Breastfeeding FAQ

**This post has been entered in Works for Me Wednesdays at We Are THAT Family and Frugal Fridays at Life as Mom!**

Me, nursing Daniel recently

Now it’s time for a bunch of common breastfeeding questions!  If you have one that’s not answered here, feel free to ask it below.  I’m answering questions because I have 2+ years of breastfeeding experience, including breastfeeding two newborns, breastfeeding through pregnancy, extended (after age 2) breastfeeding, and tandem nursing.  I’m also working on my certification as a Certified Lactation Educator (CLE) through CAPPA.

Q: Will breastfeeding hurt?  If so, why and how long?

A: Yes, it will hurt — a little.  Your breasts just aren’t used to their new job.  It is common for your breasts to ache a little at latch-on and after feedings (if you can leave them open to the air, they won’t hurt as much.  They tend to hurt between feedings because they’re tender from the unaccustomed suckling and moisture and they’re being rubbed by your bra/clothes).  This will last 2 – 4 weeks on average.  However, extreme pain, pain that continues throughout a feed, pain that is accompanied by fever, lumps in the breast, a hot red spot, which causes your nipples to bleed is never normal.  If you experience more than a minor, aching pain, please see a lactation consultant to make sure your baby is latching properly.

Q: What does a proper latch look like?

A: Baby’s mouth should be open WIDE, and should cover most of your areola.  His bottom lip should be against your breast (the inside of the lip) and his tongue over his bottom gums, curved around your breast.  His jaw should remain open wide the entire time he’s nursing.  You can find pictures and good step-by-step guidelines here.

Q: Can I give my baby pacifiers or occasional bottles?

A: It’s not recommended in the first 6 weeks.  Some babies will suffer from “nipple confusion.”  This is where baby forgets how to breastfeed properly because bottles and pacifiers don’t require the same type of sucking.  They are easier to suck on, too, so some babies will not want to “work” to nurse when bottles are easier.  After the first 6 weeks it is possible to introduce bottles and pacifiers if desired (for example, if you have to go back to work and someone else will need to feed the baby).  Be aware that it is possible for babies to suffer nipple confusion or refuse to breastfeed even after 6 weeks if you introduce bottles.  From my personal experience, however, my first baby had a pacifier at one day old and a bottle at two days old and went back and forth with no problems.  My second had a pacifier from around a week old (never a bottle though) and also had no problems.  But, not all babies are alike.

Q: How do I know my baby’s eating enough?

A: Pay attention to the baby’s signs.  Is the baby having 6 – 8 wet diapers per day (after the first couple days)?  Pooping most days (and sometimes at every change)?  Is the baby happy?  Calm?  Goes to sleep after feeding?  Gaining weight well?  The baby is getting enough to eat.  If the baby seems frantic, wants to nurse often, cries a lot, isn’t gaining weight, isn’t wetting or pooping enough, then the baby may not be getting enough to eat (or there could be another problem, like a food intolerance).  Either way, seek help if that is the case.  MOST babies do get enough to eat, and be aware that some babies will want to nurse ALL the time even if they are getting enough to eat.  If your baby wants to nurse very frequently but is still gaining, peeing, pooping, then the baby may want comfort or may be going through a growth spurt, but all is well.

Q: HELP! My breasts are huge and my baby can’t latch, and I’m in pain.  Is this normal?

A: Yes, unfortunately.  Although breastfeeding MORE is the solution to help stop this and even prevent this.  What’s happening is that your breasts have become engorged.  But it’s not the milk causing it (though yes, there’s a lot of milk too).  It’s that there is so much blood flow to the breasts as they adjust to making milk, so they are swollen.  If your baby can’t latch, put cold or hot compresses on them (whatever feels better to you; hot can help to get the milk out and cold can help bring down the swelling) and massage them to get some milk out.  Then feed your baby.  Make sure you feed your baby on demand.  Within a few days this will go away.  You won’t ever be quite so engorged again, even if you skip a couple feedings.  Right now your body is trying to adjust to its new job, so it might be doing it a little TOO well.

Q: My breasts are no longer engorged!  They don’t seem to have any milk in them!  Am I producing?

