Category: Breastfeeding

Breast Reduction


If you’ve got disproportionately large breasts that are causing neck pain, back pain or other physical symptoms, you may want to consider a breast reduction.

According to the American Society of Plastic Surgeons, there are more than 90,000 breast redction procedures a year. The procedure carries tremendous psychological effects and most women who undergo breast reduction are very satisfied with the results.

It is also important to note that this surgery isn’t just for women, either. Men who have conditions such as gynecomastia (where male breasts are enlarged abnormally) also may seek a breast reduction. According to the American Society of Plastic Surgeons, there are more than 20,000 breast reduction procedures in men.


Your consultation for breast reduction surgery

Before getting breast reduction surgery, you will go in for a pre-operative consultation, during which time your surgeon will take a detailed medical history, including whether or not you’ve ever had a lump removed from your breast or any other medical conditions affecting your breasts. He or she also will take a detailed family history. You should be in good physical and mental shape in order to undergo this surgery.

It’s important that you are completely honest during this consultation. That includes being completely open with your medical history. It also means being very open as to why you’re seeking a breast reduction . You should expect to discuss the emotional issues you’ve dealt with; that is, how have you felt dealing with your breast size? How has it made you feel, physically? What types of physical conditions have you experienced?

Your surgeon may take photos of your breasts and measure them. During this time, the surgeon also will discuss how much breast tissue should be removed to achieve the desired results. You also will learn about how to prepare for the surgery and how to plan for your recovery. Your surgeon may prepare you for this procedure by performing a mammography and breast exam.


How is breast reduction done?

Depending on your personal situation, the procedure can be performed in an outpatient facility or you may have to stay at least one night in the hospital. In either case, you will be given general anesthesia, which means you will sleep through for the procedure. It’s important to have someone with you who can drive you home and stay with you at least the first night if you’re not staying in the hospital.

The surgery itself will take about three to five hours. Your surgeon will make an incision around your nipple, then downward on the breast, in a keyhole form. The excess skin, tissue and fat are removed and your nipple is relocated for cosmetic purposes. Your surgeon may use drainage tubes and the incision site is then sutured. Your breasts will be wrapped in special gauze. If required, you may also wear a surgical bra.


How to prepare for the breast reduction

You need to be in good physical shape to ensure proper healing, so follow your surgeon’s instructions on vitamins you can take before and after the surgery. Likewise, it’s very important to eat well-balanced meals. This is no time for a diet!

During your preoperative consultation, your surgeon will ask about your habits, including whether you smoke or what medications you take. You may have to quit smoking for a period before and after surgery to ensure proper healing. You may also be asked to lose weight because being overweight can increase your risk for complications after breast reduction.

Likewise, you also may have to cease taking certain medications, such as aspirin or certain anti-inflammatory drugs such as Motrin or Aleve. Your surgeon will instruct you on this.

Before you undergo surgery, you’ll need to get your home ready for your recovery. This should include:

  • Plenty of ice
  • Gauze and clean washcloths and towels
  • Loose, comfortable t-shirts and blouses
  • Soft bras. Your surgeon can recommend where to buy these
  • Special ointments or creams as recommended by your surgeon for incision site
  • Telephone within reaching distance of your primary rest area
  • Magazines, movies, or other quiet forms of relaxation.

Recovery and follow-up care for breast reduction

You will need to take at least one week off from work or school. Some patients require two weeks, but each situation varies. Your surgeon will instruct you on follow up appointments to remove bandages and sutures.

If you are a physically active person, you will not be able to resume your activity for at least one month after surgery. It is very important that you realize the emotional impact of surgery. A lot of people experience depression, but this is normal! Make sure you communicate with your doctor about all your concerns.


Complications and side effects of breast reduction

You should expect to feel tired and you will have breast pain. This is normal!

Your surgeon will give you a prescription antibiotic ointment and oral painkiller to ease you through the first few days after surgery. You should avoid heavy lifting at all costs, as this can promote scarring.

It’s important to note that a breast reduction will cause scars as a normal side effect. However, the scars can be made worse if you lift heavy objects prematurely. Though they are rare, some people may experience certain complications such as inadequate healing of the nipple area, which may require a skin graft.


When should I call my doctor after breast reduction surgery?

