Things I Wish Everyone Knew Before Breastfeeding

By: Dr. Lindsey Moore

My son, Henry, is now 3 years old. For the first 2 years of his life, he was breastfed. Initially, it was incredibly hard with concerns of poor weight gain, struggles with a tongue tie and the pain of a disorganized latch. However, with the help of friends, our monthly breastfeeding support group, my amazing husband, and an angel of an IBCLC (International Board Certified Lactation Consultant), we finally caught our stride and were successful. Warming my heart, Henry is now able to tell people that he used to have “Mama’s Milk”. Here are some things that I learned on my breastfeeding journey that I wish I had known at the outset!

It can be hard.
While some new moms sail through breastfeeding and make it look easy, many of us struggle – with supply, with pain, with feelings of guilt and isolation. Having a village of people who support you and can talk you through the struggles can make a world of difference.(For more on the importance of a village, please see this attached article!)
If the latch “looks perfect”, but it still hurts, then it is definitely not perfect. 
A little pain at the beginning of the latch and at the beginning of the breastfeeding journey can be normal, but your nipples should not be painful for the duration of feeds, painful after, or raw or misshapen once a feed is complete. If you are experiencing anything beyond mild pain or discomfort at the beginning of the latch, it is time to seek some assistance.
Breastfeeding looks different for everyone, and this is entirely fine.
Some people are able to exclusively breastfeed their baby directly from their breasts, some people exclusively pump breast milk for their babies, some people have to supplement with formula, and some people exclusively use formula for a variety of reasons. All of these journeys look different, but are driven by the desire to do what is best for the baby and the mother. As your pediatrician, we are here to support you no matter what your journey looks like. As parents, we should all support one another and recognize that parenting is hard and that having compassion for one another is the best way to make it through.
Feed the baby, not the freezer.
Some moms are oversuppliers (meaning they make more milk than their baby consumes) and accordingly, have very well-stocked freezers. As a new mom returning to work, it can be tempting to try to have a freezer full of pumped breast milk stock-piled. However, for most of us, we are exact-producers and can only stockpile a little milk away at a time. For me personally, it was comforting to remember that I only needed enough pumped milk for the next day when I was away from my son.
Feed the baby, not the clock.
It can be very tempting to try to get a baby “on a schedule”. However, babies cannot yet tell time and can become hungry at any point during the day. If your baby is showing hunger cues by lip-smacking, turning towards your breast, or trying to pull at your shirt, it is time to feed them, no matter when their last feed was.
Breastfed babies often like to eat frequently in the middle of the night. 
Breast milk is digested differently than formula, and breast milk production, thanks to the release of a hormone called Prolactin, peaks in the early morning hours. Thanks to these factors, as well as a few others, most breastfed babies awaken frequently to eat overnight. This is normal, but setting a good bedtime routine and having good sleep hygiene habits early on can help combat the parental fatigue that this can lead to.
Breastfeeding can sometimes be isolating and feel lonely.
Many new moms feel comfortable nursing in public and on the go, but many of us are also scared about what people may think about the way we are choosing to feed our babies or about how much skin is exposed when we are feeding babies. Many moms and babies have favorite positions, including ones such as the side-lying or laid back position, which can be difficult to replicate in public places or have a favorite breastfeeding pillow that can seem ungainly to use when out of the house. Surrounding yourself with a village that supports you and will help you work through these situations can be invaluable. Using a resource such as a breastfeeding support group where the feeding of infants is talked about in open and honest manners and where breastfeeding is normalized can be an amazing source of support.
There will be highs.
The first time you have a successful latch, the first time you use your pump successfully, the first time you pump in the car, the first smile you get when a nursing session is complete, the amazing feeling of having a baby fall asleep in your arms contentedly – these are the things that will warm your heart and soul.
There will be lows. 
Low milk supply, breast infections, clogged ducts, pressure from family or friends, pressure from yourself. There will be times when breastfeeding feels less than ideal – when you have these moments, and they will come, reach out for support.
It’s okay to stop.
Any amount of breast milk you are able to provide to your baby is worth celebrating. Focus on the positives of your breastfeeding journey, no matter how short or long, and don’t let anyone, especially yourself, make you feel guilty about what your journey looks like.
It’s okay to keep going.
Nursing a toddler is something that our culture is still learning to accept. However, increasing evidence shows benefits of prolonged nursing – in fact, the World Health Organization, recommends mothers worldwide to exclusively breastfeed infants for their first 6 months of life and to continue breastfeeding, along with nutritious, complementary foods up to the age of 2 years or beyond, if mutually desired. You should never feel embarrassed or unnatural by continuing to breastfeed your baby. You know your body and baby best, and the decision to breastfeed, and for how long, is yours to make.
At Cedar Park Pediatric Family and Medicine, we are deeply committed to helping you achieve your feeding goals. All of our pediatricians strive to stay up to date on the latest and greatest in breastfeeding medicine, we offer complimentary initial LATCH assessments (an evidence-based approach to help trouble-shoot breastfeeding difficulties) done by an area IBCLC (International Board Certified Lactation Consultant) to all nursing families every Friday afternoon by appointment at our Ronald Reagan location, and we have a monthly breastfeeding support group where we discuss the highs and lows of nursing journeys and answer any and all questions. Happy National Breastfeeding Month to each and every one of you!

