50 Frequently Asked Questions About Breastfeeding
The nursing pressure doesn’t hit until you have to set up your breast pump for the first time. Or do the math to find out whether or not that bottle of breast milk has been out on the countertop long enough to go bad. Here, answers to all the most nitty-gritty breastfeeding questions that come up in the early days with a baby.
Commonly referred to as “liquid gold,” colostrum is the thick (and slightly yellowy) milk that comes from your boobs in the first few days after delivery. It’s low in fat and high in carbohydrates, protein and antibodies to keep your baby healthy. You don’t produce a lot of it, but it’s enough nutrition to sustain your newborn in their first few days of life, according to La Leche League International.
Basically, colostrum is great because it not only provides the perfect amount of nutrition; it also contains a large amount of living cells that help protect your baby from harmful agents and bolster immunity. You should think of it as an all-natural (and totally safe) vaccine, says La Leche. Practically speaking, colostrum will also help your baby poop, prevent jaundice and seal up their gastrointestinal tract.
Usually, just a few days after giving birth, you’ll start to see your colostrum thin out a bit and become much whiter in color. Nursing your baby between 8 and 12 times every 24 hours is the most efficient way to stimulate milk production, according to the pediatrician-endorsed parenting and breastfeeding website Kelly Mom.
In the first month, you should breastfeed your baby every two to three hours during the day and every four hours at night, even if you have to wake him up to feed, says the American Academy of Pediatrics. (Keep in mind, babies are capable of feeding while drowsy, so you don’t have to fully wake them up if it’s time to nurse.)
Latch-on pain is something that occurs in the first 20 or 30 seconds of a feeding, then goes away after that. It’s basically a sign of your nipples adjusting, although the level of pain is subjective and varies mom to mom, according to Kelly Mom.
Bruised nipples could be a sign of a shallow latch. In the early days with a newborn, teaching a proper latch is key. If you don’t practice (and master) this step at the start, it can cause not just bruising, but cracked nipples, blisters and bleeding, per Kelly Mom.
The American Pregnancy Association recommends being seated in a comfy chair with proper back support in order to achieve a good breastfeeding latch. Then, using a breastfeeding pillow, position your baby so she’s tummy to tummy with you. Next, guide your baby to the breast, keeping her nose opposite the nipple. It can also help to make a “C” as you cup the breast you’re feeding from, then guide your baby to your boob.
To create a "C" hold, place four fingers under the breast you’re feeding from and set your thumb on top as you bring your nipple to your baby. (In other words, position your hand in the shape of a “C.”)
If his mouth closes around your nipple (and a little bit of your areola, too) and he starts to suckle steadily, you should be golden, according to the AAP. But if you feel any pain at all beyond that first minute or so of latching on, you should pop your baby off your boob and start again.
If you're worried about the latch, you can always talk to your pediatrician, or you could hire a lactation consultant who can inspect your latch in private. Another option: Check for local breastfeeding meet-ups where you can get support and advice from other moms. (La Leche offers sessions—including ones done via phone—in every state.)
Usually, the hospital will spot a tongue tie in the first couple of days after birth, but in case you're a curious, it's when your baby’s tongue is tied to the base of his mouth, causing a lack of motion that hinders a proper latch, according to La Leche. (Signs of a tongue tie include small blisters on your baby’s lips since that’s their only mechanism for holding on, but also clicking or popping sounds during breastfeeding.)
Nope. Just talk to your doctor at the hospital (or pediatrician) and they can suggest treament. Some may advise using surgical scissors to release the tongue or simply waiting a bit for it to stretch out. (Every case is different, says La Leche.)
There’s actually no “average” amount of time per nursing session, although the Children’s Hospital of Philadelphia recommends at least ten minutes per boob. Still, it’s most important that you take your cue from your baby. As long as he’s actively sucking, let him keep feeding. And when he pauses/drops his latch, offer him the second breast, per Kelly Mom.
Hind milk is the high fat and calorie-rich milk that comes through toward the end of a feeding and is essential for your baby’s overall health and continued growth. In the beginning of a feeding, your breast milk is a bit thinner and more watery, but as your breast starts to empty, the amount of fat in your milk ramps up, according to the Children’s Hospital of Philadelphia. Ideally, you’ll drain one breast before moving on to the other just to ensure your baby reaches the hind milk. (FYI, 10 to 15 minutes per boob should be enough to reach it.)
The devil’s in the diapers. In the first six weeks, you should expect at least five to six wet diapers a day, plus three to four poopy diapers a day, per Kelly Mom. Weight gain is another sign. The average breastfed newborn gains six ounces a week.
The breast you choose to nurse from first is your call. Just be sure to alternate which side you start on since your baby’s suck is always stronger at the beginning of the feeding, says the Children’s Hospital of Philadelphia. (An app like Baby Connect can help you keep track, or you can keep a hair elastic around your wrist and rotate it.)
A nursing bra typically comes with extra padding and easy access for feeding in a hurry. So if you decide to go the regular bra route, just be sure it’s loose and soft enough not to put any pressure on your breasts. You also should avoid underwire since it can increase the risk of clogged ducts and mastitis. (See #45.) In terms of a pumping bra, depending on the type of breast pump you choose, a pumping bra—like this one from Medela—can free up your hands as you pump. That said, a lot of new hands-free pumps like the Willow and the Freemie are hitting the market, negating the need for a pumping bra at all.
Especially in the first few weeks, it’s common to produce more milk than your baby needs, per Kelly Mom. As a result, leaks happen. Invest in a set of washable Bamboobies or similar breast pads that can soak up any leakage without causing a wardrobe malfunction.
Again, it depends on the pump, but you’ll most likely need an extra set of pump parts (God forbid you forget a crucial piece at home!), breast milk storage bags, breast pump wipes to clean your parts in between sessions (or you could try this hack), plus a cooler and ice packs for easy transport.
Remember, if your baby is gaining weight, your milk supply isn’t necessarily low. But if you’re worried, you can increase your supply by encouraging your baby to nurse longer (per Kelly Mom), nursing more frequently during the day and night, and getting more sleep. (Easier said than done, right?) You can also add one extra pumping session to your day as a tactic to trick your boobs into thinking there’s a higher demand for milk.
If your baby is gagging during feeds, try adjusting his position so that he’s nursing uphill to minimize choking. You could also experiment with something called block feeding. (Basically, if he finishes nursing on one side and still wants to eat more, you just put him back on the same breast and hand-express milk from the other side to help your supply adjust.)
Fish that’s high in mercury, spicy foods that can make your baby gassy, caffeine—although research suggests this could be a myth—are all things you may want to avoid while breastfeeding, according to WebMD.
Kelly Mom and the AAP both agree: One eight-ounce glass of wine or beer is fine, as long as you wait two hours to nurse. (FYI, alcohol peaks in your bloodstream about 30 minutes to an hour after you consume it.) Keep in mind, this is a conservative estimate—most doctors agree that it’s fine to consume one drink. (In fact, a few sips of a dark hoppy beer can even help increase your milk supply, according to studies.)
Probably best to steer clear. Babies—especially newborns—detoxify alcohol in only half the rate of adults. And while less than 2 percent of alcohol reaches a mother’s blood and milk, it can impact baby’s motor development, according to the AAP.
Pumping and dumping is actually a major breastfeeding myth, recently debunked by science (and Slate). When you drink alcohol, it doesn’t just pool in your boobs and stay there. Instead, alcohol passes into your breast milk at the same rate it goes into your bloodstream. When it leaves your bloodstream—typically about two hours later per glass—it leaves your breast milk. In other words, technically you can drink what you want as long as you wait until you’re sober to nurse and pump.
The color of your milk can actually change based on what you eat, says Kelly Mom. For example, if you eat a lot of squash and carrots, your milk might take on a hint of orange. Or green if you eat, say, a lot of spinach. If it’s red, pink, brown or black, you should contact your doctor as that could be a sign of blood. (It’s often caused by cracked nipples and not a big deal, but it’s worth looking into it to be sure.)
Breastfeeding mothers should aim to take in an additional 300 to 500 calories a day since you’re passing much of that on to the baby and burning energy while doing it, according to Kelly Mom. Still, it’s important to tune into your appetite since breastfeeding can leave new moms feeling hungry frequently and growth spurts can cause your baby to eat more than usual.
You should start pumping as soon as you want to, although experts recommend waiting to start bottle feeds for at least a couple of weeks so your baby has time to get comfortable nursing. We’re fans of beginning to pump around the three-week mark as long as your baby is latching well, in order to build up a freezer supply and increase your breast milk production overall.
Again, it depends on which pump you choose, but with pretty much any pump you invest in, you’ll need to open up the box and sterilize all the parts. After that, you can use the dishwasher (or soapy, warm water) to wash everything.
You’ll need to sterilize any bottle that comes in contact with your breast milk for that initial use. After that, you can store freshly pumped breast milk in the fridge for between four and eight days, per the AAP. If you’re pumping more than you know you’ll use that week, breast milk can be stored in the freezer (immediately after pumping) for up to six months.
It’s smart to freeze ounces in two- or four-ounce increments, says the AAP, so that when you thaw it for use, nothing goes to waste. After breast milk hits room temp, it should be consumed by your baby within two hours—or tossed. (Defrosted breast milk can be kept in the refrigerator for up to 24 hours.) It should never be put back in the freezer.
