Labor, Delivery & Life Beyond

Pregnancy Health & Complications

Preparing For Your Baby

Stages of Your Pregnancy

Podcast Details:

15.20 MB | 38:06 Min

Transcript:

Welcome to your Pea in the Podcast, I’m Bonnie Petrie with everything you need to know about your body, your baby and the big changes ahead in your life as you begin your journey as someone’s mom.

This week is one of the most important decisions that you’ll make for your baby and one of the most stressful. What will you feed your little one when it arrives. We talk to a pediatrician, “Well parents basically can do one of two things after they have their baby, they can either breastfeed or they can bottle-feed.” And we’ll walk you through those options. We’ll talk to moms who breastfed, “It’s been one of the greatest experiences of my life.” And bottle-fed, “My husband wasn’t as on board with that and I’m like the day that you can breastfeed is the day that we’ll breastfeed how does that sound?” We’ll help you prepare for the challenges that come with both options. We’ll talk about nursing in public and we’ll get you ready to go back to work, “I tried to get a freezer stash going by pumping after each feeding.” That’s all coming up in this Pea in the Podcast: Feeding Your Baby.

You wouldn’t think it would be so difficult to decide how to feed your baby when there are just two options, but it is and everyone has an opinion. Let’s find out what a pediatrician has to say, “Well obviously breastfeeding is going to have some real significant advantages for moms, or for babies rather. We have to keep in mind that breast milk is a living, breathing product that contains hemoglobin and other things that help boost a baby’s immune system and even boost their intelligence. So there are a lot of advantages that will come with breastfeeding that will last through a baby’s first couple years of life. It’s very, very important. Bottle-feeding however has obvious convenience where mothers don’t have to go through the period of adjusting to breastfeeding during the first couple of weeks which can be very difficult. Bottle-feeding is actually quite convenient and it’s a good option for moms who can’t breastfeed.”

Dr. Bryan Vartabedian is a pediatrician at Valor College of Medicine and the author of Colic Solved: The Essential Guide to Infant Reflux and the Care of your Crying, Difficult to Soothe Baby, he says if you can, give breastfeeding a try. It’s human milk which is the perfect food for a human baby. He already mentioned that studies show that breastfed babies do have an advantage when it comes to brain development. “They are not major differences but they are statistically different. One thing that we will definitely see is episodes of acute infections, diarrhea, viral diarrhea, we tend to see fewer ear infections as well in babies who are breastfed and there are a lot more examples of ways that breast milk are advantageous but those are some of the things that we often see.”

So those are some of the reasons to choose nursing. Lactation consultant and La Leche League Leader, Kate Lebbing runs down her list of reasons for considering breastfeeding, “A woman would want to choose nursing for many different reasons. One is it is just fun, whenever a woman nurses there are hormones that are released into her blood stream that are very, very relaxing and it feels good to nurse. It’s the natural continuation of the pregnancy. But looking at it from another angle is it is the healthiest choice. For every one breastfed baby that is hospitalized there are 10 formula babies that are hospitalized except in the first four months it’s one breastfed baby to 15 formula babies so this isn’t just a little bit healthier, this is a lot healthier. Breastfed children have significantly less illnesses, like I said less hospitalizations and then there are also other things like higher IQ scores, less SIDS. And mothers have advantages too. There are a lot of less cancers, less breast cancer, ovarian cancer, esophageal cancers, thyroid cancers and some other less osteoporosis in later life and things like that. So a lot of health benefits are because of breastfeeding too.”

Despite that, the decision to breastfeed remains difficult for some moms. Like Meghan who thought for much of her pregnancy that she would formula feed. “It was a pretty hard decision. Truthfully the main thing that appealed to me about breastfeeding was the price. I really didn’t think too much about the bonding aspect, in fact I wanted my husband to be able to feed the baby too. Really, my mom had a pretty strong opinion that I should at least try breastfeeding, her basis being that she had at least done it with me and my two siblings and after thinking about it I agreed to give it a try and figured if I didn’t like it or if it was difficult I would just stop.”

