We will support your decision to bottle feed as you choose, but believe you owe it to yourself and your baby to check out the links below in order to make an informed choice. Many women choose not to breastfeed their baby based on limited information such as their last experience, or the advice or experience of her mother/ friend/ sister… It is unfortunate that so many women feel they are unable to breastfeed based on these experiences and we want to assure you that we are here to help and support you in your efforts.

If you have never breastfed before or you had a less-than-optimal experience in the past, we strongly recommend you attend the relatively inexpensive class offered by Sentara, which can dramatically improve your success and satisfaction. Call 282-4000 or click on the link to find out about classes available to help you start breastfeeding or continue while you work and discover the breastfeeding information line, home health lactation visits, breastfeeding clinics and consultation resources.

Remember, each and every couplet (mother/ baby combination) is different and most are able to get the hang of things with a little proper support. If you can’t find the answers to your questions through any of the links below, please be sure to contact us.

Obstacles to breastfeeding

“I don’t have enough milk!”
The reason most women stop breastfeeding or offer formula (which leads to the loss of breastfeeding) is the belief that they do not have enough milk, especially in the first couple of days. Your baby has enough fat stores to supplement your colostrum (concentrated breast milk) until the mature milk comes in. Colostrum is nutrient-rich and babies only get about one tablespoon from each breast per feed. If your baby is nursing every 2-3 hours, wetting 2 diapers and having 2-5 bowel movements per day in the first couple of days, he or she is getting plenty of breast milk. The number of wet diapers will increase to 5-6 and feeds may spread out occasionally for up to four hours after your mature milk comes in. When your body adjusts to the proper supply and demand, your breasts will not always feel full, sore or engorged and some women take the lack of this feeling as evidence they are not producing enough milk. Remember to monitor the diaper output as proof your baby is eating plenty.

“Breastfeeding hurts”
The most common cause of pain during breastfeeding is improper latch. Be sure your midwife, nurse, or lactation consultant spends time with you during a feeding to help you get this technique down. Some babies are just naturals (although they have never done this before!) and others need a little coaxing to get it right. Keep in mind that many women continue to breastfeed – some for years – child after child and recognize this as a sign that breastfeeding, when done with the proper latch technique, does not hurt. If you are experiencing persistent pain not related to latch, please contact us, a lactation consultant or a La Leche League leader.

“My breasts are so hard and full – I just want to quit NOW!”
You will go through a period of engorgement (swelling of the breasts) 2-3 days after the baby is born. Prevention is the best cure; feed the baby as soon after birth as possible, especially if you have had a cesarean section (ask about positions especially for you), and feed the baby often. If your breasts do become engorged, continue nursing at least every two hours. Sometimes the nipple flattens out with very full breasts which can prevent your baby from getting a proper latch and lead to sore nipples. You can hand express or use a cycling breast pump on a low setting to express just enough milk for the nipple to become easy for the baby to grasp. Engorgement usually resolves in 1-2 days. Until then, you may choose from the following to make you more comfortable:

• Use your baby to empty your breasts, not a breast pump. If you pump AND feed your baby, your body will continue to make large amounts of milk.
• You may find a sports bra more comfortable than a traditional nursing bra
• Use cool compresses on your breasts for comfort (a frozen bag of peas on a washcloth feels great!)
• Apply warm compresses 3-5 minutes before a feed to soften the breast and assist let-down
• Use cabbage leaves as directed below. Be sure to assess at each change of leaves for adequate milk flow (hand express or feed baby) and stop using the leaves when sufficient relief is obtained
• You may use ibuprofen (Motrin) 800 mg (that’s 4 tablets over-the-counter) every 8 hours as needed for pain associated with swelling not relieved by any other measure

When the feeling of engorgement passes, many women feel they do not have enough breast milk. After all, you have just gone from feeling you could feed the nation to just this one little baby! If this is the case, read the first section, “I don’t have enough milk!”

Cabbage Leaves

Cabbage leaves are a very old remedy that has received much renewed interest from lactation professionals over the past 10 years. Though admittedly, there is not a lot of research on the effectiveness of using cabbage leaves to treat engorgement, they have been used and recommended for many mothers in hospitals all over the country. From our observations and mother's reports, it does seem to be quite effective at relieving engorgement, while having little chance for side effects.


To treat engorgement, place a cold cabbage leaf (see preparation methods below), covering each breast, and securing inside the bra. Change leaves when wilted, or approximately every two hours. As engorgement subsides, discontinue use. Continued use can dramatically reduce the milk supply.
When using cabbage leaf compresses, it can make it easier if you prepare enough leaves for several changes ahead of time. Wash the cabbage leaves, allow to dry and place in a zip-lock bag until needed. There are several recommended methods of preparation to choose from:

• They can be applied as is, using one or more, as necessary to cover the breast.
• The leaves can be crumpled in your hand to crush the veins prior to use
• Leaves can be softened briefly in hot water to make them more pliable, and then chilled
• Veins of the cabbage can be scored with a knife before application
• Warmed, rather than chilled cabbage leaves offer better relief for some mothers

References:

• Cool Cabbage Compresses, Rosier W, Breastfeeding Review, 1988
• Breastfeeding: A Guide for the Medical Profession, Lawrence, 1994
• Do Cabbage Leaves Prevent Breast Engorgement? A Randomized, Controlled Study, Nikodem VC, Birth, 1993
• A Comparison of Chilled Cabbage Leaves and Chilled Gelpacks in Reducing Breast Engorgement, Roberts KL, Journal of Human Lactation, 1995
• A Comparison of Chilled and Room Temperature Cabbage Leaves in Treating Breast Engorgement, Roberts KL, Journal of Human Lactation, 1995