Breast-feeding: What every mom needs to know

Breast-feeding is a learned art. But it's worth the effort. Consider these tips to get off to a good start.

You know the benefits of breast-feeding. Breast milk contains the right balance of nutrients for your baby. It's easier to digest than commercial formula, and the antibodies in breast milk will boost your baby's immune system. Breast-feeding may even help you lose weight after the baby is born.

But breast-feeding isn't always easy. You may need more practice — and patience — than you might have imagined. Here's help getting off to a good start.

Ask for help — right away

Reading about breast-feeding is one thing. Doing it on your own is something else. The first few times you breast-feed your baby — starting as soon after delivery as possible — ask for help. The maternity nurses or the hospital's lactation consultant can help you position the baby and make sure he or she is latching on correctly. Your doctor, your baby's doctor or your childbirth educator may be able to help, too. Learning correct technique from the very beginning can help you avoid trouble later on.

Feed your baby often

For the first few weeks, most newborns breast-feed every two to three hours around the clock. It's intense. But frequent breast-feeding sessions help stimulate your breasts to produce milk. And the sooner you begin each feeding, the less likely you'll need to soothe a frantic baby. Watch for early signs of hunger, such as stirring and stretching, sucking motions and lip movements. Fussing and crying are later cues.

Get comfortable

Don't bend over or lean forward to bring your breast to your baby. Instead, cradle your baby close to your breast. Sit in a chair that offers good arm and back support. Support yourself with pillows if needed. Or lie on your side with your baby on his or her side, facing you.

When you're settled, tickle your baby's lower lip with your nipple. Make sure your baby's mouth is open wide and he or she takes in part of the darker area around the nipple (areola). Your nipple should be far back in the baby's mouth, and the baby's tongue should be cupped under your breast. Listen for a rhythmic sucking and swallowing pattern.

If you need to remove the baby from your breast, first release the suction by inserting your finger into the corner of your baby's mouth.

Let your baby set the pace

Let your baby nurse from the first breast thoroughly, until the breast feels soft. Then try burping the baby. After that, offer the second breast. If your baby's still hungry, he or she will latch on. If not, simply start the next breast-feeding session with the second breast.

If your baby pauses during breast-feeding sessions to gaze at you or look around the room, enjoy the moment. Consider it an opportunity to slow down and bond with your baby.

If your baby consistently nurses on only one breast at a feeding during the first few weeks, pump the other breast to relieve pressure and protect your milk supply.

Hold off on a pacifier — at first

Some babies are happiest when they're sucking on something. Enter pacifiers — but there's a caveat. Giving your baby a pacifier too soon may interfere with breast-feeding. The American Academy of Pediatrics recommends waiting to introduce a pacifier until a baby is 1 month old.

Gauge your success

When your baby is latched on successfully, you'll feel a gentle pulling sensation on your breast — rather than a pinching or biting sensation on your nipple. Your breasts may feel firm or full before the feeding, and softer or emptier afterward. Look for your baby to gain weight steadily, produce six to eight wet diapers a day and be content between feedings. Your baby's stools will become yellow, seedy and loose.

Take care of your nipples

After each feeding, it's OK to let the milk dry naturally on your nipple. If you're in a hurry, gently pat your nipple dry. To keep your nipples dry between feedings, change bra pads often.

When you bathe, keep soap, shampoo and other cleansers away from your nipples. If your nipples are dry or cracked, try an ointment containing lanolin. Rubbing olive oil or expressed milk on your nipples may help, too.

Wear loose clothing

Many breast-feeding moms choose loose tops that can be partially unbuttoned — from the bottom up — for feedings. You can also use a receiving blanket to cover yourself and your baby while you're breast-feeding. If you'd like more privacy, ask someone to hold a baby blanket or stand in front of you while you get the baby settled.

Make healthy lifestyle choices

Your lifestyle choices are just as important when you're breast-feeding as they were when you were pregnant.

• Eat plenty of fruits, vegetables and whole grains.
• Drink lots of fluids.
• Rest as much as possible.
• Only take medication with your doctor's OK.
• Don't smoke.

