Breastfeeding Tips for Mothers

Why Should You Breastfeed Your Baby?

Pediatricians recommend breast milk for baby's health.

A mother's milk has just the right amount of fat, sugar, water, and protein that is needed for a baby's growth and development.

Most babies find it easier to digest breast milk than they do formula. The antibodies in breast milk have been proven to help protect infants from bacteria and viruses. This helps babies fight off infection and disease. In addition, there's no need to worry about the quality of the water used to make the milk; human milk straight from the breast is always sterile.

Breastfeeding is good for mom's health, too!

Breastfeeding saves times and money. You do not have to purchase, measure, and mix formula, and there are no bottles to warm in the middle of the night.

Breastfeeding also helps a mother bond with her baby. Physical contact is important to newborns and can help them feel more secure, warm, and comforted.

Nursing uses up extra calories, making it easier to lose the pounds gained from pregnancy. It also helps the uterus get back to its original size more quickly and lessens any bleeding a woman may have after giving birth.

Breastfeeding may lower the risk of breast and ovarian cancers.

The U.S. Surgeon General Recommends Breastfeeding

The U.S. Surgeon General recommends that babies be fed with breast milk only ' no formula ' for the first 6 months of life. It is better to breastfeed for 6 months and best to breastfeed for 12 months, or for as long as you and your baby wish. Solid foods can be introduced when the baby is 6 months old, while you continue to breastfeed.

Breastfeeding a Baby with Special Needs

Learning to breastfeed can be difficult for any new mother, but if your baby is born prematurely, or with a congenital condition, such as Down Syndrome or a cleft lip or palate, breastfeeding becomes even more challenging and important.

Breastfeeding can be a calming respite from the emotional ups and downs of raising a special-needs baby, and your child will reap the nutritional and immunological benefits of breast milk.

'A baby with a cleft lip or palate, for example, is often more prone to developing upper respiratory problems, such as colds, allergies, and ear infections,' says Aimee Creelman, a breastfeeding consultant at St. Luke's Hospital in San Francisco. 'Many studies show that these babies do much better when they get their mother's milk.'

Breast milk helps babies with heart problems or cystic fibrosis gain needed weight. It can also help prevent the respiratory infections and bowel problems that are common with Down Syndrome.

'Breast milk can help protect your baby from infections in surgery and help them heal afterward,' says Jan Barger, a lactation consultant in Wheaton, Illinois. 'Sometimes a mom feels helpless while the doctors are busily trying to help her child, but breastfeeding is something that only Mom can do for her baby.'

Challenges you may face breastfeeding a special needs child

A baby with a cleft lip or palate, the fourth most common birth defect, may have difficulty latching on to your areola. The cleft palate, an opening in the roof of the mouth that goes up to the inner chambers of the nose, makes it hard for a baby to create an airtight seal on the breast. Read this page on BabyCenter.com for

Your baby's sucking ability will depend on the size of the cleft, as well as on the size of your breast and the compressibility of your nipple. 'A compressible, soft nipple works best for a baby with a cleft palate, because if the breast is soft enough, it can press into the palate and suction can be created,' Creelman says.

A Down Syndrome baby may have muscles that are either poorly developed or too stiff ('hypertonic'); either condition can make it difficult to position her at your breast. She may also have problems in her mouth, such as a too-large tongue or a flat palate, which can affect the depth of latch and make your breasts sore.

The small jaw and receding chin that are symptomatic of Pierre Robin Syndrome, a rare condition, can also make it very difficult to breastfeed.

But just because your baby has been diagnosed with one of these conditions doesn't necessarily mean you won't be able to nurse. 'The amount that a disability affects breastfeeding depends on the degree and type of the condition,' Barger says. 'The only condition that I know of where you absolutely can't breastfeed is galactosemia, when the baby can't metabolize lactose.'
How do you solve these problems?

Although the challenges are different for different conditions, many of the solutions are similar. The first step is to establish your milk supply. If your baby doesn't take to your breast immediately, you should start pumping as soon as possible after the birth and pump every two or three hours, as often as a baby would nurse. It's equally important to make sure you stay well nourished and well rested. 'There's a lot of stress and anxiety for a mom whose kid is in intensive care and that can affect milk supply,' Creelman says. 'Our emotions play a big role in our milk's ability to let down.'

