August is National Breastfeeding Month, a time to highlight the beautiful and natural bonding experience between a mother and child. However, nursing an infant has its own set of challenges – some which are new due to the COVID-19 pandemic. Pamela D. Berens, MD, an obstetrician with UT Physicians and fellow of the American College of Obstetricians and Gynecologists and the Academy of Breastfeeding Medicine, offers advice for new or expecting moms during these unprecedented times.
Get help early on
Before your baby arrives, it’s important to establish a support system. Breastfeeding can be difficult and tiring, so having a team of people to confide in will be important. A lactation consultant can be a part of your team, providing you with solutions to any feeding obstacles, such as latching problems, pain while nursing, and milk production.
Nursing after birth
Breastfeeding as soon as possible, or within the first hour of delivery, can get you and your baby off to a good start. During this feeding time, babies will receive the mother’s colostrum (the first milk) that provides them with antibodies against infection and disease.
“Babies are often alert right after birth, so this is a good time for the baby to learn how to latch on. The small volume of colostrum present at birth is ideal for the baby to learn how to suck, swallow, and breathe,” said Berens, who is also a professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth).
Some challenges new parents may face during this pandemic is the decision to room with and feed an infant if the mother tests positive for COVID-19, but is not experiencing any symptoms.
“We are recommending this be a shared decision between the parents and their health care team to do what is best and most comfortable for the mother,” said Berens. “If a mother chooses to room in with her newborn after testing positive, it’s best she wear a mask and practice good hand hygiene.”
Berens also recommends keeping the baby’s crib a minimum of six feet from the mother’s bed while they are not breastfeeding.
The official statement from the Centers for Disease Control and Prevention (CDC) is that breast milk is still the best source of nutrients for most babies. It is still unclear whether mothers with a positive COVID-19 diagnosis can transmit the virus via breast milk, but limited data collected suggests that it is unlikely.
Positioning is important when breastfeeding a baby. Aiming your nipple towards the roof of your baby’s mouth will help to get a deep latch and should be more comfortable. Your baby should have your areola (dark area around the nipple) in their mouth.
Avoid becoming engorged
Engorgement happens when breast tissue becomes overfilled with milk, blood, and other fluids. This can be very painful and make breastfeeding difficult. Nursing as much as possible can help reduce the chances of becoming engorged.
“My motto to prevent engorgement is ‘early and often.’ It is also important to make sure that the baby transfers the milk, so listening for swallowing during feeding is important,” said Berens.
Take care of yourself
When nursing regularly, it’s easy for a mother’s skin to become irritated. To prevent chapped and cracked skin, it’s important not to scrub or use soaps (especially the scented variety) directly on the nipple or areola. Keeping breasts dry after feeding can help. There are also many serums and creams on the market that can soothe irritated nipples and skin, though occasionally women have experienced allergic reactions to these products. Expressing some breast milk on the affected area is another soothing option.
The right formula
When it comes to feeding a child, the mantra “whatever works” should be considered. Breastfeeding is not right for every mother. Formula is a healthy option for those who choose not to breastfeed, or who are in situations where a baby has a health concern (loss of weight, jaundice, etc.). In the latter situation, some breast milk in addition to formula continues to provide benefits for you and your baby. Speak with your health care provider and a lactation consultant should you have any questions or concerns.