Breastfeeding is an area where gynecologists have little or no respectable information, for this reason we go to the pediatrician to be him or her who gives the indications but we often notice that it seems that it is a little short. This article is based on an interview with a registered breastfeeding specialist and it seemed so enlightening that I wanted to take a lot of your experience and offer it with some linguistic modifications to the reader.

This specialist, Breastfeeding Counselor, is Dr. Ann Friedmann, assistant chief of the Obstetrics and Gynecology Service of the Dwight David Eisenhower Army Medical Center, Fort Gordon, Georgia.

Does the size of the breast matter and the ability to breastfeed?

I assure you that the vast majority of women can breastfeed successfully regardless of the size of the breast.

How much will my breasts grow? Will they keep their size?

The breasts of most of the women will be enlarged during pregnancy and subsequent lactation, a smaller part will report breast growth only after the birth of the baby but universally the breasts will return to their initial volume (not pregnant) when suspending breastfeeding . The shape of the breast will change with a tendency to drop a little more but the total volume will remain approximately the same. In some cases there may be asymmetry due to the repeated use of the same breast for a long time, usually the left breast

What is recommended if my breasts are very large? Does it affect the baby?

A change in how the baby is breastfed solves this problem, you can place a small pillow under the breast to change its shape and prevent it from falling on the baby’s face. In case of very large areolas and full of milk the pressure with the fingers before breastfeeding facilitates the shape and softens it for the baby

What can be said about breast streaks to the mother?

They should be told that they will almost certainly happen. The only advice I give them is to use lubricating creams. Many women see this as a normal and acceptable part of pregnancy. Lubricants improve discomfort caused by stretch marks (itching) but there is no treatment that makes them disappear

What does a woman with inverted nipples do?

The actual inverted nipple is extremely rare and this is discarded by taking and pressing the areola to “squeeze” the nipple forward. In most cases you get a nipple suitable for breastfeeding.

In the rare case of inverted nipple you could use a milk pump with some degree of success

What happens with women with breast implants?

In some patients with total periareolar incisions there could be disruption of the lactiferous ducts or of the important innervation of the nipple-areolar complex. Lack of sensitivity may alter breastfeeding. In general, there is no problem to breastfeed, nor is milk contaminated by the effect of implants

Is there a problem in case of breast reduction?

These patients always have enough tissue to breastfeed but the problems of breastfeeding are associated with the lesions of the milk ducts and the residual sensitivity of the areola and nipple

What happens if the patient is taking medication?

Always be careful with the medication the nursing woman takes. In most cases the medications are safe if indicated by a medical specialist.

What is the position to breastfeed?

The best position is one in which the mother is comfortable and relaxed. The semi-sitting position at 45 degrees is recommended.

When is colostrum expected to “go down”?

Colostrum drops immediately if it had not been present during pregnancy. This is demonstrated by squeezing the areola and nipple, always leaving at least a few drops. Transitional milk appears after 3 to 5 days of colostrum

What analgesics are safe during breastfeeding?

Ibuprofen and acetaminophen are safe

Any special diet during breastfeeding?

For most lactating women, a special diet is not necessary; in general, they are expected to consume 500-1000 extra calories a day compared to those ingested during pregnancy to meet the needs of breastfeeding. The use of calcium is also recommended in doses of 500 to 1000 mg per day.

If there are important nutritional deficiencies or conditions of overweight or obesity the patient should be referred to a nutritionist

A polyvitaminic can overcome deficiencies in several areas

Can the food I eat cause allergies in my baby?

No. In fact, breastfeeding is associated with a decrease in the baby’s allergic reactions. There are many cultural and family myths about what the mother may or may not eat because of the allergic effects on the baby.

How much water should I take during breastfeeding?

The amount of water sufficient to remove the thirst of the mother is indicated. Consumption increases due to the demands of breastfeeding

Can I drink coffee or soft drinks with caffeine?

Two cups of coffee a day or a cup of coffee and a soft drink do not cause stimulation in the baby

Can I drink alcohol?

