is the most natural and nutritious way to encourage your
baby’s development. Attempts to improve upon nature’s
miraculous feeding system have been unsuccessful. Neither
the nutrients found in the milk you produce nor the special
benefits these nutrients provide can be duplicated. Simply
put, nature does the best job of providing for your baby’s
Our hope is that after considering the material
presented in this booklet, you will join thousands of
other mothers who have chosen to breastfeed. As you will
see, the physiological and psychological rewards are many
for both you and your baby.
Breastfeeding is the natural next step in
the continuum of pregnancy. For the past nine months,
your body has been preparing a very special blend of nutrients
in the exact proportions your baby needs. Human milk is
a unique combination of fats, sugars, minerals, proteins,
vitamins and enzymes, custom-made to promote brain and
Colostrum is the perfect starter food for
babies. This clear to creamy to golden-yellow substance
is found in the breasts during pregnancy. A few days after
baby’s birth, it begins the change to mature milk.
Colostrum provides unmatched immunity against bacteria
and viruses, thus protecting vulnerable newborns from
a host of diseases to which they are exposed. In addition,
colostrum acts as a natural laxative to clear the meconium
(first stool) from the baby’s intestine, thus decreasing
the chance of jaundice. Colostrum also contains the natural
sugar lactose, which helps stabilize the newborn’s
blood sugar level, preventing hypoglycemia.
The advantages of breastfeeding are plentiful,
as colostrum is slowly replaced by mature milk and baby
continues to breastfeed. While cow’s milk and formula
mixtures can trigger allergic reactions and are often
difficult for baby to digest, your milk is perfectly designed
specifically for your baby. Studies show that breastfed
babies have fewer ear and diarrhea infections; experience
less vomiting and acute respiratory illness; and are at
lower risk for childhood diabetes, lymphomas and Crohn’s
disease. Even the activity of sucking at the breast enhances
the development of oral muscles and facial bones.
As an added bonus, breastfed pre-term babies
tend to have a higher IQ than their formula fed playmates.
Breastfeeding offers baby emotional as well
as nutritional benefits. Skin-to-skin contact helps to
reduce the stress babies experience as the enter the world
from the security of the womb. Tension quickly subsides
as baby is comforted by the sight of the mother’s
face and the familiar sounds of her breathing, voice,
and heartbeat. Thus begins the important process of mother-infant
And baby isn’t the only one who benefits
from the breastfeeding experience. When baby is put to
the breast immediately after birth, the resulting release
of the hormone oxytocin into mother’s system speeds
delivery of the placenta and constricts uterine blood
vessels to minimize blood loss. Repeated release of oxytocin
through nursing causes the uterus to return to it’s
pre-pregnancy size quicker.
The milk-producing hormone, prolactin, is
another wonderful by-product of breastfeeding. Called
the "mothering hormone", it have a releasing
effect on mother and stimulates maternal instincts. The
ongoing production of milk burns calories, helping you
lost weight gained during pregnancy. And women who breastfeed
have been shown to have less incidence of pre-menopausal
breast cancer, cervical cancer and osteoporosis.
Add to these primary advantages the practical
facts that your milk is always the right temperature,
absolutely fresh, perfectly clean, instantly available,
and you have the most nutritious, convenient feeding system
there is-at the lowest cost!
Before Baby Arrives
Though breastfeeding is natural, technique
is a learned skill. It is important to get started correctly,
even before your baby is born. You need to know well in
advance how to identify and avoid possible problems, and
where to turn if difficulties do arise. Most breastfeeding
problems occur during the first few weeks as you and your
baby begin establishing your nursing patterns. With proper
and prompt attention, the majority of these difficulties
disappear as quickly as they develop.
Plan to learn as much as you can about breastfeeding.
You will be making an important investment in you and
your baby’s continued good health. Reading this
booklet is a wonderful start! You may also choose from
an abundance of valuable reference materials. Several
excellent books on breastfeeding are listed in the last
section of this booklet.
Also available is an informative, beautifully
directed videotape co-produced by Medela and La Leche
League International (pronounced La Lay-Chay League).
For more personalized instruction, plant to attend La
Leche League (LLL) meetings or prenatal breastfeeding
classes given in conjunction with your childbirth education
series or by a lactation consultant.