Lebbing says some are intimidated because those first couple of weeks can be really, really difficult, “It’s not instinctive, it’s kind of a myth that all women know how to breastfeed, just like it a myth that because you are a man you know how to fix every car or to repair everything. You know these are myths and that is why we named our book “The Womanly Art of Breastfeeding” because it is just simply an art that one woman teaches another woman.”

And in the beginning it was difficult for Meghan. “He wouldn’t latch on; he was really sleepy which now I understand is quite typical. He was a pretty small baby for full-term and his mouth was pretty small. He had jaundice and low blood sugar and I think these might have all been challenges that we had to face while we were trying to get him started.”

But once Meghan got started she was determined to make it work. “I got help from the lactation consultant at the hospital while I was there for my four day luxury stay and that was very helpful, they showed me how to stretch his mouth so that he would latch on better, they showed me how to use the pump (that was glamorous) and they just got us started. He wouldn’t latch on at first so we wound up pumping and finger feeding him and Bryan my husband got to do that too so that was a really neat way for him to bond with the baby. And we just did the best we could. I also thought it was very painful at first which really surprised me and in fact I went home from the hospital bleeding in places that you wouldn’t think you should bleed from. And that really surprised me as well.”

So the learning curve can be sharp and it can take several weeks for you and the baby to work it out. “Probably a full month, we were getting better and then we had a back fly for some reason about the four week mark and I just worked through it and was very stubborn and supplemented with formula and probably about the six week mark everything was fine and back to normal.” And they never looked back. At the time of this interview Meghan was still nursing Alex, 17 months later. She and most nursing mothers who also bottle feed, which is called combination feeding, agree that once you get the hang of it nursing is far easier than bottle feeding.

Now sometimes the challenges faced by a new nursing mother come from circumstances beyond their control, and that was true for Amanda, “I was able to nurse pretty quickly after an unplanned cesarean so that was a good start. And I did nurse for a couple of days and then my daughter ended up with a minor fever and at the hospital that I was at they don’t have a sick child nursery, the baby goes straight to the NICU, the neonatal intensive care unit. So my baby was in that unit and I was separated from her and I would go down and see her every couple of hours, as much as possible but I was also recovering from surgery so I ended up pumping, I ended up offering milk through difficult means like supplemental nursing system or feeding with a syringe and those are all helpful and have their place but they were very difficult at that time. So that put a lot of challenges into our relationship and then in the first couple of weeks. And I also ended up feeding her a few bottles of mother’s milk and that made her prefer the bottle. So that could have been the end of our nursing at the breast right there. But luckily it wasn’t.”

Amanda was also determined to make nursing work despite the challenges, “It felt like the last thing I could latch onto so-to-speak after having such a hard time with the end of my pregnancy and my daughter’s birth. And I also think it just wasn’t an option to go the other way. Once I found out that I had plentiful milk, I figured that there had to be a way to get it in her that didn’t involve a breast pump all of the time, or bottles. So I figured I had the equipment, she was alright, we could work it out and I think once I submitted to the idea that it wasn’t going to be perfect, it wasn’t going to be peaceful and beautiful right away then that kind of relieved me of some of that pressure and we were able to just work together and work through it.”

Now Amanda also had a very tough recovery from her c-section, the incision didn’t heal well. She credits nursing her daughter with helping her to keep her head above water emotionally, “Well I had a lot of trauma after my daughter’s birth and I had some post surgical complications as well and I was very happy to be nursing because I felt like it kept the connection between us at all times and that doesn’t mean I don’t think I would have felt connected to her otherwise but she literally needed me at that moment and I couldn’t hand her off to anyone. And just having to be there for her, having to be ready for her, it kept me from kind of falling into despair. And I did have some postpartum depression but I think it was not as bad as it would have been if I had not been able to breastfeed directly or if I had been hooking up to the pump a dozen times right away. So I do think that it helped a lot because I just had to be there.” After all of the initial challenges Amanda is still nursing her daughter a year and half later.

So what other challenges might you face and face down if you decide to breast feed? Well your nipples might hurt. Lactation Consultant and La Leche League Leader Kate Lebbing says that one is definitely deal able, “Soreness is caused by incorrect positioning. It is just simply something that one woman would teach another how to properly hold the baby at the breast and how to put the breast into the baby’s mouth properly and deep enough so that the baby’s tongue is not touching the tip of the nipple. When the baby is properly latched onto the breast the nipple is very far back in the mouth and soreness would not be possible with that type of a latch.”