The levels of alcohol in the milk and in the blood are the same so if you drink a drink you should wait an hour to breastfeed. There is no evidence to support the use of beer or malt to stimulate breastfeeding.

What happens if I smoke?

Smoking cigarettes decreases milk production, in addition, you should not smoke near the baby

Should I continue with vitamins and iron during breastfeeding?

If you have a good and balanced diet is not necessary, but there is no problem that you take what was left of the pregnancy so as not to lose the money invested

Can I lose weight during breastfeeding?

Yes, but you can not exceed a loss of 500 grams per week. You can not use appetite suppressant medications. Diets should be planned by nutritionists and not by Gurus for weight loss.

Is it necessary to use both breasts?

It is a good idea to alternate the breasts so that each one is breastfed at about the same time each day. It is typically recommended to start with the one that was finished in the last blowjob to empty it completely and then move on to the full

Is it common for the baby to be satiated before emptying the breast?

It is not common and requires evaluation. The most frequent cause is that the mother tries to breastfeed a sleeping baby

How do we know that the baby is getting enough milk?

We know that a baby is feeding well if, in the first 3 weeks of life, he is breastfeeding between 8 and 12 times, at least 10 minutes in each feeding, if mom changes between 6 and 8 diapers with urine and observes 3 or 4 episodes of yellowish stools

Does the patient with twins have to breastfeed?

If you can and should try. The patient must synchronize both babies at the same time so that she can have time to rest and do other chores or eat in tranquility. It is very likely that it requires extra help, and if the babies do not get enough milk it is necessary to give them supplementary feeding with formula

What can be done with the nipple cracks?

First you have to check the lactation technique and remember the mother who breastfeeds with the areola and not with the nipple. Avoid using alcohol and abrasives to clean the nipple. Consult if it is suspected that there may be a local infection by bacteria or fungi (itches a lot)

What can be used to care for the nipple?

There are several brands of specially developed lotions that work very well. A cheaper and natural option is to let dry some of the milk on the nipple, if you want to quickly you can dry it with a hair dryer

Can my husband suck my breasts when we make love?

Yes, no problem. In fact there is no risk of breast infection

What are the most commonly used methods of contraception during breastfeeding?

The lactation-amenorrhea method: lactation limits the possibility of ovulation and menstruation but is not 100% reliable, lactation-amenorrhea with condoms, the minipill (only contains progestogen), the injection of progestogens (Depo-Provera), subcutaneous implants ( only progestogens, Jadelle or Implanon) and medicated or simple intrauterine devices (IUDs)

Can I use combination contraceptive pills?

Used within the first 3 weeks postpartum may increase the risk of venous thrombosis. WHO contraindicates its use during the first 6 months to avoid alterations in the volume and quality of milk, especially in poor countries and high rates of maternal and child malnutrition. The American school of pediatrics does not contraindicate its use in adequate conditions after the first month of the baby’s birth

If I get pregnant, can I continue to breastfeed?

You are right. There is no contraindication to continue doing so, it is likely to decrease volume during the second trimester but recover towards the end of pregnancy. If there is amanaza of premature labor or frequent uterine contractions it should be discontinued. Many babies are weaned alone when the mother is pregnant.

If I have breastfed during the whole pregnancy, how do I organize the breastfeeding of the two babies?

The first one to be fed should be the newborn since he should receive the colostrum and in addition he should be guaranteed adequate nutrition since his little brother could eat other things. When giving birth to the milk that the mother was producing, it becomes colostrum.

Breastfeeding and work

This depends a lot on each person and their working conditions, ideas are sought and the best is decided in each case. In our country, this translates into stopping breastfeeding in many cases since there are no favorable transport conditions, location and time available for most of the population.

How long should I breastfeed?

It is recommended at least 6 months of feeding by exclusive breastfeeding to then supplement with the introduction of new and varied foods appropriate for the age of the infant.

I am HIV positive, can I breastfeed?

Current guidelines suggest a decreased risk of transmission of the infection if the mother feeds her child with formula. Exception: if the only way to feed your child – extreme poverty – is breastfeeding WHO indicates breastfeeding so that the baby will not die from starvation.