Q: I've heard some women say that they weren't able to breastfeed as long as they had planned. How do I keep that from happening to me?
Click here for answer.
Q: How do I know if my breastfeeding baby is getting enough milk?
Answer: Babies who are taking in enough of their mother's milk will be wetting 6 or more times and stooling 2 or more times a day by 72 hours (3 days) of life. They regain birth weight by 2 weeks of age and gain 1-2 pounds a month for the next few months. They nurse often. An effective baby will swallow many times during a feeding - a good sign that milk is going into the baby.
From birth to about 4 months of age, babies average 8 to 12 nursings in a day. At 4 to 6 months of age, the average is about 6 times a day. At 6-8 months, babies become more efficient and nurse less often - about 4-5 times a day. At 9 to 12 months, the average baby nurses only about 3-4 times a day, but is still taking in large volumes of milk at these few nursing sessions. Babies older than 12 months should be eating a full diet of 3 meals and 2-3 snacks and averaging only 1-3 nursings per day.
Q: How long should a mother plan to breastfeed her baby?
Answer: Any amount of breastfeeding is good. Breastfeeding for the first year of life is best but, even a few weeks of breastfeeding is better than none.
Breastfed babies have fewer allergies, less constipation or diarrhea, and fewer stomach upsets. Babies who receive breastmilk for the first 4 months of life have 50% fewer ear infections than infants who receive formula. It is especially beneficial to give the baby breastmilk during the first 6 months of life while the gastrointestinal tract is maturing.
The breastfeeding mother also benefits. Women who breastfeed lower their risk of ovarian and breast cancer. Adults who were breastfed as infants, have less risk of developing diabetes and heart disease.
Ideally, breastfeeding would continue throughout the first year of life. However, the nutritional and psychological benefits continue beyond the first year. It is up to each mother to decide when to wean. Worldwide, the average age for weaning is 4 years.
Q: How do you prevent pain with breastfeeding?
Answer: Mild discomfort is common on the 3rd or 4th day of nursing and shouldn't last. Acetaminophen or ibuprofen will help and are OK to take during breastfeeding. A warm, wet cloth to the nipples after nursing helps too. Severe pain that starts early and becomes progressively worse, is not normal. The mother may notice that the nipples are creased, wedged, or white after nursing. They may crack, crust, or bleed. Germs may enter through the cracks and cause a breast infection. Pain with breastfeeding should be addressed right away.
Using the best possible positioning and latch on will help prevent pain, but may not solve the problem. A correctly positioned baby looks like this:
- Ear, shoulder, hip are aligned
- Body is turned in toward the mother
- Nose touches the breast
- For more help with positioning, click here.
A baby who latches on correctly will do the following:
- Opens the mouth WIDE.
- Brings the jaws down on the areola - darker part of the breast, not just the tip of the nipple.
- Flares the lips out over the breast.
Other things to try are warm, wet soaks to the nipple after nursing, rotating nursing positions, pumping instead of nursing for one or more feeding times, and massaging the breast during nursing. If the milk supply is low, pump after nursing to increase the supply. If dry skin is a problem or the nipples are sticking to bra pads, use a thin layer of lanolin or petroleum jelly on the nipples after nursing and do not wash off.
Pain that occurs after weeks of painless nursing may signal a fungal infection, especially if the infant has recently had thrush (white patches in the mouth which don't rub off). It is easily cured with medication. The medications used for this are safe and inexpensive. Because this condition can be easily confused with other problems, see a health care provider or Lactation Consultant if you think you have a fungal infection.
For more specific tips in regards to this question refer to Breastfeeding Educational Materials, Information Sheets.
Q: What is engorgement and what does a mother do about it?
Answer: Some fullness and warmth is normal in the first 3-4 days of breastfeeding. However, the breast may overfill and become hard, shiny and very swollen. That's engorgement and it's not just milk. There's also swelling from other fluids.
To relieve mild engorgement, first try standing in a warm shower, allowing the water to run over the breasts or lean down into a basin of warm water. Milk may begin to flow out and relieve the tightness. If the shower doesn't help, or if the breasts are hard and tight, cover both breasts with an ice pack (ice cubes in a plastic bag). Cold decreases the swelling of the tissues. Apply the ice packs for 3-4 minutes every 2 hours until the milk begins to flow.
Once relieved, engorgement usually doesn't come back. If the breasts continue to feel overly full, consult a Lactation Consultant.
For more specific tips in regards to this question refer to Engorgement During Breastfeeding - English | Spanish
Q: How can I continue to breastfeed after I go back to work?
Answer: There are lots of choices available to women who want to combine working and breastfeeding. The best preparation for going back to work is to get a good milk supply established during the time you have at home. Nurse often and wait to add supplemental bottle feedings until the 3rd or 4th week of age, if possible.
Decide if you want to give breastmilk or a combination of some pumped breastmilk and some formula. Some women are able to pump at work and provide all breastmilk for the baby. Moms who aren't able to pump at work can send formula to the daycare and nurse when they are with the baby.
Once the bottle is introduced, the baby should continue to get one bottle a day, though it could be as little as an ounce of pumped breastmilk or formula. The infant may prefer for someone other than the mother to give the bottle and may want to be held differently than for breastfeeding.
About 2 weeks prior to returning to work, begin slowly modifying the baby's feeding pattern to more closely resemble what it will be after you go to work. For instance, if you plan to pump at work at noon, begin pumping at home at that time. Give the baby the pumped milk by bottle. After a few days to allow you and baby to adjust, begin omitting the mid morning nursing and give a bottle instead. Slowly continue making changes, allowing several days between each change. Continue to nurse in the evening and during the night to maintain your milk supply. Many women find that in time, the body makes less milk during the day and more milk in the evening and night.
Day care staff may need to know that pumped breastmilk normally separates and looks different from formula. Show them how your baby likes to be held for bottle feeding. Talk about ways to comfort the baby. Ask them not to overfill the baby near the end of the day because you will need to nurse.
Some babies will switch easily back and forth from breast to bottle; other babies will have a preference. An occasional baby will resist taking a bottle and will prefer to wait until Mom is available for nursing. Some babies who have been sleeping most of the night, will begin to awaken more often to nurse to make up for missed daytime feedings.
Each baby and mother pair is unique. These are just a few of the many options available to mothers who want to continue to provide breastmilk for their baby after returning to work.
For help with developing a plan to return to work or school call the breastfeeding helpline at 1-800-445-6175.