What to expect when you're expecting (177 page)

Switch it. Change nursing positions from one feeding to the next (try the football hold at one feeding, the cradle hold at the next; see
page 438
). This will ensure that all the milk ducts are being emptied and may help ease the ouch of engorgement.

Get some relief. For severe pain, take acetaminophen (Tylenol) or another mild pain reliever prescribed by your practitioner.

The first few weeks of nursing can be very wet ones. Milk may leak, drip, or even spray from your breasts, and it can happen at any time, anywhere, without warning. All of a sudden, you’ll feel the tingle of letdown—and before you can grab a nursing pad or a sweater to cover up with, you’ll look down to see the telltale circle of dampness that gives new meaning to the term “wet T-shirt.”

Medication and Lactation

Besides those inopportune and public moments (“So that’s why the delivery guy was looking at me funny …”), you might find yourself springing spontaneous leaks when you’re sleeping or taking a warm shower, when you hear your baby cry, when you think about or talk about your baby. Milk may drip from one breast while you nurse from the other, and if your baby has settled into a somewhat regular feeding schedule, your breasts may be dripping with anticipation before baby latches on.

Though it may be uncomfortable, unpleasant, and endlessly embarrassing, this side effect of breastfeeding is completely normal and very common, particularly in the early weeks. (Not leaking at all or leaking only a little can be just as normal, and in fact, many second-time mothers might notice that their breasts leak less than they did the first time around.) In most cases, as breastfeeding becomes established, the system eventually settles down and leaking lessens considerably. In the meantime, while you may not be able to turn off that leaky faucet, you may be able to make living with it a little less messy:

Medication and Lactation

Many medications are known to be safe for use while you’re breastfeeding; others are known not to be; and the scientific jury’s still out on the rest. But just as you did while you were expecting, check all medications (prescription or over-the-counter) with your practitioner and your baby’s pediatrician before taking them, and be sure any physician who prescribes a new medication knows that you’re nursing. Keep in mind that it’s usually best to take medication just after a feeding, so that levels in your milk will be lowest when you nurse next time.

Stock up on nursing pads. If you’re a leaker, you’ll find that in the first postpartum weeks, you’ll be changing your nursing pads as often as you nurse—sometimes even more frequently. Keep in mind that, like a diaper, they should be changed whenever they become wet. Make sure you use pads that don’t have a plastic or waterproof liner; they’ll just trap moisture and lead to irritated nipples. Some women prefer the disposable variety, while others like the feel of the reusable cotton ones.

Protect your bed. If you find you’re leaking a lot at night, use extra nursing pads, or place a large towel under you while you sleep. The last thing you’ll want to be doing now is changing your sheets every day or, worse, shopping for a new mattress.

Don’t pump to prevent leaking. Extra pumping won’t control the leak; on the contrary, the more you stimulate your breasts, the more milk they’ll produce, and the more leaking you’ll have to contend with.

Try to stop the overflow. Once nursing is well established and your milk production has leveled off, you can try to stop the leaking by pressing your nipples (though probably not in public) or holding your arms against your breasts when you feel a leak coming on. Don’t, however, do this in the first few weeks because it may inhibit milk letdown and can lead to a clogged milk duct.

Tender nipples can make nursing a miserable—and frustrating—experience. Fortunately, most women don’t stay sore long; their nipples toughen up quickly and breastfeeding soon becomes a completely painless pleasure. But some women, especially those who have “barracuda babies” (babies with a vigorous suck) or who have been positioning their newborns incorrectly at their breasts, continue to experience soreness and cracking. To ease the discomfort so you can start enjoying breastfeeding:

Position the right way. Be sure your baby is correctly positioned, facing your breast (see box,
page 438
). Vary your nursing position so a different part of the areola is compressed at each feeding, but always keep baby facing your breasts.

Let your nipples breathe (try this at home). Expose sore or cracked nipples to the air briefly after each feeding. Protect them from clothing that rubs and other irritations, and if you’re really sore, you might want to consider surrounding them with a cushion of air by wearing breast shells (not shields).

Keep them dry. Change nursing pads as soon as they become damp. Also, make sure the nursing pads don’t have a plastic liner, which will only trap moisture. If you live in a humid climate, wave a blow dryer, set on warm, across each breast (about 6 to 8 inches away) for two or three minutes (no more) after feedings. This is very comforting, if slightly difficult to explain should someone walk in while you’re doing it.