BREASTFEEDING BASICS
Frequently asked questions

How often should I breastfeed my baby?
Feed your baby at least eight times a day the first month. That translates to every 1-1/2 to two hours. During the day, you may need to wake your baby if he has not nursed in more than three hours. At night, it's OK to let your baby sleep for four hours without nursing.

After the first month, you can wait longer between feedings. If your baby is gaining weight, feed him when he is hungry and stop waking him to nurse.

How long should I breastfeed my baby each time?
At first, to help bring in your milk supply, breastfeed 10 minutes on one breast and up to 15 minutes on the other, if your baby is actively nursing. Alternate which breast you offer first.

After your milk comes in, probably by the third day, let you baby breastfeed up to 20 minutes on the first breast. When your baby's sucking slows and your breast softens, offer the other breast. Again, alternate which breast you offer first.

How do I know if my baby is getting enough milk?
After your baby is five days old and/or your milk has come in, he should have at least:

• Three good-size, yellow, seedy bowel movements each day

• Six or more wet diapers

He should seem satisfied after each feeding. Your breast should feel full before each nursing session and soft afterwards.

See Is Your Baby Getting Enough Milk for a handy chart.
 

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What is letdown?
After you have been nursing for two to three weeks, you will experience the letdown reflex just before feeding your baby. It is the automatic release of milk into the breast milk ducts.

How can I increase my milk supply?

• Be sure you are getting plenty of sleep, including naps during the day

• Keep your stress level at a minimum.

• Make your environment relaxing

• Drink plenty of liquids, including a quart each of water and milk daily

• Breastfeed more often

• Do not let your baby use a pacifier

• Pump your breast for 10 minutes after you nurse your baby

• Speak to a lactation consultant

Do I need to feed my baby water?
No. Your breast milk contains plenty of water.

Should I keep nursing if my baby is sick?
Yes, if it is possible. You can breastfeed your baby if he has been vomiting or spitting up, or has diarrhea, a cough or jaundice.

My breast milk is leaking on my clothes. What's wrong and what can I do?
It's common for milk to leak during the first few months of breastfeeding, especially when you hear your baby cry or just think about him. This is a sign that your letdown reflex is becoming conditioned to your baby.

• Don't skip feedings.

• Use nursing pads and change them often.

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What is a plugged duct? What should I do?
A plugged milk duct may be caused by:

• Not nursing as frequently

• Stress

• Poor nutrition

It may show up as a small lump or tender area in your breast.

If you have a plugged duct:

• Get more rest.

• Breastfeed more often. Try taking your baby to bed with you so you can feed him easier during the night.

• Apply moist heat to your breast or take a warm shower or bath.

• Massage the affected breast to help the milk flow.

• Each time you nurse, try a different position so you can be sure to empty all the breast ducts.

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What is mastitis?
Mastitis is an infection of the breast. A plugged duct is usually the first symptom of mastitis. In fact, an untreated breast duct may turn into a breast infection. Symptoms of mastitis include:

• Body aches

• Flu-like feeling

• Fever

If you think you have a breast infection, call a lactation consultant or your health care provider. You probably will be prescribed an antibiotic.

In the meantime, try the suggested treatments listed above for plugged ducts to help you feel better.

If your breast is infected, the milk will not hurt your baby.

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How do I treat sore nipples?
Although your breasts may be tender when you begin breastfeeding, it will probably pass. If your nipples are sore:

• Be sure you are holding your baby in the correct position.

• Change your breastfeeding position every session.

• Try nursing more frequently but for a shorter period at each setting. If you wait too long between feeding your baby, he may be hungrier and try to nurse too hard.

• Rub breast milk on your nipples after each feeding and let them air dry.

• Avoid putting soap, alcohol or alcohol-based cleansers on your nipples.

• Try taking a mild pain reliever about 30 minutes before you breastfeed.

If your nipples crack or bleed, massage a small amount of medical-grade lanolin on the nipples. You do not have to remove it before feeding your baby.