It's easy to become overwhelmed by concern for your baby and your desire to establish a bond with her, but these emotions can become detrimental to breastfeeding. 'I always encourage moms to try and approach the first feeding without too much expectation,' Creelman says. 'The first feeding attempts are times to snuggle and let the baby be close to your breasts. Just let it be a good, close bonding experience.'

Sometimes this connection can lead naturally to breastfeeding. Creelman recommends what she calls 'kangaroo care,' or cuddling skin-to-skin with blankets over you and your baby. 'This helps the mother build her milk supply and can often segue into breastfeeding,' she says. 'Sometimes the baby will just start licking and rooting and moving its head toward the breast. It's just one of those magic moments.'

Once you have established your milk supply and created a bond with your baby, it might be necessary to try special feeding positions or equipment.

A Down Syndrome or premature baby with poorly developed muscles needs a lot of physical body support on the head and upper back. Creelman recommends the 'football position,' in which you hold your baby under your arm, because you can support the baby's chin and jaw with the same hand that's supporting your breast. Positioning is critical for a baby with Pierre Robin Syndrome; unless he is positioned virtually on his stomach, with Mom lying beneath, he will not be able to breathe.

Sometimes, despite your best efforts, a baby with special needs may be slow to take to the breast. Before his sucking reflexes are developed, you can provide breast milk through other means, such as Medela's Supplemental Nursing System (SNS). Just fill the small bottle, equipped with a tube, with breast milk and then tape the tube to your breast or finger. An SNS is also useful for a baby who can latch on but needs supplementation. 'It decreases the length of time feedings take, and you don't run the risk of creating a nipple preference for the bottle,' Barger says.

It's generally best to avoid bottles and pacifiers, because a baby may get used to the feel of the rubber nipples and refuse to go back to the breast, a state known as 'nipple confusion.' But in some cases, a bottle can help. Creelman recommends the Haberman Feeder, a bottle made by Medela, for babies with a cleft palate. 'It has a soft silicone nipple that's a bit elongated and a chamber so the person who is doing the feeding controls the flow, based on how well the baby's doing,' Creelman says.

Another helpful accessory is a nipple shield, which gives more definition and firmness to the nipple. 'This can help a baby who is having difficulty latching on,' Barger says. 'But in general, you want to use as few interventions as possible and make things as natural as you can.'

Where can I go for more help?

Even more than other children, special-needs babies must have routine checkups with a pediatrician to ensure that they are developing normally and healthily. You'll also need emotional support from your doctor, partner, and family, since learning to breastfeed your baby will require a lot of patience and flexibility.

'One of the best things to do is talk to other mothers who have been there,' says Barger. Your hospital should be able to refer you to a support group. If not, try some of these resources:

• Smiles, an organization for families of children with clefts, hosts an online discussion forum.
• The Nursing Mothers Council provides breastfeeding information and support on their 24-hour referral hotlines. Call their National Referral Line at (650) 599-3669.
• La Leche League International provides support for breastfeeding mothers. To find a group or trained leader in your area, call (800) 525-3843 or visit the La Leche League's Website. 
• The La Leche League catalog offers a variety of publications for parents of challenged babies, such as Breastfeeding a Baby With Down Syndrome, (LLL Publication #23a), Nursing a Baby With a Cleft Lip or Palate (LLL Publication #122), Special Children, Challenged Parents (LLL Publication #3791), and Give Us a Little Time: How Babies With a Cleft Lip or Cleft Palate Can Be Breastfed (LLL Publication # 3331).
• The Cleft Palate Foundation publishes a free 20-page pamphlet called Feeding an Infant with a Cleft. To order, call (800) 242-5338.

Additional Resources

• BabyCenter.com has many articles about breastfeeding including breastfeeding a baby with a cleft lip or palate, feeding positions, and nipple confusion.
• Wide Smiles, a resource for parents about cleft lips and palates, provides step-by-step basics pertaining to clefts and feeding.
• Nobody Smiles Like I Do is a first-person account of learning to breastfeed a baby with Down Syndrome and a heart condition.
• Visit the Pierre Robin Network and meet other families of children with Pierre Robin Syndrome and learn how they've dealt with the breathing and feeding problems that can arise.
   
   
  

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