*Edited* BREASTFEEDING FREQUENTLY ASKED QUESTIONS

Nicole - posted on 02/28/2010 ( 117 moms have responded )

LIST OF QUESTIONS ANSWERED IN THIS THREAD:

1) How long should I breastfeed/When should I stop breastfeeding (wean)?

2) Why does it hurt when I breastfeed?

3) How do I know my baby is getting enough breast milk?

4) Why does my baby want to breastfeed all the time?

5) When should I introduce solids to my breastfed baby?

6) Can I take birth control while breastfeeding?

7) Why is my breastfed baby gassy and fussy?

8) When will I get my period back/Is it normal to have a period while breastfeeding?

9) Can I breastfeed while pregnant?

10) My baby hasn't had a bowel movement in a few days. Is this normal?

11) Why is my milk supply going away?

12) Why can't I get much milk out when pumping?

13) Why is my baby refusing to latch on to my breast?

14) Why won't my breastfed baby take a bottle?

15) Why is my baby falling asleep at the breast?

16) Will my baby bite when he gets teeth/How do I stop my baby from biting while teething?

17) Is it possible to lose weight/gain weight while breastfeeding?









1) HOW LONG SHOULD I BREASTFEED/WHEN SHOULD I STOP BREASTFEEDING (WEAN)?

The American Academy of Pediatrics (AAP) recommends EXCLUSIVE BREASTFEEDING for the first 6 MONTHS and continued breastfeeding for AT LEAST 12 MONTHS. The World Health Organization (WHO) recommends UP TO TWO YEARS or longer if both mother and baby are comfortable.



2) WHY DOES IT HURT WHEN I BREASTFEED?

Breastfeeding SHOULD NOT hurt. If it hurts, there is a problem. Yes, breastfeeding can be uncomfortable in the beginning for some, but when breastfeeding is painful, it could be more. Most likely, it is a latch problem. When a baby is being latched to the breast, he should lead with the chin, the nose should not be smashed into the breast and the baby should be able to look up at you (meaning the nipple should be pointing towards the roof of the baby's mouth). If, with some practice, latches are still painful, seek help from someone with specialized training in lactation (i.e. Certified Lactation Consultant, La Leche League Leader, etc.). DO NOT let it get worse before seeking help.



3) HOW DO I KNOW MY BABY IS GETTING ENOUGH BREAST MILK?

Wet diapers -- A newborn should have one wet diaper the first day of life, at two days old, two wet diapers and so on until 4 days old. A baby 4 days and older should have 4-6 sopping wet diapers in 24 hours. The colour of urine is also a good indication of adequate hydration. A baby that is transferring milk well, will have light, pale urine. If it is dark (like apple juice) with a strong odor, seek the help of a professional.

Stools (bowel movements) -- If your baby is younger than 4-5 days old, she will have tar-like stools (meconium). Usually at 3 days old, the meconium starts to thin and by 5 days it should be yellow (sometimes green), watery and seedy. Babies younger than 4 weeks usually have several bowel movements in a 24 hour period.

Weight gain -- It is normal for an infant to lose weight in the first few days of life, but most babies are back to their birth weight by 2 weeks old. If your baby is 2 weeks or older and gaining weight, this is a good sign that your baby is getting enough. REMEMBER: Scales can vary and growth charts don't always include breastfed infants (they are usually based off of formula-fed infants). How your baby will gain weight can be due to genetics. As long as your baby is GAINING WEIGHT STEADILY, how ever much (or little) weight that may be, is what is important.

DO NOT JUDGE MILK SUPPLY by how much you can pump or express (babies transfer milk better), by how frequently your baby eats or if she cries after feedings, by how full (or NOT full) your breasts feel, or if your baby will take a bottle after a feeding. Only with very RARE medical conditions, does a mother's milk not provide what her baby needs. Feeding on cue (on demand) is the best way to keep up adequate milk supply.

Also see http://www.kellymom.com/newman/04enough_... for more information and always seek professional help by someone qualified in lactation and infant feeding if there are concerns about your baby's health or your milk supply.



4) WHY DOES MY BABY WANT TO BREASTFEED ALL THE TIME?

Babies (like adults) are all different. Some need to eat quite frequently, while others do not. All babies have growth spurts and usually eat more frequently during this time. Do not be discouraged by frequent feedings when weight gain is steady and baby is having adequate wet diapers (5-6 sopping wet diapers a day).



5) WHEN SHOULD I INTRODUCE SOLIDS TO MY BREASTFED BABY?

The American Academy of Pediatrics (AAP) says that a baby should receive ONLY breast milk (or formula-breast milk is preferred) for the FIRST 6 MONTHS of life. Then solids can be “introduced” as a SUPPLEMENT to breastfeeding. Try to remember the rhyme “food for fun until they are one”.



6) CAN I TAKE BIRTH CONTROL WHILE BREASTFEEDING?

It is always important to remember to never take any medication without consulting with a physician first. IF your physician determines it is okay to take birth control, then it should be a progesterone-only birth control. Avoid birth controls containing estrogen. Preferably Micronor (the “mini-pill”). Injection birth control should not be the first choice because if any ill side effects occur, it can not be undone. Birth control should never be started prior to 6 weeks postpartum when milk supply is not yet established.



7) WHY IS MY BREASTFED BABY GASSY AND FUSSY?

