Breastfeeding and Healthy Living: Common Questions
Table of Contents
Both babies and their mothers benefit from breastfeeding. Breastmilk contains antibodies and other factors that protect babies from disease, infection, and allergies.
Studies have shown that formula fed babies have a greater risk of getting ear infections, diarrhea, constipation, SIDS (Sudden Infant Death Syndrome) dental problems, and developing obesity, diabetes, lymphoma, leukemia and asthma later in life. Formula fed babies also score slightly lower on intelligence (IQ) tests later in life and are sick and hospitalized more often than breastfed babies.
Breastfeeding is good not only for the health of babies, but their mothers, too. Breastfeeding burns calories and can help a new mother return to her pre-pregnancy shape and weight more quickly. Mothers report a special bond with their breastfed babies. In addition, studies show that breastfeeding helps lower a woman’s risk for certain types of cancers, including breast cancer. Also, women formula fed as infants have more breast cancer as adults.
Breastfeeding is also good for the environment. Breastmilk is produced without the packaging, plastic waste and trash which comes with infant formula. Breastfeeding and its products do not take up space in landfills.
Most women can breastfeed. However, women who have the human immunodeficiency virus (HIV), active tuberculosis, are in chemotherapy treatment for cancer, or use recreational drugs should not breastfeed.
The American Academy of Pediatrics and the World Health Organization recommend breastfeeding as the perfect way to feed an infant. The more breastmilk a baby gets the more benefits to the baby’s health and immune system.
While you are pregnant, find people to help you with your breastfeeding. Get to know what to expect and to whom you can go for help by going to prenatal breastfeeding classes at your local hospital or breastfeeding support groups like the ones offered by La Leche League or the Nursing Mothers Counsel.
If you participate in the WIC (Women, Infants, and Children) Special Supplemental Food Program, go to their breastfeeding classes and ask if there is a breastfeeding peer counselor available to support you. Talk to other mothers who have successfully breastfed, and make sure your family and partner also know what you want.
Years ago, women were told to “toughen up” their nipples to prepare for breastfeeding. We now know that this is not necessary. To prevent sore nipples, it is more important to make sure that the baby is at the correct position at the breast, and that the baby’s mouth is open wide (like a yawn) before going to the breast, so that the baby takes more than just the nipple into the mouth.
Links to some websites that show videos with various steps in latching:
A birthing plan will let the hospital staff and your family members know your wishes during labor and delivery. Certain common procedures and medications used during labor and delivery can make it more difficult to get breastfeeding off to a good start. It is important to consider which procedures you want or do not want. Some examples of birth plans can be found at: English Birth Plan (PDF)...Spanish (Word). You can check off what you want and talk it over with your Obstetrician or Midwife as well as your family.
TIP: Who do you want to be with you in the delivery room? Do you want your baby to stay with you instead of going to the Nursery? If your baby stays with you, it will be easier to feed the baby when the baby wants. How do you want your baby fed? All of these questions and more should be discussed before you go into labor and be listed on your birth plan.
And it’s not too early to think about choosing a doctor who supports breastfeeding for your baby.
Normally, every woman can produce enough breastmilk to feed their infants. Even twins or triplets can be successfully breastfed by their mother. In only rare cases, physical or medical problems prevent the woman from making enough breastmilk.
In this case, size does NOT matter. The size of a woman’s breasts, whether small, medium or large, does not determine how much breastmilk is made. But you should notice changes in your breasts during your pregnancy. This tells you that your body is getting ready to breastfeed.
The amount of milk you make depends on how much and how well the baby breastfeeds. Giving a pacifier or bottle of formula during the first few weeks will reduce the amount of milk your body will make. Hold your baby “skin to skin” and breastfeed often (every one to two hours) or pump if your baby is unable to breastfeed to build up your breastmilk production. Waiting too long between breastfeedings, and giving your baby formula or a pacifier can decrease the amount of breastmilk your body makes.
TIP: Wait until your baby is at least 4 weeks old and has learned to breastfeed well before you give a pacifier. Some babies who get pacifiers in their early weeks of life have a harder time breastfeeding.
Newborn babies should be breastfed at least 8 times in 24 hours. Some babies will breastfeed every 1 to 3 hours, throughout the day and night. Do not expect your baby to sleep through the night, or eat at regular intervals. Wake him up at least every three hours to feed. As the baby gets older, his feeding pattern will change.
