Every first-time mom has more than a few questions about breastfeeding. Here are some of the top 15 most frequently asked questions about breastfeeding. I had each answer reviewed by an IBCLC lactation consultant for accuracy.
When Should My Milk Come In?
If this is your first child you will have colostrum until your milk comes in for the first 3-4 days (sometimes longer, which is fine). Colostrum is a nutrient-rich substance that is protective and perfectly satisfying for the newborn. This is all the baby needs as its stomach is between the size of a cherry and walnut until your milk comes in. Your breasts will start to feel firmer and fuller as your milk comes in. For subsequent children, the milk comes in sooner and sooner.
Is Breastfeeding Difficult?
Breastfeeding is easy for some and a challenge for others. It may be natural, but like walking or anything else natural, we still have to learn and work hard at it. Determine what about it is difficult for you if it hurts you might improve the latch, or ask a pediatrician if a tongue tie is the issue. If the difficulty is feeling overly emotional consider speaking with a doctor or midwife to help with your hormones. If the difficulty is the time put in and the lack of sleep, that is standard for nearly every newborn. Breastfeeding tends to be easier than formula feeding in that regard. You have milk on tap, any time of the day or night that you don’t have to measure out or warm that saves you considerable time and energy. Most women, even if things are going quite normally need some extra support at least for their first child. Consider calling a lactation consultant or joining a La Leche League group.
How Do I Know If My Baby Is Getting Enough To Eat?
You can determine this a few ways. Watch them as they drink, a baby that is receiving milk as it sucks has a certain pattern of drinking. It will open its mouth, pause, then close to swallow. The longer the pause the more milk more milk it has received. Watch the throat for swallowing motions.
You can also determine by the bowel movements. The first few days after the birth the baby should be passing meconium, which is a dark green almost black newborn poop. If the baby is still passing meconium on the 4th or 5th day this is a problem and they should be seen immediately. The poop should have lightened up by then to be usually a mustard color, watery, sometimes seedy and normal variations are green, orange, and/or containing mucus or curds. After 3-4 days of life, the baby should be producing 2-3 poopy diapers a day. After 4-6 weeks infrequent poops are common and some breastfed babies go 20 or more days without a bowel movement and are quite normal and healthy. As long as they continue to put on weight and have wet diapers this is not concerning.
So how much should the baby be peeing? The baby should be SOAKING at least 6 diapers every 24 hours, 4-5 days after birth. Weight should be checked by a care provider to ensure that it is accurate and increasing at a normal rate. Don’t be afraid to get a second opinion if you’re not sure of the first answer you get.
Should I Be Supplementing?
The short answer is probably not. Most women can successfully exclusively breastfeed their babies for the first 6 months of life if given the chance and the support. Before you consider supplementing with formula, there are other options. First, consider taking the steps to increase your milk supply, the second option is to request human milk from a local milk bank. If neither of those work with your situation, talk with a lactation consultant or care provider about supplementing properly for your situation.
What’s The Difference Between Formula And Breastmilk?
The differences are vast. First, your breastmilk is tailor-made for your baby’s every specific need. If there is a virus going around, through skin to skin contact your body will recognize its need to protect the baby from it and begin producing the correct antibodies in the milk to protect the infant. Breast milk is a live culture containing enzymes, bonding hormones, and the exact calculated vitamins and nutrients your baby needs for optimal growth, immunity, and health. All things that formula cannot ever compete with. Formula has a higher amount of casein than human milk also making it harder on the baby’s digestive system. When you compare exclusively breastfed children to exclusively formula-fed children – formula feeding increases 4 times the risk of SIDS (Sudden Infant Death Syndrome).
Why Are My Nipples Sore?
This is primarily due to incorrect or poor latching at the breast. This can be caused by a tongue tie, but most likely you both just need a little practice getting comfortable. To get a good latch, ensure that the baby is positioned securely and held firmly abdomen to abdomen. Position the head so that it’s not overextended or tucked, a slight extension upwards is good. Put the baby’s nose to your nipple and wait for it to open its mouth. When open, you want to aim the nipple to the roof of the baby’s mouth, not the middle. To see if it’s latched properly you should not see much areola below the mouth, but more above the mouth. The mouth should be wide, taking in a large amount of breast to properly express. This will prevent sore nipples, although they may still be tender in the beginning as you get used to the new pressure. Watch this video for more visual help. https://www.youtube.com/watch?v=-l5BpqllTLg
Is Breastfeeding Ever Contraindicated?
