| Foreword | xiii |
| Acknowledgements | xv |
| Introduction | xvii |
1 | Giving Effective Breastfeeding Help | 1 |
| Using Active Listening | 2 |
| Asking Questions | 3 |
| Giving Information and Suggestions | 5 |
| Respecting Differences among Mothers | 7 |
| Helping the Mother Work with Her Doctor | 11 |
| When Breastfeeding Doesn't Work Out | 13 |
2 | The Breast and How it Works | 15 |
| Breast Anatomy | 16 |
| Hormonal Influences | 18 |
| Other Physical Factors That Affect Milk Production | 19 |
3 | Breastfeeding Basics | 25 |
| Normal Breastfeeding Patterns | 26 |
| After a Cesarean Birth | 31 |
| During the Early Months | 36 |
| The Let-Down, or Milk-Ejection, Reflex | 41 |
| Common Questions | 43 |
| Breastfeeding in Emergency Situations | 54 |
4 | Positioning, Latch-On, and the Baby's Suck | 63 |
| Positioning | 64 |
| Latch-On--How the Baby Goes on to the Breast | 72 |
| The Baby's Suck | 79 |
| If Breastfeeding Hurts--Review the Basics | 98 |
5 | Fussy at the Breast and Breast Refusal | 103 |
| Determining the Cause | 104 |
| The Mother's Feelings | 105 |
| Asking Questions and Gathering Information | 106 |
| Fussy at the Breast | 107 |
| Breast Refusal | 135 |
| Persuading the Baby to Take the Breast | 138 |
| Refusal of One Breast | 140 |
6 | Weight Gain | 147 |
| Normal Growth Patterns | 148 |
| Slow Weight Gain in the Early Months | 150 |
| Slow Weight Gain in the Baby Older Than Three Months | 166 |
| Working with the Doctor and Supplementation | 171 |
| Rapid Weight Gain during the First Year | 174 |
7 | Starting Solid Foods | 179 |
| Determining a Baby's Readiness for Solids | 180 |
| How to Introduce Solids | 183 |
| What Foods to Offer | 185 |
| Foods to Avoid | 187 |
| Introducing the Cup | 188 |
8 | Weaning | 191 |
| The Mother's Feelings | 192 |
| Approaches to Weaning | 196 |
| If the Baby Refuses to Breastfeed | 205 |
| Physical Changes That Occur with Weaning | 205 |
9 | Expression and Storage of Human Milk | 209 |
| Choosing a Method of Expression | 210 |
| Basics of Milk Expression | 212 |
| Hand-Expression | 215 |
| Milk-Expression Strategies for Different Situations | 219 |
| Storage and Handling of Human Milk | 228 |
10 | Employment and Breastfeeding | 237 |
| The Mother's Feelings | 238 |
| Milk Expression | 243 |
| Home Strategies | 250 |
| Feeding Tips for the Baby's Caregiver | 252 |
11 | Newborn Jaundice | 257 |
| The Mother's Feelings | 258 |
| Causes of Newborn Jaundice and Elevated Bilirubin | 260 |
| Why and When Newborn Jaundice May Need Treatment | 265 |
| Treatment Options for a Jaundiced Baby | 267 |
| Helping the Mother Work with Her Baby's Doctor | 273 |
12 | Prematurity | 279 |
| The Mother's Feelings | 280 |
| The Advantages of Breastfeeding a Premature Baby | 282 |
| Building a Relationship between Mother and Baby | 283 |
| The Premie Weighing More Than 1500 Grams (3.3 lbs) | 287 |
| The Premie Weighing Less Than 1500 Grams (3.3 lbs) | 288 |
| The First Nursings | 302 |
| Working with Hospital Personnel | 312 |
| The First Weeks at Home | 315 |
13 | Health Problems--Baby | 327 |
| When the Baby Is III | 328 |
| Hospitalization of the Breastfed Baby | 338 |
| The Baby with a Chronic Illness or Physical Limitation | 343 |
14 | Multiples--Breastfeeding Twins, Triplets, or More | 371 |
| Reacting to the Idea of Having More Than One Baby | 372 |
| Advantages of Breastfeeding Multiples | 373 |
| Preparations during Pregnancy | 373 |
| Adjusting to Life with Multiples | 374 |
| Breastfeeding Basics for Multiple Babies | 375 |
| Mother Care for the Mother of Multiples | 380 |
| Breastfeeding Triplets, Quadruplets, and More | 382 |
15 | Relactation and Induced Lactation | 385 |
| Talk about Feelings, Goals, and Realistic Expectations | 386 |
| Relactation--Stimulating a Milk Supply | 390 |
| Induced Lactation--Stimulating a Milk Supply | 394 |
| Encouraging the Baby to Take the Breast | 399 |
| Making the Transition--How to Be Sure That Baby Is Getting Enough | 401 |
16 | Pregnancy and Tandem Nursing | 405 |
| Breastfeeding during Pregnancy | 406 |
| Tandem Nursing | 410 |
17 | Sexuality, Fertility, and Contraception | 417 |
| Breastfeeding and Sexuality | 418 |
| Breastfeeding, Fertility, and Contraception | 420 |
18 | Nutrition, Weight Loss, Exercise, and Personal Grooming | 435 |
| Nutrition for the Nursing Mother | 436 |
| Is Baby Reacting to a Food in the Mother's Diet? | 439 |
| Bone Density | 443 |
| The Vegetarian Mother | 444 |
| Fluids--Drink to Thirst | 445 |
| Weight Loss, Eating Disorders, and Obesity | 446 |
| Exercise | 448 |
| Personal Grooming | 449 |
19 | Nipple Problems | 455 |
| Sore Nipples | 456 |
| Treatment of Sore, Cracked, or Bleeding Nipples | 465 |
| Flat and Inverted Nipples | 470 |
| Teething and Biting | 478 |
| Thrush | 480 |
| Nipple Blisters and Sores | 484 |
20 | Breast Problems | 491 |
| Engorgement | 492 |
| Mastitis--Plugged Ducts and Breast Infections | 496 |
| Breast Abscess | 506 |
| Breast Lumps | 507 |
| Blood in the Milk | 509 |
| Deep Breast Pain | 510 |
| Breastfeeding after Breast Surgery or Injury | 515 |
21 | Health Problems--Mother | 529 |
| When Mother Is III | 530 |
| Specific Illnesses | 531 |
| When the Mother Is Hospitalized | 553 |
| Chronic Illness or Physical Limitation | 557 |
| Postpartum Depression | 570 |
22 | Drugs, Vitamins, Vaccines, and Diagnostic Tests | 587 |
| Prescription and Over-the-Counter Drugs | 588 |
| Substances of Concern | 597 |
| Substances of Abuse | 602 |
| Vitamin and Mineral Supplements for Babies | 604 |
| Vaccines | 607 |
| Diagnostic Materials and Tests | 608 |
| Supplements | |
A | Transfer of Drugs and Other Chemicals into Human Milk | 619 |
B | The Use of Breast Pumps and Other Products | 633 |
| Alternative Feeding Methods | 634 |
| Breast Pumps | 640 |
| Breast Shells | 650 |
| Creams, Ointments, and Hydrogel Products | 651 |
| Milk Storage Bags | 655 |
| Nipple Shields | 655 |
| Nursing Pads | 658 |
| Nursing Pillows and Footstools | 658 |
| Electronic Scales | 659 |
| Product Information | 659 |
| Appendix | |
| About La Leche League | 665 |
| Photo Credits | 669 |
| Index | 671 |