Babies should not be forced to be fed on a schedule. Instead of watching the clock to know if it is time to breastfeed your baby, watch your baby for “feeding cues” or signs that he is hungry. If your baby fidgets, sucks on his hands, smacks his lips, stretches and clenches his fist, he may be telling you it is time to eat. Breastmilk is easier to digest than manufactured formula, so a breastfed baby will want to feed more often than a formula-fed baby.
TIP: Try to feed your baby before he gets too hungry (a crying baby has more trouble learning how to breastfeed). Watch for feeding cues and offer the breast even if it has only been a short time since the last feeding. Sometimes babies burp and need to eat again because their tummy has more room, or they “cluster feed” and want to eat frequent snacks during some part of the day.
Breastfeeding should not hurt. If it does, talk to your doctor, your support person at WIC, in La Leche League or, see a lactation consultant (IBCLC). Lactation consultants are trained to help with breastfeeding problems. You can find a lactation consultant through the International Lactation Consultant Association.
If your nipples get sore, baby may not be attached to the breast or positioned correctly. Make sure that baby doesn’t just feed on the nipple. Baby should breastfeed, not nipple feed!
TIP: Seek help from a lactation consultant early if breastfeeding hurts. The baby should have all or most of the areola in his mouth, not just the nipple. See the pictures in La Leche League International’s article on the Mother-Baby Dance.
Since you cannot measure the amount of breastmilk your baby is getting, there are other ways to be sure that your baby is getting enough to eat. Feed him often, at least 8 times and often many more, in 24 hours. Listen for swallowing sounds while he is at the breast. When babies are allowed to decide (as long as they are healthy, full-term babies) when and how often and how long to eat, they are less likely to become obese. Breastfeeding “on cue” is much healthier for your baby.
TIP: Another way to check if your baby is getting enough to eat is to notice how much comes out of the other end! Count the diapers…. When baby is 5 days old, he should have at least 5 “wet” diapers and 3 “dirty” diapers. More tips on what to expect with a new baby can be found in the handout, What to Expect in the First Week of Breastfeeding (PDF).
Babies lose a few ounces of their body weight in their first week, but they should return to their birth weight by 10 to 14 days of age. After the first two weeks, babies should gain at a slow, steady rate. Please visit your baby’s doctor or other health care provider for weight checks to be sure that your baby’s growth is going well.
Many women breastfeed their babies wherever they go. There are no bottles and formula cans to carry around. There is no formula to mix and keep cold or throw away due to fear of spoiling. Breastmilk is always at the right temperature, is clean and safe, and is always ready.
In California, the law protects a woman so she can breastfeed in public. You can print this card to use when responding to anyone who asks you not to breastfeed in public.
TIP: Some women are embarrassed to breastfeed in front of other people. You don’t have to nurse your baby in a bathroom! Many stores have semi-private areas like a dressing room or a lounge. Remember, you are doing what is best for your baby. You can breastfeed and be discreet if you want to, with a little practice! Try wearing a loose-fitting shirt or a blouse that can be unbuttoned from the bottom. Some women find that special nursing bras, or tube tops under a blouse can help. Other mothers cover up their baby and breasts with a blanket, shawl or baby carrier. Even your baby’s hat can help to cover you, if you are uncomfortable. Practicing at home in front of a mirror can help you feel confident. When you are in public, look people in the eye and be PROUD of yourself! You’re doing the very best for your baby!
No, you don’t need to eat special foods or avoid others when you breastfeed. The United States Department of Agriculture has released a new guide called Choose My Plate for pregnancy and breastfeeding. Drink enough fluids (such as water, milk, or juice) to satisfy your thirst. Drinking more than that does not help make more breastmilk.
Your breastmilk is especially designed for your baby, and is full of all the nutrients your baby needs in just the right amounts. Even if you don’t have a perfect diet, most nutrients in your breastmilk are not affected. Most mothers make perfect breastmilk for their babies.
Sometimes a mom might eat or drink something and notice her baby gets fussy. If this happens, wait a couple of days before eating it again and see if your baby has the same reaction. If so, you can avoid that food for a few weeks or months then try again.
