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Breastfeeding_FAQs

Q: Why should I breastfeed my baby?

Answer

Breastfeeding helps babies, mothers, businesses, and the environment.

Breastfeeding helps babies because:

  • Human milk has what babies need for growth and brain development.
  • Human milk protects babies from many common illnesses, such as ear infections.
  • Breastfed babies are less likely to get some long-lasting illnesses, such as diabetes.
  • Breastfed babies are less likely to have allergies.
  • Feeding only breastmilk may protect babies from Sudden Infant Death Syndrome, or SIDS.
  • Human milk is very important for babies who are born early or who are born too small.

Breastfeeding can help mothers:

  • Recover from giving birth by helping the uterus contract and decreasing bleeding
  • Return to their previous weight faster if only providing breast milk to their baby
  • Avoid long-lasting illnesses, such as breast cancer, heart disease, and diabetes
  • Bond with their baby

Breastfeeding helps families and the community because:

  • It saves money by reducing health care costs
  • It decreases employee absences which is good for businesses
  • It is good for nature since it reduces waste from bottles and formula

Breastfeeding is best!

*Note: Women with some serious illnesses should not breastfeed. Talk to a health care professional to create a feeding plan that’s best for you and your baby.

Q: When do I have to decide if I want to breastfeed my baby?

Answer

There is no absolute time when you have to make this decision. However, most mothers decide how they will feed their baby during pregnancy. While you are preparing for your new baby, you can learn more about breastfeeding and get your questions answered. Your baby’s father, your partner, or other family members and friends should be included in these plans so that they can support breastfeeding!

There are things you can do right after you give birth that will help get breastfeeding off to a good start. Learn about these practices while you’re pregnant and ask your health care provider or hospital about them.

  • Hold baby skin-to-skin right after birth for at least an hour or until baby eats for the first time
  • Keep baby with you at all times
  • Ask for help as you and your baby learn how to breastfeed
  • Learn how your baby can tell you when he/she is hungry or full
  • Breastfeed your baby unless formula is recommended by a health care provider
  • Offer baby your breast instead of a pacifier or bottle for the first few weeks after birth

Q: How long into a child’s life should I breastfeed?

Answer

The American Academy of Pediatrics recommends that you give your baby only breastmilk until he or she is six months old.  This means no water, juice, other milk (such as cow’s milk) or formula. Most experts recommend that you continue to breastfeed at least the first year of your baby’s life, or for as long as is desired by you and your baby.

Q: How long does it take to breastfeed my baby? How do I know when to switch breasts when feeding my baby?

Answer

There is no set time for how long a baby should spend at the breast. Feed your baby when they are first showing signs of hunger. Babies will let you know when they are finished when they are no longer swallowing milk. Newborns spend longer at the breast than older babies. Keep your baby at the breast until you no longer hear them gulping milk. Pauses during feeding are normal and do not always mean your baby is done nursing. Using breast compression during the feeding will keep your baby actively drinking milk. Finish one breast before switching to the other. The quality of the milk changes during feedings. Breast milk is higher in sugar (lactose) and protein at the beginning of the feeding and higher in fat at the end. This is fat that babies need to grow. Start on the breast you finished up on at the last feeding.

Here are some different breastfeeding positions to try with your baby:

Q: Why does my breastmilk sometimes look different?

Answer

New research has shown that there are not two kinds of milk, once previously called “foremilk” and “hindmilk” and that there is no magic moment that the milk shifts from low-fat to high-fat. It is true that fat in breastmilk sticks to the milk ducts and increases over the course of a feeding as the milk releases from the milk ducts. This is gradual and increases as milk is removed from the breast. What can impact the fat content of milk is the length of time between feedings with long periods between feedings and an overfull breast. A long gap in breastfeeding results in milk that is initially lower in fat than if a mom is nursing frequently. However, if a baby is drinking enough breastmilk over 24 hours this does not have an impact on the baby’s weight gain. For mothers who are worried about the fat content of their milk or their baby’s weight gain pattern, breastfeeding frequently and helping the baby remove more milk is important.

Q: What might be causing sore nipples? What can I do for sore nipples?

Answer

A possible cause of sore nipples is the way you hold your baby on your breast.  Your baby’s body should be facing your body.  Make sure that your nipple is pointed up at the baby’s nose when you put your baby to your breast.  If you support your breast with your hand, make sure you place your thumb and fingers back away from the nipple.  Tickle your baby’s nose with your nipple.  As your baby opens their mouth wide, let their head tilt back.  Bring your baby to the breast chin-first.  When your baby closes their mouth over your breast they will have a mouthful of breast and a good, deep latch.

When your baby is finished eating, gently break the baby’s suction by placing the tip of your little finger in the corner of your baby’s mouth. Quickly pulling your baby off your breast and breaking the suction can hurt your nipple.