A: Yes.  Once your body adjusts to making milk, the swelling goes down and you don’t notice your breasts filling anymore.  This is NORMAL.  You are still producing plenty of milk.  As long as your baby seems fine (read above), don’t worry.  I never feel like I have much milk in my breasts, personally, and yet I am making enough to feed two kids.

Q: What happens if I give formula occasionally?  Will it hurt anything?

A: Well…not in the short term.  If you absolutely must give it, then do.  But be aware that even one bottle of formula will change your baby’s gut flora and delay (or even prevent) the gut from maturing properly.  If you are considering giving occasional bottles of formula sheerly for “convenience,” I would highly encourage you not to.  At least wait until your baby is 18 – 20 weeks old if you feel you need to for convenience reasons.  If you feel you need to because your milk supply is low, please be aware there are ways to boost your supply, and that supplementing will cause you to make LESS milk, requiring more supplements.  It is common for your baby to go through growth spurts where they are hungry all the time and seem like they are not getting enough.  They are naturally trying to boost your supply so you will make enough as they grow larger!  Supplementing is a bad idea because it will cause you to not produce enough.  Almost all women CAN produce enough for their babies and then some, if they allow their babies to nurse on demand (I’m currently producing enough for a mostly-breastfed 9 month old, and a 2 year old who nurses 3 – 4 times a day.  I’d estimate I produce 64 oz. or more in each 24-hour period!).  Be aware that at the first slight worry that your baby might not be getting enough, or fussiness, a lot of people (including many uninformed pediatricians) are quick to suggest supplementing.  If you’re worried, get to a lactation consultant and make sure things are okay, but don’t supplement unless you really need to!

Q: How long should I breastfeed (per session)?

A: All babies differ.  I’ve heard of babies who took 90 minutes to finish nursing.  Mine were always done in 5 – 10 minutes, even as newborns.  Some babies are very efficient, while others like to be lazy about it.  The average is probably around 20 – 30 minutes per feeding though.  Contrary to what many will tell you, you don’t need to limit the baby’s time on each breast, even in the beginning.  When the baby is finished (or needs a burp), s/he will unlatch and let you know.

Q: How long should I breastfeed (total time in months)?

A: As long as you can.  6 months exclusively is highly recommended.  The WHO says 2 years.  APA says 1 year (and both say “and as long after as mutually desired”).  I recommend at least 26 months, because that is when amylase and other enzyme production reaches maturity, the brain has gone through its largest developments, and the immune system is fairly mature.  But continue as long as you and baby are comfortable.

Q: What can I do to prepare for breastfeeding?

A: That depends.  The old advice of “toughening the nipples” is not good advice.  Please leave your breasts alone!  Rubbing and pulling on them doesn’t mimic what nursing will feel like and won’t help you be less sore.  However, it’s a good idea to learn all you can about proper breastfeeding technique, problems you might experience, solutions to those problems, etc.  Have the number of a local lactation consultant whom you can call in case you do experience problems, and don’t be afraid to use it!  Consider taking a breastfeeding class before your baby is born (you’ll learn all the information you need and resources to call upon in such a class).  Having some mother’s milk tea around (or mixing up your own) can help.  Lansinoh breastfeeding cream (or my cream :) ), a nursing pillow, and any other supplies you think you might need would also be good advance purchases.

Q: What foods and herbs will help me breastfeed?

A: There are several foods and herbs that are galactogues: that is, they increase milk supply.  Brewer’s yeast, oatmeal, fennel, fenugreek, alfalfa, nettle, and red raspberry leaf are just a few.  There is a cookie recipe you can make that contains oatmeal and brewer’s yeast.  Serve it up with some tea made with the herbs and you’re set!  Make sure that you are receiving plenty of healthy fats and lots of water, too.  If you are not eating enough or drinking enough you will not produce enough milk, or the composition of your milk can change.  I recently noticed that when I was thirsty and didn’t drink enough, my son’s pee (he’s mostly breastfed) became strong.  He wasn’t getting enough water through my milk because I wasn’t.  It DOES affect your baby and your milk.  I also noticed that when I was pregnant, if I ate extra fat (my favorite at that time was bread dipped in olive oil), I had more milk.  Fat + water = more milk!!

