Breastfeeding your baby

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The basics

Although breastfeeding is natural, it might not always feel that way. Nursing your baby takes practice and support.

Getting started

It may take some time for you and your baby to get into the rhythm, so be patient and don't get discouraged. There are so many benefits of breastfeeding that it's worth trying until you get it right.

Doctors, nurses, and lactation specialists can help you along the way. So can friends, family, and breastfeeding support groups.

Woman breastfeedingWe recommend giving your baby just breast milk for the first 6 months of his or her life. After 6 months, you may introduce solid foods, but we suggest you continue to breastfeed until your baby is at least 1 year old.

Unless your baby is born needing immediate medical care, try breastfeeding within 1 hour of birth. Immediate and ongoing skin-to-skin contact with your baby after delivery helps with long-term success. Avoid giving your baby supplements (water or formula) unless recommended by your doctor or nurse.

At your first newborn care visit, your doctor, nurse, or lactation consultant will check for signs of successful breastfeeding.

Your partner can help with changing diapers, burping and holding the baby after you nurse.

Breastfeeding supplies

If you know that you're going to breastfeed before your baby arrives, use the time during your pregnancy to gather the supplies you'll need to make it easier.

Since you will nurse your baby several times during the day and at night, you'll want to be comfortable. Use this breastfeeding checklist to get started:

• A chair for nursing. Some mothers prefer a rocker or glider that's comfortable and supports your arms and back.
• A pillow to support your baby comfortably (and give your arms a rest) while you feed.
• Nursing tops or loose clothing.
• Nursing bras that allow for easy access to the breast.
• Nursing pads for your bra to prevent breast milk from leaking onto your clothes. (Avoid pads with plastic liners that can irritate nipples.)
• A breast pump. In addition to frequent nursing, pumping your breasts can help relieve engorgement when your milk comes in, and lets you store extra milk for future use. Breast pumps can be bought or rented. Many plans now cover breast pumps for free so check with Member Services to see if your plan does.

Learning the positions

When breastfeeding, both you and your baby should be comfortable and relaxed. Support your body with pillows behind your back and on your sides and lap, or use a nursing pillow. Experiment with these breastfeeding positions:

  • cradle hold
  • cross-cradle hold
  • football hold
  • side-lying hold
  • laid-back or baby-led

Try alternating these positions for variety. Using different holds can help keep you from developing plugged milk ducts.

Watch our breastfeeding video.

Keeping up your milk supply

Breastfeeding works on a supply-and-demand basis: The more your baby nurses, the more milk you will produce. Since breast milk is quickly digested, your baby will need to be fed often. We recommend that you feed your baby whenever he is hungry.

Here are some suggestions for building and maintaining a good milk supply:

  • Begin nursing in the first hour of your baby's life.
  • Nurse your baby on demand — at least every 90 minutes to 3 hours or 8 to 12 times in a 24-hour period — until your baby has regained his or her original birth weight (usually by the second week after birth).
  • Allow your baby to nurse for as long as he or she wants. If your baby is still hungry after finishing the first breast, offer the second breast.
  • If your baby is very sleepy in the first few weeks, and not nursing regularly on demand, make sure that you wake him to eat. It's okay to let the baby sleep one 4-hour stretch during a 24-hour period, but more frequent feedings will help your body make more milk.

Knowing when your baby wants to eat

If you see your baby moving his lips and tongue, opening his mouth, turning his head from side to side, or getting generally fussy, there's a good chance he's ready to eat. You may also notice that your breasts feel fuller or they are leaking as you get closer to feeding time.

Newborns have very small stomachs and can only hold about 3 teaspoons of liquid. He or she is getting enough to eat if your baby:

  • has 4 to 6 wet diapers a day until day 5, then 6 to 8 wet diapers a day after that (highly absorbent disposable diapers can make it hard to tell if your baby has urinated)
  • has 3 to 4 milk stools (loose and yellow) every 24 hours by day 3, not meconium (sticky, dark green stools)
  • latches on to your breast well
  • has round, not puckered cheeks while nursing and you hear swallowing sounds after every 2 to 3 sucking movements
  • has brief active periods
  • seems relaxed and soothed after being fed and burped

Food and medications

Breastfeeding requires extra calories, so you'll need to eat well and drink plenty of fluids to make milk for your baby. It's best to eat and drink until you feel satisfied. Nutritional needs for teen mothers or mothers of twins or more are even greater.