Breastfeeding should not hurt. If you have sore nipples that are not getting better, contact a board certified lactation consultant or your medical provider.

Q: Can I give breastmilk without breastfeeding?

Answer

You can give breastmilk to your baby if you choose not to breastfeed. You can use pumped breastmilk to feed your baby. If your baby is premature, you can pump and store your breastmilk until your baby is ready to breastfeed. It does take more patience, time, and supplies to pump, store, and feed your baby breastmilk, but the benefits to you and your baby are many.

It is important to start a pumping schedule right after your baby is born to build your milk supply. Pumping at least 8 times every 24 hours will stimulate your breasts to establish an adequate milk supply.

For best pumping results, use a hospital-grade electric pump with a double collection kit. These pumps can be rented or purchased and the cost may be covered by your health insurance. Some women may qualify for a rent-free automatic pump through the WIC program. Pumping time is usually 10-15 minutes with this type of pump. You should spend enough time pumping to drain both breasts completely. Click here to learn more about expressing and saving your breastmilk. Your pumping schedule should closely follow your baby’s feeding schedule. This will help your milk supply to increase to meet your baby’s needs as they grow.

Q: How do I express my breastmilk?

Answer

Your breastmilk is the best milk for your baby and your baby is able to remove milk from your breasts better than hand expression or pumping. If you can’t be with your baby, you can express your breastmilk by using your hand or a breast pump. Milk expression should never be painful. If it is, you should stop and get help. The amount of milk collected with pumping can change and depends on the time of day, the type of pump, and how you are feeling. It is important to store and handle human milk correctly. The Centers for Disease Control and Prevention (CDC) provides the following guidelines.

How do I help my milk flow?

Your milk flows naturally when your baby is breastfeeding. Try these ideas to help your milk flow:

  • Relax and think about your baby. Looking at a picture of your baby may be helpful.
  • Heat can sometimes make your milk flow more easily. Try warm, wet washcloths on your breasts for a few minutes.
  • Massage your breasts prior to pumping or using hand expression. Using your fingertips, make small circles from your chest toward your nipple, moving around your breast.

How do I express milk using my hand?

Wash your hands with soap and water. Choose a clean container with a wide opening to collect your milk. Place your fingers and thumb about 1 inch behind the nipple. Press back toward your chest; then roll your thumb and fingers toward the nipple. Move your hand around your breast and continue to drain milk from all parts of your breast. Continue until the flow of milk slows down then repeat on the other breast. Switch between both breasts 1 or 2 more times. This will take about 20-30 minutes.

How do I express milk using a breast pump?

  • Wash your hands well with soap and water.
  • Follow the directions that come with each pump. Use a pump that was given to you for your use only, unless it is designed to be a multi-user or rental pump.
  • Massage your breasts and hand express a few drops of milk before placing the pump flange on your breast.
  • Center your nipple in the flange of the breast pump. Make sure you are using the correct size flange. If the flange is pinching your nipple or sucking in breast tissue where the nipple is to be moving it is the wrong size.
  • Use the speed and suction level of the pump that is comfortable to you. Pumping at a high suction level does not yield more milk and can cause damage to your breast tissue.
  • Express each breast until the flow of milk slows down and the breast softens. Repeating breast massage and/or using your hands to compress your breast tissue during pumping will yield more milk. Finish your pumping session with hand expression to make sure that the breast is well emptied. This is important when you are just starting a pumping routine.
  • Wash the pump parts that come into contact with breast milk after each use. Use hot, soapy water and rinse well in warm water. Allow the pump parts to air dry in an area protected from dirt and dust. Pump parts can also be cleaned in a dishwasher using hot water and a heated drying cycle.
  • For extra germ removal, sanitize pump parts, wash basin, and bottle brush at least once daily after they have been cleaned. This is especially important for infants less than 3 months of age, if baby was born prematurely or if baby has an underlying medical condition. For complete instructions on sanitizing your pump parts, visit the Center for Disease Control and Prevention (CDC) page on infant feeding.

Q: How do I bottlefeed my baby breastmilk?

Answer

It is best to wait to introduce a bottle until breastfeeding is well established, or around 6 weeks of age. Babies should always be fed when they are showing signs of hunger, rather than on a schedule. Instead of waiting until baby is crying, look for early signs of hunger:

  • Sticking tongue out, smacking/sucking sounds
  • Rooting (turning head and opening mouth)
  • Putting hands in mouth
  • Squirming, fidgeting

Hold your baby in a comfortable, upright position while you are feeding your baby. Always hold your baby and the bottle while feeding, instead of propping the bottle up in some way. Try to mimic the usual breastfeeding experience. Let baby pull the bottle nipple into their mouth, rather than pushing it in.  This is a great time to interact with your baby. Take short breaks while feeding and switch baby from one arm to the other halfway through a feed. Let your baby tell you when they are full by releasing the nipple or falling asleep. Early on, babies may only eat 2-3 ounces of breastmilk at a time. This may increase to 4-5 ounces as their stomachs grow but it is important to only offer small amounts so leftover milk is not wasted. Breastmilk changes as baby gets older, so the amount eaten does not continue to increase (as it does with formula).