Also beware of caffeine and alcohol. Too much caffeine makes some breast-fed babies irritable. If you choose to have an occasional alcoholic drink, avoid breast-feeding for two hours afterward.

Give it time

If breast-feeding is tougher than you expected, try not to get discouraged. It's OK to have a slow start. As you and your baby get to know each other, breast-feeding will begin to feel more natural.

If you're struggling, ask for help — especially if every feeding is painful. Although your nipples may be tender for the first few weeks, breast-feeding isn't supposed to hurt. Sometimes a problem with the baby's tongue or another issue may interfere with breast-feeding. Ask a lactation consultant or your doctor for help. Early support is often the key to breast-feeding success.

Breast-feeding: Pumping and maintaining your milk supply

Pumping milk while you're away from your baby can help you continue breast-feeding for as long as possible. Here's help maintaining your milk supply when you're pumping.

Breast-feeding is based on supply and demand. The more you breast-feed your baby, the more milk your breasts will produce. If you pump milk while you're away from your baby, here are some suggestions to keep your milk supply on track.

• Relax. Stress can hinder your body's natural ability to release breast milk. Find a quiet place to pump. It may help to massage your breasts or use warm compresses. Sometimes looking at a picture of the baby, thinking about the baby or listening to a recording of the baby's cry helps stimulate milk flow.
• Pump often. The more you pump, the more milk you'll produce — especially if you're using a high-quality pump. If you're working full time, try to pump for 15 minutes every few hours during the workday.
• Pump both breasts simultaneously. Pumping both breasts at the same time will increase your body's production of prolactin, the hormone responsible for milk production.
• When you're with your baby, breast-feed on demand. The more you breast-feed your baby when you're together, the greater your supply will be when you pump. Try more frequent evening, early morning or weekend feedings. Pumping after a breast-feeding session can help boost milk supply, too — even if you pump but no milk is produced.
• Avoid or limit formula feedings. Formula feedings will reduce your baby's demand for breast milk — which will lower your milk production. Remember, the more you breast-feed your baby or pump while you're apart, the more milk you'll produce. It also helps to pump ahead — either after or between breast-feeding sessions.
• Take care of yourself. Eat plenty of fruits, vegetables and whole grains. Get some exercise every day. Rest as much as you can — and don't be afraid to ask for help when you need it.
• Drink plenty of fluids. Water, juice and milk can help you stay hydrated. But limit soda, coffee and other caffeinated drinks. Too much caffeine can reduce your milk supply.
• Don't smoke or drink alcohol. Alcohol can interfere with milk letdown, and smoking can reduce your milk supply. If you choose to have an occasional alcoholic drink, avoid breast-feeding for two hours afterward.
• Avoid birth control pills. Birth control pills that contain estrogen may interfere with milk production. Ask your doctor about other birth control options.

Breast-feeding is a commitment — and your efforts to maintain your milk supply are commendable. If you're having trouble maintaining your milk supply, ask your doctor or lactation consultant for other suggestions. Counselors from La Leche League and similar organizations can help, too.

Breast-feeding: Is your baby getting enough milk?

If you're breast-feeding, you may wonder whether your baby is getting enough milk. Ask yourself these questions — and know when to seek help.

When you're breast-feeding, you can't measure the amount of milk your baby takes at each feeding. But that's OK. You can watch for reassuring signs that your baby is getting enough to eat.

Cover the basics

When you're breast-feeding, ask yourself these questions:

• Is my baby gaining weight? Steady weight gain is often the most reliable sign that a baby is getting enough to eat. Although most babies lose weight soon after birth, it's typically regained — and then some — within two weeks. Your baby will be weighed at each checkup. If you're concerned about your baby's weight, you may want to schedule more frequent weigh-ins.

• How often does my baby breast-feed? Most newborns breast-feed eight to 12 times a day — about every two to three hours. Within two to three months, your baby may begin to go longer between feedings.

  During growth spurts — often at 10 to 14 days after birth, as well as at three weeks, six weeks, three months and six months — your baby may take more at each feeding or want to breast-feed more often. Trust your body's ability to keep up with the increased demand. The more often your baby nurses, the more milk your breasts produce.