Now not everyone deals with nipple pain, I didn’t, Amanda didn’t, “I was happy to not experience too many problems in that regard and I think the reason is my friend, a La Leche League veteran suggested that keeping the breast clean and dry and not wearing a bra all of the time, that really helped a lot. Many women will wear a firm bra and then put pads in it and they don’t necessarily change the pads out often because they don’t feel wet but all of that time there is bacteria and yeast just having a party on the breast and that leads to problems like thrust or lead to infection or just the cracking and pain.”

Now you also might worry that you won’t be able to provide enough food for your baby. Many new moms convince themselves they are starving their child when they are not. Almost everyone can produce enough milk for their baby if they nurse enough. “The most common reason for not enough milk is not knowing how the milk is produced and how to make enough milk. The more the breasts are stimulated, the more milk there will be. So by nursing very frequently, at least every 2-3 hours the breast should make more than enough milk and there shouldn’t be a problem. Also some women introduce an artificial nipple too soon like a pacifier or a bottle nipple. Even if it is a bottle of expressed breast milk, in those early weeks, those first 3-4 weeks most babies can’t go back and forth between the artificial nipple and the human nipple and so we caution women against introducing an artificial nipple too soon so that babies have a few weeks of really good nursing before they have to start doing something different with their tongue and by nursing very frequently again mothers will have plenty of milk.”

Now sometimes doctors and nurses interfere with a new mom’s best efforts to nurse. For example, if your baby is jaundiced you may be pushed to give them a bottle or more than one. That may not be the best course of action, “We know that jaundice, good point is the more the baby breast feeds, the more milk we can get into the baby the faster we can get the jaundice to leave, it leaves through the stool and so by being prepared, by having people she knows that she can talk with right away if she’s having a difficulty immediately, as soon as she is having a difficulty if she knows that her doctor is very knowledgeable about breast feeding then she is fine but if there is not a doctor like that she may need to call others that can help her, who can help her, then give the doctor research from the professional literature to help her through that stage.”

So it really is a good idea to read a breast feeding book or two when you’re pregnant or maybe take La Leche League’s crash course in breast feeding so you can be prepared for things like this. But from mom, Amanda’s perspective unrealistic expectations may be the greatest challenge a new mom faces, “You can read a book and it might say that a baby nurses every two to three hours so if your baby wants to nurse every hour you might assume you don’t have enough milk or that something is wrong with your milk. These are problems I see a lot with new mothers and I even experienced them too. I read all of the same books, but the book doesn’t translate in those early days.” And in those early days don’t be surprised if your baby nurses all of the time. “Pretty much all babies go through stages where they nurse more than anything else.” It’s how they build your milk supply and their tummies are tiny too, it doesn’t take much to fill them and they empty quickly so they need to eat often. I promise the frequent nursing doesn’t last forever and when your baby is older, believe it or not you’re going to miss that time alone, in the night, together that you had with your baby.

Now the most important thing that you need to do if you plan to nurse is build a support network. “Talk to any friends who have nursed before and not necessarily the ones who had great success, talk to the ones who didn’t and see what you can hear in their stories.” And Amanda had great luck with her local La Leche League, “To be a little honest, I was a little turned off based on what I had heard from other people but after I had been breast feeding for a while I decided I was going to take the plunge and I loved it and I always want to tell new mothers don’t be afraid, don’t stay away based on something you heard from a friend or a friend of a friend that it’s something that you should go check out and every group has a different flavor so if you don’t click with the first group it doesn’t necessarily mean La Leche League is not helpful for you.”

La Leche League Leader and Lactation Consultant, Kate Lebbing says there is plenty of support at that organization, “Each group meets once a month for pregnant women to learn about breast feeding and then to support the nursing mother and her baby after birth. La Leche League Leaders not only do those monthly meetings but they also since meetings are only once a month most of the work that they do is supporting the breastfeeding mothers throughout the month, helping with phone calls and emails.” Or you can hire a Doula or a Lactation Consultant, it’s good to have them available to you when you are in the hospital, make sure you have their numbers ready. We have a link to La Leche League’s website on our website, peainthepodcast.com, check it out.

