Breast-feeding mothers - self-care

If you are a smoker, this is a great time to quit for yourself and for your baby. Nicotine and other chemicals from cigarettes are found in breast milk. If you are unable to quit, try to limit the number of cigarettes as much as possible, change to a brand with low nicotine, and visit your doctor regularly.

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DRUGS IN HUMAN MILK

Many medications (prescription and over-the-counter medications) will pass into the mother's milk. Check with your physician before taking any medications. Do NOT stop taking any prescribed medication without speaking first to your doctor.

The American Academy of Pediatrics' Committee on Drugs releases a periodic statement with a list of drugs and their compatibility with breastfeeding. Your obstetrician and pediatrician are both likely to be familiar with this publication and can answer your concerns about breastfeeding while taking medications.

LACTATION AMENORRHEA

Most breastfeeding women do not have normal menstrual periods (lactation amenorrhea). Although the risk of pregnancy is less for a woman experiencing lactation amenorrhea, pregnancy CAN occur during this time. Breastfeeding should not be used for contraception, since failure is likely.

BIRTH CONTROL

Birth control choice should be discussed with your health care provider. Barrier methods (condom, diaphragm), progesterone contraceptives (oral or injectable), and IUDs have all been shown to be safe and effective. Progesterone contraception is generally not started until the milk supply is established, usually at 4 weeks postpartum.

Estrogen-containing birth control pills are not recommended for breastfeeding women, because they may affect milk supply.

WORKING OUTSIDE THE HOME

Mothers face unique obstacles in maintaining adequate milk supply once they return to work. With planning, commitment, and skilled use of a breast pump, breastfeeding mothers can maintain their milk supply and continue breastfeeding even after returning to work outside the home.

A maternity leave is helpful for establishing your milk supply and breastfeeding skills before returning to work. An ideal work place would provide a private room for breastfeeding moms, with a comfortable chair and an electric breast pump for use by all nursing mothers.

However, many moms have had success using a hand breast pump and a bathroom stall for privacy. Many women prefer the speed of the electric breast pump. Hospital-quality pumps are available for rent through medical supply stores. Personal, portable models are available for purchase.