This article was originally published in May, 2006

It's no secret that breastfeeding provides both a mother and her baby with numerous physical and emotional health benefits.

Unfortunately, some new moms who have every intention of nursing their babies end up switching to formula within the first few weeks of their babies' lives.

Here are some of the key findings on this topic from a study published in the December 2005 issue of Pediatrics:

Reasons for stopping with breastfeeding included:

Based on my own personal experience with breastfeeding as well as the experiences of other moms who I have talked with over the past year, it's clear that all first time moms can benefit from learning about what to expect with breastfeeding, particularly in the first month. Knowing what to expect can provide first time moms with confidence and assurance that can lead to a healthy breastfeeding experience.

Here are some pointers about breastfeeding that I wish I had known about before my baby arrived:

Breastfeeding can be hard and stressful. Most books and breastfeeding support groups tend to emphasize how wonderful breastfeeding is and how good it is for the development of a healthy bond between mom and baby. A lack of awareness of how hard and stressful breastfeeding might be at times can leave many women feeling like they are the only ones dealing with a stressful breastfeeding situation. The reality is that many mothers find it difficult.

Part of the stress of breastfeeding can come from having painful nipples. La Leche League and lactation consultants tend to say that breastfeeding should not be painful. I would agree, but would add that this may not be true during the first week or so of breastfeeding. While breastfeeding, the nipples get stretched so that they reach the back of the baby's palate - close to the throat. In the first weeks of life, the baby is constantly nursing to bring up mom's breast milk supply. Constant nursing plus the stretching that the nipples are subjected to can leave mom's nipples extremely sore. The good news is that after about a week or two, the nipples get used to the rigors of nursing and don't tend to get sore anymore.

If a woman continues to experience sore nipples after a week or two of breastfeeding, the cause might be an improper latch. Latch refers to the position of the baby's mouth, lips, and tongue on the breast. A La Leche League leader, lactation consultant, or mid wife can provide guidance on how to promote a good latch while breastfeeding.

Another common source of stress can be the feeling that mom doesn't have enough or any milk in her breasts. When a woman's milk first comes in, it can take a while for her body to adjust to how much milk her baby needs. Until her milk supply regulates in this manner, her breasts will feel really full at times and really empty at other times. The reality is that breasts are never fully empty because the body is constantly producing milk as long as the baby is nursing. In my case, our baby grew so fast that I felt that my breasts were often empty, which led me to feel that my milk supply was inadequate. In actuality, my body was learning what our baby needed. All I had to do was let our baby nurse as much as he wanted - even if it seemed that no milk was coming out - because the more a baby nurses, the more milk will be produced. Thankfully, I had learned this at La Leche League meetings during my pregnancy so I was able to persevere with breastfeeding, despite my feelings of having an inadequate milk supply.

How the breasts feel is not a reliable indicator of whether a woman has enough milk or not. Neither is the amount of milk that a woman can pump out because man-made pumps are not as efficient as babies at drawing out milk. For example, the pump that I have doesn't work very well unless it's rinsed in water first to give the suction mechanism more stick. Even then, it doesn't get much milk out. I currently use my breast pump only to relieve engorgement that occurs whenever our baby's nursing patterns change.

Another potential source of stress for me was an overactive letdown. Letdown is when the baby's suckling triggers a reflex that results in milk flow. The stress that first time moms can experience with an overactive letdown is another potential feature of the breastfeeding experience that women don't tend to tell each other about. It's important to note that not all women experience an overactive letdown. With our baby, my letdown was so strong that milk would literally shoot out. He wasn't able to handle the strong surge in milk, leading to coughing and sputtering that was heart-breaking to see. Now that I look back, I didn't even realize at first that I had an overactive letdown. I just thought that I was doing something wrong or that something was wrong with our baby. If I had the opportunity to do things over again, I would have set our baby aside once my letdown was triggered, let the milk run out, and then let our baby back on the breast once the surge had diminished and he was able to nurse comfortably. Ultimately, our baby was able to overcome this problem when he grew big enough to handle my letdown, which occurred at approximately 3.5 to 4 months of age.

Some first time moms can feel stress over wanting to get the latch just right. I wanted our baby's mouth to look exactly the way that the baby's mouth in a La Leche guide looked. In truth, our baby's mouth couldn't always look "perfect" because he was trying to handle my letdown. Now that he is bigger and manages the letdown just fine, his latch looks like the classic latch when he is nursing. But even though we've got a good latch going, his mouth doesn't always look "perfect" - both lips are supposed to be flanged out, but his top lip is sometimes curled in. A good approach seems to be to let the baby latch and see how it feels. If it hurts or is uncomfortable, then change it. Sometimes babies know how to latch correctly right away, but sometimes they don't. Sometimes it is a learned skill.