New to Breastfeeding? Here are Tips and Tricks You Need to Know

Dr. Sarah Sobik, an outpatient breastfeeding medicine specialist at Arkansas Children’s Hospital in Little Rock and assistant professor in the Department of Pediatrics in the Division of Community Pediatrics at the University of Arkansas for Medical Sciences, empowers new mothers to properly breastfeed at her recently expanded Breastfeeding and Lactation Medicine Clinic at ACH’s Southwest Little Rock Community Clinic and Circle of Friends Clinic.

"Get help whenever you need it," Sobik said to new moms. "Don't be afraid to get help; ask early."

An international board-certified lactation consultant (IBCLC) and general pediatrician, Sobik has focused her research on human milk, maternal health and infant nutrition. She is the only ACH general pediatrician providing lactation support and breastfeeding appointments. Taking a breastfeeding class, reading about it and having a conversation with a lactation consultant, pediatrician or OBGYN is vital during a prenatal visit to prepare.

"I think there are so many moms that think, 'This is what's normal,' but in reality, it is normal for your baby to feed eight to 12 times a day in the newborn phase. And so just to set those expectations ahead of time can help set up success," Sobik said.

According to the 2020-21 Centers for Disease Control and Prevention’s National Immunization Survey, 83.2 percent of infants born in the United States in 2019 received some amount of breastfeeding. While the American Academy of Pediatrics recommends exclusively breastfeeding for the first six months if possible, the CDC survey noted just 24.9 percent of babies were fed this way . Breastmilk can help protect babies from infections, reduce the risk of Sudden Infant Death Syndrome (SIDS) and match each baby’s unique nutritional needs. Besides creating a unique bonding experience for mom and baby, it can lower a mother’s risk for breast and ovarian cancer, heart attacks, high blood pressure and stroke.

The survey noted 60 percent of mothers do not breastfeed as long as initially intended. Sobik shared common pitfalls and ways to make breastfeeding sustainable for mom and baby.

Don’t push through the pain

Breastfeeding is not always easy like most mothers may hope it will be.

"A lot of issues that I deal with in the early days are having pain with latch, pain when their baby latches or their baby is too sleepy to latch at first especially right after they get home. Or sometimes the opposite, their baby wants to be latched all the time," Sobik said. "'Get help' is the answer. If a mom is having pain with a latch, then they definitely need to be evaluated by a lactation consultant or somebody like myself, who can help with positioning and help readjust that latch because it can be normal to have some discomfort, but not normal to have excruciating pain with breastfeeding."

It's easier to help a mother in the first week or couple of weeks of breastfeeding than those who have powered through the pain. If the pain level is to the point of "curling their toes" while feeding, "dreading" the next feed or preferring to pump rather than feed a baby at the breast, Sobik said it's time to see a specialist.

Pain can also manifest in other ways, like when a baby begins to pinch while being fed, starting around three to four months. Sobik recommends giving the baby something to hold onto, like a teether, to deter them from pinching mom's chest. Biting, which can occur around the six-month mark when a new tooth is emerging, is discouraged by giving the baby or toddler something cold to teethe on before breastfeeding.

"Mom will notice it, and it's usually a shocker the first time they feel a bite," Sobik said. "So if mom can redirect the baby or tell them 'No' and take them off, make them stop breastfeeding for a minute, that can sometimes teach the baby, especially if they're a little bit older, closer to a toddler age."

Am I producing enough?

For a new mom, judging if they produce enough milk for their child is tough. But Sobik said the answer lies in the baby's weight. If a newborn steadily gains weight, the mother produces a good supply of breast milk. It's also a good sign if a baby is peeing and pooping significantly after every feeding.

Every mom and baby is different regarding how much time each feeding takes, and it changes over time. Newborns nurse longer, while a six-month-old may eat for five minutes, get distracted and then want to eat again.

Should I ‘pump and dump’?

One of the most common questions Sobik said she receives can be a tear-jerker for new moms - when to do the dreaded "pump and dump," pumping breastmilk and throwing it away. Moms often assume they have to dump their milk if they've taken prescribed medicines like antibiotics or pain medications given during delivery, or over-the-counter drugs like Tylenol or Ibuprofen.

"My most common answer is - do not pump and dump. Most medications are safe for breastfeeding and for baby, and if you have a lot of questions about a certain medication or concerns about side effects, please reach out to your pediatrician, an IBCLC or myself about a certain medication, but don't pump and dump," she said.

Going back to work

Going back to work after maternity leave while still breastfeeding can be challenging. In her clinic, Sobik teaches parents how to feed milk in a syringe or cup feed if a baby refuses to try a bottle. However, she said most babies eventually take a bottle in a different environment, like at daycare, if mom is not around.

Refrigerated and freshly pumped breastmilk can be safely mixed, no matter the temperature difference.

Sobik said new moms need to know their rights about pumping breastmilk at their jobs. In 2009, the Arkansas Legislature passed Act 621 mandating employers allow reasonable, unpaid break time and provide a “private, secure and sanitary room,” other than a bathroom stall, for breastfeeding mothers to pump. Sobik, who has written letters for patients to inform their workplace about the law, suggests new mothers email their managers to explain what they need besides a safe space, like a refrigerator.

To support breastfeeding employees and patient families, Arkansas Children’s Hospital recently opened a lactation space with pumps, seating and a microwave to clean pump parts.

"It's hard enough to be separated from your baby. So anything a job can do or an office can do to make that separation easier is really special to a mom," Sobik said.

Nutrients needed after breastfeeding

There are options when a child is transitioning from breastfeeding and refuses to drink cow's milk. Sobik said if a child has a milk protein allergy, there are alternatives like soy, oat, pea milk or pea protein.

"If there's a baby who just won't drink cow's milk because they've been breastfed their whole lives and they don't want cow's milk, they don't necessarily have to have a milk-source alternative. They can eat yogurt and cheese, and that can be their replacement for calcium and Vitamin D," Sobik said.

How can I get more help?

Appointments with Sobik are available Monday and Thursday mornings at the ACH Southwest Little Rock Community Clinic. Appointments will be available at Circle of Friends Clinic in late September.

Issues like newborn positioning latch issues, pain, poor weight gain and tongue-tie problems can be discussed at an appointment. Sobik also sees moms and babies in the NICU with more complex needs.

"So I usually see moms and babies for an appointment because it's all about the breastfeeding relationship. And the problem the mom has also affects the baby and vice versa," Sobik said.