When can I give my baby a bottle?
After your baby is a month old, you can begin to introduce a bottle.

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When will my periods start?
If you are breastfeeding solely and not giving your baby formula or solid food, you probably won't have a period for several months, depending on your hormonal level.

Can I get pregnant while nursing?
Yes, it is definitely possible to get pregnant while you are still nursing your baby. If you do not want to take the risk, ask your healthcare provider about safe and effective birth control methods.

Can I take birth control pills?
Yes, you can use birth control pills, but safety varies among the types, so ask your healthcare provider. Also, some types may decrease your milk volume. You might want to explore other options such as condoms or a diaphragm.

My baby has white patches on his tongue. What could this be?

Thrush is a yeast infection in the baby's mouth. Symptoms are white patches on the baby's tongue and gums and inside cheeks or as red dots or a rash in the diaper area. It may happen when you or your baby take antibiotics.

Thrush often spreads to the mother's nipples, making them red and painful.

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What can I do about thrush?
If you suspect thrush, immediately contact a lactation consultant or your health care provider.

Thrush is usually treated by applying nystatin (Mycostatin) drops or ointment in the baby's mouth and on the mother's nipples.

What can I eat while I'm breastfeeding?
Most mothers can eat whatever healthy foods they want. But some babies get fussy if mothers eat spicy foods, like Mexican or Italian food, or foods that cause gas like beans or broccoli. It's usually because the baby’s digestive systems is not mature yet.

If your baby seems to be reacting to something you're eating, try introducing foods one at a time to gauge his reaction. If something seems to bother your baby, wait a few weeks and try again.

Is caffeine OK?
Caffeine transfers to your baby through your milk. If you must have coffee, tea or caffeinated soft drinks, closely limit them.

What about drinking alcohol? Is a beer or a glass of wine OK?
Alcohol passes through your milk to your baby, so you should be careful. An occasional drink is probably OK, but it's best to drink after you feed your baby so there will be a low amount of alcohol in your milk.
 

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I'm trying to quit smoking, but I haven't gotten there yet. How harmful is it to my baby?
Nicotine enters your milk and can be passed to your baby when you smoke.

Never smoke or allow anyone to smoke around your baby. Second-hand smoke is dangerous for babies.

What should I do if I have a cold or the flu? What medications can I take?
Try non-medication approaches first, such as increasing your rest and drinking more fluids. If you need medicine for cold or flu, take a type that says it is "non-drowsy." Avoid:

• Antihistimines

• Time-release medications

It's usually safe to take:

• Acetaminophen

• Ibuprofen

• Penicillin

• Erythromycin

• Cephalosporins

• Decongestants

• Cough drops

• Nose drops, eyedrops

Before taking any medications, Texas Children's Hospital recommends that you speak to a  lactation consultant or your health care provider.

It's best to take any medications at the end of a nursing session.

When you are sick, your milk supply may decrease as a normal response to your illness. But keep breastfeeding, even if you have a fever. Your breast milk can help keep your baby from getting infected.

Be sure to wash your hands frequently, especially after using the bathroom or blowing your nose.

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I have a chronic condition/disease. Can I still breastfeed?

Many women with certain diseases or conditions can still safely breastfeed. However, it's better to err on the side of safety and check with your health care provider. You'll especially want to speak to your doctor or a lactation consultant if you have:

• HIV/AIDS

• Herpes simplex rash (fever blisters) on the nipple/areola

• Substance or alcohol abuse

• Tuberculosis

Can I breastfeed if I have breast implants?
Many women with breast implants successfully nurse their babies. Research has not shown that saline or silicone pass into mother's milk. You may, however, be more susceptible to engorgement. Talk to a lactation consultant if you have concerns.

Is it OK to breastfeed if I am trying to lose weight?
Some women lose weight more slowly when they're breastfeeding; others drop pounds more quickly. If you want to lose weight, be sure to do it slowly and safely. Eat a balanced diet that has enough calories to sustain your milk production.