Q: What might affect my milk coming in?  Can it happen that it just doesn’t?

A: Some women are extremely sensitive to certain drugs used in labor, antibiotics, other drugs (like cold medicine), stress, etc.  For some women, these factors can cause your milk not to come in, or to dry up after it has come in.  This is rare, and for a lot of women these things don’t affect them.  But it CAN happen.  Probably 97% of women will have their milk come in no matter what happens (unless you take a drug specifically to prevent it) and things will go fine as long as you’re breastfeeding often.  But, it does happen sometimes that your milk just doesn’t come in.  To make sure this is the case, wait at least 7 days after birth and weigh your baby before and after feeding.  If there is no weight gain, then your milk has not come in.  Make sure you are under the care of a doctor and/or lactation consultant if you suspect this is happening to you.

Q: What happens if I CAN’T breastfeed for some reason?

A: It’s rare (much more so than people want you to think — right now over 60% of women think they “can’t” breastfeed, but it’s more like 1 – 3%.  These women think they can’t because they have received no support or bad support, which is something we definitely need to address!).  But if it happens, there are options.  There is commercial formula, of course.  There’s also homemade formulas that you can try.  Weston A. Price foundation has an excellent homemade formula recipe (with options for cow’s milk, goat’s milk, and milk-free formulas).  Most doctors will tell you not to use these, but if I were unable to breastfeed this is what I would do.  If you do choose to use commercial formulas, it is a good idea to add some coconut oil and other supplements to it (this is also on the WAP website) to help it more closely match breastmilk.

Please feel free to leave any additional questions, comments, advice, etc. below!

Comments

  1. Janae says

    I have a 3 week old preemie (born at 32 weeks) and have been feeding him my breastmilk plus Neosure via bottle (or bottle and feeding tube while still in hospital) up until we got home. I nursed every other feeding as advised by doctors and pumped and bottlefed bmilk plus Neosure which ended up being most of what he got.

    My dilema is that my frozen milk supply will run out today and I'm barely getting any milk when I pump (20 ml total at most!). Yesterday and today I am taking Mother's Milk tea, eating oatmeal, drinking more water, and for the most part, just staying in bed with my son sleeping and nursing. Also, I stopped pumping, so that I will be more apt to have some milk for him when he wants to eat. I don't know what to do to get my milk supply back up and I don't know what to do in the meantime so he doesn't starve. He's a preemie and though is a strong kid and doing better (maturing faster) than any doctor expected, I don't want him to lose weight and get sick, etc.

    Normally I would wake him up to eat every 3 hours but I've just been letting him sleep until he wakes up to eat. He nurses well and I believe he gets more than my pump does, but he doesn't seem completely satisfied when he's done. He'll fall asleep and then wake up later and want to eat but doesn't always latch on. So that's why I'm worried he's not getting enough.

    Any suggestions? I will probably have to resort to the Neosure formula today and I really don't want to! It's bad enough that I've been supplementing my bmilk with it to add calories. But I can't starve the poor kid!

  2. ModernAMama says

    Janae,

    If he is nursing well, and is nursing on demand (which, since you're mostly just in bed with him, sounds like he is), he probably IS getting enough. If he seems happy and not fussy, and is having plenty of wet/dirty diapers, he is doing okay. You have to be careful with preemies, but if he really is nursing well he is probably fine. He may want to nurse when he's NOT hungry just for comfort, which is fine (it'll stimulate your milk supply, and make him feel better), but it doesn't mean your supply is low. If you are truly concerned, you could see a lactation consultant in your area to see what she has to say. There is a device called a "Lact-aid" that is basically a tiny tube that is taped to your breast. Your baby gets a small amount of other milk (pumped milk or formula) through this tube while nursing. That's probably the best way to ensure that he's getting enough yet is associating nursing with getting fed and not a bottle. As he gets older and stronger it won't be such a concern. Keep going! I know it's hard, but you can do it and it will be so worth it!



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