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| Common Breastfeeding
Questions |
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How do I know if my breastfeeding baby is getting
enough milk? |
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| Babies who are taking in enough of their
mother’s milk will be wetting six or more times and stooling two or more times a day
by 72 hours (three days) of life. They regain birthweight by two weeks of age and gain one
to two 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 eight to twelve nursings in a day. At four
to six months of age, the average is about six times a day. At six to eight months, babies
become more efficient and nurse less often – about four to five times a day. At nine
to twelve months, the average baby nurses only about three to four times a day, but is
still taking large volumes of milk at these few nursing sessions. Babies older than twelve
months should be eating a full diet of three meals and two to three snacks and averaging
only one to three nursings per day. |
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| How long should a mother plan to breastfeed her baby? |
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| 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 less stomach upsets.
Babies who receive breastmilk for the first four 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 six 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 should 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. World wide, the average age for weaning is four years. |
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| How does a mother avoid having pain with breastfeeding? |
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| Mild discomfort is common on the third or
fourth day of nursing and shouldn’t last. Acetaminophen (Tylenol ®) or ibuprofen
(Advil ®) 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. |
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| Using the best
possible positioning and latch on will help both kinds of pain, but may not solve the
problem. A correctly positioned baby looks like this: |
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Ear, shoulder, hip are aligned. |
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Body is turned in toward the
mother. |
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Nose touches the breast. |
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| A baby who latches on
correctly will do the following: |
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Opens the mouth WIDE. |
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Brings the jaws down on the brown
part of the breast, not just
the tip of the nipple. |
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Flares the lips out over the
breast. |
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Swallows. |
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| 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 nipples are sticking
to bra pads, apply a thin layer of lanolin or petroleum jelly after nursing and do not
wash off.
Pain that occurs after weeks of pain-free nursing may signal a fungal infection,
especially if the infant has recently had thrush (white patches in the mouth that
don’t rub off). It is easily cured with medications that are safe and inexpensive.
Because this condition can be easily confused with other problems, see a health care
provider or Lactation Consultant. |
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| What is engorgement? What does a mother do about it? |
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| Some fullness and warmth is normal in the
first three to four days of breastfeeding. However, the breast may overfill and become
hard, shiny and very swollen. This is engorgement and it’s not just milk.
There’s also swelling. To relieve 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, try
covering the breasts with a very warm wet towel.
Gently massage the breasts while the towel is in place. If the breasts begin to soften,
attempt to nurse the baby or use a breast pump. Repeat this cycle of wet soaks, massage
and nursing three or four times more until relief is obtained. If you still don’t get
relief, change to cold. Cover both breasts with an ice pack (ice cubes in a plastic bag).
Once the breasts soften, attempt to nurse or pump.
Once relieved, engorgement usually doesn’t come back.
If the breasts continue to feel overly full, consult a Lactation Consultant. |
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| How can I continue to breastfeed after I go back to work? |
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| 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 first few weeks at home. Nurse
often and wait to add supplemental bottle feedings until the third or fourth week of age.
Decide whether to give all breastmilk or a combination of some pumped breastmilk and
some formula. Some women are able to pump at work while others send formula to the
baby’s day care, but 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 two weeks prior to returning to work, the mother should begin slowly modifying
the baby’s feeding pattern to more closely resemble what it will be after she returns
to work. For instance, if the mother plans 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 the
mother’s body and the 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 the milk supply.
Many women find that in time, the body makes less milk during the day and more milk in the
evening and night.
Tell the childcare staff to expect pumped breastmilk to separate and look different
from formula. Show them how the baby likes to be held for bottle-feeding. Ask them not to
overfill the baby near the end of the day so that the baby will nurse as soon as the
mother gets home.
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 wait until the
mother comes. Some babies will begin to awaken more often at night to make up for missed
daytime feedings.
Each baby and mother 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.
<Breastfeeding
FAQs> <ADH
Celebrates World Breastfeeding Week>
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