Now one final thing that intimidates new mothers is nursing in public and it can take some getting used to. But mom, Amanda says you can do it and you can do it discreetly, “I actually wear pretty modest clothes, probably overly modest by some people’s opinion but I don’t hesitate to nurse in public because it’s not about my breast, it’s about my daughter needing to eat.” Now it does take some practice to figure out what works for you and your baby, “The first time I nursed my daughter in public, we were in an extremely crowded waiting room waiting for our oil to get changed and I was wearing a heavy poncho over my outer garments and so I ended up nursing her under this heavy poncho and it was so hot for both of us and her head, I brought her out and her hair was all sweaty and I just felt so grossed out by it. So I decided that I wasn’t going to do that way anymore. So what I learned to do was to just cover my breast while not covering her head and then we were both happier.”

Some moms use blankets, some moms nurse in slings, for me the secret was good nursing shirts and bras, I’m well endowed and if you think anyone was going to have a problem nursing in public it would be someone like me. But my baby and I became so good at it we nursed everywhere, at the store, in restaurants, even at a professional baseball stadium and no one ever got a hint of boob, well maybe just a hint but that’s all. Legally most states say you can nurse your baby anywhere you have the right to be. So don’t feel as though you have to nurse in the bathroom, who wants to eat in the bathroom? I’m sure your baby doesn’t. You don’t have to nurse isolated in your car either, just practice until you and your baby feel comfortable and go for it. Ultimately for many moms nursing becomes more than just a way to feed your baby, “It’s been one of the greatest experiences of my life and most of the time it’s just a quiet and sweet thing and it’s just utter simplicity and just such an easy connection, I just am very grateful for it.”

Now some of you will still choose to formula feed your baby, Lynn did, “My husband wasn’t as onboard with that, he kind of wanted the whole breastfeeding thing, and I was like the day you can breastfeed is the day that we’ll breastfeed, how does that sound? He’s like okay I guess you win this one.” Now Lynn knew throughout her pregnancy that that was the way that she was going to go. And Pediatrician Bryan Vartabedian says formula is fine, “Formula is nutritionally complete, there are some differences in infectious outcomes that we’ve seen breastfed versus bottle-fed babies but for those parents who can’t breastfeed they can feel reassured that the formulas that are available on the market today are actually quite complete.”

So if formula feeding is for you, where do you begin? “Bottles, lots of bottles. I actually bought 3 different kinds of bottles to start with because I had no idea what I was doing. I didn’t know anything about bottles and so I bought Dr Brown’s, I bought one free Advent bottles, I had some Vent Airs and then because I am like these are drop in liners that looks like so easy and lazy mom way to go, I bought some of those. And when we brought her home from the hospital we could actually use the bottles that they provided in the hospital but they only held 1 ounce and so by the time she was past needing an ounce we had to use something we had at home. And we actually went through all of the bottles and ended up using the ones with the drop-ins just because they worked the best for her. I was like oh lazy mom and the drop-ins and they work.”

Some moms find they have more trouble finding the right nipple, they come in all shapes and flow rates. Slow flow for the new baby who is still learning to suck and develop their muscles, medium flow for the older infant and fast flow for the baby who is ready to have a bottle and go. So you like Lynn may find the recommended flow rate doesn’t work for you. “The nipples they gave us in the hospital with the bottles seemed to be very fast flowing compared to the slow flow nipples that all of the boxes and everybody recommends for a newborn and she would get so frustrated that she would fall asleep in the middle of the bottle, wake up 30 minutes later so hungry because she hadn’t finished the original bottle and so I went back to the store, I tried out all of these different nipples and eventually went to fast flow nipples which aren’t recommended until they are 6 or 8 months old and I went to them when she was 4 weeks old and there was some dribbles but at least she was eating enough that she wasn’t waking up 20 minutes later starving because she had fallen asleep because she was working so hard to get anything out. So that was our biggest struggle, the nipples and the flow.”