  • At the first sign of infection, including fever
  • If you have any unusual discharge from the incision site (including pus)
  • If any of the sutures come out before you are due to have them removed


Is smoking harmful when breastfeeding?

Tobacco smoking is always harmful, and all mothers should be encouraged to quit smoking prior to pregnancy and breastfeeding. However, smoking cigarettes is not considered to be a reason for not breastfeeding, since breastfeeding is the optimal nutrition for newborns. According to the American Academy of Pediatrics’ policy statement on breastfeeding, “tobacco smoking by mothers is not a contraindication to breastfeeding, but health care professionals should advise all tobacco-using mothers to avoid smoking within the home and to make every effort to wean themselves from tobacco as rapidly as possible.”

Nursing mothers should understand that nicotine is passed to the baby in breast milk, and they should never nurse their baby immediately after smoking or while smoking. Babies exposed to secondhand smoke also are at risk for a number of health issues, so if a woman smokes, she should nurse her baby after smoking, in a room away from cigarette smoke. Of course, the safest policy for both mother and baby is to abstain from tobacco use while breastfeeding and forever thereafter.

Introducing your breastfed baby to the bottle or cup

What’s the best way to introduce my baby to a bottle?

Most lactation experts suggest waiting until your baby is at least a month old and breastfeeding is well established before introducing a bottle. If you’re returning to work, start bottle-feeding at least two weeks before your start date so you both have time to adjust. (Find more information on such topics as sterilizing bottles and how often to bottle-feed in our article on bottle-feeding basics.)

Sucking milk from a bottle requires different mouth and tongue movements than breastfeeding, so it may take your baby a little time to get used to the change. Try these tips for a smooth transition:

  • Offer him a bottle in the evening after his regular feeding to get him used to the nipple. Start with a small amount of breast milk – about half an ounce.
  • Try a slow-flow nipple. For some babies, especially infants, a regular nipple may flood them with milk. If your baby gags when using a bottle, replace his nipple with a slow-flow one to see if that helps.
  • Let someone else feed him the first bottle. If you try to give your baby his first bottle, he may wonder why he’s not getting your breast. He may be less confused if someone else makes the introduction. Ask your mother, your partner, a childcare provider, or a friend to help.
  • Try to be out of the house. A baby can smell his mother, even from a distance, so he may know that you (and your breasts) are just in the next room.

Tory Winnick introduced her son Philip to the bottle when he was 3 weeks old. “I pumped and put my breast milk in a bottle so my husband Mike could experience feeding the baby,” she remembers. “We had to try a few different nipples until we found one that most closely simulated the breast. It really made Mike feel great that he could feed the baby too.”

Your baby may not eat very much when you aren’t home and may begin waking more frequently at night if you’re apart all day. Don’t be surprised if this happens, and just take advantage of these quiet and intimate times to reconnect with your baby.

What can I do if my baby resists taking a bottle?

Some babies take to the bottle without much fuss, but others struggle quite a bit with the transition. If your baby is having a hard time, try these techniques:

  • Use a bottle nipple similar to her pacifier. If she sucks on a latex pacifier, use a latex bottle nipple (rather than a silicone one) and vice versa. Warm the nipple with water to make it feel more appealing.
  • Put some breast milk on the nipple. When your baby tastes it, she may start sucking to get more. (Don’t use honey, which can cause infant botulism in children younger than 12 months.)
  • Let your baby play with the nipple so she can familiarize herself with it. If she just chews on it, let her for now. She may actually start sucking on it soon.
  • Hold her in a different position: Put her in an infant or car seat so she is semi-upright, and then feed her the bottle while facing her. Or try feeding her on your lap with her back to your chest. Once she is used to taking a bottle, you can hold her as you usually would for feedings.
  • Try different temperatures. It could be your baby prefers her milk slightly warmer or colder than you’ve been giving it to her. Experiment with different temperatures to see what she prefers. You might also see if there’s a difference between giving her fresh milk or milk that’s been frozen.
  • Offer the bottle at other times of day. If your baby won’t take the bottle during the day, try offering it during a nighttime feeding or vice versa.

One resourceful father put on his wife’s bathrobe and tucked the bottle under his arm while holding the baby in a breastfeeding position. That won’t work for you, but it might work for Dad!

