Do I need a Lactation Consultant? If you or baby are feeling frustrated with breastfeeding, a lactation consultant can help. Breastfeeding should not hurt. Your baby should attach readily to the breast, and should suck and swallow actively, and let go or fall asleep and be content for awhile. (top)
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How do I know my baby is getting enough milk? The best way to know what is going into baby is to watch what is coming out. The first 5 days of life, baby should wet at least one wet diaper per day of life: one on day 1, two on day 2, etc. The urine should be pale yellow or straw colored, not orange or pink. Baby should also stool (poop) 3 or more times a day, starting out sticky and greenish black immediately after birth, then becoming brown, last turning yellow by at least day 3 or 4.(top)
How can I tell if my baby's diapers are wet enough? If you are using disposable diapers, it can be hard to tell if baby is wet. If when pinching the diaper, you can move the gel in the diaper, it is wet; if the diaper feels solid, it is dry. You can also go by the weight of the diaper. Try taking a clean diaper and pouring 2-3 measuring tablespoons of water into it. That's what a wet diaper will feel like in the first week. Another wetness indicator you can use is a white tissue placed in the diaper where the baby is most likely to wet it, you will be able to tell right away if the tissue is wet when you open the diaper.(top)
Is this blood in my baby's diaper? If your baby is a little girl, she might have a little bit of vaginal bleeding, and will probably pass some yellow mucous as well. This is normal, and nothing to worry about. Blood usually sits on the surface of the diaper. If there is a pink or orange stain deeper in the diaper, that is probably concentrated urine. If the urine is pink or orange, the baby needs to eat more. Breastfeed the baby more often, and call a Lactation Consultant to make sure baby is feeding well.(top)
How do I know that my baby is really eating? Baby should start the feeding sucking vigourously with his eyes open. He should not be hurting your nipples or breast. He should suck and swallow several times before stopping for a 5-6 second rest to catch his breath. You should hear little "cuh" sounds as he swallows. As the feeding goes on, baby will start to relax, and will either fall asleep at the breast, or push the nipple out of his mouth and go to sleep. He will look loose and relaxed after eating. If your baby falls asleep as soon as she goes to the breast, she has probably not figured out how to breastfeed, and you should find help.(top)
How often should I breastfeed my baby? Your newborn will probably want to breastfeed at least 10-12 times a day in the first few days. This will help your milk increase in abundance very quickly. After a few weeks, baby will probably feed about 8-10 times a day, and at about 3 months or so, about 8 times. Remember that these are only averages. Every mom and baby pair is different. The number of feedings is dependent on how fast the mother makes milk, how much she can store at once, and how well the baby can get it. Also, the more the baby feeds, the more milk you will make. Trying to use a schedule may interfere with the supply and demand feedback. Your baby's hunger should be your guide to feed him. It is common for babies to breastfeed more frequently in the evening. This allows the baby to get a lot of high fat milk that will allow him (and you) to sleep a little longer.(top)
When should I switch breasts? You probably should not remove the baby from the breast to switch him, because only he knows his ideal balance of high protein and high fat milk. Milk starts out high in sugar and protein, and ends up higher in fat each time the milk ejection reflex occurs. If baby lets go of the first breast and seems to be looking for more milk, try offering the other breast. If baby is sound asleep after feeding from the first breast, use the other breast at the next feeding.(top)
Is crying good for my baby? Crying is a distress signal. Babies do not cry to exercise their lungs, they cry to let you know they need something, usually food, help relaxing to sleep, or relief from loneliness or discomfort. As your baby grows, you will learn to read his signals so he does not need to cry except in emergencies. For instance, babies signal hunger by bringing their hands to their mouths, rooting toward the breast, or wrinking their foreheads. Small babies may wake up crying because they have not learned to wake up and eat sooner yet. Baby might need some soothing and rocking before he is able to relaxed enough to eat if he has been crying. If this happens with your baby, picking him up to feed as soon as he starts wiggling in his sleep will catch him before he gets too upset to feed easily.(top)
Should I wake my sleeping baby to eat? If your baby is less than 2 weeks old, and sleeps more than about 3 hours during the day or more than 5-6 hours at night, you should probably wake him to feed. It may take baby a few days or weeks to understand what that empty feeling in their tummy means, since they were fed constantly inside you, and were never hungry before.(top)
How do I wake my baby? If you wait for your baby to be in active sleep, it will be easier to wake him. Signs of active sleep include fluttering eyelids, sucking movements, and body movements. Picking him up may be enough to wake him, or you may need to take off some of his clothes, or gently massage his arms and legs.(top)