Some babies prefer the breast and will refuse to take a bottle. You can try different strategies, like feeding the baby in a different environment or position or trying a different container, such as a cup or spoon. If you are concerned about how much your baby is eating or your baby’s growth, contact your health care provider.

Q: Can I breastfeed and supplement with formula?

Answer

The simple answer to this question is “Yes!” But, there are a few things to think about.

First, what is the reason that you want to supplement with formula? Will you be returning to work or school soon? Are you planning on weaning from the breast soon? Do you feel that you are not making enough milk for your baby? How you answer one or more of these questions may influence whether or not you should breastfeed and supplement with formula.

Second, think about the needs of your baby at different ages. Introducing a supplemental formula feeding in the early weeks following the birth of your baby can bring a quick end to breastfeeding. Remember the law of supply and demand. The more you nurse, the more milk you will make. If you start introducing supplemental formula bottles in the early weeks following birth, your milk supply may be reduced, because baby is not sucking at your breast, telling your body to make more milk. This may not be what you had wanted. Also, in the early weeks following delivery, baby can be easily confused by the difference in nipples. Baby will suck from the bottle differently than he will suck from your breast. Some babies will prefer the bottle nipple over the breast nipple, because they do not need to work as hard to get what they want. The milk is right there for immediate satisfaction! The good news is that most babies will get past this nipple confusion by 3 to 4 weeks of age. After that age, if you introduce a bottle now and then, baby will take both the breast and the bottle.

Finally, if you will be returning to work or school soon, the good news is that you do not need to quickly end your breastfeeding experience. You may continue to breastfeed when you are home with your baby and another caretaker may feed formula to your baby when you are at work or school. Another option you may want to consider is pumping your breastmilk and storing it in the refrigerator or freezer for later use. Did you know that the bottle is not the only way of offering an alternative feeding? Depending on the age of your baby, you can offer supplemental breastmilk or formula using a spoon or cup.

Only you can decide what is best for you and your baby. Whether it is one day, one week, one month, or one year, any amount of breastmilk is always better than none.

Q: Can I breastfeed and go to work or school?

Answer

Many mothers continue to breastfeed their babies after returning to work or school. It takes a little planning, but the benefits are worth it! Breastfeeding can even calm you after a busy day. Consider the following:

How to prepare for your return to work

  • Talk with your boss about your plans to breastfeed before you have your baby. Discuss possible options for returning to work, like starting back part-time or with a more flexible schedule.  Work fewer hours, if possible.
  • Ask your employer about a place and time to pump. Learn about your rights under the federal Break Time for Nursing Mothers law, which may require your employer to provide you with a space and reasonable break time to pump and if you can adjust your break times for pumping.
  • Explore your childcare options to make sure they will support you in feeding your baby pumped or expressed milk. Or you may be able to find a caregiver close to work or school, and go there for breaks to breastfeed your baby or have the caregiver bring your baby to you to for feedings.
  • Pump milk a few times a day at home to practice before returning to work or school. Collect milk whenever your breasts feel extra full. You can build up a supply of breastmilk this way. Breastmilk will stay fresh in the refrigerator for five days. For longer storage, breastmilk needs to be kept in a freezer and can be stored for three to six months.
  • Help your baby practice taking breastmilk from a bottle a few weeks before you return to work or school. Most babies accept the bottle better from someone other than their mothers. You can try having someone else offer your baby 1 to 2 ounces of breastmilk from a bottle once a day.

Once you return to work

  • Breastfeed before you leave your baby and when you pick up your baby.
  • Pump your milk as often as your baby usually eats. Try to pump every 3 hours when you are away from your baby. This will help keep a good milk supply.
  • Alter your pumping schedule as needed, as your baby gets older. Talk to your boss about adjusting your break time to fit your needs.
  • Talk to your caregiver to make sure you are working together to maintain your milk supply.  Your caregiver should not feed your baby more milk than you pumped the day before. Some babies may even eat less during the day when they are away from their mothers and then breastfeed more often at night.
  • your caregiver to avoid feeding your baby if you will arrive in the next hour. Your baby will be hungry and ready to breastfeed when you arrive.
  • Store your expressed milk correctly to keep it safe.  Follow these guidelines from the Center for Disease Control and Prevention (CDC) and share them with your caregiver.
  • Breastfeed as often as possible on your days off and avoid bottle feeding.