I’ve tried everything, but my baby is only getting more frustrated and resistant.

Your baby needs time to get used to new sensations, so stick with the same nipple, bottle, and feeding technique for a while before trying something new. Constantly changing the feeding position or switching out new nipples may just end up confusing (and frustrating) him.

Make sure you have lots of time to take it slow during this process. If your baby starts crying and pushes the bottle away, back off, comfort him, and then try again. If you’ve tried offering the bottle and your baby has refused three times, let it go for now. (Wait at least five minutes before breastfeeding – that way he won’t associate refusing the bottle with immediate gratification.)

Offer the bottle again in an hour or two, when your baby is alert and receptive but not frantically hungry.

My baby took to the bottle easily at first, but now she wants only to breastfeed.

Early success isn’t necessarily an ironclad guarantee that your baby will always take a bottle. Many babies who have been getting bottles all along suddenly decide they simply prefer breastfeeding and don’t want a bottle anymore. And why not? Breastfeeding is warm, cozy, and involves their favorite person – Mom.

But don’t worry: For most babies, this is just a short-lived developmental step. If your baby suddenly refuses to take a bottle, talk to your child’s doctor to rule out a medical reason then try reintroducing it at another time.

What if I want to skip the bottle and teach my baby to drink from a cup?

In some countries, infants who can’t nurse are taught to use a cup from the get-go. There are some advantages to this method: There’s no chance of nipple confusion, and you won’t be tempted to prop up your baby with a bottle at nap time or bedtime (which can lead to tooth decay). You’ll also never have to break a bottle habit.

Of course, helping your baby drink from a cup is time-consuming. Unless you use a sippy cup or a cup with a built-in straw, you’ll have to help her drink – and be prepared for the inevitable mess. Daycare providers may not be able to accommodate this arrangement.

Many of the same principles of introducing your baby to a bottle hold true for using a cup. Have her get used to a cup at an early age (but not until breastfeeding is well established), and introduce it gradually – one feeding a day. If you’re going back to work, start a few weeks before so your child has time to get used to this new feeding method.

My baby absolutely refuses to take a bottle. What should I do?

When this happens, it’s not uncommon to blame yourself, saying, “If only I had given him a bottle a day from the beginning, this wouldn’t be happening.” But this just isn’t true. Some babies never take a bottle.

Others may tell you that if you just wait him out, he’ll eventually be hungry enough to take a bottle. That’s not necessarily true, and making a baby go for long stretches without eating isn’t a good idea. Don’t make mealtime into a battleground.

If all attempts to bottle-feed him fail, go the cup route. Hold him upright in one arm and bring the cup to his mouth, tilting it gently until a bit of milk or formula drips in. He’ll lap it up at first and then figure out to drink it. You can also use a hollow-handled medicine spoon to do the same thing.

What if I decide to wean my baby from the breast?

If you’ve decided to wean your baby, or to nurse only before and after work, you deserve congratulations and support for having given your baby weeks or months of breast milk. Just be sure that your baby gets the same one-on-one, physically nurturing and affectionate time with you during bottle-feeding that she did with breastfeeding.

Weaning: When and how to stop breastfeeding

What does it mean to have weaned a child?

Your baby is considered weaned when he stops nursing and gets all his nutrition from sources other than the breast. Although babies are also weaned from the bottle, the term usually refers to when a baby stops breastfeeding.

Weaning doesn’t necessarily signal the end of the intimate bond you and your child created through nursing. It just means you’re nourishing and nurturing him in different ways.

For example, if you often nursed your child for comfort, you’ll have to find other ways to make him feel better. Read a book, sing a song together, or play outside instead. If your child protests, try to stay calm and be firm. If you need to, hand him to your partner for a cuddle.

When should I start weaning?

You’re the best judge of when it’s time to wean, and you don’t have to set a deadline until you and your child are ready. The American Academy of Pediatrics recommends that mothers breastfeed for at least a year – and encourages women to breastfeed even longer if both you and your baby want to.

Despite what friends, relatives, or even strangers may say, there’s no right or wrong way to wean. You can choose a time that feels right to you, or let your child wean naturally when she’s older.

