Becoming a mom comes with plenty of unknowns, but one of the biggest is breastfeeding.
Preparation is key, according to Theresa Bryan, a lactation consultant at Methodist Hospital | Stone Oak.
“It’s not as easy as everybody thinks,” she said. “Get all the information you can.”
Benefits of breastfeeding
Bryan said there are several benefits of breastfeeding, but it’s a personal choice.
“Breastfeeding is kind of like Starbucks,” she said. “The baby gets to customize the breast milk, and every time the baby latches to the mom’s breast, the baby’s saliva goes into the mom and hits the feedback receptors.”
Mom’s milk is customized for the baby’s needs within 30 minutes.
“(The saliva) calls in the baby’s order: How much milk, what kind of milk, how much sugar, how many calories, what kind of antibodies they need,” Bryan said.
This is especially helpful if they were exposed to something while out in public.
She said breast milk is processed easier in the baby’s immature gut.
“Whatever the baby consumes for the first three months helps to build the lining for their immune system for the rest of their life,” she said. “It also helps to provide probiotics and prebiotics.”
Preparing for nursing
Bryan said the best thing any expectant mom can do to prepare for nursing is to get all the information she can, consider taking a breastfeeding class and see if WIC is an option.
“Talk to your obstetrician and see how they feel about breastfeeding,” Bryan said. “If your OB doesn’t have any information, ask them for resources; there’s so much out there.”
Breastfeeding classes are great for any questions you might have, especially when in the hospital.
The Methodist Women’s Health Center Lactation Center can help moms with breastfeeding.
“Anybody can get free breastfeeding help there,” Bryan said.
How long should I breastfeed?
When it comes to the length moms should breastfeed, the American Academy of Pediatrics recommends a year, but it’s ultimately up to mom and baby.
“It’s a relationship; it’s a choice,” Bryan said. “It’s not for everybody, but if you can give it a good three months, you are a champion.”
She said any breastfeeding that a mom can do is great, but it’s not uncommon to see women experience issues.
“Right at the six-month mark, many moms struggle because babies hit a learning leap and a growth spurt. The mom’s hormones change and there’s a big shift there.”
For those who are able to continue breastfeeding longer, Bryan said even past 2 years old is great.
“They’re still gaining immunity. They’re still getting whatever their mouths are telling their mom’s bodies,” she said.
Just as the length of time a mom chooses to breastfeed is important, so is deciding whether to do it at all.
“It’s not for everyone; it’s a personal choice,” Bryan said. “Breastfeeding is an emotional, hormonal driven act that is very intimate.”
The hormone cortisol that’s released when we are stressed or have anxiety can block oxytocin release (which releases milk), so negative feelings toward breastfeeding can hinder milk production.
“If someone has negative feelings, they should talk to their doctor, counselor, therapist or board-certified lactation consultant to work through their feelings, whether they decide to breastfeed or not. Healing trauma and having education to make the best decision for yourself and your baby is the goal.”
Breastfeeding struggles
Many new moms experience struggles early on with breastfeeding. Bryan urged women to ask for help in the hospital.
“I try to give moms all the education -- what I would have wanted to hear and wish somebody would’ve told me,” she said. “I look at all the handouts with them and review what to expect.”
Doing a hospital tour before delivery can be helpful, as well, as it’s a great time to meet with a lactation consultant and ask questions like: What do I do? How do I start? What happens if my baby goes to NICU?
Bryan often encounters moms who have met obstacles or birthing interventions that have impacted breastfeeding, like varying hormone issues, PCOS, gestational diabetes or flat or inverted nipples.
“Maybe mom had a C-section, then baby is born, has a little bit of stress, is a little bit gaggy and spitty from extra amniotic fluid,” Bryan said. “Talk to your lactation consultant and say, ‘I feel this way about my body because of this. I don’t think it’s going to make good milk because of this.’”
Regardless of the reason, Bryan said to take advantage of your lactation consultant before you leave the hospital.
“I can’t stress early intervention enough. You can get help to overcome anything that you’re going through. Even if you had breast reduction or breast implants, we can help.”
Utilizing a breast pump
Bryan said there are times when moms might need to pump in between breastfeeding sessions, such as if the baby isn’t latching, is in the NICU and can only do a little bit at the breast, or mom needs extra stimulation.
Other than a handful of circumstances, she said it’s typically unnecessary.
“There are times we do use a pump in addition to latching at the beginning, but for the most part, you want to wait at least two weeks,” Bryan said. “Let your breast milk supply get regulated by your baby before you try to use a pump. We don’t want to double up and end up with clogged ducts or mastitis.”
If you’re going to use a pump in the early days of initiating your supply, talk to your lactation consultants.
