Breastfeeding Q & A

Lactation Counseling Information

How soon after childbirth should I begin to breastfeed?

Infants are born with the instinct to nurse and will naturally turn towards a mother’s nipple and open their mouth to begin sucking. The first two weeks of nursing may be more difficult than bottle feeding because of the time it takes for the baby and mother to become accustomed to the breastfeeding process.

How do I breastfeed my child?

When you are ready to begin nursing, you should find a comfortable position that permits you to cup your breast in one hand and stroke your baby’s lower lip with your nipple. Your baby will then open his or her mouth and you should quickly center your nipple in your baby’s mouth, making sure that the tongue is down while pulling your baby close to you. 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 10 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 and make sucking motions or put their hands to their mouths.  Crying is a late sign of hunger.   A newborn nurses frequently during the first week of life, up to 8 –12 times in 24 hours.

How will I know if breastfeeding is nourishing my baby properly and whether supplemental nutrition is needed?

Vitamin D supplements are recommended for exclusively breastfeeding infants.  Other vitamin and mineral supplements are not required for an average healthy, full-term breastfed baby during the first year. Breast milk should provide all the nutrition that your baby needs for at least the first six months of life.  Your doctor will talk to you at your baby’s well visits about introducing solids when developmentally appropriate.  Water and juice are NOT recommended for infants under six months of age, but may be used in special circumstances if your physician advises.

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

If 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, develops a rash, has diarrhea or congestion after nursing, please 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 different amounts of milk at each feeding. Mothers should store their milk in small quantities at first (1-2 ounces). This allows you to tailor each feeding to a baby’s need.  Storing the milk in small units makes it is easier to thaw and limits waste.

As your baby becomes more accustomed to taking stored breast milk, he or she may start to take a consistent amount at each feeding.   Once this occurs, you may find it easier to store milk in that amount. You should also store smaller amounts for when your baby wants a little more as he or she grows.

For mothers exclusively providing pumped breast milk to their child, consider providing at least some of the feedings at the breast to take advantage of the health benefits that may only be 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?

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.  Due to this, there are very few drugs that should not be taken by a nursing mother.

In most cases, nursing mothers do not need to interrupt breastfeeding to take medications—prescription or over-the-counter medications. In situations where a drug is not safe to take while nursing, there may be alternative medications or treatments available.

We recommend that you speak with your baby’s physician or a pharmacist prior to starting any new medications.

A few “rules of thumb” that can help determine if it is safe to take a medication during breastfeeding are:

  1. If a medication is commonly prescribed for infants, it is likely safe to take while nursing.  The amount of the medication which the baby would receive from the breastmilk will be lower than if he or she is taking the medication directly.
  2. Medications 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 for further information on breastfeeding or visit our page on breastfeeding information and lactation counseling.

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