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Introduction: With a relentless focus on excellence in healthcare. Pullman Regional Hospital presents The Health Podcast.

Caitlin Whyte: Breastfeeding may be the oldest way to feed your newborn, but it doesn't always come easy to everyone. With some tips on breastfeeding, like how to start and how long to do it for is Laura Keogh, a Registered Nurse and Certified Lactation Consultant at Pullman Regional Hospital. Laura, to start out, tell us how important is breastfeeding.

Laura Keogh: I think breastfeeding is probably the most important gifts that you can give your baby. Breast milk is a living fluid and it is specifically designed for a human baby. And it changes as the baby grows, and breast milk doesn't just have nutrients for the baby to grow. It has antibodies and it has other living cells that help the baby fight infection and fight viruses and harmful bacteria and pathogens. There's also STEM cells and anti-cancer components in the breast milk and there's even enzymes and hormones that help your baby grow. There are good bacteria even in the breast milk and the breast milk even has little packages of food for that good bacteria so it can set up home in the baby's gut. And create a healthy gut microbiome and all of this helps the baby build a robust immune system. And because of that, breastfed babies have less risk of ear infections and respiratory tract infections and lower GI tract infections and bladder infections. And they also have a reduced risk of SIDS and diabetes and even other chronic diseases like Crohn's disease and celiac disease.

I mean, the list goes on, you know, less cardiovascular disease, asthma, allergies, and even decrease childhood obesity and less risk of several types of cancers. But it's not just baby that benefits, it's even mom who benefits. And a lot of people don't realize that moms have a reduced anemia after birth. Whenever mom breastfeeds, she releases oxytocin, which helps her uterus to contract and that tight uterus loses less blood and so she's less anemic. It also helps moms reduce their risk of developing diabetes as they age. And if a mom is already diabetic, her insulin needs are less while she's breastfeeding. And breastfeeding also lowers her blood pressure, which improves her cardiovascular health. And breastfeeding reduces the risk of several types of cancers like breast cancer and ovarian, uterine and endometrial cancers. And it even helps moms have stronger bones. So there's less risk of osteoporosis as they age. And it even helps moms with postpartum depression.

Host: Wow. So pretty important, huh? So Laura, how soon after birth can new mothers start breastfeeding and reaping all these benefits?

Laura Keogh: So ideally babies would begin breastfeeding immediately after birth. So as long as both mom and baby are stable, we would place baby right on mom's chest, skin to skin and baby could initiate breastfeeding. And it's usually best to leave baby right there on mom's chest until he's completed his first breastfeed. And that can usually take at least one to two hours. And research shows that babies who spend this golden hour skin to skin with their moms immediately after birth and initiate breastfeeding, that they will go on to breastfeed better and longer. And even moms who have a C-section, we can also do that right in the operating room. We can place that a healthy baby right on mom's chest and that baby can even initiate breastfeeding right in the operating room.

Host: So whether you're a new mom or you know you've had a couple of kids, what can you do to get breastfeeding off to a good start?

Laura Keogh: A couple things come to mind. So like I would probably educate myself like doing things like taking a good breastfeeding class, like one we offer here at the hospital, I would attend breastfeeding support groups. We have a breastfeeding group that meets here at the hospital. There are also Lula chi groups in the community. And then if you have any special concerns, I would meet with the lactation consultant and you know, either dispel those concerns or develop a feeding plan. And then the second thing I would do is I would plan for a baby moon and that would look like after the baby's born that you would just limit visitors in your home and you would plan to spend lots of time with your baby skin to skin and breastfeed with abandon. And that will really help get breastfeeding off to a good start.

Host: So you mentioned breastfeeding with abandon, but how often should you breastfeed your baby?

Laura Keogh: Yeah, I think that's a great question. So ideally you would breastfeed your baby whenever your baby cues to breastfeed. So whenever they're asking, and for most young babies for newborns, they will need to breastfeed every one to three hours or, a minimum of eight to 12 times a day. And that frequent breastfeeding will really help establish mom's milk supply. But also you want to remember that breastfeeding for a baby is not just about food. It comforts them when they're scared or lonely and they breastfeed because maybe they're in pain. And then of course, because they're hungry. And then also you want to know that babies learn to breastfeed by breastfeeding. So the more they practice and practice in those early weeks, the better and better they'll get at it.

Host: So when it comes to nutrition, do breastfed babies need any additional, you know, food or formula or water?

