Pediatric Health Library

Breastfeeding Support Questions and Answers

Lactation Counseling Information

How soon after childbirth can I begin to breastfeed?

Infants are born with the instinct to nurse and will naturally turn towards a mother’s nipple and open his or her mouth and begin sucking. It is important to note that the first two weeks of nursing can be more difficult than bottle feeding because of the time it takes for the baby and mother to become accustom to the breastfeeding process.

How do I breastfeed my child?

When a mother is ready to begin nursing, she should find a comfortable position that permits her to cup her breast in her hand and stroke the baby’s lower lip with her nipple. The baby will open his or her mouth and when this occurs and the mother should quickly center her nipple in the baby’s mouth, making sure that the tongue is down while pulling the baby close to her. A mother should always bring her baby to her breast – not her breast to her baby.

How long should a breastfeeding session last?

It is important to let your baby set his or her own nursing pattern. Most newborns nurse for 1-0 to 15 minutes on each breast. Infants who nurse for very long times (i.e. 30 minutes per breast) may be having difficulty getting enough milk.

How will I know when it is time to feed my baby? When babies are hungry, they will nuzzle against your breast, make sucking motions, or put their hands to their mouths. If they cry it is a late sign of hunger. You may find that you may nurse very often (8 –12 times in 24 hours) during the baby’s first week of life.

How will I know if my breastfeeding is nourishing my baby properly and whether or not supplemental nutrition is needed?

Vitamin and mineral supplements are not required for an average healthy, full-term breastfed baby during the first year. Breast milk is all that your baby needs for at least the first six months of life. Research has shown that vitamins, fluoride, iron, water, juice, formula and solid foods are rarely beneficial to healthy breastfed babies during the first six months, and some may even be harmful. There are certain cases where a vitamin supplement may be needed for a breastfed baby during the first year, but these cases are the exception and are prescribed by a physician.

Will I need to change my diet when it is time to feed my baby?

When you are breastfeeding, you need more food and nutrients than normal to provide fuel for milk production. Follow these guidelines:

  • Eat a well–balanced diet that includes about 500 calories a day more than you did before you became pregnant or about 2,500 calories a day for most women.
  • Get 1,000 mg of calcium a day. Check with your physician to see if you should be taking a daily vitamin.
  • Avoid foods that affect the baby. If your baby acts fussy, gets a rash, has diarrhea or congestion after nursing, speak with your doctor. This may be due to a food allergy from your diet.
  • Drink at least eight glasses of liquid a day.

How do I continue breastfeeding after I return to work?

If you want to breastfeed when you return to work, you may consider buying or renting a breast pump. You also can express breast milk by hand. Talk to your employer about pumping at work. Find out if there is a clean, private place you can go to pump and a place for storage. Practice with the pump a few weeks before your first day back at work. Be sure the pumped milk is stored properly. Give some of the pumped milk to your baby in a bottle or cup. This will help your baby get used to drinking your milk from a cup or a bottle. Talk to your doctor or your baby's doctor about when to start trying the bottle.

How much milk can I pump in advance and how should I store it?

Babies commonly take a variety of amounts at each feeding. Mothers should store their milk in small increments at first, usually one or two ounce increments. This makes it easier to tailor each feeding to a baby's need. Because the milk is stored in small units, it is easy to thaw and warm and there is little waste.

As your baby becomes more accustomed to taking stored breast milk, you may notice he or she takes a similar amount at each feeding and it may be easier to store that amount. You should also store smaller increments for when your baby wants a little more as he or she grows.

For mothers exclusively providing stored breast milk to their child, consider providing at least some of the feedings at the breast to take advantage of some of the health benefits that are only received by direct breastfeeding.

Breast milk can be safely stored in glass or hard plastic bottles with tight fitting lids, or bags especially designed for storing breast milk. Avoid containers made with the controversial chemical bisphenol A (BPA). Bags made especially for storing breast milk are designed to protect the nutrients and anti-infective qualities of human milk. They are thicker than the bottle liners sold for use with disposable bottle systems, which may split during freezing and may cause a decrease in the antibodies and fat which adhere to the sides of the bags. Since some of the white blood cells in human milk are destroyed by freezing, it makes sense to refrigerate milk whenever you will be using it within 8 days.

Should I continue breastfeeding if my baby is sick?

Whenever a sick baby can take anything by mouth, it should be breast milk. Breast milk provides antibodies specifically tailored to fight baby's illness, and is quickly and easily digested. Nursing is extremely comforting to an ill baby and a major part of the healing process. For babies who have a cold or who are congested breastfeeding may be difficult. However, it is almost always easier for a sick baby to nurse than to take a bottle.

Are there any OTC drugs or supplements that I should avoid while breastfeeding?

The answer is usually "yes” since:

    • Nearly all medications taken by a mother pass into human milk, BUT only in very small amounts—usually less than 1 percent of the dosage taken by the mother;
    • Because only a very small amount even passes into milk, there are very few drugs that shouldn’t be taken by a nursing mother; and
    • Therefore, in most cases, nursing mothers do not need to interrupt breastfeeding to take medications—prescription or over-the-counter medications. In the rare situations when a drug should not be taken, an alternative drug, non-drug, or procedure can be tried.

Three "rules of thumb" that can help determine if it is safe to take a medication during breastfeeding follow:

If a drug is commonly prescribed for infants, it is likely safe to take while nursing, since the baby would generally receive a lower dose from breast milk than from taking the drug directly.

Drugs considered safe to take during pregnancy are, with few exceptions, safe to take while nursing.

When in doubt consult your pediatrician at Elmwood Pediatric Group. Call us at (585) 244-9720 or (585) 381-3780 for further information on breastfeeding. Also visit our page on breastfeeding information and lactation counseling in Rochester