Q: Can I breastfeed in public?

Answer

Breastfeeding is a natural way to feed your baby. Forty-nine states, the District of Columbia and the Virgin Islands have laws that specifically allow women to breastfeed in any public or private location. Wisconsin’s law protects mothers and prohibits anyone from asking a mom to move or cover up while breastfeeding.

You have the right to breastfeed your baby whenever your baby is hungry. It may help if you wear clothing that allows easy access your breasts. You can use a nursing cover, scarf, or blanket draped over your baby if it might make you more comfortable. Some public spaces or buildings may also have areas available if you would like a more private space.

Q: How do I know if my baby is getting enough milk?

Answer

Signs to watch for in the first few weeks

  • Your baby is breastfeeding 8 to 12 times in 24 hours. The feedings will most likely not be evenly spaced throughout the day. Cluster feeding is normal.
  • Your baby is having frequent dirty and wet diapers. The number of dirty diapers should increase from day 2 after birth to day 5. After day 5, most babies will have 4-5 dirty diapers and 6-8 wet diapers each day.
  • Your baby ends the feedings and comes off your breast contented (relaxes tightened fists, appears satisfied).
  • Your breasts feel full before feeding and soft after feeding.
  • You will be able to hear gulping sounds as the baby is feeding.
  • Your baby is back up to his or her birth weight by 7-14 days and is gaining 1/2 ounce to 1 ounce per day (4 – 7 ounces after the 4th day of life).
  • Baby is alert and active, appears healthy, good color, firm skin, and growing in length.

Call a breastfeeding specialist or your health care provider if any of the above statements are not true.

Growth spurts

Suddenly, your baby is eating all the time. This is called a growth spurt. Breastfeeding more often is your baby’s way of building your milk supply to meet his new growth needs. You may notice growth spurts when your baby is:

  • 7-10 days old
  • 3 weeks old
  • 6 weeks old
  • 3 months old
  • 6 months old

Your body will adjust to your baby’s needs by making more milk when you breastfeed more often.

Q: How can I maintain or increase my milk supply?

Answer

It is important to figure out what may be interfering with your milk production, keeping in mind that your baby needs to feed 8-12 times in a 24hr period.  If it seems that your supply is low and your baby’s needs are not being met, then some things to consider are:

Removal of Milk

Allowing your baby to come off the breast when they are satisfied will help in assuring an adequate milk supply. Cutting your baby’s feedings short may prevent your supply from increasing.

On the other hand, a baby who breastfeeds for long intervals and does not seem satisfied may not be sucking correctly or removing milk at the breast. When your baby has a long pause in feeding, use breast compressions.  Place your free hand on your breast and compress gently while baby nurses to help your baby transfer more milk. This reminds your baby to keep nursing and take in more milk.

Keep in mind that replacing breast feedings with bottles of formula tells your body that less breastmilk is needed. If your goal is to provide more breastmilk, you may need to take steps to increase your breastmilk supply which may include pumping, milk removal, and increasing feeding frequency. An empty breast makes more milk than a full breast. Any milk left in the breast tells your body to make less milk.

Baby Feeding Schedule

Watching the clock and only feeding your baby at certain times can interfere with the “supply and demand” rule. Learn your baby’s hunger cues and offer your breast on demand.

On the other hand, if your baby sleeps most of the time and only breastfeeds for short periods, it is important for you to wake your baby up regularly (at least every 2-3 hours) and put them to your breast.

Feeding off of one breast per feeding

If you are working on trying to increase your milk supply, feed off of both breasts at each feeding but do not limit your baby’s sucking time at the first breast.

There is nothing magical about making enough milk to satisfy your baby’s needs. Milk in your breast is produced by “supply and demand.” The more your baby nurses effectively, the more milk there will be. Allowing milk to accumulate in your breast and not offering your baby the breast often (at least every 2-3 hours) signals your body to make less milk.

Q: What do I do if I am concerned that my breastfed baby is not gaining enough weight?

Answer

Most newborns lose weight in the first days of life. Weight loss of up to 7% of birth weight is normal. Breastfeeding begins with the baby receiving small amounts of colostrum and this is all your baby needs at this time. After 3-4 days, your milk begins to come in. This is when your baby will begin to gain weight, usually 4-7 ounces per week. Your baby should return to its birth weight by 10 days of age.