• Can I hear my baby swallowing? If you listen carefully, you'll be able to hear your baby swallowing. Also look for a strong, steady, rhythmic motion in your baby's cheek. There may be a pause while your baby swallows. A small amount of milk may even dribble out of your baby's mouth.
• How do my breasts feel? When your baby is latched on successfully, you'll feel a gentle pulling sensation on your breast — rather than a pinching or biting sensation on your nipple. Your breasts may feel firm or full before the feeding, and softer or emptier afterward. If breast-feeding hurts, ask for help. Your baby's doctor may offer suggestions, and many hospitals have lactation consultants on staff.
• What about my baby's diapers? For the first few weeks, expect your baby to have six to eight wet diapers a day. A wet diaper will weigh about the same as a dry disposable diaper filled with 2 to 4 tablespoons of water. Also expect regular bowel movements — often three or more a day. The stool will be dark and sticky for the first few days, eventually becoming seedy, loose and golden yellow.
• Does my baby seem healthy? A baby who seems satisfied after a feeding and is alert and active at other times is likely getting enough to eat. Also look for a healthy skin tone.

Trust your instincts

You know your baby best. If you sense something isn't right, contact your baby's doctor — especially if your baby:

• Isn't gaining weight
• Isn't wetting six to eight diapers a day or having regular bowel movements
• Is consistently fussy after feedings
• Seems sleepy all the time
• Isn't interested in breast-feeding
• Spits up forcefully or more than a tablespoon or two after each feeding

Remember, every baby is unique. You may be surprised by your baby's hunger — or lack of appetite. As long as your baby grows and develops normally, you can be sure that you're meeting his or her nutritional needs.

Breast-feeding: Choosing a breast pump

If you're breast-feeding your baby, a breast pump may offer welcome flexibility. But how do you know which type of pump is best? Ask yourself these questions.

Breast-feeding is a round-the-clock commitment. That's why many breast-feeding mothers consider breast pumps as important as car seats and baby wipes.

Whether you're going back to work or simply want the flexibility a breast pump offers, you'll have many choices. Some breast pumps are hand-operated, and others run on electricity. The designs also vary. Some models attach to only one breast. Others let you express milk from both breasts at once.

To decide which type of breast pump is best for you, ask yourself these questions.

How often do you plan to use the breast pump?

If you'll be away from the baby only occasionally, a simple hand pump may be all you need. These pumps are small and inexpensive. You simply squeeze the handle to express the milk. You may even choose to pump one breast while the baby nurses on the other breast.

If you're returning to work full-time or you're planning to be away from your baby for more than a few hours a day, you may want to invest in an electric pump. Electric pumps stimulate the breasts more effectively than hand pumps. This helps empty your breasts and protect your milk supply.

How long will it take to pump each breast?

Electric breast pumps are faster than manual pumps. If you'll be pumping at work or in other time-crunched situations, you may want to invest in a model that allows you to pump both breasts at once. Double breast pumps help stimulate milk production while cutting pumping time in half.

Is the pump easy to assemble?

If the breast pump is difficult to assemble, take apart or clean, it's bound to be frustrating — which may reduce your enthusiasm for pumping. Make sure you can remove any parts of the pump that come in contact with your skin or milk for cleaning after use.

Is the suction adjustable?

What's comfortable for one woman may be uncomfortable for another. Choose a pump that allows you to control the degree of suction. Some manual models allow you to adjust the position of the pump handle.

Is the pump heavy?

If you'll be toting the pump to work every day or traveling with the pump, look for a lighter-weight model. Some breast pumps come in a carrying case with an insulated section for storing expressed milk.

How noisy is the pump?

Some electric models are quieter than others. If it's important to be discreet, make sure the pump's noise level is acceptable.

Are the breast shields the correct size?

Every pump has a shield to place over your breast. If you're concerned that the standard breast shield is too small, check with individual manufacturers about other options. If you want to pump both breasts at once, make sure the pump is equipped with two breast shields.

If you're considering an electric pump, does it have backup power options?

An electric pump needs to be plugged in. If an outlet isn't accessible, you'll need a rechargeable battery pack. Some models offer adapters that run on a car's cigarette lighter.