TIP: Don’t worry that eating spicy or strong-flavored foods will make your milk turn bad. Eating different foods does change the taste of your breastmilk. This will probably help your baby to accept foods of different tastes when he is older.
Caffeine is a stimulant that can pass into your breastmilk, making your baby fussier and more awake than usual. Coffee, tea, hot chocolate, colas, energy drinks, and other beverages with caffeine are safe to drink in moderation (about three 8- ounce cups per day). If you need to take medicines or cold remedies, discuss these with your doctor, and read their labels as some may also contain caffeine. If you are watching your weight, be aware that many calories can be consumed while drinking beverages.
Alcohol will pass into breastmilk. An occasional glass of beer, wine, or other alcoholic beverage is not harmful to most nursing babies. But if you drink more frequently or in large amounts, it can be harmful for you and your baby. It can prevent your milk from letting down and affect your baby’s sleep-wake pattern. If you have had too many drinks you might be unable to care for your baby. If you are not using birth control, avoid alcohol as it can cause great harm to your next baby, even before you know you are pregnant.
TIP: If you do drink alcohol, stop after one drink, and wait at least 3 hours before breastfeeding your baby. If baby can’t wait that long, feed him a bottle of warmed-up breastmilk from the freezer. More information on Breastfeeding and Alcohol can be found at the La Leche League website: http://www.llli.org//FAQ/alcohol.html, and in the Sonoma County's MCAH Website's document "Counseling Guidelines:Breastfeeding and MaternalAlcohol, Tobacco and Other Drug Use" (PDF)of May 2008.
See also: The Infant Risk Center’s article on “Alcohol Usage” updated 6/23/10
If you are going to be drinking more than one drink of alcohol, make sure your baby has a safe place to stay until you can take care of him and breastfeed again.
Nicotine is an addictive drug that will pass into breastmilk, can make babies fussy and can reduce your milk production. Women who smoke often stop breastfeeding sooner than they planned. Your smoking puts your baby at risk of having more respiratory problems. In most cases is still better to breastfeed even if you are a smoker.
Remember that smoking and being around someone else’s smoke (second-hand smoke) is unhealthy for you and the baby. Do not smoke in the same room or in the car with your baby, and avoid smoking where your baby will be sleeping.
TIP: If you can’t quit smoking, cut down on the number of cigarettes smoked each day. Wait until after you have fed your baby to smoke.
Free help to reduce or stop smoking is as close as your phone: Call the California Smoker’s Helpline: 1-800-NO-BUTTS
Most medications are safe to take while breastfeeding. Talk to your health care provider before you take any prescription or over-the-counter medications. Some medicines, such as some cold or allergy remedies, and birth control pills can reduce your milk supply. Most women should continue to breastfeed when they have a cold, flu, or mild infections. Your baby was exposed to the illness even before you knew you were sick. Your body makes antibodies much more quickly than your baby’s body. Most antibodies will pass to your baby through the breast milk, protecting your baby from becoming as sick as he/she would be if you were formula-feeding.
TIP: If you do need to take medications, be sure to tell your health care provider that you are breastfeeding. Sometimes there is a better choice between two medications when breastfeeding. You can learn more about medications and breastfeeding with the Medications and Breastfeeding
Going back to work or school doesn’t mean you have to stop breastfeeding or can’t give your baby breastmilk. Many women continue to breastfeed after they return to work or school.
TIP: Pumped breast milk can be stored for 3 – 6 months in the freezer. Begin to build up your supply of stored breastmilk a few weeks before you go back to work or school. Between feedings, use a breast pump or hand express your breastmilk into a milk storage bag or bottle. Label, date and freeze these containers. This milk can be thawed and given to your baby by your day care provider in the future.
California has a law that requires employers to provide a clean place other than a bathroom to pump and allow unpaid time for pumping. Discuss with your employer what arrangements can be made before returning to work. An empty office or cubicle can be used. See more suggestions or The Business Case for Breastfeeding to help you when returning to work or school.
The California Department of Public Health, WIC, and the American Academy of Pediatrics agree that breastfeeding should continue through the first birthday, or longer, with the introduction of infant foods at around six months. For more information on infant feeding guidelines, see: Normal Infant Feeding Guidelines (PDF)or Education Materials for Infants or Children