For immediate use, thawing frozen breast milk is as simple as placing the bag in a bowl of warm water or running it under warm water until it defrosts. If you have more time, you can thaw it in the fridge overnight. (It usually takes 12 hours.) It is never safe to microwave breast milk, according to the AAP.
You can invest in a bottle warmer or you can run it under the warm tap until it hits body temperature—approximately 99 degrees F.
Yes and no. You can combine expressed milk with milk you’ve expressed the day before as long as both containers have been chilled in the fridge. In other words, don’t add body-temperature milk to already cooled milk, says the AAP.
The fat always rises to the top, according to the AAP, which is why your breast milk looks layered after it’s been in the fridge. Before a feeding, swirl the bottle to mix it, versus vigorously shaking it, which can cause the nutritional value to break down.
It probably has an excess of lipase, which is an enzyme that’s normally found in human milk that helps break down the milk fat so it’s well-mixed and digestible, according to Kelly Mom. The down side is that an excess production of it can cause milk to smell or taste soapy, although in most cases the change is mild and babies don’t notice.
As long as you’re not uncomfortable, you can sleep, too, and skip the pumping session, according to Kid’s Health. Breastfeeding is all about supply and demand, and your body will adjust as your baby goes longer stretches.
Basically, a dream feed is a genius mom tactic where you pre-empt your baby’s middle-of-the-night feeding by picking her out of the crib (right before your own bedtime) and encouraging her to nurse while she’s still asleep. Since most babies are incapable of sleeping through the night until six months (or longer), it helps them load up on calories, which could carry them through to morning.
You should pump every two to three hours in the beginning, assuming you’re exclusively feeding your baby breast milk. (If you’re supplementing with formula, it’s totally fine to pump less often.) You basically want to mimic the feeding schedule you follow at home, according to Lactation Matters. Each session should empty your boobs (double pumping with a hands-free bra is ideal) so you’ll want to allow 15 to 20 minutes each time.
Missing a pumping session every now and again shouldn’t impact your supply as long as you pump (or nurse) as soon as you can, but a series of missed feedings could cause it to diminish, especially if they’re consecutive. In other words, keep to your schedule as best you can, but don’t beat yourself up if you miss one session every now and again.
It's OK to introduce solids between four and six months. (Kelly Mom and the AAP both recommend waiting until six months for babies who are exclusively breastfed.) Just watch for cues—a sudden interest in food, for example—and start out with one meal a day.
In the first year, solids tend to gradually make up about 25 percent of your baby’s diet over time. That said, you should continue to nurse your baby before feeding him solids—a good rule of thumb is to nurse, then feed an hour later just to space things out. Your baby should naturally start to balance their milk intake with solid foods, according to Kelly Mom.
Mastitis is an inflammation of the breast tissue that signals an infection. Symptoms include breast pain, swelling and fever. It can also cause you to feel pretty run-down, per the Mayo Clinic.
According to Kelly Mom, there are a variety of risk factors for mastitis: a poor latch, cutting feedings short (which can lead to a backup of milk), nipple damage that causes bacteria to grow, and more. In fact, the best prevention tactic is easier than you think: Sticking to a regular feeding and pumping schedule. It’s also important to rotate your boobs at feedings.
If you have mastitis, typically, your doctor will prescribe a pain reliever (and, occasionally, an antibiotic) that’s anti-inflammatory, plus advice to drink plenty of fluids and get some rest. Keep in mind, you still have to breastfeed to maintain your milk supply, but this—in addition to taking a hot shower and massaging your breasts—can actually speed up recovery.
Yep, in fact you should continue nursing even if you have a cold, sore throat, fever, flu, stomach bug, food poisoning and more, according to Kelly Mom. In fact, it’s very rare that an illness would cause you to stop nursing, but you should consult your doctor to be sure. Also, be sure to remind her you’re nursing so she can prescribe medication that’s breastfeeding compatible.
The length of time you breastfeed for is entirely up to you. A recent study out of the University of Virginia School of Medicine found that breastfeeding for just two months can cut your SIDS risk in half. The AAP advises 12 months as a benchmark to help protect infants against illness and disease. Still, you have to do what’s best for you and your body and your schedule. Also, important to keep in mind, recent research from Harvard Medical School suggests that breastfeeding may in fact be genetic—aka go easy on yourself if you need to supplement or make alternative arrangements.
Kelly Mom recommends eliminating one feeding at a time every 3 to 7 days when you’re ready to wind down breastfeeding. The reason for this is to allow your milk supply to decrease at a measured pace, which can help reduce fullness and discomfort. When you drop a feeding, you can offer a sippy cup or snack as a distraction. Naptime, bedtime and first-thing-in-the-a.m. feeds are the last to go.
Yes. But be forewarned that some women report ending up with smaller breasts than they had before childbirth. Go figure...