Is cost a concern?

You can buy breast pumps from medical supply stores and most drug and baby stores. Manual models cost less than $50. Electric pumps that include a carrying case and insulated section for storing milk may cost more than $200. Some hospitals rent hospital-grade breast pumps, although the equipment that attaches your breast to the pump must be purchased. Because there is a small risk of contamination, borrowing a breast pump or buying a used pump isn't recommended.

Find out if your health insurance plan covers the cost of buying or renting a breast pump.

What if you're just not sure?

Ask for help. A lactation consultant can help you make the best choice — and offer support as you start to use your breast pump or if you run into trouble. If you haven't worked with a lactation consultant, ask your doctor for a referral. Counselors from La Leche League and similar organizations can help, too.

Breast-feeding and guilt: Interview with a Mayo Clinic specialist

The benefits of breast-feeding are well established — but the decision to use formula shouldn't lead to guilt.

The benefits of breast-feeding are well established. Breast milk contains the right balance of nutrients for your baby, and the antibodies in breast milk boost your baby's immune system. But in some cases, exclusive breast-feeding isn't possible or practical. The decision to use formula shouldn't lead to guilt, says Jay Hoecker, M.D., a pediatrician at Mayo Clinic, Rochester, Minn.

How long are mothers encouraged to breast-feed?

Breast-feeding for at least four months helps boost your baby's immune system. Breast-feeding throughout the first year is ideal. Most breast-feeding mothers in my practice wean their babies between ages 9 and 15 months.

What factors can promote successful breast-feeding?

Taking good care of yourself can go a long way toward promoting successful breast-feeding. Eat healthy foods, drink plenty of fluids and rest as much as possible. To boost your confidence, learn as much as you can about breast-feeding. Keep the environment calm and relaxed. Look to your partner and other loved ones for support. If things aren't going well, ask for help. Friends who've successfully breast-fed may be a good source of information. Lactation consultants are available at many hospitals and clinics. Your baby's doctor can help, too.

Is it risky not to breast-feed?

Breast milk is the best food for babies — but risk is a relative term. Although breast-feeding your baby is certainly beneficial, proper nourishment is absolutely necessary. If breast-feeding isn't working for you despite your best attempts to succeed, your baby may not receive adequate hydration or nutrition. In this case, sticking with it for your baby's sake may pose serious risks.

Does infant formula pose any risks to a baby?

Commercial infant formulas don't contain the immunity-boosting elements of breast milk. But when prepared as directed with clean water, infant formula poses no risks to healthy babies with typical dietary needs.

Can mothers combine breast-feeding and formula-feeding?

Many mothers successfully combine breast-feeding and formula-feeding. If exclusive breast-feeding isn't possible or practical for you, remember that babies need consistency. Determine the right compromise between breast-feeding and formula-feeding and follow a consistent schedule.

How should mothers who choose not to breast-feed handle feelings of guilt or inadequacy?

Guilt has no place in a thoughtful decision about breast-feeding. Instead, focus on your baby. Nurture your baby, and make sure he or she is well nourished. Don't feel guilty for doing what makes the most sense for you and your baby — whether it's combining breast-feeding and formula-feeding or using formula exclusively. If you're struggling with your decision not to breast-feed, it may help to share your feelings with your baby's doctor or another caring and knowledgeable person.

What to do when your newborn cries

Most newborns cry a lot. Just ask any new parent! Find out why babies cry — and how to cope with the tears.

The dream: Your baby sleeps through the night after just a few weeks, gurgles happily while you run errands and only fusses when hunger strikes.

The reality: Your baby's favorite playtime is after the 2 a.m. feeding. Crankiness peaks when you're out and about. You had no idea a baby could cry this much.

Sound familiar?

In any given day, the average newborn cries for more than two hours. Find out why babies cry — and how to cope with the tears.