The most important contact before and during
your breastfeeding experience will be with certified lactation
consultants and/or support organizations such as La Leche
League International and the Nursing Mothers’ Council.
By attending League meetings, for example, you will have
the opportunity to meet and compare notes with other breastfeeding
mothers. As your questions are answered, you will receive
the helpful tips and reassurance you need to make your
breastfeeding experience even more rewarding.
As with any skill, the keys to successful
breastfeeding are practice and patience. Learn all you
can and then surround yourself with people who will offer
you the encouragement you need. Be easy on yourself. Relax
and enjoy this special and wondrous experience.
A Simple Nipple Test
To determine if your nipples are flat or
inverted, simply place your thumb and index finger on
the areola, the dark area surrounding the nipple. At the
base of the nipple, compress gently but firmly. If you
nipple flattens or retracts (inverts) into the breast,
you can begin wearing breast shells during the last couple
of weeks of pregnancy. These plastic shells are worn under
a bra and create slight pressure at the base of the nipple,
drawing it out. It is important to do this "pinch
test" because although some nipples appear erect,
they may invert when the areola is compressed.
After birth, if baby still has difficulty
attaching to your breast, contact a lactation consultant,
LLL Leader, or the Nursing Mothers’ Council.
How Your Breasts Produce Milk
Milk is produces and stored in the glandular
tissues (alveoli) of your breasts. It collects in pockets
(lactiferous sinuses) located beneath the areola until
it is released by a baby’s sucking. Stimulation
of the nipples causes the mother’s pituitary gland,
located in the bran, to secrete prolactin, which initiates
and maintains milk production. The first milk your baby
receives at each feeding is the milk that has collected
in the pockets between feedings. This low-fat foremilk
is high in protein and satisfies the baby’s thirst.
As breastfeeding continues, a second hormone called oxytocin
is secreted. Oxytocin causes the tissue around the alveoli
to contract, thus squeezing the high-fat hindmilk down
the ducts and into the pockets where it is available to
satisfy your baby’s hunger.
Many mothers experience a tingling or rushing
sensation in the breasts as this "let-Down"
or milk ejection reflex (MER) occurs. Other mothers notice
only that sucking becomes longer and slower, and that
baby begins to swallow rhythmically. Keys to establishing
a quick let-down are relaxation and confidence that your
body is doing exactly what it was designed to do: feeding
your baby the world’s best baby milk – products
Successful breastfeeding is the combined
result of practice, patience, and proper positioning.
Breastfeeding as soon as possible-preferably within an
hour after birth-will get both of you off to a good start.
Keeping your infant with you during your hospital stay
will help you get to know and immediately respond to his
cues. In addition to beginning the important cycle of
milk supply and demand, early breastfeeding allows your
baby to receive the benefits of colostrum. Rich in nutrients
and antibodies, colostrum is the first milk you produce
and is your baby’s perfect starter food.
Immediately after birth, your baby will
be in a quiet alert state and generally receptive to breastfeeding.
(If your baby isn’t ready the very first time you
try to breastfeed, try again within the next half-hour
or so.) Within a couple of hours, your baby will become
quite sleepy; drowsiness may last for several days.
Avoiding Artificial Nipple Preference/Confusion
Your Baby begins to learn and practice the
correct breastfeeding suck with the very first nursing
experience. When both breasts and bottle are offered in
the early days, your baby may become nipple confused or
may simply prefer the bottle nipple. Breastfeeding is
a process for the baby; bottle-feeding, however, is passive
and requires a different type of suck. A baby who is bottle-fed
early can have difficulty transferring to the breast.
Avoid using any rubber teat (nipples) or pacifiers (soothers,
dummies) during the first weeks. If your baby needs supplementation
for a medical reason, use a cup. Yes, even a tiny baby
can drink from a small medicine or paper cup!
