Breastfeeding Basics

Breastfeeding is the healthiest, most natural way to feed your baby. Each mother's breast milk is uniquely formulated for her own baby and is full of infection-fighting cells and protein that will help keep a baby both happy and healthy. Breastfeeding can be enjoyable for both of you. It can take some practice at first, but there are many, many reasons to give breastfeeding your best effort.

 Why Breast Is Best — The Benefits for Baby

 The Benefits for Mom

 What to Expect at First

 Establishing a Good Milk Supply

 Bottle Strategies

 When to Feed Your Baby

 How Much Is Enough?

 How Much Is Not Enough?

 Milk on the Go





Why Breast Is Best — The Benefits for Baby

The American Academy of Pediatrics recommends that mothers breastfeed their babies for at least the first year of life, and exclusively for the first six months. There are good reasons for such a strong policy statement. Breastfed children are less likely to have ear infections, allergies, vomiting, diarrhea, pneumonia, juvenile diabetes, and meningitis. New data also suggest that breast milk enhances your baby's brain growth. Breast milk is easier for babies to digest than formula, cow's milk, or goat's milk. It contains all the right minerals and the right balance of nutrients. And breast milk is convenient: It's free, and it's always ready when your baby is hungry, with no preparation involved. The health benefits continue for as long as a mother and her baby want to keep breastfeeding.

The Benefits for Mom

Breastfeeding provides definite health benefits for you as well as your baby. Besides being an ideal way to closely bond with your new child, nursing helps stimulate hormones that shrink your uterus back to its pre-pregnancy size. According to some studies, women who breastfeed are 50 percent less likely to get pre-menopausal breast cancer, and are at lowered risk for ovarian cancer and osteoporosis as well.

Breastfeeding also helps you lose weight after pregnancy because it uses up the special kind of fat you put on with pregnancy before it becomes an established part of your body shape. Nursing helps you lose that weight at exactly the right pace. You don't want to lose too much weight right after giving birth, though. Nursing women need an extra 5 to 10 pounds over their pre-pregnancy weight to keep their body healthy while they nourish their child. If you lose weight too rapidly, it could hurt your milk supply when your baby has a growth spurt and needs to eat more. Those extra pounds will slip away naturally over the first six months.

What to Expect at First

Your breast milk will come in a few days after your baby is born. Until then, your breasts will be busy producing colostrum for your baby to drink instead. This thick, yellowish substance is full of protein and antibodies that will help your baby fight off diseases. Colostrum is intended to be your baby's very first food and his first "immunization" against diseases. He has lots of stored water and fat to use while he takes in this precious material. His tummy can only hold a teaspoon of liquid at this age, so he doesn't need a lot to fill it.

Your body was made for breastfeeding, and your baby was made to nurse, but that doesn't mean you won't need a little help to get started. While you're still in the hospital, someone should help you put your baby to your breast as soon as possible, help your baby latch onto your nipple, and show you how to tell when he's nursing correctly. Ideally, breastfeeding right after delivery helps get things started. If you still need help after you go home, ask the staff at the hospital whether they can recommend any resources. Lactation services, the hospital itself, and health care offices are good sources of help. Everyone needs some help, and even very experienced moms will encounter special issues.

Before your milk comes in fully, your newborn may start nursing every hour for the first day or two of life. This helps your body create a good milk supply, one perfectly tailored to your baby's needs. In just two to four days, your body will adjust itself to this "information," and your baby will need to nurse less often, about every two to three hours, or 8 to 12 times in a 24-hour period.

This is part of the normal transition process, and it doesn't mean he's dissatisfied with you, your milk, or your care. His fussing and crying means that he knows what he needs, and how to signal those who can provide it for him. At this age, you can expect a typical feeding to last between 10 and 15 minutes on each breast. Longer is fine if your baby has learned the proper nursing technique (see below).

Establishing a Good Milk Supply

When you are nursing, your good nutrition, plenty of fluids, and rest are all essential. Sleep when the baby sleeps, and drink plenty of healthy liquids. Milk, water, and juice are all good options. Relax. Get rid of unessential tasks, disruptive people, and pressure and focus on you and your baby.

You will need to maintain a basic healthy diet to keep up your breast milk production, but you don't need anything fancy. Some breastfeeding babies are quite sensitive to certain things in their mother's diet, but most do well no matter what Mom eats. If your baby seems fussy after you've had a spicy meal, that may be the problem. But in general, nursing mothers can eat whatever they wish, as long as it's healthy.

Vegetarian mothers who breastfeed need to make extra sure they're getting enough vitamins and minerals in their diet. Your health care provider will be able to refer you to a nutritionist or dietician who can help you plan a menu if you feel uncertain. Three healthy meals and two snacks will help you feel better and maintain a good milk supply.

Sucking is very soothing to babies. But keep in mind that if you give your baby a pacifier in the early weeks, he may eat less at your breast, which will in turn affect your milk supply. Several recent studies have shown that early pacifier use can interfere with the success of breastfeeding. So it's a good idea to hold off on a pacifier until your milk supply is well established, which generally happens by the end of the first month. Try swaddling your baby so his hands are close to his mouth instead. That way he can soothe himself by sucking on his hands, as he did in the womb.