Drink a glass of water when you sit down to nurse.

"It's a good habit to drink a glass of water when you sit down to nurse," says Lisa Marquardt, Kaiser Permanente physician assistant.

Generally, there aren't any foods you can't have while nursing. Limit alcohol and avoid tobacco because they can pass through your breast milk and harm your baby.

It takes 2 to 3 hours for 1 drink to clear out of breast milk. The more you drink, the longer it takes until your breast milk is free of alcohol.

Drink less caffeine (coffee, tea, and soda) while breastfeeding. A morning cup of coffee is not likely to harm your baby, but too much caffeine may make your baby fussy or sleepless.

Some over-the-counter medications are safe to take while breastfeeding, including ibuprofen (Advil, Motrin) and acetaminophen (Tylenol). But others, such as aspirin, can be harmful to your baby. Talk to your practitioner before taking any over-the-counter medication, prescription drug, or herbal product. Learn more about using medications when breastfeeding.

Preventing engorgement

Your breasts start making milk 12 to 48 hours after your baby is born. When your milk comes in, your breasts will most likely feel warm and heavy. Some women feel only slight swelling, while others feel uncomfortably swollen (engorgement). You can help ease breast engorgement by:

  • nursing regularly
  • taking a warm shower or applying moist heat to the breast before nursing
  • expressing milk by hand or with a pump before nursing to help your baby latch on
  • applying a cool compress to the breast after nursing

If you continue to feel engorged, talk with your practitioner or a lactation consultant. Prolonged engorgement can lead to more serious problems such as blocked milk ducts or mastitis.

Easing discomforts

You may have some initial latch-on soreness in the early weeks, but breastfeeding shouldn't hurt. If it does, chances are the baby is not positioned correctly or isn't latching on. Talk to a lactation nurse in the hospital before you leave for help with correct breastfeeding positions. You may also be able to get help from a lactation consultant after you get home.

If you experience a pinching sensation when the baby latches on, or at any time while the baby is feeding, try these tips:

  • Tickle baby's lower lip with your nipple and wait for your baby's mouth to make a wide "O" before putting offering the breast.
  • Hold your baby so that the head is at the level of your breast. Turn the baby's face, chest, and knees toward you so that you are tummy-to-tummy.
  • Place the nipple in your baby's mouth, with a good portion of your areola (the darker area around the nipple) also in the mouth.
  • Make sure the baby's chin is touching your areola or breast.
  • Make sure the baby's tongue is down and below the nipple. Some babies lift their tongues and the nipple goes underneath. If the baby's mouth is open wide, the tongue should stay down.
  • Adjust the baby's lower lip so that the inner surface is against the breast. (Some babies tuck in their lower lips.)
  • Use a nipple cream that contains lanolin (such as PureLan or Lansinoh) to prevent cracked or sore nipples.

Introducing a bottle

Getting food from a breast is different than taking it from a bottle. In fact, different sets of facial muscles are used for each way of eating.

After your baby is at least 3 weeks old and doing well with breastfeeding, it's okay to introduce breast milk in a bottle. Waiting a few weeks before offering a bottle helps you build up your breast milk supply. It also gives your baby time to learn to breastfeed.

If you plan to follow our recommendation of exclusively breastfeeding your baby for the first 6 months of life, it's important to remember that any breastfeeding session that you skip will decrease your milk supply. Expressing your milk, and giving it to your baby in a bottle if you need to skip a feeding, will help keep your milk supply up. Learn more about breastfeeding while working outside the home, using a breast pump, storing breast milk, and bottle feeding with formula.

Sources: Adapted from copyrighted material of The Permanente Medical Group, Inc. and the American Academy of PediatricsKaiser Permanente is not responsible for the content or policies of external Internet sites, or mobile apps.

Reviewed by: Jeff Convissar, MD, November 2015
Additional Kaiser Permanente reviewers

© 2015 Kaiser Permanente

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