Here are some encouraging signs that your baby is getting enough milk:

  • My baby nurses often enough and long enough, 8-12 times in 24 hours and feedings are not time limited.
  • My baby latches on and I can hear or see the baby swallowing.
  • My baby is active and alert.
  • My baby is content after feedings (e.g., relaxes tightened fists, appears satisfied, or falls asleep).
  • My baby has clear or pale yellow urine and has six or more soaking wet diapers daily by day five.
  • My baby’s stool changes from black to yellow by day five.
  • My baby passes stools daily with the number of stools increasing to four or more by day five.

Q: I am having twins. How do I breastfeed them?

Answer

Women can produce enough milk to exclusively breastfeed their infants for the first six months and longer, whether they have one or more babies. Milk production is based on the law of supply and demand or the more you breastfeed, the more milk you produce. Two babies will eat twice as much as one baby, therefore your body will make twice as much milk. Concerns about your milk supply can be addressed by improving milk removal using a variety of techniques.

Caring for and breastfeeding twins may require more organization and planning. Ideally, you should start breastfeeding within one hour or as soon as possible after the birth of your twins. Some twins are born prematurely. Your milk contains just the right amount of nutrients to meet a premature baby’s needs. If the babies are not able to begin breastfeeding right away, you should pump your breasts to initiate milk production. If needed, you can simultaneously breastfeed on one side and pump on the other to keep up your milk supply.

“Tandem feeding” is breastfeeding your babies at the same time. Doing this will save you time. However, before you try to tandem breastfeed, at least one baby should be strong enough to latch on and breastfeed easily. There are several ways that you can position your babies in order to tandem nurse. Look at the pictures below for some positions that might work for you.

 

Before you leave the hospital, work with your lactation consultant to find a comfortable feeding position for you and your babies. If you find that once you are at home you or your babies are having difficulties with breastfeeding, call your health care provider, lactation consultant, or local chapter of the La Leche League. Get the help you need for you and your babies.

Here are a few more helpful tips about breastfeeding twins:

  • Pillows or rolled up towels may be helpful. There are special pillows available that help in positioning twins, or you can make a nursing pillow yourself. Make sure any pillow you use is large enough to hold the two babies together. Some of the pillows available in stores are smaller and made for nursing only one baby at a time.
  • It is very common to have one baby who latches on more quickly or more easily than the other. Put that baby to the breast first and then you will have ample time to work with settling the other baby who may need a little more coaxing and attention with latching.
  • Alternate feeding each baby from both breasts. This evens out their particular needs and also helps your babies’ eyes get equal exercise and stimulation. If it is too hard to keep track of who was on each breast, alternate breasts every 24 hours, so baby A is fed on the left side on odd numbered days, etc.

Q: Can I breastfeed my premature baby?

Answer

A premature baby is a baby that was born before 37 weeks gestation. Your premature baby’s nutritional needs and feeding skills will vary depending on their birthweight and gestational age. Premature babies can be breastfed—even those needing special care.

Your milk contains nutrients to help meet your baby’s needs. Providing your milk to your premature baby, either by breastfeeding or by pumping, benefits both of you in many ways. When you pump milk for your baby or breastfeed, you secrete hormones that enhance the bonding process. Also, if your premature baby receives breastmilk, they are less likely to develop infections that are common to babies fed breastmilk substitutes.  Your baby will also be protected by the immunities in your milk while their own immature immune system is developing.

Many premature babies are not strong enough to breastfeed, so you may need to begin pumping as soon after birth as possible. The goal is to pump as frequently as a newborn would eat, every two to three hours. This will help establish a good milk supply. You will need to use a full-size, hospital-grade pump, with a double-pump kit. Many neonatal intensive care units (NICUs) have these available for mothers to use. Research has found that breastfeeding is less stressful than bottle feeding for babies. Let your health care provider know you want to begin breastfeeding your baby as soon as baby is ready.

In the beginning, your baby might need to be fed a special liquid through a small tube or needle that is placed in one of their veins (intravenous feeding). As their condition improves, he can be fed your breastmilk through a small tube that is passed through their nose into their stomach (gavage feeding).

Once your baby is strong enough to begin breastfeeding, you will want to work with a lactation specialist or health care provider knowledgeable about breastfeeding premature babies. It may take some learning time--don’t be discouraged. Your milk supply may be low despite regular pumping. Breastmilk (your frozen milk or banked donor milk) or breastmilk substitutes may need to be given with a supplemental feeding device if you are breastfeeding.

Although your milk provides nutrients that your baby needs, it is normal for premature babies to need extra nutrition so that they can grow as fast as they would have in your womb. Different ages of premature babies have different nutritional needs. Very premature babies often need to have extra protein and vitamins added to breastmilk. Babies that are only a few days or a week early may only need a small amount of extra formula or pumped breastmilk with each feed. The goal of adding extra feedings is to help baby have enough energy to grow and enough energy to keep breastfeeding.

