How not to feel like you are “failing at breastfeeding” (and 5 signs that it’s actually going well!)
As a lactation consultant, one of the most common concerns I hear from people who are pregnant or newly postpartum is that breastfeeding “won’t work out.” I understand the concern. Feeding a child from the same body that just grew and birthed it is a primal and universal desire. It isn’t just something that we choose, like paper or plastic, it’s part of what makes us human.
We know that most people who plan to breastfeed don’t meet their goals. Breastfeeding grief is soooooooo common. Even when things “go well”, there are often feelings of regret around the experience.
I believe that most people would feel less regret if they were truly supported during breastfeeding. Think about how we live now compared to how our species lived pre-industrialization. These days, we’re cloistered off in our own dwellings, often far from our extended families, left to figure out how to be parents on our own, with only social media, pop culture and google as our guides.
To top it off, we still don’t have federal parental leave in the U.S., so the best we can hope for is that we live in a state or work for a company that grants us a few unpaid months off.
No wonder most new parents are struggling.
So what’s the solution? A complete overhaul of our culture won’t be happening anytime soon, so while we advocate for change, how can we best support people who are having babies right now?
It starts with educating people about what’s normal. Most of us don’t know how our bodies work and the process of lactation can feel pretty mysterious.
When I talk with people who have just given birth, and I ask them how breastfeeding is going, they almost always say something like, “I have no idea if my baby is getting anything.” This is where we can provide education and (usually) reassurance.
Here are the things that I discuss with new parents in those early days:
1.“Did you notice changes in your breasts during pregnancy?”
Physical changes indicate that the breasts underwent growth of glandular tissue, which is required to make milk. A lot of people are surprised to hear that their bodies started producing colostrum (the first milk our bodies make) around the middle of pregnancy. During pregnancy, it’s normal and reassuring to see darker and larger areolas and nipples, breast growth, increased breast and nipple sensitivity, and sometimes a small amount of colostrum leaking. (The absence of leaking milk at any point is NOT a sign of a problem. Some people are just leakier than others.)
2. “How is breastfeeding feeling?”
I once had a new mom tell me on the second day of her baby’s life that she was concerned breastfeeding wasn’t going well because she expected it to be painful. It was really surprising (and relieving!) for her to hear that pain is an indication of a problem. Breastfeeding sometimes feels weird, strong or unpleasant to people, but it shouldn’t feel painful. Pain (such as a biting or pinching sensation) and nipple damage usually means that baby is not feeding well. Intact nipples and pain-free feeds are definitely reassuring.
3. “How does the baby seem during and after feeds?”
During and after a satisfying feed, babies look the way adults look after a good meal; blissful and sleepy. Look for relaxation in the face and limbs, with open, floppy fingers. These are your baby’s fullness cues. A satisfied and relaxed baby is a reassuring sign.
4. “Are you hearing swallowing?”
We can’t see breastmilk going from the breast to the baby’s mouth, but what you can do is listen for swallows. These are quiet and sporatic in the early days, then become more frequent as the milk changes from colostrum to mature milk. Swallowing is a very reassuring sign.
5. “Is your baby making enough pee and poop?”
The minimum number of pees, poops and their color will be different from day to day in that first week of your baby’s life. Make sure you know what’s normal depending on your baby’s age. It’s helpful to keep track in the first week just to be sure that your baby is reaching at least the minimum goals. What goes in, comes out.
BONUS QUESTION:“Have you tried hand expressing?”
Although this doesn’t tell us how much the baby is actually getting, parents can reassure themselves about the presence of milk in the early days by hand expressing. Hand expression is a valuable tool to have in your toolkit throughout lactation, and I encourage all freshly postpartum people (as well as people at the end of pregnancy) to learn this skill. Seeing your colostrum for the first time is often reassuring to people in those first few days, when your breasts don’t actually feel different yet.
When all of the above signs are present, I can usually reassure new parents that breastfeeding is going well.
I also strongly encourage people to prepare for breastfeeding during pregnancy. Watching a few YouTube videos and crossing your fingers is actually not the most effective plan. I put together a 5-step guide to follow before your baby is born. It walks you through how to build your confidence and your knowledge base about breastfeeding so that when your baby is born, you aren’t starting from scratch. Click the button below to download this free guide.
Since most of us haven’t spent time around people when they’re breastfeeding, we have a large gap in our understanding of this basic body function. I want every parent to know how to assess their baby’s feeding, and I encourage them to call a lactation consultant if there are any concerns.
By preparing yourself ahead of time, and asking yourself the right questions once you begin breastfeeding, you can take charge of your breastfeeding experience.
