New mothers often find breast-feeding a challenge

ATHENS, OHIO -- After a week of pain, sleepless nights and dread at the thought of the next feeding, new mother Paula Linscott was on the brink of giving up her attempts to nurse.

"It took like a month or two before it stopped hurting," said the Ph.D. candidate at Ohio University in Athens, Ohio. "I thought it was just going to be fine, like it was this natural thing you do."

Nipples can crack and bleed. Breasts can become engorged with milk. If done correctly, breast-feeding is painless and easy, but many women face challenges like Linscott. An expert to help can be difficult to find, despite the American Academy of Pediatrics' recommendation that babies should get breast milk exclusively for six months (no water, formula or solids) with continued breast-feeding for at least a year.

Most women want to breast-feed and try to do it, but few stick with it, according to the U.S. Centers for Disease Control 2010 Breastfeeding Report Card, released in December. The report said the number of babies breast-fed at least once while in the hospital reached a record 75 percent. But only 43 percent of mothers are still breast-feeding at six months, and just 22 percent are still doing it at 12 months.

Linscott eventually prevailed with help from a lactation consultant and support from her husband. Many hospitals have lactation consultants on duty for new mothers; some even make house calls. Saint Francis Medical Center offers a breast-feeding class for expectant mothers in their last months of pregnancy, and Southeast Hospital covers the topic during its childbirth preparation class.

Another option is to get involved with La Leche, even before you give birth. The organization helps breast-feeding moms through peer-to-peer support, often by holding meetings in neighborhood homes and other localities where women can informally gather, make friends with other nursing moms and get advice.

You also need to learn when the baby is really hungry.

"Crying is a late sign of hunger," said Jennifer Cochran, a La Leche League Leader based in Athens, and mother of two. "By the time they've reached the crying state, they're already distressed."

A distressed baby can be hard to position properly, especially for an inexperienced mom, she said.

Some mothers -- especially those who need to go back to work soon or whose babies were born prematurely -- use manual or electric pumps to express milk, which is then fed to the baby with a bottle. It's considered the best alternative to feeding at the breast, according to health officials.

Some women think their milk supply is inadequate, but often other factors are at play -- engorged breasts, problems with the baby's tongue, even lack of confidence. Lactation consultants can often help solve these issues. In rare cases where mothers can't nurse but want to feed breast milk anyway, donated human milk from a milk bank may be an option, though it can be expensive and hard to find.

Women often turn to doctors for nursing advice, but surprisingly, "physicians are uniquely uneducated in this area," said Dr. Karla Shepard Rubinger, executive director of the Academy of Breastfeeding Medicine.

The academy's co-founder, Dr. Ruth Lawrence, began her crusade to educate doctors after realizing that women weren't getting good advice from them.

"I thought to myself, 'Things aren't going to change until every physician knows how good breast milk is and knows how it happens,'" said Lawrence, a professor of pediatrics, obstetrics and gynecology at the University of Rochester School of Medicine and author of the textbook, "Breastfeeding: A Guide for the Medical Profession."

Formula is the only option for some mothers. Some can't manage nursing with a preemie or if they have to return to work with an infant at home.

Still, Linscott stresses, mothers who want to breast-feed should keep this in mind: "If it hurts, you're not doing it right. You need to get help, and it'll be fine."