There are 2 conditions in which a baby would need formula instead of breast milk. Galactosemia, which is a rare metabolic disorder that prevents it from metabolizing sugar galactose properly. The other one is maple syrup urine disease, preventing the breakdown of amino acid. PKU disease was previously thought to be a contraindication to breastfeeding, but it’s been found to raise the IQ of the developing child and contains less phenylalanine than formula. This must be done with careful monitoring.
There may be physical deformities making breastfeeding difficult, but simple surgeries are available which usually resolve the issue.
There may be reasons though in which you should not or cannot breastfeed.
1. True low milk supply from previous radiation therapy, insufficient glandular tissue, PCOS, hypothyroidism, or previous breast surgery may prevent you from breastfeeding exclusively.
2. You should not try to breastfeed if you are dependent on illegal (street) drugs, as these can pass to the baby through the milk. If this is the case please reach out for the help you need to be the mother your child needs, you can reach out to this addiction hotline 24/7 http://drughelpline.org/.
3. There are a few medications that are dangerous for breastfed infants, if you’re concerned you can contact infant risk +1 (806) 352-2519, or talk to your doctor about a safe replacement.
4. There are a few infections that contraindicate breastfeeding in the US, including HIV, HTLV, an active tuberculosis infection (this depends on the onset, you may be able to still breastfeed), and active herpes lesions on the breasts. If there are active herpes lesions on one breast and not the other you can still breastfeed from the unaffected breast.
Where Is My Local Milk Bank?
Here is a list from the Human Milk Banking Association of North America of pasteurized donor milk with their contact list – https://www.hmbana.org/find-a-milk-bank/overview.html.
There are also several Facebook groups that you can join and ask if any donor in your area has milk. These groups have rules against selling, only free milk donation allowed. https://www.facebook.com/groups/2055556058022976/
https://www.facebook.com/groups/2491931147/
A Kansas group https://www.facebook.com/HM4HBKS/
A Missouri group https://www.facebook.com/HM4HBMissouri/
Why Are My Emotions All Over The Place?
Breastfeeding is commonly an emotional time as your hormones are in a frenzy, however, there are a few markers you should watch out for.
If you’re feeling sad/angry/anxious right before your milk lets down, this is called Dysmorphic Milk Ejection Reflex (D-MER). You may feel wildly devastated suddenly for no reason at all for 30-90 seconds while your milk is preparing to let down. The feelings can vary, but the words commonly used to describe the feelings are a hollow feeling in the stomach, anxiety, sadness, dread, introspectiveness, nervousness, anxiousness, emotional upset, angst, irritability, hopelessness, and general negativity. The moms that experience D-MER will often say that for this 30-90 seconds they are feeling suicidal or wanting to self-harm in some way. Rarely do they act on it, it’s not a negative experience creating this feeling but rather a hormone fluctuation, although at the time it may be hard to distinguish. These moms should not be treated as an abuse risk but rather be well supported and cared for as they care for their newborns. Causes and treatments are unknown but a solid nutrient-rich diet may be beneficial. Read more about D-MER here: https://d-mer.org/understanding-d-mer
Many mothers also struggle with postpartum depression (PPD) for many of the same reasons. Your hormones are on a pendulum, while you are lacking in proper sleep, and taking on probably the hardest job of your life – being a 24/7 on-call mother. Your body is working hard to give your baby every nutrient it needs expecting that you will replace them as needed. If you aren’t eating a nutrient-rich diet you may be experiencing a deficiency that could be causing it as well. These are the warning signs for postpartum depression: a constant feeling of panic or anxiety, unwanted scary or racing thoughts, wanting to hurt yourself or the baby, regretting motherhood, difficulty sleeping or eating even when you have the chance, deep anger and/or sadness, feeling detached and unable to bond with the baby, obsessive irrational fears about the baby (worrying is normal), uncontrollable mood swings even towards the baby. If you’re having these feelings you certainly aren’t alone, but you shouldn’t deal with them on your own either. A good solution for one person may not help the next person struggling with PPD. For this reason consider seeing a professional in your area to find out if you need a diet change, emotional support or counseling, antidepressant medication, or maybe just a nap and some help around the house.
