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Breastfeeding: Questions and Answers
Why Should I Breastfeed? Here are just some of the many good reasons why you should breastfeed your baby:
Babies should be fed with breast milk only — no formula — for the first six months of life. The longer a mom and baby breastfeeds, the greater the benefits are for both mom and baby. Ideally, babies should receive breast milk through the first year of life, or for as long as both you and your baby wish. Solid foods can be added to your baby’s diet, while you continue to breastfeed, when your baby is 6-months-old. For at least the first six months, breastfed babies don't need supplements of water, juice or other fluids. These can interfere with your milk supply if they are introduced during this time. One of the best things that only you can do is to breastfeed your baby for as long as possible. How Do I Know That My Baby Is Getting Enough Milk From Breastfeeding? In the first few days, when you're in the hospital your baby should stay with you in your room if there are no complications with the delivery or with your baby's health. The baby will be sleepy. Don't expect the baby to wake you up when he or she is hungry. You will have to wake the baby every one to two hours to feed him or her. At first you will be feeding your baby colostrum, a thick, yellowish fluid secreted from the breast during pregnancy and the first few days after childbirth. Even though it looks like only a small amount, this is the only food your baby needs. In the beginning, you can expect your baby to lose some weight. This is very normal and is not from breastfeeding. As long as the baby doesn't lose more than 7 percent to 10 percent of his or her birth weight during the first three to five days, your baby is getting enough to eat. You can tell your baby is getting enough milk by keeping track of the number of wet and dirty diapers. In the first few days, when your milk is low in volume and high in nutrients, your baby will have only one or two wet diapers a day. After your milk supply has increased, your baby should have five to six wet diapers and three to four dirty diapers every day. Consult your baby’s doctor if you are concerned about your baby’s weight gain. You should visit the doctor three to five days after your baby's birth, and then again at 2 to 3 weeks of age. This chart shows the minimum number of diapers for most babies. It is fine if your baby has more.
After you and your baby go home from the hospital, your baby still needs to eat about every one to two hours and should need several diaper changes. You still may need to wake your baby to feed him or her because babies are usually sleepy for the first month. In the early weeks after birth, you should wake your baby to feed if four hours have passed since the beginning of the feeding. If you are having a hard time waking your baby, you can try undressing or wiping his or her face with a cool washcloth. If your baby falls asleep while breastfeeding, you can try breast compression. As your milk comes in after the baby is born, there will be more and more diaper changes. The baby’s stools will become runny, yellowish and may have little white bumpy “seeds.” Overall, you can feel confident that your baby is getting enough to eat because your breasts will regulate the amount of milk your baby needs. If your baby needs to eat more or more often, your breasts will increase the amount of milk they produce. To keep up your milk supply when you give bottles of expressed breast milk for feedings, pump your milk when your baby gets a bottle of breast milk. Is There Any Time When I Should Not Breastfeed? A few viruses can pass through breast milk. HIV, the virus that causes AIDS, is one of them. If you are HIV positive, you should not breastfeed. If you have HIV and want to breastfeed, you can get breast milk for your baby from a milk bank. Sometimes babies can be born with a condition called galactosemia, in which they can't tolerate breast milk. This is because their bodies can't break down the sugar galactose. Babies with classic galactosemia may have liver problems, malnutrition or mental retardation. Since both human and animal milk contain the sugar lactose that splits into galactose and glucose, babies with classic galactosemia must be fed a special diet that is free of lactose and galactose. Mothers who have active, untreated TB (tuberculosis) or who are receiving any type of chemotherapy drugs should not breastfeed. If you are breastfeeding, you should not take illegal drugs. Some drugs, such as cocaine and PCP, can affect your baby and cause serious side effects. Other drugs, such as heroin and marijuana can cause irritability, poor sleeping patterns, tremors and vomiting. Babies can become addicted to these drugs. If you smoke tobacco, it is best for you and your baby if you try to quit as soon as possible. If you can't quit, it is still better to breastfeed. You also should avoid drinking alcohol. An occasional drink is okay, but avoid breastfeeding for two hours after the drink. Sometimes a baby may have a reaction to something you eat, but this doesn't mean your baby is allergic to your milk. Usually, if you have eaten a food throughout pregnancy, your baby has already become used to the flavor of this food. If you stop eating whatever is bothering your baby, the problem usually goes away on its own. Some women think that when they are sick, they should not breastfeed. But, most common illnesses, such as colds, flu or diarrhea, can't be passed through breast milk. In fact, if you are sick, your breast milk will have antibodies in it. These antibodies will help protect your baby from getting the same sickness. Is It Safe to Take Medications While Breastfeeding? Always talk with your doctor before taking any medications. Most medications pass into your milk in small amounts. If you take medication for a chronic condition such as high blood pressure, diabetes or asthma, your medication may already have been studied in breastfeeding women, so you should be able to find information to help you make an informed