CPPFM Doctor Recommended Snacks

We have been sharing healthy recommendations all week on Facebook, Instagram, and Twitter for Every Kid Eat Healthy Week. We wanted to end the week with our Cedar Park Pediatric & Family Medicine Doctor’s favorite recommended snacks:

Dr. Keegan

  • Yogurt
  • Fruit (sometimes with nut butters)
  • Nuts

Dr. Moore

  • String cheese
  • Yogurt

Dr. Jennifer Cardwell

  • Fresh fruit: my kids like mandarin oranges
  • Nuts: I keep at work the Emerald 100 calorie packs of almonds and walnuts
  • String cheese

Dr. Brent Cardwell

  • Nuts: Almonds
  • Vegetables: Carrots
  • Trail Mix

The Cookie Catastrophe

On one beautiful Friday afternoon, a very kind patient had cookies delivered to me at the office. After sharing with my wonderful work colleagues, I set one aside for my son, Henry, thinking he would be thrilled to partake in this indulgence on our ride home from daycare. He was beyond thrilled with his cookie, and it made my heart so happy to see him munching happily in his car seat. Once the cookie was gone, he politely asked for another cookie. I calmly answered that he had eaten the only remaining cookie. “But I would like another cookie,” came the happy, still upbeat retort from the backseat. Again, I channeled my inner calm and let him know that there were no more cookies. “I WANT another cookie,” which then escalated to “I NEED another cookie” and then dissolved rapidly into tears and “I MUST HAVE ANOTHER COOKIE! I DON’T LIKE THERE TO BE NO MORE COOKIE!” Oh boy … 

Henry is currently 2.5 years old, and feeling all of the joys and tribulations of being this age, as am I as his mother. While I wish for him to be smart and successful, my greatest desire is that he is kind and compassionate, which means that lately I have been thinking a lot about discipline techniques and how best to employ them. Two of my favorite resources for toddler discipline are the book “How To Talk So Little Kids Will Listen” and the website which allows you to search for discipline ideas by age. What follows are some of my favorite things to remember regarding discipline in the toddler years.
1. Be a good role model. Using kind words and thoughtful actions when interacting with others, and especially in moments of frustration, can be invaluable in teaching your children to do the same. Most kids, especially toddlers, tend to mimic a lot, so giving them kind, but confident, behavior to mimic can go a long way.
2. Have house rules. Setting clear and consistent rules allows kids to know what is expected from them. Making sure all adults are on the same page regarding these rules can make sure one caregiver is not stuck enforcing these rules all of the time and can prevent confusion for kids who are expected to behave one way with one caregiver and a totally different way for another caregiver.
3. Ignore. While some behaviors need to be corrected immediately, as long as your child is not doing something dangerous to themselves or others, ignoring the bad behavior can be an effective way to stop it. A lot of children’s misbehavior is a direct result of trying to get attention, so ignoring the behavior teaches them that they won’t receive attention, positive or negative, for it, so often extinguishes the undesired activity. Ignoring certain antics, can also result in kids learning natural consequences of their action as well. For example, if you play roughly with a toy, it can break or if you throw food, the food is all gone.
4. Catch them being good. Positive praise is a wonderful form of discipline and shows kids what sorts of behaviors are desirable. It is also very easy to feel like you are constantly saying “no” as a parent, so finding small things to praise can really add up and result in immediate improvements in behaviors.
5. Set them up for success. Having reasonable expectations of what kids can endure and what sorts of triggers for meltdowns each child has can help prevent problem behaviors. Scheduling a fancy dinner out at their bedtime is likely not a good idea if good behavior is desired, and likewise, expecting a child to remain calm while running countless errands on an empty stomach is also asking too much. A full tummy and adequate rest definitely helps maximize good behavior.
6. Give consequences, and stick to them. Be very clear about telling your child what consequences will happen if a certain behavior continues. Be prepared to follow through, and make sure the consequence is an immediate one (ie. the toy will go in time out if it continues to be thrown) as future consequences can be hard for adults and young children to remember and you want to make sure they understand the consequence is a direct result of their action. Make sure to never take away something your child truly needs, such as a meal, or anything that will make your life as a parent more difficult in the long run (ie. taking away a 2 year old’s favorite toy for the whole weekend that he spends hours playing with will likely result in increased stress on the parent’s part).
7. Listen and help kids name emotions. Taking time to listen to a child’s version of what happened and allowing them to process their emotions is important. Sometimes just naming a child’s emotion (ie. “You are mad, mad, mad”) can help them feel better by having their feelings acknowledged and help caregivers be more empathetic in trying situations.
8. Distract. Sometimes misbehavior occurs as a direct result of being bored. Engaging them in another activity can help prevent situations from escalating.
9. Offer choices and have some fun. When you are 2 and every aspect of your life is controlled, it can feel good to have choices, even if the choice is would you like to chomp your carrots like a bunny or chew your carrots like a cow (same end result, but a choice nonetheless!). Using puppets or telling fun, fictional stories to demonstrate good and bad behavior can be a useful tool to help kids understand how their actions can affect others and can have different outcomes based on their choices.
9. Spanking and harsh words don’t work and are harmful.Research has shown physical punishment, yelling and shaming children is an ineffective form of discipline and can also be damaging to long-term physical and mental well-being. For full information on this, an excellent article can be found here:
10. Be patient with yourself. There is no one size fits all formula for disciplining every unique child in every unique situation. It’s important to remember that we are all human and doing the best we can, so be kind to yourself as a parent and be mindful of what works best for you and your child, knowing that not one of us is perfect.
The cookie catastrophe outlined at the beginning was deftly and miraculously deescalated by acknowledging the fact that my son was sad the cookies were all gone and by telling a made up story in which a fictional child in a fictional village ate the last cookie that had been made that day and was happy to have been chosen to do so. While I’m glad (and frankly, astonished) that those techniques worked so well in that particular situation, I know that other situations will arise that will require different approaches. I find myself pulling from the above-mentioned tool box numerous times each day, and I hope you find it useful as well!
Written by Dr. Moore