Baby-led weaning: Weaning is easiest when your child begins to lose interest in nursing, and that can happen any time after she starts eating solids (around 4 to 6 months). Some babies are more interested in solid food than breast milk by 12 months, after they’ve tried a variety of foods and can drink from a cup

Toddlers may become less interested in nursing when they grow more active and aren’t inclined to sit still long enough to nurse. If your child is fussy and impatient while nursing or is easily distracted, she may be giving you signs that she’s ready.

Mother-led weaning: You may decide to start weaning because you’re returning to work. Or maybe it just feels like the right time. If you’re ready but your child isn’t showing signs she wants to stop nursing, you can wean her off the breast gradually.

When it’s the mother’s idea, weaning can take a lot of time and patience. It also depends on your child’s age and how she adjusts to change.

It’s a good idea to avoid the ‘cold turkey’ approach to weaning. For example, a weekend away from your baby or toddler is not a good way to end the breastfeeding relationship. Experts say that abruptly withholding your breast can be traumatic for your baby and could cause plugged ducts or a breast infection for you.

How do I wean?

Go slowly, and expect to see signs of frustration from your baby at first. Ease the transition by using these methods:

Skip a feeding. See what happens if you offer a bottle or cup of milk instead of nursing. You can substitute pumped breast milk, formula, or whole cow’s milk (if your child is at least a year old).

Reducing feedings one at a time over a period of weeks gives your child time to adjust. Your milk supply also diminishes gradually this way, without leaving your breasts engorged or causing mastitis.

Shorten nursing time. Start by limiting how long your child is on the breast. If he usually nurses for ten minutes, try five.

Depending on his age, follow the feeding with a healthy snack, such as unsweetened applesauce or a cup of milk or formula. (Some babies younger than 6 months may not be ready for solids.) Solid food is complementary to breast milk until your baby is a year old.

Bedtime feedings may be harder to shorten because they’re usually the last to go.

Postpone and distract. Try postponing feedings if you’re only nursing a couple of times a day.

This method works well if you have an older child you can reason with. If your child asks to nurse, reassure him that you will soon and distract him with a different activity. If he wants to nurse in the early evening, explain that he has to wait until bedtime.

To ease your baby’s transition to a bottle, try putting a few drops of breast milk on his lips or tongue before slipping the bottle’s nipple into his mouth. You can also try giving him a small amount of breast milk in a bottle a couple of hours after breastfeeding but before he’s so hungry that he’s impatient and frustrated.

Will my child get enough nutrients?

Even exclusively breastfed infants need extra nutrients that breast milk can’t provide, like vitamin D. If you wean your baby before she reaches her first birthday, she’ll need to continue to drink breast milk or iron-fortified formula until she’s a year old. Then once your child reaches toddlerhood, it’ll be necessary to give her a wider variety of foods that offer the range of nutrients she needs to help her grow.

What to do when weaning becomes a struggle

If you’ve tried everything to wean your child and nothing is working, maybe the time isn’t right.

Have you recently gone back to work? Your child may still be adjusting to the new routine.

Is your child sick? Babies often want to nurse more frequently when they don’t feel well. And breastfeeding a sick child is not only comforting, but also a good source of nutrition.

Is your household going through a major life change? Events such as a move or divorce can also make weaning more difficult. Even going through a new developmental stage can make it hard to wean.

Try again in another month. Sooner or later, it’ll happen.

Breast Pumping & Bottle Feeding

Many moms want or need to pump their breast milk. Find out why you might decide to pump, how to pump and store breast milk, and how to solve common breast pumping problems. Also learn about bottle-feeding your baby, from how to pick nipples and bottles to how to prepare bottles for a feeding and introduce your breastfed baby to the bottle.


Weaning can be simple or a struggle, depending on your circumstances and how attached your child is to breastfeeding. Get advice on how to wean, when to know if it’s time to start weaning, and how to address problems that might be pressuring you to give up breastfeeding. Also, get the scoop on introducing cow’s milk to your child.


What’s in breast milk?

What’s in breast milk depends on when it’s being made and for whom. One of the wonderful characteristics of human milk is the way it changes to meet your baby’s needs as he grows. The breast milk a mother produces for her premature baby differs from the milk she would produce for a full-term newborn, and that differs from the milk she’ll have for her 6-month-old baby. All breast milk, however, contains exactly the nutritional and protective components needed most by each baby at every age.