The Law of Supply and Demand
Milk production works on the principle of
supply and demand. The more your baby breastfeeds, the
more milk you will produce, totally meeting your baby’s
needs. It is the frequency of breastfeeding as well as
the milk removed from the breast that stimulates further
milk production. Babies who are given supplemental bottles
of water or formula breastfeed less frequently, ultimately
decreasing the milk supply. Supplements, unless medically
indicated, should be avoided for three to four weeks,
until your milk supply is well-established and your baby
is latching on to the breast without difficulty. Babies
need to be breastfed at least 8 to 12 times in 24 hours
the first 2 to 4 weeks, or until well above birth weight.
Attaching Baby to The Breast
Latching the baby on correctly is the key
to a pleasant, rewarding breastfeeding experience. Nursing
behavior patterns are established early. One set, bad
habits are difficult to correct. Make sure you and your
baby get off to a good start. A variety of reading materials
and videos are helpful, but there is nothing like hands-on
assistance from an experienced healthcare provider. Don’s
hesitate to ask for help the first few times. If you are
still having difficulty by the time you leave the hospital,
contact a lactation consultant or a LLL Leader.
For most women, sitting up in bed or in
a comfortable chair is easiest for breastfeeding. Make
sure you are relaxed before you put your baby to the breast.
Use pillows on your lap, under your arms and behind your
back. Putting your feet on a footstool to raise your knees
slightly above your hips will eliminate back strain and
put your body at the right angle. The Nursing Stool from
Medela is a footstool designed especially for breastfeeding.
If you do not have a stool, use a thick telephone book
or an overturned wastebasket.
Make sure your baby is comfortable and feels
secure and supported. Nestle the baby in your arm at the
level of your breast. The baby should be turned toward
you, chest to chest, his head and trunk in a straight
line, so that he doesn’t have to strain or turn
his head to attach to the breast. Tuck the baby’s
lower arm into the pocket betw4een the two of you; if
necessary, hold his upper arm down gently with the thumb
of your supporting hand. Be careful not to tilt the baby’s
head down, as it will be difficult for him to swallow
in that position. A very slight extension of the baby’s
head, with his chin touching your breast, will help keep
his nose clear without your having to press on your breast
Hold your breast with your fingers underneath
and thumb on top, making sure all of your fingers are
placed well away from the areola. It is sometimes helpful
if you roll your nipple between your fingers for a couple
of seconds to help it become more erect. Then manually
express a couple of drops of colostrum to entice the baby
to take the breast. A woman with large breasts may find
it comfortable to help support the weight with a follows
washcloth or diaper under the breast.
Gently tickle the baby’s lower lip
with your nipple to encourage him to open his mouth wide.
The moment he opens wide, almost like a yawn, quickly
pull him in close to you. Do not lean forward, trying
to put your breast into the baby’s mouth. Instead,
pull the baby toward you so that he has a large mouthful
of breast tissue. His chin should be pressing into your
breast; his nose should be just touching your breast.
Keep supporting your breast with your hand until the baby
is latched on and is sucking well. Women with large breasts
may have to support their breast throughout the entire
feeding; smaller breasted women may not need to do this.
The key to successful latch-on and preventing
nipple soreness is teaching your baby to take a large
portion of the areola into his mouth.
As mentioned earlier, your milk collects
in the pockets located beneath the areola. To empty these
reservoirs effectively, the baby’s mouth must be
position over them. If the baby sucks only on the nipple,
little milk will be drawn out, and you will become quite
sore. If your baby doesn’t latch on properly right
away, continue to encourage him to open his mouth wide
and then pull him close to you again. Don’t be afraid
to repeat these steps several times until your baby gets
If you feel any pain after your baby starts
sucking rhythmically, stop, and break the suction by inserting
your finger into the corner of his mouth between the gums.
Then try again. Latch-on discomfort is common in the first
week or two, but any pain should subside in a few seconds.
Take a deep breath, relax, and enjoy breastfeeding! You
may even find yourself drifting off to sleep-a good sign
the prolactin and oxytocin are flowing. Grab a little
catnap while you are at it!
Just as babies have different personalities,
so too do they exhibit a variety of breastfeeding styles.
Some babies latch-on and start sucking immediately, getting
right down to business. Others take the slow and easy
approach, simply enjoying this special time with mom.
