Mother May Need Help in Nursing : Public health: How to feed baby was once traditional knowledge. Nowadays, professional advice may be in order.

Something was wrong with Megan Liberty.

She was 6 weeks old and losing weight. Nursing her was such a painful ordeal that Joann Natoli Liberty cringed every time she heard her daughter cry.

The family’s pediatrician in Brooklyn, N.Y., paid little attention when she told him she believed Megan wasn’t nursing properly. He said she would need to supplement feedings with formula to allow her to “rest” and replenish her milk. She should nurse Megan no more often than once in three hours, even if she cried, and for no longer than nine minutes at each breast. And she should follow every nursing with a formula feeding.

“You obviously don’t have enough milk,” the doctor told her.

She was devastated. And determined.

“This whole thing, to me, sounded so wrong. I had read enough to know that this was really ridiculous, that the idea you didn’t have enough milk was so far-fetched, so rare,” Liberty said.

She contacted the lactation clinic at Beth Israel Hospital, where a consultant watched her nurse and quickly diagnosed the problem: The baby was “tongue-tied.” Her frenulum, the connecting tissue on the underside of the tongue, was so short and tight that it made it difficult for her to nurse properly.

“She said, ‘You have plenty of milk. The problem is not with you.’ And I just sat down and cried,” Liberty said. “This is what I had felt all along.”

Liberty used a device that allowed Megan to receive supplemental breast milk or formula while she was nursing. She and her husband also did “stretching exercises” with Megan to loosen her frenulum.

Almost two years later, they are still nursing, and Liberty is more sure than ever that her persistence has paid off.

“I know that there’s such a closeness I feel with her, there’s such a peace when you sit down to nurse,” she said. “I don’t think you can get that anywhere else.”

Patti Perret had spent the last 15 of her 36 years carefully considering the kinds of food she put into her own body. That’s why deciding what to feed her newborn son took less than a second.

“I didn’t want to put anything but mother’s milk into my baby,” the New Orleans woman said. “It was never a question. It came with the territory.”

Perret learned, however, that doing what nature intended doesn’t necessarily come naturally. The first attempt to nurse Shannon minutes after his birth was unsuccessful. Later, with the help of an experienced nurse, mom and baby figured out what to do, and continued breast-feeding happily for the next two years.

“If you don’t know anything about it, you can’t just put the baby to the breast,” said Perret, who got much of her information from “The Womanly Art of Breast-feeding,” La Leche League’s book. “It requires some mechanics to it.”

Like many moms who breast-feed exclusively, Perret weaned Shannon directly to a cup, and plans to do the same with Riley, born last May. Neither child has ever had a pacifier. Shannon had an occasional bottle of breast milk while Perret, a photographer, was at work part time. Riley never has had a bottle.

“When a baby wants something, nursing usually takes care of it,” said Perret, who has fed her babies while shopping, sitting on the porch and dining out.

“It has always been something very easy for me to do. I feel l can camouflage it very well if I want to,” she said. “To us it’s a completely natural thing, so it’s a natural thing to other people.”

Lynn Clifton thought the third time would be a charm. Three Cesarean sections, three boys, three attempts at nursing.

The first two had ended after six weeks or so because of medical problems, but Clifton felt confident that breast-feeding would go well with her third and last child, Christopher. He was healthy and she was sure that she knew what to do.

“I didn’t think I needed any specific help,” the Las Vegas mother said. “I thought this was going to work this time.”

Looking back, she believes the problems began in the hospital. The staff insisted that she feed Christopher water in a bottle after each nursing. Her incision made it difficult to position the baby comfortably. No nurse or lactation specialist came by to help her.

“I came home with bottles of water and my baby--and the complementary pack of formula they give you, a six-pack of something,” Clifton said.

In those early weeks she enjoyed nursing Christopher, and made a little ritual of rocking and singing to him at each feeding. A water bottle always followed, as the hospital staff had recommended. But when his first weigh-in showed that Christopher had lost weight, his pediatrician suggested cutting out the bottles and breast-feeding exclusively for a day or two.

“At this point, Christopher was a very lazy nurser,” Clifton said. “The way the doctor put it was, ‘You’d much rather go up an elevator than use the stairs.’ The bottle is just easier. He’d nurse and then wait for that water bottle. He knew it was coming.”

Christopher continued to lose weight, and the doctor insisted that Lynn supplement feedings with formula. She breast-fed and bottle-fed for a while, but the bottle soon took over.

“I was very depressed. I cried. I wondered if it was the bottles, or me, or a combination,” she said. “I guess we’ll never know.”