Many mothers of premature babies find the cross cradle hold to be very useful for “learning” how to breastfeed. This technique allows you to get a better view of your baby’s face, and to control the baby's head.

Cross Cradle Hold:

 

  1. Position the baby across your lap, turned in towards you, chest to chest. Use pillows to bring your baby up to the level of your breast.
  2. If you are offering your right breast, hold your baby's head in your left hand, and support your breast with your right hand.
  3. A lactation consultant can show you the Dancer Hold Position. This position supports your baby's chin in the web [“U”] between your thumb and index finger. This helps your baby maintain a good latch.
  4. Pull your baby close and enjoy! You may need to repeat these steps as you and your baby learn together. Take time to soothe both of you with plenty of skin-to-skin contact.

Q: Can I breastfeed after a C-section?

Answer

The answer is YES! Women who have planned or unplanned C-sections can usually start breastfeeding their babies in the recovery room. For some mothers and babies, breastfeeding may get off to a slower start and milk production may be slightly delayed. Having a C-section can also make finding a comfortable position to breastfeed in more challenging. These problems are usually easy to solve and don’t last very long.

No matter how you deliver your baby, breastfeeding early and often offers many health advantages for both you and your baby. As such, put your baby to breast as soon as possible after your C-section. Breastfeeding provides important skin to skin time that keeps your baby warm and helps your baby get used to the world. Breastfeeding after your C-section also helps your uterus and your body start to recover and can help your body to start making breastmilk. Your baby can start learning how to breastfeed while you are in recovery from your C-section.

You might have to try different holding positions with your baby while you heal. It is sometimes difficult to find a comfortable breastfeeding position that doesn’t put pressure on your incision. With the help of a nurse, midwife, or lactation consultant, you will be able to figure out the easiest and most comfortable breastfeeding position for you. If all positions you try are painful, you can try pumping breastmilk for a short period of time until you are feeling more comfortable

Pain medications are given to mothers after a C-section and are a helpful tool to manage discomfort after surgery.  Most pain medications are compatible with breastfeeding as very little of it passes into breastmilk and they do not stay in your body very long.  The exception is pain relief medications that contain codeine or tramadol.  These are not recommended to be given to breastfeeding women.  Talk to your health care provider about the medications that are being used, the length of time that they may be necessary, and any adverse effects that you should watch for with your baby.

If you know you will be delivering by C-section before the birth, you will be able to make some choices in advance that will help you have a successful breastfeeding experience. Check with your hospital on their policies regarding breastfeeding, rooming in, and availability of electric breast pumps. Discuss with your health care provider any questions or concerns you have about breastfeeding after your C-section, including choices in anesthesia and pain medications.

Q: How will I know when my baby is ready to start solid foods?

Answer

Breastmilk is the most important food that you can offer your baby throughout the first year.  According to the American Academy of Pediatrics, your baby will show developmental readiness for solid foods around 6 months of age.  Adding infant cereals and pureed foods to your baby’s diet will not only provide nutrients but will also expose them to flavors and textures and will teach them to master eating skills.
 

Look for these signs of readiness for solids:

  • Sits up with support
  • Holds their head steady
  • Reaches for things and can hold them
  • Watches food, waits with an open mouth for food, and then closes mouth over food
  • Takes infant cereal or pureed food from a spoon and swallows it easily

Keep in mind that every baby is an individual and your little one will develop at their own pace. Starting solids is an important step for you and your baby. Don’t let anyone pressure you into starting solid foods before they are developmentally ready. Discuss this issue with your baby’s doctor.

What foods should I start with?

Once you and your baby’s doctor decide it’s a good time to teach your baby about solid foods, start with single-ingredient foods, preferably iron and zinc-fortified infant cereal or pureed meats. Around the middle of the first year, these two nutrients become limited in the diets of solely breastfed babies. This is no reflection on you or the quality of your breastmilk but part of the natural growth of your baby and their changing needs.

Next, start with pureed vegetables and then move on to pureed fruits. Try to include all the colors of the rainbow. The more variety, the better! Offer just one new food every 2 to 4 days in a row before starting a new one. This makes it easy to watch for a possible reaction to the food. Once your baby has tried single-ingredient foods, you can move on to mixed varieties. Try mixing a couple of his favorites together or try “combination” jarred baby foods.

The America Academy of Pediatrics supports giving a variety of foods that are appropriate in texture. No longer do you need to avoid offering different foods to your baby because of fear of allergies. This includes peanut, egg, fish, wheat, and other common allergens. For example, if you have a family history of peanut allergy, talk to your pediatrician about how to introduce peanuts early to your baby to avoid developing this food allergy.

How long will it take for my baby to get used to a new food?