Should my nipples be sore? What can I do for my sore nipples? Breastfeeding should not hurt. Though most women have some nipple tenderness in the early days, this is probably due to inexperience on the part of both mother and baby. Getting baby latched onto the breast so that he has a lot of breast beyond the nipple in his mouth (particularly the lower part of his mouth) will put your nipple far back where his jaws cannot hurt it. This will also give baby more milk per suck. Get help right away if your nipples are sore or damaged. Lansinoh can be used on sore nipples to help them heal, and hydrogel and glycerin gel dressings are now being used to both soothe and heal nipple wounds.(top)
How can I treat engorgement? If your breasts are overfull, ice is the best treatment to relieve the swelling. Use an ice pack (or bag of frozen veggies), with a thin cloth between the ice and your breast skin, for about 5-10 minutes, then try expressing some milk. If engorgement is severe and baby cannot attach to the breast, you will probably need to rent a hospital grade electric breastpump, and you should consult a lactation consultant to determine the reason for the engorgement.(top)
When should I start feeding my baby solids? When baby is big enough to sit up unsupported, pick up food, and put it in his own mouth, he is ready for solids. This usually occurs at about 6 months of age, but may happen a little later. Baby should breastfeed first, then take solids afterward, because breastmilk is still his most important food. After about a year of age, baby can have solids or breastfeed at separate meals.(top)
How do I choose a breastpump? The FDA does not yet have standards for breastpump effectiveness or safety, so there are many less than ideal pumps on the market. If you only need a pump for occasional use, a hand pump may be enough. If you are returning to employment or school and will be seperated from your baby, either a rental pump or one of the personal double electric pumps like Hollister's Purely Yours or Medela's Pump in Style should meet your needs. If you have a baby with breastfeeding difficulties, you would be better off renting a hospital grade pump to help protect your milk supply. A Lactation Consultant will be able to help you decide which pump is best for your own personal situation.(top)
How do I feed my jaundiced baby?
It is normal for babies to become mildly jaundiced. Fetuses have a special hemoglobin (the red pigment in blood that carries oxygen) in their red blood cells. Once they are born, they no longer need this type of hemoglobin, so they break down large numbers of red blood cells and make new ones that contain adult hemoglobin. Since the baby's liver is immature, it usually falls behind in conjugating bilirubin, which allows it to be discarded in the baby's stools. The extra bilirubin gets stored in the skin temporarily, leading to the yellowish color. It is important for the baby to get food, so he or she will be able to "poop" out the bilirubin. Colostrum, your first milk, has a laxative effect, and helps baby get rid of meconium (the stool that built up during fetal life, which is full of bilirubin). If baby does not get enough to eat, or if something such as a blood type incompatability is making baby break down red blood cells faster than usual, jaundice may get out of hand. If your baby is more than mildly jaundiced, you should see a Lactation Consultant to have feeding evaluated, and help baby get more milk if necessary. (top)
Does my baby need vitamins?
There are a few situations in which a breastfeeding baby might need vitamins. If you and baby have darkly pigmented skin and live in a Northern climate such as New York, baby might need vitamin D, especially if you and baby get little sun exposure. If you follow a vegan diet, you might need additional vitamin B-12 in order to supply baby with enough through your milk. If you don't drink flouridated NYC tap water, baby might benefit from flouride supplements beginning at about age 6 months. And if baby was born prematurely, baby might need iron supplements at about 3 months of age, since babies generally store enough iron during their last month in the womb to last until they start solids at about 6 months of age.(top)
When can I expect my menstrual period to resume?
Many exclusively breastfeeding mothers do not get their period until their baby starts eating solids, or even later if the baby nurses frequently. You are unlikely to get your period if baby nurses about 100 minutes a day, and sleeps no more than 6 hours at night. This lactational amenorrhea gives your body time to rebuild your iron stores after pregnancy and birth.(top)
What about contraception while breastfeeding?
Breastfeeding mothers can use most forms of contraception. Hormonal contraception (oral contraceptive pills, shots, and implants) should be used with caution, since some women report reduction in milk supply with these methods, especially if they are started too early. It is recommended that hormonal contraceptives be started after the milk supply is well established, after 6 weeks postpartum. Progesterone only pills (the "mini-pill") is preferred over the combination pill, especially when the baby is under 6 months old and totally dependent on mother's milk, because the estrogen in the combination pills changes the protein composition of the milk. Barrier methods such as condoms are preferable in non-monagamous relationships, to help prevent HIV infection. Finally, exclusive unrestricted breastfeeding (no bottles, no pacifiers, nothing but mom's milk) can lead to temporary infertility while the mom has NOT resumed her menstrual periods. This is known as the lactational amenorrhea method.(top)
What about West Nile Virus in Breastmilk?
Even though West Nile virus was found in breast milk and might have passed to one baby, that baby never got sick from the virus. The US Centers for Disease Control and Prevention recommends that mothers continue to breastfeed, since West Nile virus is a mild illness in babies, and breastfeeding is so important for both mother and baby's overall health.(top)