Breastfeeding is not only a mode of providing nutrition,
it is also a special way of nurturing your baby. Although
the terms "breastfeeding" and "nursing"
are used interchangeably, breastfeeding could be used
to describe the nutritive sucking that your baby does
while feeding. Nursing describes the non-nutritive, sleepy
type of suck your baby does when simply relaxing and enjoying
being at the breast. Nutritive sucking is a slow, long,
drawing, rhythmic sucking accompanied by swallowing. Non-nutritive
sucking is lighter, faster, and less intense. Swallowing
is minimal or absent. Babies will often suck quickly and
intensely at the breast when they first attach, a sort
of "priming the pump" to initiate the let-downs
before they settle into the rhythmic deep sucking that
In the very early days of breastfeeding,
most babies will swallow little or no air and may not
burp at all after feeding. Breastfed babies generally
swallow less air than bottle-fed babies. After your baby
has finished feeding on one side, burp him before offering
the other side. Remember, effective burping techniques
require placing firm pressure on your baby’s tummy.
Lean the baby’s weight against the heel of your
hand as he sits on your lap, or drape him over your shoulder
or on one knee, and firmly pat or rub his back. If your
baby doesn’t burp in a minute or so, don’t
worry; just continue with his feeding.
Working and Breastfeeding
In addition to understanding and mastering
the art of breastfeeding, working mothers face added challenges
imposed by their schedules. Growing support by employers
and a variety of innovative aids are making breastfeeding
a viable option for mothers who work outside the home.
First and foremost, take full advantage
of your maternity leave to establish a good supply of
milk before going back to the job. The longer you can
stay home and concentrate on breastfeeding your baby,
the easier it will be to maintain your milk supply after
you go back to work. Fatigue is a working mother’s
biggest enemy, regardless of how you choose to feed your
baby. One of the ways to minimize fatigue in your first
few weeks back is to return to work on a Thursday rather
than on a Monday. If possible, take the nest two Wednesdays
off, so that you aren’t working more than two days
in a row. This schedule will get you back into the swing
of things slowly, giving both you and your baby a bit
more time to adjust to the change in routine.
Breast pumping Tips
Breast pumps come in a variety of styles.
Most important is that they breast pump be safe, effective
and comfortable. Always read the manufacturer’s
instructions before using your pump.
A healthy infant is far more effective at
emptying the breast than any pump. Remember, breastfeeding
is a learned process. Be patient. It may take several
tries before you are comfortable and proficient.
Here are some basic tips to boost your breast
Always wash your hands before breast pumping.
Use deep breathing techniques to relax and assist with
Apply warm compresses to your breasts 10 minutes before
Move the pump’s breast shield around to stimulate
more milk ducts.
If let-down is difficult, have a drink of water, juice
or tea before or during pumping.
Your ideal pumping time will depend on your baby’s
schedule. If you want to prepare a bottle, try pumping
in the morning after feeding when milk is most plentiful.
To maintain an adequate milk supply, frequent
feeding or pumping is essential. Milk supply may diminish
over time, especially if your baby is ill. When he/she
begins breastfeeding again, however, milk production will
Finally, remember to take good care of yourself!
East a balanced diet, drink plenty of fluids and get lots
Recipe for Working Mothers
It is especially important for working mothers
to remember that milk production is based upon the principle
of supply and demand. The key to maintaining a sufficient
milk supply is to breastfeed often.
If your baby is under four months old, you
should express your milk during the work week when your
baby would breastfeed if you were home. Additionally,
you should breastfeed in the morning just before going
to work, again as soon as possible after work, frequently
during the evening and whenever baby wakes at night. Breastfeeding
at night causes your prolactin level to rise, thus helping
you to relax and enjoy a good night’s sleep. On
weekends or days off, breastfeed your baby as often as
possible. Keep in mind that it isn’t unusual for
your milk supply to drop toward the end of the work week.
Breastfeeding as much as possible and luxuriating in the
rest that it provides, will help increase your supply
for the next week. When the baby is four months old, you
can probably reduce the number of pumping to one or two
times during your working hours.
Some companies offer on-site breast pumps
and access to lactation professionals.
Double pumping kits offer time-saving benefits
by allowing you to express both breasts simultaneously.