[Texas Lactation Support Hotline: 855-550-6667]
For women who pump exclusively, baby can still get all the same benefits.
“The baby still gets antibodies from mom’s body. A key I tell my exclusive pumping moms is to do what’s called seeding: Swab the inside of baby’s cheeks with a Q-tip, just get some saliva and put it on their nipple. They don’t have to do it every time they pump, but maybe twice a day.”
How much food and water should I have?
In those early days, before milk comes in, it’s all about supply and demand. Colostrum (newborn milk) is thicker and in smaller quantities so that newborn infants can learn to suck, swallow and breathe. Latching baby or hand expressing the colostrum helps to initiate your breastmilk supply. If the infant is unable to latch, pumping and hand expressing in the hospital is crucial.
Bryan said once your milk comes in, eat a balanced diet. A great resource to figure out how much you should be ingesting according to how much you are breastfeeding is MyPlate.gov.
“Everybody is different, so everybody has different calorie needs. You can put your height, weight, how much you breastfeed and activity level, and it gives you how many calories you need.”
It also provides recipes and a shopping list.
“I always share this information with moms who are concerned with nutrition or who are thinking about weight loss. Many moms want to lose the baby weight but don’t want it to impact their supply,” Bryan said. “Even though breastfeeding helps you drop postpartum weight after your supply is established, our body holds on to a little weight in our gut just in case of emergency, and there’s nothing that we can do about it.”
Bryan suggested drinking water to your thirst level. You don’t have to drink a gallon of water a day, but always have water on hand.
Drinks like Gatorade are fine, but pay attention to how much sugar and sodium you are drinking.
“Water and sugar-free drinks are always going to be best. We really want to stay hydrated, not overhydrate. There’s no magic number. When you get thirsty, take a drink.”
Bryan said for every one cup or glass of soda or coffee, drink a bottle of water.
“Caffeine can make babies irritable, excited, not sleep well. It’s not just in sodas and coffee, it can be in foods that you eat, as well.”
If you’re going to have alcohol, the general rule is usually for every glass of wine, 12-ounce beer or 1 ounce of alcohol, wait two hours to breastfeed.
“Because alcohol also dehydrates our body, make sure you drink water, too. In the meantime, know you’re not able to nurse. If you drink three glasses of wine straight, that means you need to wait six hours to breastfeed. During that time, mom would need to pump and dump.”
She said not to rely on alcohol strips but to adhere to the two-hour rule.
Bariatric moms and other special cases
It’s important for women who have had bariatric surgeries to be in touch with a dietician prenatally and postpartum to give them direction and peace of mind about meeting nutritional goals.
“Keep in touch with your baby’s doctor and your doctor, follow your protein and calories,” Bryan said. “If you can’t get in your fluids like you normally do, that can hinder post bariatric surgery moms. Even if you dropped off and are not following your dietitian, let’s pick it back up.”
She said to talk to your doctor to understand what supplements and vitamins you need.
“Don’t just take something your friend gave you or something you saw on the shelf or TikTok.”
Moms with varying conditions should also be aware of what they’re ingesting. She said some women ask about mother’s milk tea or fenugreek, but these things might affect women differently if they have gestational diabetes or thyroid issues.
“You need to talk to your doctor before you take any milk enhancing products. You can do more harm to you and your baby if you’re taking those things without any medical advice.”
Nutrition and gut health
Claudia Zapata Elliott, registered dietician and ambassador for Methodist Healthcare, shared that nursing moms should prioritize nutrient-dense foods, including fiber and protein for satiety, blood sugar control and weight management, as well as healthy fats and antioxidants for heart health and brain health.
“Nursing moms are also busy moms, so meals and snacks that are easy to prep and portable enough to pop into a diaper bag are a great choice,” she said.
Elliot provided a recipe to her nutty energy bites, which she says checks all the boxes while also being delicious.
“Nursing babies will thrive and nursing moms -- along with spouses and older siblings -- will all enjoy this yummy blend of old-fashioned oats, peanut butter, dark chocolate, heart-healthy seeds, cinnamon and a touch of honey and salt.”
Click here for the full nutty energy bites recipe.
Bryan added that another good meal might be a salad with dark leafy greens, chicken, strawberries and almonds with the balsamic vinaigrette.
“That’s making their iron go up. It’s helping mom to be healthy, getting her the proteins, iron and vitamin C to help that iron absorb into her body, plus make her milk stronger.”
Lactation classes
As Bryan stated, lactation classes are a great way to prepare moms for what’s to come with breastfeeding. It’s an opportunity to meet with lactation consultants, ask questions and set the expectation.
Methodist Healthcare provides classes in person and online, for convenience.
Click or tap here to find a class near you.
To learn more about Methodist Healthcare’s women’s health services, click or tap here.