Tips on how to breastfeed (and answers to other common questions) from a lactation expert.
Breastfeeding can be a special time for a mother and baby as they continue to strengthen their bond, but it is not without its challenges — many of which are unique to each mother/child duo. Questions may arise as you begin your breastfeeding journey, and lactation consultants and doctors are great resources for addressing you and your infant’s specific nutritional, emotional, and physical needs.
Kathy Cloninger, a Registered Nurse and International Board-Certified Lactation Consultant, shares her expertise and tips on breastfeeding for expectant and new moms.
How can I tell if I will be able to make enough breastmilk for my baby?
Most women will witness changes in their breasts as pregnancy advances. Some of these changes are breast tenderness, changes to the size or darkness of the areola, and breast fullness. These are signs that your body is preparing to make breastmilk. While these changes are normal during pregnancy, the absence of these changes DOES NOT mean that a woman will not be able to make enough breastmilk for her baby. Most women will not know if their breasts are working sufficiently until they begin their breastfeeding journey.
If the breast changes noted above are not seen, talk to your healthcare team. Plan to carefully monitor your infant to ensure that she/he gets an adequate amount of breastmilk. Try breastfeeding and see what happens.
Is there anything about my breasts or body that should concern me when I am contemplating breastfeeding?
Small breasted women can usually produce enough milk for an infant if the hormones required to make milk are present. As soon as an infant is born, hormones become key in breastmilk production. However, women without fully functioning breast parts may struggle to make breastmilk. Likewise, women who have had chest tubes or breast surgeries (e.g., breast reduction, augmentation, or resection) may struggle to make breastmilk.
Body processes which decrease or imbalance hormones can delay or decrease long-term milk production.
- Some of these processes might be Hypothyroidism, Polycystic Ovarian Syndrome, infertility, advanced maternal age, postpartum hemorrhage, and/or stress which leads to pituitary damage. Check out some of our favorite meditation apps to help reduce stress.
- Women who cannot or do not stimulate their milk making hormones adequately in the first four days of a baby’s life, may also struggle to make enough breastmilk later.
- Women with diabetes and those carrying excess body weight can make enough milk for baby, but it may take longer for a full milk supply to be established.
- A retained piece of placenta in the uterus, when not removed, may prevent a woman’s hormones from fully transitioning to post-delivery amounts, potentially making it difficult for her to produce a full milk supply.
In situations where fully functioning breasts or hormones are a concern, supplementation may be needed until a full supply is established.
If you have ANY of the challenges mentioned above, be sure to discuss them with your healthcare team. Plan to carefully monitor your infant to ensure that they get an adequate amount of breastmilk. Try breastfeeding and see what happens.
Should I wake up my baby to feed them?
Newborns need to eat often, as they are growing quickly and have small stomachs at birth. It is usually recommended that infants eat 8-12 times per day to ensure they are getting adequate nutrition. This means that you may need to wake up your infant if they have not fed in 3-4 hours to ensure they are maintaining their feeding schedule and eating enough. It’s important to use feeding frequency, wet/dirty diapers, signs of swallowing, satiation and weight gain to help assess if baby is getting enough to eat. Feeding your infant 8-12 times per day helps maintain adequate milk production and ensure adequate breastmilk intake.
Begin your breastfeeding journey by talking to your healthcare team about how often baby needs to eat and how to ensure that baby is getting enough nutrition. Emptying your breasts in the first hour after delivery and then eight times a day will be key in developing an adequate milk supply for your baby. Humans are pattern seekers so developing and sticking to routines is one strategy some parents use to keep older babies on track as they grow. (Don’t forget: a time will come when nurturing and maintaining a sleep routine will optimally support your growing infant.)
Breastfeeding can be a wonderfully rewarding yet challenging experience for both mother and child. Use the resources and expertise of your healthcare professionals to determine if your baby is getting enough breastmilk. If there is a question about how much milk baby is getting and are not able to access your healthcare team at the time, offer baby as much expressed breastmilk (or formula in the absence of breastmilk) as she/he wants, until you can get help assessing the situation.