AboutSally Wendkos Olds Expertise What do you want to know about breastfeeding? I can tell you what`s good
for the baby, what`s good for the mother -- and the father, how it`s
related to a woman`s sexuality, how working moms can nurse, how to
overcome obstacles, and lots more. As the author of THE COMPLETE BOOK OF
BREASTFEEDING and author or coauthor of 8 other books and more than 200
articles about child and adult development, I can offer sound, sensible
advice on breastfeeding, child care and family issues.
Experience I nursed my 3 daughters and am the grandmother of 5 breastfed children. My book THE COMPLETE BOOK OF BREASTFEEDING (written in consultation with pediatrician Marvin S. Eiger, M.D.) was first published in 1972, and in 1999 came out in an updated 3rd Edition by Workman Publishing & Bantam Books. It is now a classic, with over 2 million copies in print. I am now revising this book for a fourth edition, consulting with pediatrician Laura M. Marks, M.D. This new edition will be published September 2009. I welcome any and all suggestions for the new edition.
I coauthored college textbooks A CHILD'S WORLD: INFANCY THROUGH ADOLESCENCE, and HUMAN DEVELOPMENT; both are leading texts in their fields and have been read by 2 million students. I am the coauthor of HELPING YOUR CHILD FIND VALUES TO LIVE BY and RAISING A HYPERACTIVE CHILD, and author of THE WORKING PARENTS' SURVIVAL GUIDE & THE ETERNAL GARDEN: SEASONS OF OUR SEXUALITY. My newest book, A BALCONY IN NEPAL: GLIMPSES OF A HIMALAYAN VILLAGE, published in 2002, tells the story of the way of life in a remote village in Nepal, where all the women breastfeed! My book, SUPER GRANNY: COOL PROJECTS, ACTIVITIES, AND OTHER GREAT STUFF TO DO WITH YOUR GRANDKIDS, will be published March 2009.
I speak often to professional, parent and general audiences and make many radio and TV appearances.
Credentials
I received my B.A. in English Literature from the University of Pennsylvania, where I minored in Psychology, was elected to Phi Beta Kappa and graduated summa cum laude.
Other points of interest
I have received national awards for my writing, and am a former president of the American Society of Journalists & Authors. I am listed in the World Who's Who of Women, International Authors & Writers Who's Who, and Contemporary Authors, and am a member of several professional and civic organizations. I believe: that all parents are working parents; that parents employed outside the home need special support; that mothers' well-being is crucial to their children's welfare; and that the family is the best institution in the world and the one for which we are least prepared. My thrills come when parents or kids tell me they were helped by my writing or speaking or just understanding.
To find out more about me, go to
Question My 4 1/2 month old son weighs 11 lbs 9 oz. How underweight is this? His Dr. says the quality of my breastmilk is probably not adequate and has instructed me to feed him only formula(higher calorie content) and pump to keep my supply up. Can I breastfeed my baby and supplement with breastmilk? He has gained 2 ounces in 2 days is that normal? Won't my supply just go down if he isn't allowed to breast feed?
Answer Dear Melanie,
First, congratulations for giving your son the best start in life by breastfeeding him!
It's hard to tell whether he is underweight, since I don't know what he weighed at birth and what his weight gain has been since then. I'm a little concerned about your pediatrician's telling you that the quality of your milk is not adequate -- and that formula has a higher calorie content. Unless your doctor is recommending a special high-calorie formula, the calorie content of both breast milk and formula are usually about the same. Furthermore, there is no such thing as low-quality breast milk. Quantity is a different matter, and it's possible that your supply may be inadequate.
A weight gain of two ounces in two days sounds good to me. And yes, you should continue to nurse even if you do offer formula. If you do not nurse at all, your supply would go down.
It might be a good idea for you to consult a lactation consultant to assess your son's breastfeeding situation. She can ask you about your son's nursing habits, watch you breastfeed, assess his latch-on, etc. There's no substitute for a knowledgeable person you can meet with face-to-face. To find an LC in your area, you can go to www.ilca.org.