By cutting pumping time virtually in half, you can successfully
complete a pumping session during a regular break period
(15 minutes). In addition, research indicates that double
pumping may increase prolactin levels, your milk producing
hormone. This unexpected side benefit is important to
working mothers and mother or preterm infants who may
have difficulty maintaining and increasing milk supply
when the baby isn’t available for breast stimulation.
Mothers experience in using double pumping can learn single-hand
techniques for even easier pumping.
Storing Breast milk
Human milk varies in color, consistency
and odor, depending on the mother’s diet and storage
container used. Because breast milk is not homogenized,
the cream will separate and rise to the top of the container.
Breast milk may be safely stored by carefully following
Wash your hands well with soap and water
before touching your breasts or any milk containers. Avoid
touching the inside of bottles or caps.
Pump or express milk into a clean collection cup.
Transfer the milk into a clean storage container. If you
can pump directly into a storage container, such as a
Medela CSF bag, it will lessen the chance of contamination.
Label the container with the date and amount of milk collected;
be sure to use the oldest milk first.
To inhibit the growth of bacteria, breast milk, which
is not used immediately, should be refrigerated, or if
stored for more than 24 hours, frozen. Check with your
hospital for specific storage instructions.
For longer storage, freeze your breast milk.
Frozen milk may be stored in a refrigerator freezer for
six months or in a deep freeze (-20 C) for up to 12 months.
Fill the container only ¾ full to
allow room for expansion during freezing. Freeze the milk
in 2oz. to 4oz. Portions. These smaller amounts will thaw
quicker. If your baby doesn’t drink the entire portion,
there is less waste. It is possible to combine fresh milk
with frozen milk. To prevent premature thawing, always
cool milk before combining it with previously frozen milk.
The amount of newly added milk must be less that the amount
of milk already frozen. Never refreeze breast milk.
Thawing Frozen Breast milk
Place the sealed container of milk in a
bowl of warm water for about 30 minutes, or hold the container
under warm running water. Never microwave breast milk;
micro waving can alter the composition of the breast milk
and result in burning your baby.
Swirl the container to blend any fat that my have separated
and risen during thawing.
Feed thawed milk immediately or store in the refrigerator
for a maximum of 24 hours.
Traveling With Breast milk
When caregivers take bottles of breast milk
along on outings, milk should be kept cold until feeding
time to ensure that it will be fresh and safe for your
Engorgement: During the first week after
delivery, as colostrum is changing to mature milk, your
breasts will become full. This normal postpartum fullness
usually diminishes within three to five days. Engorgement
may develop if your baby does not adequately remove the
milk from your breasts. During this time, your breasts
will feel hard, painful, and hot. The fullness is due
in part to extra blood, lymph and swelling, not entirely
to accumulated milk. Excessive fullness of the breasts
can also lead to swollen areolas and flattened nipples,
making it difficult for the baby to latch on and subsequently
causing sore nipples.
You can prevent engorgement by:
Breastfeeding your baby frequently-8-12-time
in 24 hours
Avoiding supplements of water or formula for the first
3 to 4 weeks unless medically indicated.
Expressing your milk if you miss a feeding.
Weaning your baby gradually.
If you do become engorged:
Apply warm, moist compresses to the breast
for a few minutes just prior to breastfeeding. Avoid any
additional heat to the breast as this brings more blood
to the area increasing swelling.
Hand express to soften the areola before breastfeeding.
Gently massage your breasts before and during breastfeeding.
If your baby is unable to latch on, you will need to express
your milk. In this case, using a hospital-type electric
pump is best.
After breastfeeding or pumping, try using icy cold compresses
on the breasts to relieve discomfort and decrease swelling.
Wear a good fitting, supportive bra.
If you have further problems, contact you lactation consultant
of LL Leader.
Sore Nipples: Some mothers will experience nipple tenderness
for the first few days when baby starts nursing. This
latch-on discomfort should disappear as soon as the baby
begins rhythmic, nutritive sucking. Pain after this initial
discomfort generally indicates that the baby is not attached
to your breast correctly. Incorrect latch-on and/or improper
positioning not only causes sore nipples, but can contribute
to ineffective emptying of the breast as well. If you
have blisters, cracking, burning, bleeding, and/or pain
throughout the entire feeding or between feedings, it
is recommended that you talk with a lactation consultant,
LLL Leader, or the Nursing Mothers’ Council.