Now like with so many mommy issues it is all trial and error. This is certainly true when you’re trying to pick a formula. There are so many out there that it can be overwhelming, “The hospital had given us some Enfamil and not really know what formula we wanted, didn’t want, I had of course had gone out and signed up on all of the formula websites to get free samples and stuff so we had some stuff at home but when they sent us home from the hospital they gave us whatever was in her cart to take home and so we fed that until it was gone. Then we had another can of Enfamil at home, we just used that. And then all we had left was the Similac so we tried that and of course being paranoid she didn’t poop for like 36 hours after she had that and I’m like okay we’re just going back to the Enfamil because obviously the Similac just doesn’t work as well for her. So we went out to the store, bought the Enfamil, within 12 hours she was pooping again and I’m like oh okay we’re just going to stick with that. Maybe a couple of weeks later I was like you know it’s so expensive let’s go to a cheaper, off-brand like the Wal-Mart brand or whatever, tried it and 36 hours later she still hadn’t pooped and I was like okay this is a sign, we’re just going to stick with the Enfamil.”

With formula feeding like breastfeeding there are challenges and one of the big ones is that a lot of babies are sensitive to cow’s milk protein. Of course formula is made of cow’s milk, not human milk. You can’t predict who will have trouble and who won’t but if you have a cow’s milk protein sensitive baby and I did, after a couple of weeks you will definitely know it. Doctor Vartabedian says there are an array of symptoms, “Profound irritability, diarrhea, mucus in the stool, even vomiting and reflux like symptoms. Often times you’ll see blood in the stool. Those are some of the big issues that we’ll see with babies who are bottle-fed.” He mentioned profound irritability, otherwise known as colic, my baby had it bad. Sometimes the only symptom of cow’s milk protein intolerance will be reflux or another baby might just have constipation and third baby might just have eczema, or another baby might have all of the symptoms that Doctor Vartabedian mentioned together. Cow’s milk protein intolerance is sometimes called an allergy but it’s not a true allergy and the doctor says in infants you can’t test for it. “The allergic activity we see in infancy is different than a lot of the other types of food allergies that we see in an 8 year old and a 10 year old. The allergic inflammation in many babies tends to be of the lining of the intestines so all we’ll see in a baby may be loose stools, mucus, irritability, colicky behavior, sometimes vomiting. Rash can sometimes be seen but it is seen in a minority of babies.”

So if you’re formula feeding and you baby starts showing signs of cow’s milk protein intolerance what do you do? Well if you’re combo feeding you can try to move to exclusive breastfeeding, if you are exclusively formula feeding you can try to re-lactate that is get your milk supply back so that you can try breastfeeding again. There is a lot of great advice about that at a wonderful breastfeeding support website called calimom.com; we have a link at our site. Re-lactating can be difficult but it can be done. Or if you’re just going to stick with formula you can try one of the partially hydrolyzed formula, in them the cow’s milk protein is partially broken down that is what partially hydrolyzed means. Now the cow’s milk proteins are partially broken down it may be easier for your baby to digest and they will have fewer allergic symptoms. There are a couple of brands on the market and one of them has now added proibotics, you know the good stuff that is in yogurt? “Nestle Good Start is the first FDA approved formula available in the US market supplemental with a particular probiotic and this probiotic is helping bottle-fed babies develop colonic flora those are the good bacteria in the colon that match that of breastfed babies and it is felt that bacterial colonization in the breastfed babies is one of the things that lead to improved health.”

So if your baby still seems to be struggling with symptoms of cow’s milk protein intolerance after moving to a partially hydrolyzed formula you can try a fully hydrolyzed formula, in those the cow’s milk protein is completely broken down. My combination fed daughter needed this type of formula. The only problem is this is expensive. “No kidding, for nutramigen which is the new Johnson product for a 3-4 month old baby will run you about $600 per month which is pretty costly so you really want to make sure that you have a good case for protein allergy. You want to talk to the doctor, check that they are checking the poop for microscopic blood, that is a helpful clue or if you are seeing lots of mucus in the stool and colicky behavior that is often a strong clue.”

Some health insurance companies will help you pay for this formula if your doctor says your baby needs it. WIC will cover it too. Some people will suggest you get lactose-free formula for a cow’s milk intolerant baby. Doctor Vartabedian says that won’t help, “There’s a lot of confusion about milk protein allergy and lactose intolerance. They are two entirely different things. With milk protein allergy the baby is actually having an allergic reaction to the protein found in that milk. Lactose intolerance is an entirely different thing. Lactose intolerance occurs when we take the milk sugar, lactose, again not the protein, it’s sugar lactose and it doesn’t get absorbed up high in the intestines, gets dumped down into the lower intestines and gets fermented and makes gas and diarrhea. Lactose intolerance is actually quite rare in babies. We can see it after viral infections and we can see it come on in older children but it is quite unusual in babies.”

Some will suggest a cow’s milk protein intolerant baby should try soy formula; very often those babies will have a bad reaction in soy formula as well. We skipped soy formula and just went to the partially and then fully hydrolyzed formulas, that was just us. And a final note about cow’s milk protein intolerance, breastfed babies aren’t immune to it although it is more rare, “It’s important for breastfeeding moms to understand that the protein that they take in in their diet will be expressed in small pieces in your breast milk but I do always make the point with breastfeeding moms that a baby is reacting to the protein in your milk, not necessarily to your milk because parent’s get, mother’s feel very, very bad if they think their baby is reacting to them.” If your breastfed baby is cow’s milk protein intolerant they will do better if you temporarily eliminate the dairy from your diet. By the way are least one study has shown that cow’s milk protein intolerance is more common in babies born by c-section.

After all that talk about cow’s milk protein intolerance it is important to note that many babies have no problem tolerating formulate. Lynn’s daughter did fine on it, she had a few minor problems, “She had a little bit of silent reflux right from the start where she was not a terrible spitter but she would spit up a little bit after every feeding but we kind of took care of that with using the drop-in liners and pressing all of the air out of the bottles before we fed her so we didn’t have the switch formulas or anything like that.” Lynn says keeping bottles clean and ready wasn’t too big of a problem for her, “The bottles that we used were not, the Dr. Brown’s bottles have a lot of parts to them so yeah they are kind of a pain but ours were really easy because we used drop-in liners and we basically just threw the nipples, we bought a little basket for the dishwasher, we threw the nipples in there and everything and just washed the bottles in the dishwasher and be done with it.” And she found a way to make travel easy too. “I would fill a bottle with tap water before we would leave home and just keep it in the diaper bag and when it was time for her to eat I’d put the formula in, shake it up, press the air out and feed it to her and she was happy with that.”

And another thing, a lot of people will tell you you need to warm up formula bottles. You really don’t. “We did at first because we thought that was the thing to do but she had most of her bottles made with room temperature, or I mean tap water room temperature water. We didn’t really heat them up or anything like that. Unless I made a bag and put in the fridge then I would put it in a cup of hot tap water and just take the edge off. She always took her bottles pretty much room temperature or even a little cooler than that and so we never microwave them, we never put anything, we had a bottle warmer, I actually gave it to the neighbor when she had a baby because she was going to breastfeed and she was like I need a bottle warmer, I was like you can have ours we never use it. I didn’t really use that.”

So what advice does Lynn have for you if you are preparing to bottle-feed? “I would say have a couple of different bottles on hand, maybe a couple different kind of formulas and start with that, you can always go out to the store or send your husband out if you need something different but it is easy to do and it works. I think it was the right decision for us as a family and it worked out well for us.”

Most moms who plan to return to work will be bottle feeding some of the time and nursing moms will have special concerns there. You’ll need to pump at work and that will take some fancy footwork. Mom, Meghan got started early trying to fill her freezer with expressed breast milk, “I tried to get a freezer stash going by pumping after each feeding which is very difficult and I tried to practice with a pump and the week before I went to work I actually had Alex start two days at preschool early and just practiced pumping at times when I would normally be feeding to see how my body responded to the pump and the new routine and that actually went a lot better than I thought and just took the time when he was at preschool to relax a little and try to get my bearing for what was ahead.”