How many times will it take your baby to get used to a new food? It may take up to 10-15 times before your baby accepts some new foods. Just remember the motto: “If at first you don’t succeed, try, try again.”

You know your baby best. These feeding tips are intended only as a guide. They must be adjusted based on your baby’s needs. Be sure to talk to your baby’s doctor about the right time for your little one to begin solid foods.

Q: Is there a special diet I should follow while I am breastfeeding?

Answer

It is recommended that women eat a balanced, healthy diet before, during, and after pregnancy.  You may need to eat and drink more often while you are producing milk. Drink water whenever you are thirsty or try drinking a glass of water or a nutritious beverage every time you feed your baby.  Eating small meals more often may also be helpful. Continue to take your prenatal vitamin supplement.

Q: Can I go on a weight loss diet while I am breastfeeding?

Answer

Eating a healthy diet and returning to your pre-pregnancy weight is important for your overall health.  Breastfeeding along with a healthy diet provides a natural way for you to lose weight gained during pregnancy.  Being physically active at least 30 minutes every day will also help with weight loss.  Losing too much weight too fast during this time can impact your milk supply and prevent you from getting enough nutrients.  Aim for a healthy weight loss of about one pound per week while breastfeeding.

The total number of calories you need to maintain the quality and quantity of your breastmilk depends on your activity level, age, weight, how often you breastfeed your baby, and if your baby receives nutrition from other sources, such as formula. Very low calorie diets may not provide enough of the vitamins and minerals you and your baby need and may decrease milk production.  If you are nursing frequently, you may need to consume 300-500 more calories per day to keep up your energy and milk production for the first 6 months. 

For resources and a healthy meal plan while breastfeeding, visit https://www.choosemyplate.gov/moms-breastfeeding-weight-loss.

Q: Can I take herbal dietary supplements while I am breastfeeding?

Answer

Be careful about taking herbal dietary supplements while breastfeeding. Herbal and dietary supplements are not regulated by the U.S. Food and Drug Administration and their safety cannot be guaranteed. Product labels may list only some of the ingredients included. Labels may not include herbs such as ginkgo, ginseng, kava, and valerian, which can cause harmful side effects if taken in large quantities over time. If using a tea designed for breastfeeding mothers, choose a tea that does not contain active herbal ingredients.  Orange, cinnamon, lemon, and raspberry teas are good choices. Use all herbal teas in moderate amounts. When in doubt, when you are breastfeeding, avoid all herbal supplements or talk to your health care provider about the safety of these products.

Fenugreek is one popular dietary supplement recommended for breastfeeding mothers to increase their milk supply. Be cautious when using it, since it may be dangerous. It may cause:

  • Worsening asthma symptoms.
  • Allergic reactions including stuffy nose, wheezing, facial swelling, and shock.
  • Allergic reactions in those allergic to soybeans, peanuts, and green peas.
  • Low blood sugar if taken in large amounts.
  • Diarrhea, gas, and increased sweating.
Use caution with fenugreek if you are at risk for bleeding. Consult your health care provider before taking this supplement.

Q: Can I take prescribed or over-the-counter medications when I am breastfeeding?

Answer

Some medications are okay to use when breastfeeding while others should be used with caution.  Talk to your health care provider before taking any medications while breastfeeding. If you are thinking about taking an over-the-counter medication, make sure to read the package labeling about its safety for pregnant and breastfeeding women. Please visit the American Academy of Pediatrics' Healthy Children Web site for medication safety tips for breastfeeding mothers.

Q: When do I need to call my baby’s health care provider?

Answer

Breastfeeding is a learning experience for both you and your baby.  While problems may come up during the early weeks you can prevent serious problems if you know what to look for during this time.  If your baby is less than 6 weeks of age and any of the following occur, call your baby’s health care provider:

  • Fewer than 3 bowel movements a day during the first 3 days or fewer than 4 bowel movements a day during the next 4 weeks
  • Fewer than 3 wet diapers a day during the first 3 days or fewer than 6 wet diapers a day during the next 4 weeks
  • Fewer than 8 breastfeedings in a 24-hour period
  • No sign of suckling and swallowing when breastfeeding
  • No evidence of any milk in baby’s mouth
  • Your baby is either restless and fussy or listless and sleepy for long periods of time

You may want to arrange weight checks with your baby’s health care provider to make sure that:

  • Your baby has not lost more than 7% of their birth weight
  • Your baby is not below birth weight at 2 weeks of age
  • Your baby is not gaining less than 4-8 ounces each week

Adapted from Spangler. A. (2000). Breastfeeding: A Parent’s Guide (7th ed.).

Q: What is a Certified Lactation Consultant? What is the difference between the various specialists trained to help breastfeeding mothers?