You can prevent sore nipples by:
Positioning your baby correctly at the breast,
chest to chest, so that both of you are comfortable.
Breastfeeding your baby frequently, 8 to 12 times in 24
Making sure your baby opens his mouth wide and attaches
properly to the breast with his mouth well behind the
nipple on the areola.
Releasing the baby’s suction prior to taking him
off the breast.
Gently patting your nipples dry after each feeding.
Expressing a little breast milk onto the nipples and massaging
it into the nipples and areola.
Massaging in a small amount of USP Modified Lanolin if
your nipples are dry.
Avoid using soap on the breasts or nipples; soap can remove
natural protective oils. Water is all you need to clean
your breasts when you bathe.
Limiting the amount of time your baby sucks non-nutritive
during the first few weeks.
You can manage sore nipples by:
Determining the cause of soreness by contacting
a lactation consultant, LLL Leader or the Nursing Mothers’
Using deep breathing, soft music, or other relaxation
techniques before and during breastfeeding.
Limiting feeding time on the sore nipple.
Breastfeeding on the least-sore side first.
Expressing a little milk to stimulate let-down. (Also
express if the breasts become engorged.) Expressing makes
the areola softer, the nipple more erect, and latch-on
Using nonplastic-lined bras, and/or bra pads. Change the
pads frequently to keep the nipples dry.
Using a little USP Modified Lanolin on the nipples if
they become dry or cracked. The lanolin forms a moisture
barrier so nipples stay dry.
Using Medela breast shells to keep clothing and west nursing
pads off the nipple to prevent further irritation.
Inadequate Milk Supply: Most mothers will produce a sufficient
milk supply if they breastfeed their baby often and long
enough. If your baby does not regain his birth weight
by three weeks, or is gaining very slowly, it is possible
your milk supply is low. Contact a lactation consultant
or LLL Leader to determine the reason for your low milk
supply. Medela’s SNS may be helpful if your baby
needs supplementation. The system will provide appropriate
breast stimulation while you are supplementing, which
will help increase your milk supply. It might be helpful
to keep a breastfeeding diary for the first four to five
days after delivery.
When will my milk come in?
Mature milk production begins about 30 hours after delivery,
but may not be evident for two to five days. Timing varies
depending on you baby’s ability to latch on properly
and how frequently and effectively your baby sucks. Generally,
the more babies you have had, the sooner your silk "comes
in." Keep in mind that until mature milk is present,
your baby is receiving rich colostrum, which has three
times the protein of mature milk and is just right for
meeting your baby’s needs during those first few
How often (and long) should I feed my baby?
Babies need to be nursed as often as they indicate a desire
to breastfeed. Watch for your baby’s cues. Rooting,
brushing a hand across his face, or making little sucking
motions are all indications that it is time to breastfeed.
Babies will demonstrate feeding cues for up to 30 minutes
before they start crying. Crying can cause your baby to
have an uncoordinated suck, making it more difficult to
Most babies need to breastfeed at least
8 to 12 times in 24 hours for the first few weeks. Once
you and your baby are synchronized, the frequency and
duration of feedings per day will decrease. This process
takes about six weeks, just about the length of time it
takes for you to completely recover physically from the
birth process! Let your baby breastfeed as long as he
wants to on the first breast; he’ll let you know
when he Is finished, either by spontaneously coming of
the breast or by drowsily moving into non-nutritive "nursing."
You can burp the baby and offer the other breast. If your
baby takes it, fine; if not, that’s fine too.
There aren’t any "rules"
about having to take both breasts at a feeding. The next
time the baby is ready to feed, you can offer the side
he finished on or didn’t take. Keep in mind that
sometimes babies love to be put to the breast simply for
closeness and comfort, not because they are necessarily
hungry. Generally speaking, most babies will breastfeed
every 1 ½ to 3 hours for 5 to 15 minutes per breast.
Does my baby need bottles?