When you get to work you may your boss isn’t prepared to allow you to take breaks to pump and they may not have any place set aside where you can do it privately. Dr. Wanda Jones of the US Department of Health and Human Services says while they really don’t have to, “Many states have no work place relevance; there is no national legislation that provides a basic level of fundamental right. So you know it is very much an employer/employee relationship that has to be entertained to facilitate pumping and lactation support in the work place.” But Dr. Jones says employer should see the benefit to the bottom line of allowing their employees to pump three times a day, “The businesses, the employers should recognize the direct benefits when the infant is less likely to be sick due to an ear infection, a respiratory illness or diarrhea because of being breastfed exclusively mom is going to miss a lot less work. When daycare requires that infants be fever free for 24 hours, it might actually mean that mom has to miss two days of work caring for an infant that has been sick. So when employers can recognize that there is a direct benefit here it also increases loyalty, female employees who are supported actually report a much more positive attitude toward their employer and it does cost an employer money to lose employees and have to hire and train new ones.”

Mom, Meghan said she had break some new ground to get the kind of support she needed at the work place, “Although I had some challenges getting people I work with to understand why it wasn’t really appropriate to pump in the bathroom, eventually they either got it or they humored me and that worked out and in fact although I was the first woman to ever pump on the job, at the first company I worked for when I returned for leave are now pumping for their new babies so I’m proud of that too.”

So how do you approach your boss? Dr. Jones at the US Department of Health and Human Services has a couple of ideas, “Well it is difficult and I think for new moms or particularly for women who are pregnant who are considering for breastfeeding to find out how other women have navigated the conversation with their employers. It might be possible to call upon the La Leche League Chapter or another breast feeding support group locally that you can talk to women about how they have made this work for them, what they have presented to their employer, how they have adapted.” Now it’s best to talk about this to your boss now while you’re still pregnant and not your first back from maternity leave and Meghan says go in with confidence, “Don’t give up your rights. If you don’t have any rights, push for them anyway and pretend that it is your right.”

Some moms are surprised that at first they have trouble getting a lot of milk when they pump, “I wouldn’t have expected that either but it’s not a natural contraption and it just kind of takes some getting used to.” Yeah you sort of have to train your breasts to produce for the pump, it’s not the same as a baby and the lactation consultant and La Leche League Leader, Kate Lebbing says it’s totally normal not to get much, “The pump does not pull out as much as the baby, there are some exceptions to that, there are some hospital grade pumps, there are some mothers who choose to exclusively pump and there are pumps that we can guide them to for that as well.”

Now if you find you can’t keep up with your baby’s needs there is also combination feeding, a lot of moms do this and Meghan did. “Well I just wasn’t able to pump enough at work to be able to meet his needs and so he would get as much mother’s milk as he could during the day and anything that he still needed we would just make up the difference with formula once the freezer stash was exhausted and I wish he hadn’t had to have so much formula but it can’t be helped and I’m not going to beat myself up over it.” Now you only have to pump several times a day for a couple of months and then you ease back to two times a day and then once and then you could eventually put the pump away.

So there you go. Probably more than you wanted to know about breastfeeding and formula feeding. If you have more questions we can link you up to some more information at our website Peainthepodcast.com. And Dr. Bryan Vartabedian the author of Colic Solved: The Essential Guide to Infant Reflux and the Care of your Crying, Difficult to Soothe Baby says you can always reach out to your pediatrician, “Pediatrician is going to help guide these decisions. I would say in general if you can try breastfeeding first that’s going to be an easy first options. Look to your pediatrician for guidance, my book Colic Solved has a lot of great information about how to recognize feeding intolerance versus allergy and all of the problems that babies can run into with their formulas.”

And Lactation Consultant Katy Lebbing says no matter whether you choose breastfeeding or formula feeding those early weeks are going to be intense. “No matter how you are feeding your baby, if you’ve never had a baby before it is a giant learning curve. Babies need our help constantly, they want to be held constantly no matter how they are fed and mothers don’t often understand the intensity of the needs of a newborn. So that again is where it is so important to meet with other mothers and to observe how they handle their little ones.”

Support is key mommy. Start rounding up your friends and family now!

We hope you’ve enjoyed this Pea in the Podcast: Feeding Your Baby. Please visit our website peainthepodcast.com for more information about our experts, to find links and transcripts and to register to receive tailored week by week shows for each week and stage of your pregnancy. It’s everything you need to know about your body, your baby and the big changes ahead in your life in your journey to becoming a mommy. For Pea in the Podcast, I’m Bonnie Petrie. Thanks for listening.