look for bottles that have a wide base and wide nipples – similar to what your breast looks like. As the lactating parent, it can be difficult to get baby to take a bottle from you; this is a great time to get your partner or family involved with feeding.

5. What does a letdown feel like?

This is a question I get frequently, but is often reported as, “my breast hurts while feeding or pumping! What’s going on??” After asking a few questions, the answer is usually a woman starting to feel her letdown or milk ejection reflex. It can be triggered by a baby suckling at the breast or by using a breast pump. Some women can feel their letdown reflex as tingling, warmth, or little jolt of electricity going through their breast; sometimes this new sensation gets categorized as pain due to it being unfamiliar. Other women don’t feel their letdown at all. Many women experience an uncontrolled letdown reflex when they hear a baby cry or think of their child. Their milk will begin to flow even if their baby is not nursing. Letdown is often the butt of a joke on TV or in a movie, but it can happen in real life as you hear a baby cry a few aisles away while at Target.

6. How do I unlatch my baby?

Okay, I’m going to get a little boob nerdy here and explain some of the intricacies of latch: when a baby latches on to the breast properly, they take in more than the nipple – they take in enough breast tissue to bring everything back between the juncture of their hard and soft palate, towards the back of their mouth. A vacuum is formed once baby starts using its tongue in peristaltic waves to initiate letdown. Because of the negative pressure, it is important not to just pull baby off. Your nipple tissue is VERY stretchy, and you could end up hurting yourself badly! Instead, make a hook out of your pinky or index finger, and slide it into the corner of baby’s mouth. Slide it between baby’s gums in order to break the vacuum, and then slip your nipple and breast tissue out of baby’s mouth. It can take some effort to get your finger between baby’s gums, but it is important to unlatch baby in a way that is painless for mama!

7. When do I call a lactation consultant?

There are a number of reasons to contact a lactation consultant: concerns about baby’s intake, weight loss or gain, questions on milk supply, sore or cracked nipples, preparing to go back to work, distracted feeding, you get the idea. Many women also seek support from a LC to make sure that breastfeeding is going well. Since the Affordable Care Act went into effect, most insurance companies have to cover breastfeeding support, including a new breast pump with each pregnancy. Be sure to reach out to your insurance company before baby is born to see what is covered. If your lactation consultant is not in-network with your provider, she may be able to provide you with a super bill to submit for reimbursement.

8. What can I expect at a lactation consultant visit?

An initial in-home lactation visit can take anywhere from 90 to 120 minutes. During that time, you can expect:
• A full evaluation of parent and baby’s medical history
• Assistance with latch
• Proper positioning techniques
• Weighed feeding (pre/post feed weights)
• Oral assessment of infant
• Evaluation of milk transfer
In addition, your lactation consultant should address your primary concerns and challenges with evidence-based information, and provide you with a customized care plan to help you reach your feeding goal. I often end up speaking to families about things like sleep, self care for a new mom, how to involve dad, baby wearing, and more. If I don’t know the answer, I can get you in touch with someone who does! I also follow up with clients after visits and provide additional support.

Breastfeeding may be the most natural thing in the world, but it doesn’t come naturally for some. Remember that it’s okay to need help with breastfeeding, even if it isn’t your first baby. Each experience is different – think of it as learning to dance with a new partner. There will be a period of time where you step on each other’s feet, but you’ll soon be dancing beautifully in time to the music. You and your baby are learning to work together.
Naya Weber is an International Board Certified Lactation Consultant and self-described boob nerd. She lives in southwest Austin with her husband and two sons. In her spare time, she enjoys reading, napping, and occasionally writes the blog Lactivist in Louboutins. She is on the board for the Central Texas Breastfeeding Coalition and the Texas Breastfeeding Coalition, and a volunteer leader for Partners in Parenting. You can follow her on Instagram, Facebook, or visit her website to learn more about her services.