Giving your baby supplemental bottles in the early days
may lead to nipple confusion/preference and can adversely
affect your milk supply. Unless you are advised to do
so for a medical reason, you should not give a breastfeeding
baby bottles or water or formula for the first 3 to 4
weeks. If supplementation is necessary, it can be done
with a small medicine spoon or a cup. Giving bottles every
day or every other day so your baby "gets used to
taking a bottle" is not necessary. After the first
few weeks, giving him a bottle of expressed breast milk
periodically, when it is convenient for both of you, is
all you need to do. If your baby balks at taking a bottle,
you can always feed him using a small cup or a medicine
What if I don’t have enough milk or
my baby is gaining weight poorly?
Most delays in milk production result from an upset in
the supply and demand balance. Avoid giving supplemental
bottles. Temporarily postpone your other commitments to
focus your energies toward establishing a breastfeeding
routine with your baby. Try these methods for increasing
Take your baby to bed with you. Nap-and
night-nursings are time-tested remedies for enhancing
a baby’s weight gain.
Remember the law of supply and demand, and increase the
frequency of feedings to at least one every two to three
hours. Wake your baby during the day if he sleeps more
than three hours. Even a sleepy baby will nestle at your
breast and stimulate milk production.
Look at, caress, and groom your baby as he breastfeeds.
These maternal behaviors stimulate milk production.
Undress your baby before feeding to allow skin-to-skin
contact. This action may help awaken sleepy babies and
stimulate less enthusiastic nursers.
Watch for your baby’s feeding cues and capitalize
on the times that he seems ready to eat.
Don’t try to wake your baby from a deep sleep; wait
until he is in a light sleep or drowsy state.
Try "switch-nursing" to encourage more enthusiastic
breastfeeding if your baby seems to fall asleep quickly.
Also called the "burp and switch" method, switch-nursing
allows your baby to feed on the first breast until his
suck diminishes and his eyes begin to close. Take the
baby off your breast, burp him and latch him on to the
other breast. When sucking diminishes, take him off, burp
and switch again so he nurses at least twice on both sides.
Double-nursing is another effective method for increasing
the volume and fate content of your milk. Feed your baby
until he is content; keep him upright instead of putting
him down to sleep; burp him well, and 10 to 20 minutes
later, breastfeed him a second time. Be sure to keep him
upright for 10 to 20 minutes after a feeding to allow
the trapped air bubble to be burped up, leaving room for
a "topping off."
Above all, relax during breastfeeding to permit an effective
milk ejection reflex. Seek the support of breastfeeding
and mothering organizations such as LLLI or contact a
How do I know if my baby is getting enough
After the first month or so, you will intuitively know
that your baby has been satisfied by his heavier look
and weight. In the first few weeks, it is not as easy
to tell, particularly for first-time mothers. Here are
some signs to look for:
Your baby will have 6 to 9 wet cloth diapers
(4 to 5 disposable diapers) and 2 to 5 (or more) bowel
movements every 24 hours. The color of the stools can
vary from yellow to tan with a mustard-like consistency.
Urine should be pale yellow to almost clear in color.
Your breasts may feel full before a feeding, less full
after. You may leak between feedings or leak on one side
while feeding on the other.
You will feel your baby sucking vigorously and hear him
swallowing. Many mothers (though not all) feel a tingly
or pinchy sensation with the milk ejection reflex. Often
baby will drift off to sleep at the breast after a vigorous
feed, a good indication that he is satisfied.
Sometimes a baby will seem satisfied at the breast, but
when he is put down, will start to fuss and root again.
This behavior is not necessarily an indication that your
milk supply is inadequate. Your baby may simply enjoy
being held and cuddled. And not want to give it up for
a crib or an infant seat. Using a baby sling during the
day will keep him cuddled next to you while you go about
your daily routine.
Why does my baby want to nurse all the time?
Your baby will breastfeed more frequently in response
to sudden growth spurts. Babies can grow as much as ½
inch in a 24-hour period. No wonder they need to breastfeed
frequently for several days! Breastfeed as frequently
as your baby indicates a desire. Your milk supply will
soon catch up to his increased needs. Giving bottles of
formula at this time will only sabotage the natural supply
and demand cycle, and you will be unable to catch up with
you baby’s needs.