Decoding the tears

Newborn crying jags are inevitable. Your job is to figure out why your baby is crying and what — if anything — you can do about it. Consider what your baby may be thinking:

• I'm hungry. Most newborns eat every few hours around the clock. Some babies become frantic when hunger strikes. They may get so worked up by the time the feeding begins that they gulp air with the milk, which may cause spitting up, trapped gas or more crying. To avoid such frenzy, respond to early signs of hunger. If your baby begins to gulp during the feeding, take a break.
• I need to burp. During and after each feeding, take time to burp your baby. But don't stop there. Your baby may need to burp between feedings as well.
• I pooped. For some babies, a wet or soiled diaper is a surefire way to trigger tears. Gas or indigestion may have the same effect. Check your baby's diaper often to make sure it's clean and dry.
• I'm tired. Tired babies are often fussy. Make sure your baby is getting enough sleep. For newborns, this often means up to 16 hours — or even more — every day.
• I'd rather be bundled. Some babies feel most secure in a swaddle wrap. Snugly wrap your baby in a receiving blanket or other small, lightweight blanket.
• I want to move. Sometimes a rocking session or walk through the house is enough to soothe a crying baby. In other cases, a change of position is all that's needed. Keeping safety precautions in mind, try a baby swing or vibrating infant seat. Weather permitting, head outdoors with the stroller. You may even want to buckle up for a ride in the car.
• I'm lonely. Sometimes simply seeing you, hearing your voice or being cuddled may stop the tears. Gentle massage or light pats on the back may work, too.
• I'm hot. A baby who's too hot or cold is likely to be uncomfortable. Add or remove a layer of your baby's clothing as needed.
• I want to suck on something. Sucking is a natural reflex. For many babies, it's a comforting, soothing activity. If your baby isn't hungry, try a clean finger or pacifier.
• I've had enough. Too much noise, movement or visual stimulation may drive your baby to tears. Move to a calmer environment or place your baby in the crib. White noise — such as a recording of ocean waves or the monotonous sound of an electric fan or vacuum cleaner — may help your baby relax.
• It's just that time of day. Many babies have predictable periods of fussiness during the day. There may be little you can do but comfort your baby as the crying runs its course.
• My tummy hurts. If you're breast-feeding your baby, he or she may be fussier than usual after you eat spicy or gas-producing foods. Too much caffeine may be an issue as well. If you suspect a certain food is causing trouble, avoid it for several days to see if it makes a difference.

Is it just fussiness, or is it colic?

Some babies have frustrating periods of intense, inconsolable crying known as colic. Colic is often defined as crying more than three hours a day, three days a week for more than three weeks in an otherwise well-fed, healthy baby. Colic episodes are most common in the late afternoon or evening. The crying often begins suddenly and for no apparent reason. During an episode, your baby may be difficult — or even impossible — to comfort.

What causes colic remains a mystery. If you're concerned about colic, consult your baby's doctor. He or she can make sure your baby is otherwise healthy and help you learn how to care for a colicky baby.

Taking care of yourself

It's tough to listen to your baby cry. To take the best care of your baby, it's important to take care of yourself, too.

• Take a break. When you've done what you can, ask your spouse or another loved one to take over for a while. Take advantage of baby-sitting offers from friends or neighbors. Even an hour on your own can help renew your coping strength.
• Make healthy lifestyle choices. Eat healthy foods. Make time for exercise, such as a brisk daily walk. If you can, sleep when the baby sleeps — even during the day. Avoid alcohol and other drugs.
• Remember that it's temporary. Crying spells often peak at about six weeks and then gradually decrease.
• Know when to call the doctor. If you're concerned about the crying or your baby isn't eating, sleeping or behaving like usual, call your baby's doctor. He or she can help you tell the difference between normal tears and something more serious.

It's also important to recognize your limits. If your baby's crying is causing you to lose control, put the baby in a safe place — such as a crib — and go to another room to collect yourself. If necessary, contact your doctor, a local crisis intervention service or a mental health help line for additional support.

What to do when your newborn cries

Most newborns cry a lot. Just ask any new parent! Find out why babies cry — and how to cope with the tears.

The dream: Your baby sleeps through the night after just a few weeks, gurgles happily while you run errands and only fusses when hunger strikes.

The reality: Your baby's favorite playtime is after the 2 a.m. feeding. Crankiness peaks when you're out and about. You had no idea a baby could cry this much.