decision with the help of your doctor. Newer medications and medications for rare disorders may have less information available. The American Academy of Pediatrics has information about many prescription and over-the-counter medications posted on their web site at: www.aap.org. Can I Breastfeed If My Breasts Are Small? Of course! Breast size is not related to the ability to produce milk for a baby. Breast size is determined by the amount of fatty tissue in the breast, not by the amount of milk. Most women, with all sizes of breasts, can make enough milk for their babies. Will Breastfeeding Keep Me From Getting Pregnant? When you breastfeed, your ovaries can stop releasing eggs, making it harder for you to get pregnant. Your periods also can stop. But, there are no guarantees that you will not get pregnant while you are nursing. The only way to make sure pregnancy does not occur is to use a method of birth control. If you want to use a birth control pill while breastfeeding, the safest type is the "mini-pill." However, talk with your doctor or nurse about what birth control method is best for you to use while breastfeeding. Will Breastfeeding Tie Me to My Home? Not at all! Breastfeeding can be convenient no matter where you are because you don't have to bring along feeding equipment like bottles, water or formula. Your baby is all you need. Even if you want to breastfeed in private, you usually can find a woman's lounge or fitting room. If you want to go out without your baby, you can pump your milk beforehand, and leave it for someone else to give your baby while you are gone. How Much Do Breastfeeding Pumps Cost and What Kind Will I Need? Breast pumps range in price from under $50 (manual pumps) to more than $200 (electrical pumps that include a carrying case and an insulated section for storing milk containers). If you're only going to be away from your baby a few hours a week, then you can purchase a manual pump or one of the less expensive ones. If you're going back to work, it is worth investing in a good quality electric pump. Some pumps can be purchased at baby supply stores or general department stores, but most high quality automatic pumps have to be purchased or rented from a lactation consultant, at a local hospital or from a breastfeeding organization. What Are Some of the Reasons Why a Woman Chooses to Pump All of Her Breast Milk for Her Baby? Some mothers choose to replace breastfeeding with pumping all of their milk to feed to their babies in a bottle. In these cases, the babies are still getting all the health benefits of human milk. Some mothers may choose this way of feeding because they are uncomfortable with the act of breastfeeding. Others might have found that their babies had problems latching on due to a physical problem like a cleft palate, or that the babies preferred bottles after a long temporary weaning. For mothers who have sore nipples at the beginning of breastfeeding, some feel that pumping does not hurt or that pumping and bottle feeding better meets the needs of their lifestyles. How Can I Breastfeed Discreetly in Public? You can breastfeed discreetly in public by wearing clothes that allow easy access to your breasts, such as button down shirts. By draping a receiving blanket over your baby and your breast, most people won't even realize that you are breastfeeding. It's helpful to nurse the baby before he/she becomes fussy so you can get into a comfortable position to nurse. You also can purchase a nursing cover or baby sling for added discretion. Many stores have women's lounges or dressing rooms, if you want to slip into one of those to breastfeed. If I Decide to Breastfeed, Is There a Right Way To Do So? There are several tips for making breastfeeding a good experience for both you and your baby. However, you can prevent the most common challenges or problems by following the three most important tips about breastfeeding:
Breastfeeding does not hurt. There may be some tenderness at first, but it should gradually go away as the days go by. Your breasts and nipples are designed to deliver milk to your baby. When your baby is breastfeeding effectively, it should be calming and comfortable for both of you. If breastfeeding becomes painful for you, seek help from someone who is knowledgeable about breastfeeding. To minimize soreness, your baby's mouth should be wide open, with as much of the areola (the darker area around the nipple) as far back into his or her mouth as possible. The baby should never nurse on the nipple only. If it hurts, take the baby off of your breast and try again. The baby may not be latched on right. Break your baby's suction to your breast by gently placing your finger in the corner of his/her mouth, and re-position your baby. Can I Give My Baby a Pacifier If I Breastfeed? Most breastfeeding counselors recommend avoiding bottle nipples or pacifiers for about the first month because they may interfere with your baby's ability to learn to breastfeed. After you and your baby have learned to breastfeed well, you can make your own decision about whether or not to offer a pacifier. I’ve Heard That Breastfed Babies May Not Get Enough Vitamin D. What Does This Mean for My Breastfed Baby? Vitamin D helps your baby build strong bones. Sunlight can be a major source of vitamin D, but it is hard to measure how much sunlight your baby gets. Things like where you live, the amount of pigment in your baby's skin, how much time your baby is in the sun, and the use of sunscreens all affect how much vitamin D your baby's body can make from sunlight. The AAP suggests that all children receive 400 IU a day of vitamin D, beginning in the first few days of life. The Academy recommends that breastfed and partially breastfed infants be supplemented with 400 IU a day of vitamin D. You can buy vitamin D supplements for infants at a drug store or grocery store. Talk with your baby’s doctor to make sure your baby gets the right amount of vitamin D. Last Update: October 2008 Source: Office on Women's Health, Department of Health and Human Services Related Articles
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