Baby Blues are fairly common and not much to worry about. It can be defined by some simple parameters. It may begin 2 days after birth, but usually much better or gone by week 2. The feelings should be getting progressively better and not worse. If they don’t go away or get better this is when it is defined as Postpartum Depression rather than Baby Blues.
Hang in there mama! Don’t go it alone, and don’t be ashamed or embarrassed about what you’re experiencing. You’re not alone and there is someone who would be happy to help you and support you through this tough journey.
How Do I Increase My Milk Supply?
The most effective way to increase your milk supply is to increase its demand. Your body makes whatever has been needed in the past. Please wait until your milk has come in (day 3-6) and beginning to establish supply. If you believe your baby isn’t getting enough based on the signs above, you can begin to take measures in increasing your milk supply.
Breastfeed your baby first, then when your baby is done, pump right afterward for 10-15 minutes on each side, do this as often as possible (about every 3 hours). Keeping your breasts regularly ‘emptied out’ for 3 days in a row (or sooner) will tell your body that the needs have increased.
There are supplements you can take that may increase supply or that may support your body in its efforts. Fenugreek is the most popular one, you can take it in capsule or make a tea from it. Many people also encapsulate their placenta after birth to help with their milk supply if they suspect it will be an issue, the research on the benefits of this is controversial, but placentas are not thought to be harmful as long as you had a healthy uncomplicated pregnancy.
How Do I Decrease My Milk Supply?
Moms that are often experiencing engorgement, plugged ducts, or mastitis due to an oversupply of milk may desire to decrease their supply. You can do this by breastfeeding on just one side per feed. Let your baby drink as much as it wants on just the one side and only express a small amount on the other side if you’re experiencing engorgement. Just enough to relieve some pressure. At the next feed, you’ll switch sides and do the same thing. Sage tea decreases milk supply significantly, I would be very careful with this as you could react strongly to it and lose your milk supply. Start with half a cup of tea and go from there. Sage may be a good option for mothers that have miscarried and do not want to donate their milk.
When Should I Nurse My Baby?
The most beneficial way to feed your baby is ‘on-demand’. This implies that it is baby-led, as the baby’s body knows when it needs more to get through a growth spurt, a developmental milestone, or movement into its next phase of an eating and sleeping schedule. Babies don’t take more than they need when breastfeeding, although they will if formula-fed. This actually benefits them by helping them create a lifelong discipline of only eating when hungry and not overeating just because it’s ‘time to eat’. Scheduled eating can create a fear of the baby not knowing when it’s next meal is coming so it overfeeds itself.
Is It Legal To Breastfeed In Public?
It is legal to breastfeed anywhere you need to public or private. You do not have to move to the bathroom, car, or put on a cover. In fact, it’s not just protected in all 50 states (including The District of Columbia and the Virgin Islands), it is illegal for someone even to ask you to leave or to harass you for breastfeeding your child. Be free to feed your child, put on a cover if you prefer to remain modest but you should not leave any establishment for anyone else’s lack of comfortability, they can look away or decide to get comfortable. You may even help someone else feel brave enough to stick it out with breastfeeding.
What Are My Local Resources For Breastfeeding Support?
There are many different kinds of breastfeeding support. To connect with a La Leche League group for education, information, support, encouragement, and friendship with other breastfeeding moms check out https://www.lllusa.org/locator/ and search your location.
This is the list for groups in the greater Kansas City area. http://www.lllofgreaterkc.org/find-local-support.html
For a lactation consultant search here https://www.ilca.org/why-ibclc/falc
For Kansas City mom’s I highly recommend lactation consultant Summer Friedmann
Will Breastfeeding Help Me Lose Weight?
Breastfeeding is not just good for your baby, it’s great for you too. Breastfeeding helps your uterus contract back down efficiently after birth. It decreases your chances of breast and ovarian cancer, especially if you do it for over a year (collectively with each child counts as well). And there’s more, it heals your body after delivery and provides a natural form of birth control (not 100% effective.)
And yes, it helps you lose weight by burning on average an extra 500 calories a day. If you exclusively breastfeed your body will go back to its pre-pregnancy weight fairly quickly, although it may be slower to do so with each subsequent child. Give yourself grace and patience, you just did the most amazing thing a human body can do. You grew another human being and gave birth to it. Your body is incredible in all of its shapes, nourish and care for yourself not in disappointment but out of love and respect.