Sound familiar?

In any given day, the average newborn cries for more than two hours. Find out why babies cry — and how to cope with the tears.

Decoding the tears

Newborn crying jags are inevitable. Your job is to figure out why your baby is crying and what — if anything — you can do about it. Consider what your baby may be thinking:

• I'm hungry. Most newborns eat every few hours around the clock. Some babies become frantic when hunger strikes. They may get so worked up by the time the feeding begins that they gulp air with the milk, which may cause spitting up, trapped gas or more crying. To avoid such frenzy, respond to early signs of hunger. If your baby begins to gulp during the feeding, take a break.
• I need to burp. During and after each feeding, take time to burp your baby. But don't stop there. Your baby may need to burp between feedings as well.
• I pooped. For some babies, a wet or soiled diaper is a surefire way to trigger tears. Gas or indigestion may have the same effect. Check your baby's diaper often to make sure it's clean and dry.
• I'm tired. Tired babies are often fussy. Make sure your baby is getting enough sleep. For newborns, this often means up to 16 hours — or even more — every day.
• I'd rather be bundled. Some babies feel most secure in a swaddle wrap. Snugly wrap your baby in a receiving blanket or other small, lightweight blanket.
• I want to move. Sometimes a rocking session or walk through the house is enough to soothe a crying baby. In other cases, a change of position is all that's needed. Keeping safety precautions in mind, try a baby swing or vibrating infant seat. Weather permitting, head outdoors with the stroller. You may even want to buckle up for a ride in the car.
• I'm lonely. Sometimes simply seeing you, hearing your voice or being cuddled may stop the tears. Gentle massage or light pats on the back may work, too.
• I'm hot. A baby who's too hot or cold is likely to be uncomfortable. Add or remove a layer of your baby's clothing as needed.
• I want to suck on something. Sucking is a natural reflex. For many babies, it's a comforting, soothing activity. If your baby isn't hungry, try a clean finger or pacifier.
• I've had enough. Too much noise, movement or visual stimulation may drive your baby to tears. Move to a calmer environment or place your baby in the crib. White noise — such as a recording of ocean waves or the monotonous sound of an electric fan or vacuum cleaner — may help your baby relax.
• It's just that time of day. Many babies have predictable periods of fussiness during the day. There may be little you can do but comfort your baby as the crying runs its course.
• My tummy hurts. If you're breast-feeding your baby, he or she may be fussier than usual after you eat spicy or gas-producing foods. Too much caffeine may be an issue as well. If you suspect a certain food is causing trouble, avoid it for several days to see if it makes a difference.

Is it just fussiness, or is it colic?

Some babies have frustrating periods of intense, inconsolable crying known as colic. Colic is often defined as crying more than three hours a day, three days a week for more than three weeks in an otherwise well-fed, healthy baby. Colic episodes are most common in the late afternoon or evening. The crying often begins suddenly and for no apparent reason. During an episode, your baby may be difficult — or even impossible — to comfort.

What causes colic remains a mystery. If you're concerned about colic, consult your baby's doctor. He or she can make sure your baby is otherwise healthy and help you learn how to care for a colicky baby.

Taking care of yourself

It's tough to listen to your baby cry. To take the best care of your baby, it's important to take care of yourself, too.

• Take a break. When you've done what you can, ask your spouse or another loved one to take over for a while. Take advantage of baby-sitting offers from friends or neighbors. Even an hour on your own can help renew your coping strength.
• Make healthy lifestyle choices. Eat healthy foods. Make time for exercise, such as a brisk daily walk. If you can, sleep when the baby sleeps — even during the day. Avoid alcohol and other drugs.
• Remember that it's temporary. Crying spells often peak at about six weeks and then gradually decrease.
• Know when to call the doctor. If you're concerned about the crying or your baby isn't eating, sleeping or behaving like usual, call your baby's doctor. He or she can help you tell the difference between normal tears and something more serious.

It's also important to recognize your limits. If your baby's crying is causing you to lose control, put the baby in a safe place — such as a crib — and go to another room to collect yourself. If necessary, contact your doctor, a local crisis intervention service or a mental health help line for additional support.