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Melanie Cole (Host):  Breastfeeding is a bonding experience that benefits both mom and baby. My guest today is Sue Lindekugel. She’s an Aspirus international board certified lactation consultant and registered nurse. Welcome to the show, Sue. Tell us a little bit at the beginning here about the benefits that we know about for breastfeeding.

Sue Lindekugel (Guest):  Hi, Melanie. This is very important because there are so many benefits to both mother and baby. It protects the baby from infections, risk of asthma, eczema, obesity, heart disease later in life, ulcerative colitis, even decreases the risk of diabetes and baby is less likely to suffer from some forms of childhood cancers like Hodgkin’s disease and leukemia. For mothers, the risk of breast and ovarian cancer is lower, protection against osteoporosis, decreased risk of rheumatoid arthritis, and decreased risk of cardiovascular disease later in life, along with the risk of type II diabetes. The cost of breastfeeding does save the country about $3.6 million dollars to treat conditions and diseases that are preventable by breastfeeding.

Melanie:  Is there anything you want moms to be, to know, to plan in advance, to begin nursing once the baby is born?

Sue:  As far as beginning to nurse, you can plan for it, get ready, talk to your employer if you have to go back to work, getting a good start, have a natural labor delivery, perform skin to skin after delivery, rooming in, avoid unnecessary supplementation of pacifiers. Get it off to a good start. So, do all the reading, take a breastfeeding course if you can just to help you understand what breastfeeding is all about.

Melanie:  So, how do you work with people? How do they begin? What's the first thing? New moms are exhausted and they're nervous. Right away, first thing, does the baby latch on right away or is there a learning curve that goes with this?

Sue:  There's a learning curve and everybody must understand that. You're dancing with a new partner. Getting it off to a good start by having the baby skin to skin with you right after birth. Room in with the baby so you know the baby's dance and you can dance with the baby. Avoid pacifiers, just getting it off to a good start and understanding that it may take a while before you really feel comfortable breastfeeding--sometimes up to three or four weeks.

Melanie:   How do you know the baby is getting enough milk?

Sue:  There are all kinds of ways to see. A mother has natural instincts. What goes in comes out. So, if you take a breastfeeding log sheet and monitor your baby's number of feedings and number of wets. If your babies is content after feeding. They do feed frequently sometimes up to 8-12 times a day.  So, frequency of feeding has no indication on how much milk it’s getting but if you keep a diaper diary and how many stools and how many wets they're having. Babies’ stomachs are small. They don't need much, they digest it very rapidly and they eat frequently.

Melanie:   So, what do they do if a mom says to you, "It hurts.  My nipples are sore. They're cracked and drying. This is not very comfortable for me at all. Will it get more comfortable?”

Sue:  Actually, signs of sore nipples are a definite problem. If it hurts to nurse--it may be tender.  We expect some tenderness, sensitivity but if it hurts to nurse, that's my job. I can correct that. Generally, with repositioning baby and getting a deeper latch, we can solve some of the minor problems that occur in the beginning. Having a board certified lactation consultant to consult with, which we have available, is always helpful for moms. Don't be afraid to ask for help or ask questions.

Melanie:   Is there something you want new moms to do for their own behavior and lifestyle that can help them make more milk? Is there certain foods they should avoid? Give us some of your best advice there.

Sue:   As far as a diet for mothers, there's no special diet they have to follow. They have to have good nutrition. I always tell moms that moms are more than capable of producing adequate amounts of milk if babies are feeding frequently. She doesn't have to add anything to her diet to increase milk production. Just getting it off to a good start and frequently breastfeeding always helps to maintain a good milk supply.

Melanie:   What about medication, Sue? What if the mom is on diabetes medication or blood pressure medication? Can these things be continued while nursing?

Sue:  Yes. Most medications are safe with breastfeeding. The American Academy of Pediatrics came out several years ago stating that most of your common medications are safe with breastfeeding. There may be some alternatives that we have to juggle around to make it more appropriate for babies but most medications are safe and you can feel free. Always check with your practitioner or a board certified lactation consultant for information before you start any medications.

Melanie:  What about getting other family members and dad involved? If they want to do that, what do you think of breast pumps? Or, if you're someone who has to go back to work? Speak about getting other people involved.

Sue:  Family need to really be a part of this and support it. So, they need all the information too. So, any family member or your significant other can attend a breastfeeding class with you to learn about it. There are all kinds of webinars online and websites you can go to to learn more about breastfeeding. Even your day care provider, getting them involved when you get back to work. Having a good pump and time to pump. There are laws out there for women that your employer must provide you the time and the space to pump in.

Melanie:  So, when women are breastfeeding, if they've gotten into this routine, then what about if you are at work or you're out and about some place? What do you then? You spoke about laws right now but what if you're somebody who is out and about?  There's a little controversy surrounding feeding in public. What do you think about that?

Sue:  Yes. Feeding in public has always been a controversy. Some people get offended by it but mothers do have the right. Most every state in the United States has laws on the board that mothers have the right to breastfeed any place--any public place that she can be--and she does not have to cover up. But most mothers are modest and cover up in public and we see a lot more on TV than we see with breastfeeding mothers.

Melanie:   Absolutely. What advice you have for mothers about the ways to get started--holding the baby, the skin to skin contact? What do you tell mothers right at the beginning?

Sue:  Right at the beginning, we recommend putting the baby to skin on skin on mother's chest. Mother's chest increases in temperature, so she's going to act as a furnace to keep baby warm. Babies often self-attach when they're on skin to skin. It's kind of baby led latching to get a good latch. In the first hour, the babies are most alert, so that's when they get off to a best start. Rooming in with the baby so you know baby's clues. Research has shown that mothers sleep no less than a mother that's formula feeding. Avoid pacifiers, any unnecessary supplements, get a deep comfortable latch and know signs of a good feeding. Know how to hand-express your breast, so you can entice babies to breast. It also comes in handy when you're in need of  electricity. Keep that breastfeeding log going. That's what the recommendations are.

Melanie:  How long do you want women to continue to try and nurse?

Sue:  The recommendations by the American Academy of Pediatrics is exclusively for the first six months before you introduce any solid foods and then as long as mother and baby so desire, up to a year or longer. It's a decision between a mom and her baby. Sometimes, baby makes the decision before mom.

Melanie:  Absolutely, that can happen. It's great advice. In just the last few minutes, Sue, give us your best advice for new mothers and breastfeeding:  the importance of it, the benefits and why they should come to Aspirus for their new mother care.

Sue:  Aspirus has a whole program for lactation support. Being an institution that supports breastfeeding and has help available and follow up help for mom is very important. We have a board certified lactation consultant on daily to see mothers and help them with breastfeeding. But getting off to a good start, relax with your baby. Breasting is normal. It can be done. All mothers have experienced some nervousness with it so that is normal. Just talk to people, get all the information you can and get off to a good start.

Melanie:  Thank you so much, Sue. You're listening to Aspirus Health Talk. For more information, you can go to Aspirus.org. That's Aspirus.org. This is Melanie Cole. Thanks so much for listening.