Bottle Strategies

If you want your baby to try a bottle, start at 2 to 4 weeks at the earliest. But don't be surprised if at first your baby refuses to take a bottle of expressed breast milk. A breastfed baby simply knows better than to take breast milk from a bottle when mom is right there. He can smell his mother and knows the routine. You will probably have better luck if you have Dad or the babysitter offer a bottle of expressed breast milk without you there.

If you start to add formula to a breastfeeding baby's diet, your milk supply will diminish by the amount of formula you give your baby. It's certainly up to you, but think twice about introducing formula once your milk supply is established. Whatever you decide, be confident that any amount of breast milk is better than none as far as protecting your baby's health goes.

When to Feed Your Baby

Feed your hungry newborn on demand — that is, whenever he wants to eat. He won't eat much at any one feeding in the first days since his stomach is so small, but he'll want to nurse often. Most newborns will need about 10 to 12 feedings in a 24-hour period, or one feeding every one to three hours.

When establishing your milk supply, wake your baby up to feed if he sleeps more than three hours during the day or four hours during the night. Otherwise he'll wake up too hungry to feed well. When things get up and running, he'll wake you up as he needs to.

How do you know your newborn is hungry? Look for signs such as: Breast milk is all a baby needs by way of nutrition until the sixth month. That's when the AAP recommends introducing a baby to solid foods to supplement his diet. He'll continue to get most of his nutrition from breast milk (or formula), however, until he's 1 year old.

How Much Is Enough?

Like lots of breastfeeding mothers, you might not be sure when your baby has had enough to eat. You will know he is getting something if you can hear him swallowing as he nurses. Another clue is how well your baby sleeps after a meal. If his tummy is full and his diaper is clean, he will probably fall right back asleep after feeding.

Other signs your newborn is getting enough to eat: During the first week of life, it's expected that a baby will lose several ounces, up to 10 percent of his birth weight. After the first week, however, your baby should be steadily gaining, and should at least be back at his birth weight by the end of the second week. By the third week his face should be rounding out as well. Your health care provider will weigh your baby at each visit.

If your baby doesn't seem to be thriving or gaining weight, or you're worried about any signs that he's not getting enough, contact your health care provider.

How Much Is Not Enough?

Occasionally you may feel that your baby isn't getting enough milk. Your baby may seem hungry after a prolonged feeding, and yet you feel "empty." This is nature's way of making your milk supply keep up with your baby's growth spurts. This is the way the system works.

To help you increase your milk production when this happens, nurse frequently as your baby demands. You also need to drink more fluids and get enough rest. This may mean that for a day or two, you have to divert more time to nursing and resting yourself than to your other activities. Be assured that your baby is fine as long as he feeds vigorously and continues to urinate and stool normally as suggested above. Your increased milk supply will meet his adjusted need.

It takes about 36 to 48 hours for your body to adjust to your baby's increased needs. It's your baby's job to nurse frequently enough to give your body the right signals. So let him do his job. If you give him a bottle, he'll get lazy on the job, and your body won't get the "increase" order.

All nursing mothers go through brief periods where supply doesn't meet demand. Nature's way of meeting this increased demand is for the baby to nurse. Relax and enjoy these natural rhythms.

Milk on the Go

If you're going back to work, you can still breastfeed your baby by pumping milk at work once or twice each day and bringing the milk home for the next day's lunch. And we recommend that you do. It's one way to feel very close even when you have to be away. Nursing frequently in the evening and at night will keep up your milk supply and can give you the special closeness to your baby that you may have missed while at work. Nighttime nursing is even more effective than nursing during the day, so you may want to nurse more at night, even longer than your baby needs it, in order to maintain a strong milk supply.

There are several ways to express your breast milk — by hand, with a hand pump, or with a motorized electric pump. Renting an electric pump for a few months may produce the best results.

You can leave expressed breast milk at room temperature for about six to eight hours, or in the refrigerator or a cooler for 3 to 5 days, if you need to, since it contains natural preservatives. You can also freeze breast milk for future use. It wilt lose some of its disease-fighting properties, but even after freezing, it still contains the best balance of nutrients for your baby. Thaw frozen milk by setting it out at room temperature or running it under warm water. Once unfrozen, do not refreeze.

Stored milk should be gently shaken, as the fat will have separated and risen to the top. Mix it up for an even meal and an easy flow through the nipple.

Be sure your workplace has a clean, private, relaxing place for you to express your milk. It will make a lot of difference in your attitude and your success. If such a place isn't made available, speak up. Many employers are willing to help out if you let them know what's needed for you and the other nursing women at your workplace. There is a real financial payoff for employers who help out: less absenteeism for parents who are at work (because of fewer days spent at home with sick kids), higher employee satisfaction, and better retention, too. There've been a lot of studies to show these benefits to businesses.