Answer

There are many people who can support you throughout your breastfeeding experience. This includes consultants, counselors, and educators who may have different titles. They all have received specialized training to help you while you are breastfeeding. If you are curious to know more about what is required for each title, please see the detailed information below.

International Board Certified Lactation Consultant (IBCLC®) is the certification granted by the International Board of Lactation Consultant Examiners. It requires continuing education and repeated testing to maintain the IBCLC® credential. An IBCLC® usually has another health care degree in an area such as nursing, medicine, or dietetics. IBCLC s ® are trained to provide specialized breastfeeding support and clinical lactation management. For a registry of certified lactation consultants, visit the following site: https://iblce.org/.

Certified Lactation Educator™ (CLE®) is granted by CAPPA® after completion of five days of classroom instruction, written coursework, and community observation. The certificate is a statement of education and does not require continuing education to maintain certification. A CLE® can provide basic breastfeeding education and support. For course information visit the following site: http://www.cappa.net/lactation-educator.

Certified Lactation Counselor® (CLC®) is granted by the Center for Breastfeeding Education after completion of a five-day training that provides comprehensive breastfeeding management with a strong focus on counseling skills. A CLC® can provide basic breastfeeding education and support. For more information visit the following site: www.healthychildren.cc.

Certified Lactation Specialist Course (CLSC®) is a five-day course along with a test designed for health professionals who want to improve their skills in working with breastfeeding moms and their babies. This certification is a stepping-stone to the IBCLC® credential and exam. All areas of the IBCLC® exam are covered in this course.  This certification is valid for five years.; For more information visit the following site: http://lactationeducationconsultants.com/cls-recert.shtml.

Certified Breastfeeding Educator™ (CBE™) is granted by Lactation Consultant Services™ in Oklahoma after attendance and participation in the Breastfeeding Educator Program™, attendance for three days of didactic instruction, participation in small group activities during the Breastfeeding Educator Program™, clinical role-playing, and an exam. The certification is in effect for five years and a one-day update is required for recertification. A CBEcan provide basic breastfeeding education and support. For course information visit the following site: http://lactation-consultant-services.webstarts.com/index.html

Breastfeeding Peer Counselors provide mom-to-mom breastfeeding support through breastfeeding education, support, and role modeling.  Since 2004, the Loving Support© Model has been used to provide WIC programs with a framework to design and maintain peer-counseling programs, including best practices and policies. A peer counselor may be located in a clinic, hospital, or home. For more information on Breastfeeding Peer Counselors please visit: https://lovingsupport.fns.usda.gov/moms.    

In addition to these programs, there are other peer-to-peer breastfeeding support groups available.  These include but are not limited to groups such as LaLeche League, the African American Breastfeeding Network (AABN), and local support groups through your health care provider.

Q: Is donor breastmilk safe for my baby?

Answer

Human milk obtained from a registered milk bank is safe according to the American Academy of Pediatrics (AAP). Milk donors go through a screening process, including a health history interview, blood testing, medication restrictions, and approval from a health care provider. All donor milk is pasteurized and rules are in place to assure the age of the milk is appropriate and that it has been stored correctly.

Q: Where can I get donor breastmilk and how much does it cost?

Answer

Donor breastmilk is available through formal and informal means.

Milk Banks

Milk banks are a way to purchase donor breastmilk from dispensaries or milk banks. Here are important points to consider:

  • Milk bank or dispensary involves donor lab testing, health screening, and safety education. One Wisconsin dispensary is Mother’s Milk Bank of the Western Great Lakes.
  • Often, donor milk is available in Neonatal Intensive Care Unit (NICU) settings for premature or ill babies who cannot obtain milk from their mothers.
  • To obtain donor breastmilk, you need a prescription and as of 2018, it costs about $4 per ounce. Commercial insurance does not reimburse for the cost of human milk.

Informal Milk or Online Sharing

Informal milk sharing or online milk sharing includes getting donor breastmilk from family, friends, moms in social media groups, or other local support groups.

Human milk obtained outside of a registered milk bank is not recommended by the American Academy of Pediatrics (AAP) because of increased risks of bacterial or viral contamination of unpasteurized milk and the possibility of exposure to medications, drugs, or other substances, including cow milk protein.

Q: How do I donate breastmilk?

Answer

To donate breastmilk to a milk bank, there are several requirements. For current requirements for donating breastmilk in Wisconsin and to find a depot near you, please click here.  Human milk donated outside of a registered milk bank is not recommended by the American Academy of Pediatrics (AAP) because of increased risks of bacterial or viral contamination of unpasteurized milk and the possibility of exposure to medications, drugs, or other substances, including cow milk protein.

Q: Are there other Web sites I can visit?

Answer

There are numerous Web sites that offer information about breastfeeding.  Here are a few you may find helpful: