Here are some breastfeeding basics that you may find helpful. Talk to your
baby's doctor, nurse or your lactation specialist if you have other
No special foods or diets are needed for breastfeeding. Some helpful tips:
• Choose a variety of healthy foods for your meals and snacks each
day. Eating healthy will help you and your baby feel well.
• Eat 4 to 5 servings of dairy products each day. A calcium supplement
can help you get enough calcium.
• Drink water or fruit juices when you are thirsty.
• Take your prenatal vitamins as directed by your doctor.
• Limit caffeine and artificial sweeteners in your diet. Caffeine
is in chocolate, coffee, and tea. Artificial sweeteners are in diet soft
drinks and in some low calorie or diet foods.
• Avoid drinking alcohol. Alcohol takes about 2 to 3 hours per serving
to leave breast milk.
• It takes about 4 to 6 hours for the foods you eat to show up in
your breast milk. If you have a family history of an allergy or your baby
seems fussy after you eat a certain food, avoid that food and see if your
baby feels better. Some babies have a hard time when a mother ·
eats dairy products or vegetables such as broccoli, beans, onions or peppers.
If the problem persists, talk to your doctor.
• Avoid weight loss diets. To lose weight, walk more and limit high-calorie foods.
Colostrum, the first milk your body makes, is very good for your baby.
Over the next few days, your breasts will feel fuller, and you will have
more milk. Your milk supply will depend on how much milk and how often
your baby takes from the breast. The more milk your baby takes, the more
milk your breasts will make.
The nurses will help you and your baby learn how to breastfeed. Relax and
give yourself time to learn.
Your baby may be very sleepy the first few days. Your baby's stomach
is small so your baby will need to feed often. You may feel increased
thirst while nursing, drowsiness during breastfeeding and mild uterine
contractions while breastfeeding the first few days.
Avoid feeding your baby from a bottle, either breastmilk or formula, for
the first 3 to 4 weeks or until your baby learns to feed well. Sucking
from a bottle is a different mouth action. Bottle sucking may interfere
with the baby's nursing at the breast.
After the first 3 to 4 weeks, you can try to feed your baby breast milk
through a bottle if you would like. If your baby is not able to breastfeed,
you can pump your breast milk, feed your baby the breast milk through
the bottle or freeze the breast milk in a closed container for later use.
Your baby will give you signs of hunger called feeding cues. Your baby's
feeding cues may include:
• Clenched fists
• Hands to mouth
• Licking of lips
• Moving of arms and legs
• Turning the head towards your body
Try to begin feeding your baby before he or she becomes too upset.
How is my baby doing with breastfeeding?
Watch for signs that your baby is latched on to your nipple well and getting
milk. Signs may include:
• A fast, shallow motion in the cheeks as your baby first latches
on that changes to a deep, slow, rhythmic motion.
• Motion near your baby's ear and temple as your baby's lower
jaw moves up and down.
• Seeing, hearing, or feeling your baby swallowing.
• Feeling a tingling sensation in the breast.
Is my baby getting enough milk?
If your baby is getting enough milk, your breasts will be full with milk,
soft after feedings and refill between feedings. Your baby will:
• Have 6 or more wet diapers in a 24 hour period
• Sleep between feedings
• Have more than 2 bowel movements each day
• Gain weight
A healthy, full-term baby who is nursing well does not need extra water·
or formula. Do not feed your baby extra water or formula unless ordered
to do so by your baby's doctor. Talk to your baby's doctor, nurse
or your lactation specialist if you do not think that your baby is getting
How often will my baby feed?
Feedings are timed from the start of one feeding to the start of the next.
At first, try to feed your baby every 2 to 3 hours during the day and
evening, and at least every 4 hours during the night. If your baby gives
feeding cues, feed your baby. Your baby may want several feedings very
close together. By the end of the first week, your baby will be nursing
8 to 12 times in 24 hours. As your baby and your milk supply grow, your
baby may begin feeding less often.
Even after babies are able to sleep for longer periods, their sleep is
sometimes disturbed by dreams, hunger or a busy day. Expect that your
baby will wake at night and may need to be fed.
Babies have growth spurts in their first 6 months and will nurse more often
during them. By feeding more often, your body will make more milk to get
through the growth spurts. These spurts often last 3 to 5 days.
How long will my baby feed?
Feed your baby until he shows signs that he is full such as slowing down
sucking and then detaching himself from the breast, and relaxing his hands,
arms and legs. If you stop before your baby is done, your baby may not
get the high-fat milk. This is the milk that is best for growth.
Allow your baby to completely finish feeding on the first breast. This
may take 10 to 25 minutes. Then offer the second breast. Your baby
may feed for a while on that breast, or not want the second breast at all.
Alternate the breast you begin with at each feeding. Some mothers track
which breast to begin with by pinning a safety pin to their bra strap.
Waking the Sleeping Baby
If your baby is in a deep sleep, do not wake your baby for a feeding. If
your baby is asleep but has some body motions such as eye motion under
the lid, active mouth and tongue motion, or sucking in sleep, this is
the best time to wake your baby for a feeding.
At night, dim the lights and keep the room quiet. Avoid startling movements.
Wake the baby gently by moving your baby or you can change your baby's
diaper. If after 15 minutes your baby shows poor interest in breastfeeding,
try an hour later.
Talk to a doctor; nurse or lactation specialist if you have any questions
Pumping and Storing Breast Milk
You may need to express or pump breast milk to relieve engorgement, to
increase your milk supply or to feed your baby breast milk with a bottle.
Why and When to Pump
• To soften your breasts if your baby is having trouble latching on.
• Pump for a few minutes and try your baby at your breast again.
• To have a milk supply when your baby is unable to breastfeed or
to store breast milk.
• Pump every 2 to 4 hours through the day and one time at night.
• To increase your milk supply.
• Pump every 2 to 3 hours if you are not breastfeeding, or
• Pump between feedings as often as you can.
• Pump on the second breast if your baby only nurses on one side.
• To prepare to return to work or school.
• Pump one time each day, between feedings to store extra milk.
• Morning is a good time to pump.
• Pump extra milk and store it at least 2 weeks before your return date.
• Pump at least every 4 hours when away.
Ways to Express Breast Milk
• By hand
• Massage breast toward nipple to express milk
• With a pump:
• There are manual and electric breast pumps.
• Pump for about minutes on each breast any time you pump.
• Wash your hands with soap and water.
• Have a clean container ready for collecting the milk.
• Find a relaxing position in a quiet spot and think about your baby.
• Massage your breast and take slow easy breaths.
• For privacy while pumping, cover your breasts and pump container
with a blanket or towel.
Collecting and Storing Breast Milk
• Use sterile glass bottles, plastic bottles or milk storage bags
made for breast milk.
Do not use disposable bottle liners because they are too thin.
• Store breast milk in 2 to 5 ounce portions to avoid wasting breast milk.
• Breast milk from different pumpings can be added together if the
milk is pumped during the same 24-hour day.
• Breast milk should be chilled as soon as possible after it is pumped.
• It is normal for pumped milk to vary in color and thickness.
• Stored milk separates into layers. Cream will rise to the top as
the milk warms. Mix the milk layers before feeding.
• If you are not going to use the breast milk within 48 hours after
pumping, :freeze the milk.
• Always use :freshly pumped milk first. Then use refrigerated or
frozen milk by the oldest date first.
• If breast milk has a sour or strange smell, throw it away. If there
is any doubt,
do not use the milk.
Handling Fresh Breast Milk
• If you washed your hands well before pumping, :fresh milk may remain
at room temperature (no warmer than 77°F or 25°C) for use in
4 to 8 hours. If you are not going to use it, store it in the refrigerator
as soon as possible.
• Refrigerate milk right away if the room, car or outside air temperature
is above 77°F or 25°C. When you are away from home, use a lunch
box size cooler with an ice pack to keep milk cool.
Breast Milk Storage
These guidelines are for a full-term, healthy baby. You may be given different
guidelines to follow.
• Store at room temperature (no warmer than 77°F or 25°C)
for 4 to 8 hours. If the temperature is higher, cool the milk right away.
• The milk can be stored in the refrigerator (32 to 39°F or 0
to 3.9°C) for 5 to 7 days.
• Frozen milk can be stored for 3 months in the refrigerator freezer
and 6 months in a deep freezer (0°F or -l7.8°C).
• Once thawed, frozen milk can be stored in the refrigerator for 24 hours.
Thawing Frozen Breast Milk
• Thaw frozen milk in a cup of warm water. This takes 5 to 10 minutes.
• You can also thaw frozen milk 8 to 12 hours or overnight in the
• Thawed milk can remain refrigerated but should be used within 24 hours.
Do not thaw breast milk by sitting it on the counter at room temperature.
Do not warm breast milk in a microwave oven. It can change the breast milk and
reduce the quality of the milk. Microwave ovens heat the milk unevenly
to cause a chance of burning your baby's mouth.
Do not refreeze thawed milk.
Warming Breast Milk
• Remove the milk from the refrigerator just before using.
• Warm the milk by holding the container under
warm running tap water or sit it in a bowl of warm water for 5 to 10 minutes.
• Rotate the bottle gently and test the warmth of the milk by placing
a drop on the inside of your wrist before feeding your baby.
•Milk left over in the container after a feeding may be offered at
the next feeding before discarding. Do not reheat milk that has been heated.
Breast milk can safely stand at room temperature for 4 to 8 hours.
Do not warm breast milk by sitting it on the counter at room temperature.
•Do not warm breast milk in a microwave oven. It can change the breast milk and
reduce the quality of the milk. Microwave ovens heat the milk unevenly
to cause a chance of burning your baby's mouth.
Breastfeeding problems are common, but they last a short time. These tips
may help. If you find that the problems persist, call your doctor, nurse
or lactation specialist.
Engorgement is when the breasts become full, firm, tender and sometimes
painful as your breast starts to produce milk. This often occurs 3 to
5 days after delivery.
Signs of engorgement often last 24 to 48 hours. Signs include:
• Larger, heavier and tender breasts
• Breasts that are hard, painful and warm to the touch
• Swelling of the breasts
• Firm nipples and areola
Ways to Prevent Engorgement
• Feed your baby at least 8 to 12 times each day.
• Wear a support bra 24 hours a day while your breasts are heavy.
Use a sport or comfort style bra without underwires. Some mothers find
more comfort without a bra.
If your breasts become engorged:
• Place a clean, hot, damp cloth over each breast for 3 to 5 minutes
before nursing or get into a warm shower and let very warm water flow
over your shoulders. Heating the breasts will help your milk flow easily
to your baby. After heating the breasts, massage them in a circular motion
towards the areola and the nipple. Massaging will move the milk down.
Massage under the arms and the collarbone area if this area is firm and
• Soften the breast using hand expression or a breast pump. Express
enough breast milk to soften the areola so that baby can easily attach.
• Breastfeed right away. Gently massage your breasts whlle nursing.
• If the breasts are still painful, full and swollen after a breastfeeding,
or refill within a half hour after feeding, you may pump to soften the breasts.
• Apply cold packs to the breasts for 20 minutes after nursing.
Nipple soreness often occurs when the baby is not attached well to the
breast or positioned correctly. Make sure yom baby's jaws are deeply
over your areola and about 1/2 inch behind the base of your nipple. Your
nipple should be rounded and erect after the baby detaches.
Ways to Prevent Nipple Soreness
• If you feel pinching, rubbing or biting pain during the feeding,
check the baby's position and attachment.
• Air-dry your nipples by leaving your bra flaps down for a couple
of minutes after a feeding.
• Express a small amount of colostrum or milk and spread it around
the nipple and areola after air-drying.
• Avoid the use of soap, alcohol and extra water on the breast. Clean
your breasts by allowing water to flow over them when showering.
You Have Nipple Soreness:
• Feed your baby more often for shorter periods of time.
• Do not allow your baby to become too hungry.
• Do not use an mii:ficialnipple shield over the breast for feeding.
They can cause damage to your nipple and interfere with milk flow.
• Use a purified lanolin product or gel pad to heal cracked or open areas.
• Begin feeding on the least sore nipple. Be sure to break suction
carefully by sliding your finger inside your baby's mouth.
• If it remains painful when your baby first latches on, remove your
baby and try again.
• A fast, deep latch will put your baby's jaws behind the nipple
and tender areas.
A plugged duct is a tender or painful lump in the breast. If left untreated,
it may lead to an infection. Plugs often occur from changes in the baby's
feeding pattern or pressure on the breast. Check your breast for pressure
points that occur from a bra that is too tight or fi·om bunched
clothing on the breast.
You Have a Plugged Duct:
• Apply moist heat to the breast 15 to 20 minutes before each feeding.
• Massage the breast from the area behind the discomfort toward the nipple.
• Change positions lining-up the baby's chin and jaw toward the plug.
• Let the baby nurse first on the affected breast. The stronger suck
will help relieve the plug.
A breast infection occurs from a blocked duct or from bacteria that has
entered the breast, often through a cracked nipple. Even though the breast
tissue is inflamed, the baby will not become ill from feeding on the infected breast.
Signs of breast infection may include:
• A headache, aching joints, fever or chills
• A hard, red and painful breast
• A fussy or unwilling to nurse baby when using the infected breast
Call your doctor right away if you think you may have a breast infection.
• Your doctor may order medicine to treat the infection. Take the
medicine for the full time ordered. Do not stop taking your medicine,
even if you feel better, without first talking to your doctor.
• Continue to breastfeed your baby often to drain the infected breast.
If your breast is too painful to breastfeed, you may need to use a breast
pump until you are able to breastfeed your baby again.
• Rest often and drink a lot of fluids.
Talk to your doctor or nurse if you have any questions or concerns.