Frequently Asked Questions About Breastfeeding
“How do I know my baby is getting enough?”
This is a common concern among breastfeeding mothers. Don't worry if your baby loses weight in the first few days. This is normal for all newborns. Within two weeks, your baby should be back to his or her birth weight and begin a steady weight gain. The best way to know your baby is “getting enough” before seeing steady weight gain is to watch for adequate swallowing during breastfeedings and track appropriate wet and dirty diapers.
During a feeding your baby's suckling pace becomes slower, the chin drops lower and he or she pauses. This pause indicates a mouthful of milk as the baby swallows. The pauses may be subtle in the first couple days but should increase and become more noticeable as milk volume increases.
On day one, you can expect your baby to have at least one wet and one black/sticky stool. By day five, you can expect to see five to six soaking wet diapers. By day three,stools will increase to approximately three become lighter in color and appear loose, yellow and seedy by day 5. Your baby will be active, alert and content after feedings. A Breastfeeding Log for First Week will be provided and reviewed before discharge.
“When will my milk come in?”
Your breasts should start filling with mature milk three to five days after delivery. This can vary from mother to mother, however. Do not be concerned that you have “no milk” for your baby in the first few days, because there is actually a very important type of breast milk present in small amounts. Colostrum is early breast milk and is available in small amounts, drops to teaspoons, at each feeding. It is very rich and provides your baby with important nutrients and immune-boosting benefits. Colostrum protects your baby from bacteria, viruses and allergens. The small amounts present are perfect for your baby with a tummy about the size of a marble at birth.
“Is it normal to have nipple pain/soreness?”
You may notice mild nipple tenderness at the beginning of a feeding immediately following the latch, but that should ease during the feeding. This tenderness is associated with correct latching and should go away within the first week. If your nipple pain does not ease or your nipples become cracked, blistered, bleed or appear pinched after feedings, this is not normal. To ease sore nipples you should determine the cause and assess your baby’s latch. Correcting a shallow latch often resolves the nipple discomfort.
Signs of a correct latch include: holding your baby belly-to-belly, tucking your baby’s hips close to you, pressing the nipple to baby’s nose, pointing the nipple to the roof of baby’s mouth, baby's lips flanged with wide open mouth around darker area beyond nipple, baby's chin closer than nose, no clicking or smacking sounds, and the nipple appears to be a normal shape after feedings. Seek the help of a nurse or lactation team member to review signs of a correct latch and treatment options for nipples that have become cracked and sore.
“Do I need to follow a special diet or avoid specific foods while breastfeeding?”
We encourage you to eat a healthy, well-balanced diet of a variety of foods. You should be taking in around 500 extra calories a day, drinking to thirst and taking multivitamins as needed. Speak with a lactation consultant early on if you currently follow a specific diet such as vegetarian, vegan or lactose-free, to ensure you are meeting nutritional needs for yourself and your milk supply. You should limit or avoid all alcohol and caffeine.
If truly concerned a specific food or foods are affecting your baby, avoid those foods for a few days to a week and see if symptoms improve. Speak with the baby’s doctor or a lactation consultant if you have concerns about a possible milk protein allergy. Babies will become less sensitive to bothersome foods and caffeine as they get older.
“My baby wants to nurse all the time! Is this normal?”
Don't worry. It's normal for breastfeeding babies to nurse often. You can expect eitght to 12 feedings in 24 hours. These frequent feedings will help establish a healthy, abundant milk supply. Breast milk is easily and quickly digested, so frequent feedings are common.
You may find your baby doing what is called “cluster feeding." This is when several feedings occur close together during certain times of the day, most often in the evening to early night-time. Typically, after a “cluster feeding” session, your baby will sleep for a longer stretch of time. Cluster feedings can also be expected during growth spurts. It is your baby’s way to boost milk supply/intake to meet their needs. The more often milk is emptied from your breasts the more milk is made. These times of cluster feedings and growth spurts can last a few days and can be expected on average around two days, seven to 10 days, two to three weeks, four to six weeks, three months, four months, six months, and nine months. Making note of these dates on your calendar after delivery may help remind you these are normal and expected.
Your baby should continue to have plenty of wet and dirty diapers each day and gain weight appropriately. Following your baby’s desire to nurse often will naturally boost your milk supply to meet their growing needs.
“What do I do when my baby is sleepy and won't latch?”
It's normal for your baby to go through sleepy times in the first couple days. It is important for mothers to be patient and give the baby time to sleep. Do as much skin-to-skin time as possible, keeping you and your baby covered with a blanket. Learn hand expression if your baby has not latched successfully in several hours after birth and safely spoon or cup feed expressed colostrum to your baby and place drops on your baby's lips. Watch for early feeding cues and gently position baby to breast.
If your baby continues to be sleepy beyond 24-48 hours and won’t latch, you will be advised to pump your breasts approxamently 15 minutes or until softened and well past last drop of milk, eight or more times a day. Call your baby’s doctor and seek assistance from a lactation consultant if you have questions or concerns. Some babies may need more time to transition to active breastfeeders or may need further evaluation.
“Is it ok to give my baby a pacifier?”
According to the American Academy of Pediatrics, you should avoid pacifier use for three to four weeks while your baby is learning to correctly latch and establish a milk supply from its mother. It should be introduced only when breastfeeding is well established. Routine pacifier use reduces the time at the breast, and is often used to postpone or delay feedings. Establishing a full milk supply is dependent on frequent effective feedings; therefore, it can be negatively affected by pacifier use.
Current SIDS guidelines do recommend the use of pacifiers at nap time and bedtime. However, they do recommend you delay introduction of pacifiers to breastfeeding infants until after 1 month of age with breastfeeding firmly established. Breastfeeding is also recommended to reduce the risk for SIDS.
“When should I be concerned and call my physician?”
You will need to call your baby’s doctor right away for urgent care needs including:
- Not enough wet and dirty diapers
- Black/dark stools beyond the fourth day of life
- Excessive sleepiness
- Sleeping through two feedings in a row
- Poor tone
- Yellow color to skin or whites of eyes
- If you have red, swollen breasts or a painful lump
- If you have fever or flu-like symptoms
“Where can I get breastfeeding support?”
If you need extra assistance, are having trouble breastfeeding or want to know more, here are some local resources to explore:
Our Resources and References:
- Riordan, J. & Wambach, K. (2010). Breastfeeding and Human Lactation, 4th ed
- UPMC Susquehanna “The Birthplace Breastfeeding Log for the First Week”
- UPMC Susquehanna “Breastfeeding Your Baby”