From the nation's leading midwife and the author of "Ina May's Guide to Childbirth" comes this deeply compassionate and comprehensive guide to making breastfeeding a joyful experience for both mother and child. bw illustrations throughout.

Ina May Gaskin, certified professional midwife, has been a midwife for more than thirty years at The Farm Midwifery Center at The Farm, in Summertown, Tennessee.

Introduction: Breast Is Best	p. 3
How Breastfeeding Works, and How It Relates to Mothering	p. 17
Preparing for Nursing	p. 33
How Birth Practices Affect Breastfeeding	p. 51
Getting Started: The Basics	p. 80
Your Baby's Needs-and Yours-During the First Week	p. 103
Problem-Solving During the First Week	p. 123
Sleeping Arrangements	p. 144
If You Have a Job Outside Your Home	p. 153
The First Three Months	p. 169
As Your Baby Gets Older	p. 188
Nursing Twins...and More	p. 200
When Babies Get Sick or Need Hospitalization	p. 211
Weaning	p. 220
Shared Nursing, Wet-Nursing, and Forgotten Lore	p. 225
Nipplephobia: What It Is and Why We Should Eradicate It	p. 248
Creating a Breastfeeding Culture	p. 275
Acknowledgments	p. 281
	p. 285
	p. 297
	p. 303
Resources	p. 305
Notes	p. 311
Image Credits and Permissions	p. 323
Index	p. 325
Author Bio	p. 341
Table of Contents provided by Ingram. All Rights Reserved.

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Chapter One

How Breastfeeding Works,and How It Relates to Mothering

We women are all born with the right equipment for breastfeeding. Big breasts, tiny breasts, long nipples, flat nipples, light nipples, and dark nipples all work very well for milk-making and breastfeeding. The basic milk-producing equipment is present in all the variations that we see in the human female. Why, then, is it so much easier for some women to breastfeed than it is for others? This chapter is intended to give you a foundation for understanding why this is so. There are external factors that can interfere with your innate ability to nurse your baby, but the important thing for you to remember is that these have nothing to do with the body you are dealt at birth, which has the capacity to work right.

Breasts are amazing, complex organs, which are able to produce, secrete, and deliver the most perfect food possible to your baby, who is hardwired to take it in. Your breasts are even talented enough to adjust the composition of your milk according to the gestational age of your baby at birth and to the amount of heat and humidity in your environment at any given moment.

Let’s take a quick look now at the different kinds of tissues that make up your breasts. First there is the glandular tissue of your breasts, the network of grapelike clusters (alveoli) and ducts that make the milk and move it along. Next, your breasts contain a web of ligaments that help to support their weight. Then there are the nerves of the breast and nipple, which make them sensitive to touch. It is this network of nerves that responds to your baby’s nuzzling, suckling, head-bobbing, and caressing, by sending the message to your pituitary gland to secrete prolactin, the hormone that signals your breasts to make milk. You’ll probably learn later on that your baby’s cry and even the thought of your baby can do the same thing. The rest of your breast tissues are the more-liquid components: the blood, which nourishes all the rest of the tissues and provides the nutrients needed to make milk, and the lymph, which removes wastes.

By the way, none of the tissues mentioned so far has anything to do with the size of your breasts. Breast size depends upon the amount of fatty tissue in your breasts, not upon the amount of glandular (milk- making) tissue. Some of us have a lot of fat in our breasts, while others have more-moderate amounts or very little. The amount of fat has no effect on our ability to make milk. Pregnancy means dramatic breast growth in some women, but women who still have tiny breasts at the end of pregnancy are quite able to fully breastfeed their babies.

Your nipple sticks out from your areola; it is in the middle of the darker-colored part of your breast. Both nipple and areola contain erectile muscle tissue. When your nipple is stimulated by touch, cold, or a visual or auditory cue, these muscles contract, and your nipple becomes hard and erect. Once your baby takes it into her mouth properly, it will take on an entirely different shape, doubling in length and conforming to the shape of your baby’s mouth cavity.

Hormones That Affect Lactation and How to Elicit Them

It takes more than the right “equipment” to make milk—it is also necessary for that equipment to get the signal that it is time to start producing and releasing the milk. This is the job of certain hormones that are produced in the body, hormones that may rise or fall according to the mother’s stress level and the atmosphere in which she first starts suckling her baby.

Oxytocin

The hormone oxytocin plays as large a role in lactation and mothering as it does in the process of labor and birth. When you feel your uterus contract during or after labor, you are feeling just one of the many effects of oxytocin: in this case, the ability to expel something from a bodily

Excerpted from Ina May's Guide to Breastfeeding by Ina May Gaskin
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