Some babies love to be held and nursed frequently
as a way of helping them to adjust to life outside the
womb. In fact, the first three to four months of life
for all babies is a transition from the womb to the world.
During "increased appetite" days, set aside
other commitments to focus your energies on your baby.
Sleep when your baby sleeps to recharge your system after
these high-need periods. "Wearing" your baby
in a sling or front carrier may be helpful. Just as a
toddler needs a periodic hug and kiss to make the world
right again, a newborn may need to be cuddled and even
nursed for a while. As babies get older, they learn other
ways of self-comforting, and breastfeeding sessions generally
become shorter and less frequent.
What diet should I follow while breastfeeding?
There are not "rules" to follow about your diet.
A healthy, well-balanced diet, high in protein and complex
carbohydrates, similar to the one you consumed during
pregnancy, is all that is necessary. Because a lactating
woman is extremely energy efficient, there is no need
for extra calories. Drink water or other beverages when
you are thirsty; eat when you are hungry. Lose weight
by avoiding high-calorie/low-nutrition snacks. Control
your weight through regular exercise rather than crash
diets, which can present health risks to both you and
your nursing baby. If you must diet while breastfeeding,
contact your lactation consultant, physician, LLL Leader,
or the Nursing Mothers’ Council for specifics.
Are there foods to avoid while breastfeeding?
Although you will get plenty of unsolicited advice about
dietary restrictions while you are breastfeeding, there
aren’t any foods that a mother should routinely
avoid. Babies can be fussy and can have excess gas-just
because babies are fussy and babies have gas, not because
you had broccoli for dinner last night. Occasionally,
a baby may be sensitive to something in the mother’s
diet. The most common sensitivities are to protein antigens
that are found in cow’s milk, soy, wheat, fish,
corn, eggs, and nuts. If you believe your baby is reacting
to something in your diet, eliminate that food for two
to three weeks, then try it again. Generally speaking,
you should east a healthy, well-balanced diet, with no
restriction. Any food (even chocolate!) in moderation
is usually fine. If your baby continues to be unusually
fussy and gassy, contact a lactation consultant, LLL Leader
or the Nursing Mothers’ Council.
What about breastpumps?
Breastpumps are helpful in stimulating, maintaining and
expressing milk in cases involving working or engorged
mothers, and premature or sick infants. Breastpumps are
available in a variety of types, depending on your preferences
and needs. For a rental station in your area, call Medela’s
Breastfeeding National Network (BNN) at 1-800-TELL YOU.
I’m a tense person. How can I relax
better during nursing?
While the milk-producing hormone prolactin has a natural
relaxing effect on the breastfeeding mother, sometimes
additional help is needed. The Medela audiotape Breastfeeding
Your Baby, includes specific relaxation techniques that
will help improve your milk ejection reflex. Setting up
a special "breastfeeding station" in your home
may help create an environment in which you can unwind.
Select a comfortable chair (a big easy chair
or rocking chair with arms is nice), and a footstool to
raise your lap . Surround yourself with everything you
might need: pillows, telephone, books, nutritious nibbles,
juice, water, and extra diapers. Try relaxing to soothing
classical music or use the relaxation techniques you learned
in your childbirth class or on the Medela cassette. If
you have a toddler who demands your attention, set up
your nursing station on the floor or in the child’s
room. Include an assortment of pastime supplies for him,
such as special toys, snacks, books, and music.
When should I wean my baby?
Around the world, babies are breastfed an average of two
to three years. There is, however, no "right"
time to wean. Weaning is an individual decision for each
mother and baby. Most babies will not show signs of wanting
to wean before eight to nine months at the earliest. The
American Academy of Pediatrics recommends breastfeeding
exclusively for the first four to six months, gradually
introducing new foods after that time. Breast milk for
at least a year is preferred, using formula if your wean
before that time. When you or your baby decide to wean,
you should do so gradually to prevent the discomfort of
engorgement and to help maintain your baby’s sense
of security. Dropping one feeding every few days and replacing
it with formula or cow’s milk (depending upon your
baby’s age), will allow your breasts to adjust to
the decreased demand in comfort. Most mothers drop the
late night or early morning feeding last as this feeding
is often a special snuggle time with the baby.
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