I'm attaching an excerpt from the new edition of my book, with suggestions for judging your son's intake and for building up your milk supply -- I hope some of them help.
Good luck!
Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with Laura M. Marks, M.D.
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How to Tell When Your Baby Is Getting Enough Milk
One of the biggest problems of nursing, in the minds of many women, is that they cannot tell how much milk their babies are drinking. This is actually one of its biggest advantages, since the nursing mother is not tempted to urge her baby to drain the last drop, thus taking more than he needs. If you feed your baby on cue, your supply of milk should keep up with his appetite. If you’re well and if you take reasonably good care of yourself (see Chapter 9), you’re virtually assured of having plenty of milk—especially if you don’t worry too much about it.
After you’ve been nursing for a while, you’ll notice that your breasts are no longer hard and full the way they were at first. This does not mean that you’re producing less milk. The glandular changes in your breasts and the increased blood circulation caused their initial fullness. Once your milk production is fully established, your breasts may become softer and smaller, even while producing copious amounts of milk. After about a month of nursing, a woman’s milk supply typically reaches a plateau of about 25 to 30 ounces a day (700 to 850 ml), or a little less than a quart a day. It will stay about at this level for the next several months until your baby starts eating solid foods, at which point it will gradually diminish.
The section beginning on page tk lists ways to tell whether your baby is getting enough to eat. As we suggested in Chapter 6, it’s sometimes helpful to keep a daily log of your baby’s feedings, urination, and bowel movements, either on your computer or by pencil and paper (easier to carry around with you). The following information focuses primarily on the very young baby, but also is applicable to babies several months of age.
If you’re worried or if you’re having trouble with nursing, call a health professional (doctor, nurse, midwife, or lactation consultant), a friend or relative who has breastfeeding experience, or another breastfeeding support person. The person you consult may be able to reassure you over the phone or may want to see you and your baby in person. Ask for help sooner rather than later, to prevent little problems from becoming big ones.
Appetite Spurts
Very often babies who have been on fairly regular schedules that everyone seems happy with suddenly begin to clamor for more food. This seems to occur most often at about three weeks, six weeks, three months, and six months of age. Your baby may be undergoing a “growth spurt,” a period of rapid growth that makes her especially hungry. Or you may be in an “activity spurt,” doing so many other things that you get overtired and produce less milk. Whatever the reason, the best way to satisfy your baby’s expanded appetite is to nurse more frequently for a few days to increase your milk supply. More suggestions on building up your milk follow.
Ways to Build Up Your Milk Production
New mothers sometimes fear that they won’t have enough milk to feed their babies. They hear stories about other women who “didn’t have enough milk,” and they worry that they might be in this category. But when you look closely at the situations of these other women, the problem can almost always be ascribed to lack of information, lack of encouragement, or faulty nursing technique by either mother or baby. You need to tell yourself that millions of other women nurse their babies, and you can, too. Following one or more of the suggestions below should increase your milk supply within a few days.
• Nurse your baby more frequently for several days, using both breasts at each feeding. This is the single best way to enhance your flow of milk.
• Wake your baby, if necessary, to feed him more often.
* Pump or express milk between feedings. But don’t get discouraged if your pumping yields as little as half an ounce of breast milk. Your baby is almost certainly getting more than this. Even the best pump is less effective than a vigorously nursing baby. (More about pumping in Chapters 16 and 17.)
• See a lactation specialist if your baby is not suckling well or nurses only a few minutes at a time.
• Cut back on your schedule. Do less. Rest more. Nap at least once a day, more often if you can manage it. Ask someone else to help with marketing, cooking simple meals (or getting take-out food), and doing basic laundry. Most people like to help a new mother, so take advantage of this willingness now. You can always reciprocate later on.
* Even though everyone wants to see the new baby, ask visitors not to come for several days -- or even weeks -- unless they’re people who will wait on you, not expect you to entertain them. Let your answering machine take phone calls – which you can return later when you’re not so tired. Well-meaning family and friends can wear out the new mom.