Laura Keogh: That's actually one of the great advantages of exclusive breastfeeding is that your baby doesn't need anything but your milk for the first six months. So breast milk has all the nutrients your baby needs to grow and thrive. And even on the hottest days in the summertime, you don't even need to give your baby extra water because your milk has the right amount of water for your baby. And so for the first six months, you know, traveling can be actually quite easy with a young baby because you don't need to pack anything extra just you because you have the right amount of milk. It's the right temperature, it's clean, you don't need to wash any bottles. It can be, you know, pretty liberating.

Host: So how long should you breastfeed your baby for?

Laura Keogh: Ideally, you would exclusively breastfeed your baby for six months until your baby is showing signs of readiness for solid foods. And your baby will show that he's ready by sitting up without support and picking things up with his hands and putting them in his mouth. He'll lose that little tongue thrust reflex. And you know, once you're seeing all these things and your babies around six months of age, you can start introducing complimentary foods to the baby's diet. But you want to remember that you're not replacing breastfeeding with food. You're complimenting breastfeeding and breast milk has enzymes in it that help your baby digest the food. And we find that when babies are still breastfeeding, while they're learning to eat solid foods, they have less risk of food allergies. And I think it's also nice to know that the American Academy of Pediatrics, they recommend exclusive breastfeeding for six months. And then adding complementary foods while continuing to breastfeed until babies, at least a full year old and beyond, as desired by mom and baby. And the World Health Organization, they recommend breastfeeding exclusively for six months, and then adding complimentary foods while continuing to breastfeed until babies at least two years old, and beyond as desired by mom and baby.

Host: So I know breastfeeding doesn't always come easy for every mom. What should you do if you experience problems with breastfeeding?

Laura Keogh: Sure. So first of all, I like moms to know that they're not alone and that many moms experience challenges somewhere along their breastfeeding journey. And so I would like them to know that they can always seek advice from an IB CLC, you know, any lactation consultant, they can call or make an appointment. They can also call Lula chi leader in the community for information and support. And then I also think attending breastfeeding support groups, Lu laches league meetings and getting that mother to mother support can really also help normalize breastfeeding. Like be able to determine what's normal and what's not normal and when you need professional help. But always the bottom line is if you're having any breastfeeding problems to get help right away. And you know, because it's really important to keep breastfeeding successfully. So we're here to help you in any way.

Host: If you run into roadblocks, breastfeeding your baby, what are some other options for feeding?

Laura Keogh: When babies are born, sometimes they aren't always ready to breastfeed too like, for example, if a baby's had a really long and difficult labor, those babies aren't necessarily you ready to go as soon as they're born or a sick baby is not ready to breastfeed or a baby who's preterm, those babies are not going to be ready to breastfeed or breastfeed well at first. These babies really need breast milk because of all the healing properties of the milk. And so we really want to protect mom's milk supply. And so that might look like us showing the mom how to hand express her milk, showing her how to use a breast pump and then really encouraging mom to express milk at least eight times a day or more to really help build her milk supply and collect that milk, that living fluid for her baby. And then that milk can be fed to the baby in a variety of ways. And it kind of depends on, you know, how the baby's doing and what works for the baby.

But we can spoon feed milk to babies. We can cup feed it. Another way is to finger feed the milk and that might look like mom or dad having baby suckle on their finger. And then we run a little tiny feeding tube alongside the finger and the milk that she has pumped can be fed that way to the baby. But we can also take that same feeding tube and run it alongside the breast and the baby can practice breast feeding while getting some of that pumped milk, that easy milk. And then of course we can bottle feed and we would use something called paced bottle feeding where we make the bottle act kind of like a breast, so that the baby can transition to breastfeeding. And those methods are usually temporary until the baby grows or recovers from the illness or from labor. And then always, you know, in the end we're here to help. So, lactation consultants are trained to help babies transition to the breast. So we're here to support moms and babies and get that going. And then of course some moms for personal reasons do choose to exclusively breast pump and bottle feed. So that is an option too.

Host: Well thank you so much for your time and this information today, Laura. I hope we helped a lot of moms feed their new babies today. That was Laura Keogh, a registered nurse and certified lactation consultant at Pullman Regional Hospital. Learn more about Pullman Regional, as well as find more episodes like this one at pullmanregional.org. This has been The Health Podcast from Pullman Regional. I'm your host, Caitlin Whyte. We'll see you next time.