Colostrum is the first pale yellow milk your breasts produce after giving birth. (You may have noticed beads of colostrum on your nipples in the last weeks of pregnancy.) It’s so high in antibodies that some people call it a baby’s first immunization. It’s higher in protein, minerals, salt, vitamin A, nitrogen, white blood cells, and certain antibodies, and has less fat and sugar than mature milk. Colostrum also has a slightly laxative effect and helps a newborn rinse his gastrointestinal tract of meconium, the waste product accumulated before birth, thereby reducing the risk of jaundice. A little colostrum goes a long way. You may not feel as if you’re producing much, but each drop is packed with nutritional and protective components.

Mature milk comes in approximately two to four days after your baby’s born, depending on the frequency of nursing in the first hours and days after birth. and is produced in greater amounts than colostrum. (Moms often produce too much at first, until their baby’s appetite and nursing frequency match the amount produced to the amount needed.) Mature milk contains water, fat, carbohydrates, protein, vitamins and minerals, amino acids, enzymes, and white cells. Over the course of a feeding, breast milk changes from foremilk, high in water and lactose, to hindmilk, high in fat and calories. After the first few weeks of nursing, your breast milk will contain fewer white cells and more of another antibacterial enzyme, lysozyme, the level of which stays high as long as breastfeeding continues. The quantity of milk you produce increases along with your baby’s weight and appetite until solid food becomes a daily part of his diet.

Breast milk contains more than 200 known beneficial elements, with more being discovered all the time. For example, researchers believe that a recently discovered fatty acid in breast milk promotes the growth of a baby’s brain and retina and may even enhance cognitive development. Many of these elements, including infection-fighting white cells, can’t be manufactured.

breastfeeding benefits

Breastfeeding may boost your child’s intelligence

Various researchers have found a connection between breastfeeding and cognitive development. In a study of more than 17,000 infants followed from birth to 6 1/2 years, researchers concluded from IQ scores and other intelligence tests that prolonged and exclusive breastfeeding significantly improves cognitive development.

Another study of almost 4,000 children showed that babies who were breastfed had significantly higher scores on a vocabulary test at 5 years of age than children who were not breastfed. And the scores were higher the longer they had been nursed.

Preterm infants with extremely low birth weight who received breast milk shortly after birth improved their mental development scores at 18 months when compared with preterm infants who weren’t given breast milk. In a later study, researchers found that the higher scores held at 30 months, and that the babies who received breast milk were also less likely to be hospitalized again because of respiratory infections.

Experts say that the emotional bonding that takes place during breastfeeding probably contributes to some of the brainpower benefits, but that the fatty acids in breast milk may play the biggest role.

Breastfeeding may protect your child from obesity

The American Academy of Pediatrics recommends breastfeeding as a way to help reduce your child’s risk of becoming overweight or obese. An analysis of 17 studies published in the American Journal of Epidemiology shows that breastfeeding reduces a child’s risk of becoming overweight as a teen or adult. The strongest effect is in children who were exclusively breastfed, and the longer the baby was breastfed the stronger the link.

Experts think that breastfeeding may affect later weight gain for several reasons:

  • Breastfed babies are better at eating until their hunger is satisfied, leading to healthier eating patterns as they grow.
  • Breast milk contains less insulin than formula. (Insulin stimulates the creation of fat.)
  • Breastfed babies have more leptin in their system, a hormone that researchers believe plays a role in regulating appetite and fat.
  • Compared with breastfed babies, formula-fed infants gain weight more rapidly in the first weeks of life. This rapid weight gain is associated with later obesity. Bastfeeding may lower your baby’s risk of SIDS

A large German study published in 2009 found that breastfeeding – either exclusively or partially – is associated with a lower risk of sudden infant death syndrome (SIDS). The researchers concluded that exclusive breastfeeding at 1 month of age cut the risk of SIDS in half.

The U.S. Centers for Disease Control and Prevention (CDC) recommends breastfeeding for as long as possible to reduce the risk of SIDS.