• If you can, take an occasional day or two off from work or from other obligations (by, for example, having someone come in to care for your other children) so that you can focus only on nursing your baby.
• Check your diet. Are you eating enough? Are you eating the right foods? Are you drinking enough fluids? Some women find that eating or drinking more seems to produce more milk. Keeping a glass of water or juice near the spot where you nurse is a good idea. You don’t need to drink any more than you need to meet your thirst, but some nursing moms find that they are thirstier than usual.
• Make a special effort to relax, as suggested in the box on page tk. Of course, this is hard when you’re concerned that your baby isn’t getting enough milk—but the more you can relax, the more milk your baby is likely to receive.
• Develop a few affirmations that you can repeat to yourself, such as: “I am a bounteous supplier of milk for my baby”; “I am doing the best thing I can as a mother”; “My baby is growing fit and healthy from my milk”; “My milk is my baby’s perfect food.”
* Visualize your baby at a little older age, looking well fed and happy.
* Galactogogues: Virtually every culture in the world has recommended certain foods or substances to nursing mothers, in the belief that they help to make milk. In China, nursing mothers have been urged to eat “a mixture of pork fat and red gram (a type of bean), cuttlefish soup, shrimps’ heads in wine, and a special sweet wine made from glutinous rice, given together with the larvae of the blow-fly.” In India, it’s garlic, tamarind, and cottonseed; in France, powdered fennel; and in Nepal, chicken soup, buffalo milk, butter, and rice. In the U.S. vitamin B complex, brewer’s yeast, and the herbs fenugreek (also called fenugeek) and blessed thistle are sometimes recommended, as is the controversial prescription drug domperidone, which has not been approved for any use by the U.S. Food and Drug Administration. (See Chapter 10 and the Websites Appendix for more about drugs and lactation.)
Cheston M. Berlin, Jr., M.D., a professor of pediatrics and pharmacology who has an interest in drugs and lactation, has concluded that the effects of such potions may be largely psychological. The mother thinks that a certain substance will increase her milk supply, so she relaxes and has a good let-down reflex, thus “proving” its value.
As we have stated, though, the best way to build up your milk supply isn’t what you eat. It’s what—and how much—and how often—your baby eats. The cutting edge research of Dr. Peter E. Hartmann’s Australian team (discussed in Chapter 3) has confirmed what many breastfeeding experts have known for years: that emptying the breast is the best stimulus to milk production. The more often you nurse your baby and the more vigorously she nurses, the more milk you’re likely to have.
• Believe in yourself and trust your body.
Note: Do not offer your baby formula while you’re building up your milk supply. A few ounces soon turn into a full bottle, which soon turns into several bottles, until you find that you’re producing even less milk. If your baby is drinking from a bottle, he is not stimulating your breasts and thus not doing the most effective thing that will increase your supply of milk. In most cases, a breastfed baby should not be offered a bottle until nursing is well established—by at least six weeks of age.
The only exception to this is if your baby’s doctor (not your friends or relatives!) feels that he absolutely needs a supplement. Your doctor may be worried if your baby is sick, dehydrated, so small that his health is endangered, or if he is not gaining enough weight. Any one of these conditions may leave him without enough energy to nurse vigorously and thereby stimulate your milk production. If you do supplement with formula, you might try offering the bottle first before nursing him. Christina Smillie, M.D., a pediatrician and board-certified lactation consultant, recommends this reversal of the usual order of breast-followed-by-supplement so that the baby’s immediate hunger will be satisfied and that he will receive necessary nourishment – but that he will get his final sense of satiety from breast milk, and associate this good feeling with his mother. Another way of supplementing is to use a nursing supplementer, a device that lets your baby suckle at your breast (thus stimulating your milk production) while at the same time receiving formula (see page tk for a description).
Once breastfeeding is well established, you may want to give your baby an occasional bottle of breast milk or formula. Ideally, you should wait until your baby is six months old to feed anything besides your good breast milk (see Chapters 11, 12, and 17).
