FAQ: Breastfeeding Basics

When can I introduce a bottle to my baby?

In general, you can offer an occasional bottle to your baby once your milk supply has been well established and your baby has been nursing well for about 2 to 3 weeks. Some parents give a bottle as early as 2 weeks, some prefer to wait longer. Some mothers even wait until about a week before they return to work. You can decide when is the best time for you and your baby. Try not to skip a breastfeeding until you have to. When your baby is learning to take a bottle, put an ounce (or less) of breastmilk in it, and let someone other than Mom give it to baby. Make a new game out of the experience. Give it when the baby is not too hungry to play. Don’t expect him to start sucking right away. Let the baby explore the nipple with his mouth and tongue first. Be gentle, do not force. If baby is resistant, try again later.

I want to breastfeed at night (or daytime) only, and give bottles of formula at the other feedings. Is that OK?

Breastmilk is made, and keeps being made, if the baby nurses (or an efficient breastpump is used if necessary) frequently enough to maintain the milk-making hormone, prolactin, at high levels for the first 2 to 3 months. Prolactin levels start to fall after about 3 hours unless the breast is stimulated. This means that in order to establish and maintain a good milk supply, the baby should feed at the breast every feeding. It is best not to skip breastfeedings or to use bottles of formula unless it is absolutely necessary.

Is it OK to continue to breastfeed if I get pregnant?

Yes. According to research, breastfeeding while pregnant does not increase the risk of miscarriage or abnormalities of the growing fetus. You will need extra rest and extra nourishment, so take good care of yourself. Many mothers continue to breastfeed a toddler as well as the new baby. This is called “Tandem Nursing”. The lactation nurses can advise you if you want to do this.

How long can (or should) I breastfeed?

You can breastfeed for as long as you and the baby want to. That is your personal decision. Your breasts will continue to make milk if you nurse your baby as often and as long as the baby wants. The AAP and the Surgeon General recommend exclusive breastfeeding for the first 6 months, and continuing to breastfeed along with giving baby foods until at least 1 year, and longer for as long as both you and the baby want.

When does my milk come in?

There is colostrum present from about the 5th or 6th month of pregnancy. The milk starts to get made about 12 to 48 hours after the placenta comes out. This mixes with colostrum for a week to 10 days, so this transitional milk looks yellowish and watery. Mature milk is usually bluish white, and looks somewhat like skim milk. (Even though human milk looks watery, about 50% of the calories in breastmilk come from fat.) Around 2 to 5 days after the baby is born, the mother’s breasts will feel firm and full. Milk may start to leak from one side while the baby is nursing the other side. This mild engorgement is commonly referred to as “the milk coming in.”

How do I know if my milk is good?

Mothers’ milk does not “go bad”. It does not look like formula or cow’s milk. Your milk is the perfect nutrition for your baby.

How can I make enough milk for my baby? What if I have twins?

You can make enough milk by breastfeeding the baby as often as he/she wants and for as long as he/she wants. One breast can make enough milk for one baby, so most mothers can make enough milk for twins. If the baby is not nursing well, a hospital quality electric breastpump will usually help establish a good milk supply. Positioning correctly, and latching the baby correctly will usually enable him/her to nurse efficiently. The instructor for this class will teach you the basics. The nurses in the hospital will help you and the baby learn how to breastfeed after the birth. There are lactation consultants available in the hospital and in the clinic who can help if there are milk supply problems.

Can I breastfeed if I get sick, or if I have a fever?

Yes. illnesses and fevers do not come through the breastmilk. In fact, before you have symptoms, the baby has been exposed to the illness. AND, by the time you have symptoms, your breastmilk will have antibodies against that illness that will protect your baby from it. So you should continue to breastfeed your baby if you are able to do so.

Does my baby need water?

No. Only breastmilk is required.

When will my baby sleep through the night?

Newborns are night time people. Their tummies are small and breastmilk is easily digested, so babies need to eat every 2 to 3 hours in order to grow. In fact, your baby will probably feed more often at night than during the daytime for the first few weeks. Mothers can cope with this by napping whenever the baby sleeps, and by getting help for household chores and meals. Most babies do not sleep through the night until they are at least 6 months or older. When you breastfeed, you do not have to get up to fix anything for the nighttime feedings.

When should I give my baby cereal (or start solids)?

Babies only need breastmilk for the first 6 months. Baby foods can be started after that. In most cases, anything given sooner than 6 months is not nutritionally necessary. Babies do not have the enzymes to digest cereal until they are at least 4 months old, so cereals should not be given before then. This recommendation does not change even if baby is “big” or “small” for his/her age. Cereals should not be given to help a baby sleep longer!!!

What foods do I have to avoid while I am breastfeeding?

There is nothing that you have to eat, and nothing that you can’t eat when you are breastfeeding. Mothers all over the world eat their regular foods while they breastfeed. If the food agrees with you, it is ok to eat it. Eat a variety of foods, and try not to skip meals. Drink enough fluids to satisfy your thirst.
A few things, like caffeinated drinks and chocolate may need to be limited if they seem to make the baby irritable. It is best to avoid alcoholic beverages while nursing. You don’t have to drink milk to make milk. Talk to your OB provider if you do not drink milk, since you will need other sources of calcium.

What foods or drinks should I eat/drink to help breastfeeding?

Eat a variety of healthy foods, and do not skip meals. It is best not to try to diet (you will lose weight naturally while you are breastfeeding). Drinking extra water does not increase milk supply. It is important to drink enough so you are not thirsty. The amount of milk a mother makes depends on how much is taken out, especially in the first few days after birth (known as “supply and demand”).

What should I do if my milk supply decreases?

Increase your rest and nurse the baby frequently (Try staying in bed in your nightclothes and keep the baby with you to let him/her nurse on demand). Make sure that you are drinking enough fluids to satisfy your thirst. If this does not help within a couple days, contact the lactation consultant for further help.

Can you still breastfeed if you have reconstructive breast surgery?

Yes. After any surgery to the breast, breastfeeding is still possible. A few may have low milk supply or have a higher risk of other problems such as plugged ducts. Make sure your postpartum nurse and the lactation consultant know about your breast surgery history. They can help you get off to a good start.

What should I do if I have blocked milk ducts? And how do I prevent them?

Plugged ducts can happen for a number of reasons. If you have a plugged duct, take off your bra, use warm wet soaks to the breast before the feedings, and nurse the baby frequently, starting on the affected side. The plug should resolve within 1 to 3 days. To prevent plugged ducts, do not wear a bra all the time: take it off at night and for some of the feedings. Make sure your bra is the proper size, and fits well. Nurse the baby frequently, and do not limit the feedings. Contact the lactation consultant for further help if you have problems with plugged ducts.

How long should you breastfeed on each side? What if the baby falls asleep before you get to the other side?

The baby should be allowed to nurse the first side until he/she self detaches looking satisfied, then the mother can offer him/her the second side. If the baby only nurses one side and falls asleep looking satisfied, the other side should be offered first at the next feeding. If the baby still looks hungry after nursing both sides, nurse him/her again. (Think of this as dessert!!) In general, newborns take about 30 to 45 minutes total time to finish most feedings. After the first few weeks, this time usually shortens. Don’t worry about making the minutes equal on each breast at a single feeding. One sided feedings are fine if the baby is satisfied. Just rotate the sides at each feeding.

I did not have enough milk for my first baby. What can I do differently this time to have enough milk?

Nurse the baby as soon after birth as possible, and do not limit the frequency or length of the feedings. Make sure that the baby is positioned correctly and latched well. Keep your newborn with you, skin to skin as much as possible, to increase your milk making hormone (prolactin) levels. Let the postpartum nurse and the lactation consultant know that you had a low