Breastfeeding can reduce your stress level and your risk of postpartum depression

The National Institutes of Health reviewed more than 9,000 study abstracts and concluded that women who didn’t breastfeed or who stopped breastfeeding early on had a higher risk of postpartum depression.

Many women report feeling relaxed while breastfeeding. That’s because nursing triggers the release of the hormone oxytocin. Numerous studies in animals and humans have found that oxytocin promotes nurturing and relaxation. (Oxytocin released while nursing also helps your uterus contract after birth, resulting in less postpartum bleeding.)

One study found that women who had high amounts of oxytocin in their system (50 percent of breastfeeding moms as opposed to 8 percent of bottle-feeding moms) had lower blood pressure after being asked to talk about a stressful personal problem.

By the way, if you’re being treated for depression, you can still breastfeed your baby. Your healthcare practitioner can help you identify safe ways to treat your depression while nursing.

Breastfeeding may reduce your risk of some types of cancer

Numerous studies have found that the longer women breastfeed, the more they’re protected against breast and ovarian cancer. For breast cancer, nursing for at least a year appears to have the most protective effect.

It’s not entirely clear how breastfeeding helps, but it may have to do with the structural changes in breast tissue caused by breastfeeding and the fact that lactation suppresses the amount of estrogen your body produces. Researchers think the effect on ovarian cancer may be related to estrogen suppression as well.

How breastfeeding benefits you and your baby

How breastfeeding benefits you and your baby

Breast milk is best for your baby, and the benefits of breastfeeding extend well beyond basic nutrition. In addition to containing all the vitamins and nutrients your baby needs in the first six months of life, breast milk is packed with disease-fighting substances that protect your baby from illness.

That’s one reason the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months (although any amount of breastfeeding is beneficial). And scientific studies have shown that breastfeeding is good for your health, too.

Here’s a look at some of the most important benefits breastfeeding offers you and your baby.

Breastfeeding protects your baby from a long list of illnesses

Numerous studies from around the world have shown that stomach viruses, lower respiratory illnesses, ear infections, and meningitis occur less often in breastfed babies and are less severe when they do happen. Exclusive breastfeeding (meaning no solid food, formula, or water) for at least six months seems to offer the most protection

One large study by the National Institute of Environmental Health Sciences showed that children who are breastfed have a 20 percent lower risk of dying between the ages of 28 days and 1 year than children who weren’t breastfed, with longer breastfeeding associated with lower risk.

The main immune factor at work here is a substance called secretory immunoglobulin A (IgA) that’s present in large amounts in colostrum, the first milk your body produces for your baby. (Secretory IgA is present in lower concentrations in mature breast milk.) The substance guards against invading germs by forming a protective layer on the mucous membranes in your baby’s intestines, nose, and throat.

Your breast milk is specifically tailored to your baby. Your body responds to pathogens (virus and bacteria) that are in your body and makes secretory IgA that’s specific to those pathogens, creating protection for your baby based on whatever you’re exposed to.

Breastfeeding’s protection against illness lasts beyond your baby’s breastfeeding stage, too. Studies have shown that breastfeeding can reduce a child’s risk of developing certain childhood cancers. Scientists don’t know exactly how breast milk reduces the risk, but they think antibodies in breast milk may give a baby’s immune system a boost.

Breastfeeding may also help children avoid a host of diseases that strike later in life, such as type 1 and type 2 diabetes, high cholesterol, and inflammatory bowel disease. In fact, preemies given breast milk as babies are less likely to have high blood pressure by the time they’re teenagers.

For babies who aren’t breastfed, researchers have documented a link between lack of breastfeeding and later development of Crohn’s disease and ulcerative colitis.

Breastfeeding can protect your baby from developing allergies

Babies who are fed a formula based on cow’s milk or soy tend to have more allergic reactions than breastfed babies.

Scientists think that immune factors such as secretory IgA (only available in breast milk) help prevent allergic reactions to food by providing a layer of protection to a baby’s intestinal tract. Without this protection, inflammation can develop and the wall of the intestine can become “leaky.” This allows undigested proteins to cross the gut where they can cause an allergic reaction and other health problems.

Babies who are fed formula rather than breast milk don’t get this layer of protection, so they’re more vulnerable to inflammation, allergies, and other eventual health issues.