It is normal for a baby (just like adults) to become gassy from time to time. It can be just as uncomfortable to them as it can be for us. But there are a few things that can cause a baby to have very uncomfortable gas and tummy troubles. 1) Some can be attributed to what the breastfeeding mother eats. An intolerance to cow's milk is quite common in humans. Soy can also be an irritant. Other gassy foods may bother your baby's stomach. You can eliminate these things if you notice that it becomes a problem. 2) Foremilk/Hindmilk Inbalance happens when a baby gets too much foremilk and not enough hindmilk. This can happen for a few reasons. Some examples are an over-active letdown or an oversupply, not enough time at the breast during each feeding or switching from one side to the other in the same feeding too early. “Block nursing” can help (see: http://www.kellymom.com/bf/supply/fast-l... under “Adjust your supply to better match baby's needs”). 3) And of course, anytime your baby seems uncomfortable, please remember to also seek medical advice from a physician to be sure.



8) WHEN WILL I GET MY PERIOD BACK/IS IT NORMAL TO HAVE A PERIOD WHILE BREASTFEEDING? This varies from woman to woman. How often your baby breastfeeds, whether you supplement, or if you take birth control can determine when you will have a period. It is quite normal for some breastfeeding women to get a period within weeks of delivering, while some might not have their monthly visitor for a year or more.



9) CAN I BREASTFEED WHILE PREGNANT?

It is usually perfectly safe to breastfeed while pregnant. Many women breastfeed during their pregnancies and then go on to "tandem" nurse (nurse both their newborn child and older toddler). If you are still worried, or have a history of miscarriage, it is always best to consult the professional attending your pregnancy (i.e. your midwife, obstetrician, certified nurse midwife).



10) MY BABY HASN'T HAD A BOWEL MOVEMENT IN A FEW DAYS. IS THIS NORMAL?

Every baby is different. Although it is quite common for breastfed babies to have very frequent bowel movements, some may not. Breast milk is very easily digested and for some babies this may mean they have very little to discard. There is no need to worry if your baby can go up to a week without a bowel movement UNLESS your baby is showing signs of distress. It never hurts to ask a doctor if you are concerned.



11) WHY IS MY MILK SUPPLY GOING AWAY?

1) ALWAYS FEED YOUR BABY ON CUE. (Cues-rooting, putting hands/fingers/fist in mouth, smacking lips, etc. Crying is a late feeding cue.) This will help keep an adequate milk supply. 2) If you are supplementing it is quite common for a mother to start losing her milk supply. This is why supplementation should be avoided, UNLESS medically necessary. 3) If you are not supplementing and you are feeding on cue, it may just APPEAR that your milk supply is reducing. Pumps are not a good indicator of milk supply. Pumps do not transfer milk as well as a baby. So, while pumping a woman may only get one ounce of milk (or even less), her baby is getting much more. Nursing frequency is also not a good indicator of milk supply. If a baby is going through a growth spurt, is sick, or in need of comfort for any reason, he may need to nurse more frequently during this time.



12) WHY CAN'T I GET MUCH MILK OUT WHEN PUMPING?

First, you should know that a pump does not transfer milk as efficiently as your baby does. Second, your breasts are probably supplying JUST ENOUGH to sustain your baby's needs and it takes time for your breasts to respond to the pump. PUMPING TIPS: 1) Always breastfeed your baby FIRST. Pump between feedings. If your baby wants to eat right after pumping, this is okay, let them eat at the breast. This will only encourage more milk production. 2) Do not get discouraged! Keep pumping even if you notice that nothing is coming out. It will take a few sessions for the breasts to respond to the stimulation of the pump. 3) Continue to pump at least 5 minutes AFTER the flow has stopped. 4) If you can become coordinated enough, pumping one breast while your baby eats at the other is a great way to get expressed milk AND to build supply. REMEMBER: The pump is NOT a good indicator of your actual milk supply.



13) WHY IS MY BABY REFUSING TO LATCH ON TO MY BREAST?

This can be attributed to several things: Baby was introduced to an artificial nipple (bottle/pacifier) too early (it is best to wait at least 4 weeks before giving artificial nipples), baby is sick (a stuffy nose can make it hard to breathe, an ear infection can make it painful to breastfeed, etc.), baby was aggressively forced/pushed to the breast to achieve latch on, etc. If baby is sick, make sure to get the baby seen by a doctor and keep her nose free of mucus by suctioning nose before feedings. Using a humidifier may help, too. MOST IMPORTANT when trying to latch a non-latcher: SKIN TO SKIN CONTACT! Lots of it! Your baby needs to associate your breasts with a place of comfort and warmth and love. This WILL encourage them to latch on. AND RELAX! A baby will not want to latch on to a stressed mother, so remember to give yourself lots of praise and cut yourself some slack.



14) WHY WON'T MY BREASTFED BABY TAKE A BOTTLE?

It is quite common for a breastfed baby to refuse to eat from a bottle and some may never take a bottle from their mother, but here are some tips: Always use a nipple that is wider at the base and thinner at the top (like a breast nipple), use very slow flowing nipple, have someone else give the bottle where the baby does not see or hear you, hold him in his favorite breastfeeding position while feeding with the bottle and, last but not least, be patient. REMEMBER: Make sure to express your milk when your baby receives milk from a bottle and expressed milk is the preferable supplement.



15) WHY IS MY BABY FALLING ASLEEP AT THE BREAST?

Jaundice, medications passing from your breast milk, or a slow let-down are some of the more common reasons a baby will fall asleep before eating at the breast. Stripping your baby down to her diaper, limiting sedation-causing medication, tickling her feet, and using breast compressions (see: http://www.kellymom.com/newman/15breast_...) are some ways you can keep a sleepy baby awake at the breast.



16) WILL MY BABY BITE WHEN HE GETS TEETH/HOW DO I STOP MY BABY FROM BITING WHILE TEETHING?

Very simple. If your baby is biting, he is not eating or not latched on properly. It is impossible for a baby that is latched correctly, to bite. Remove your baby from the breast if you notice that he is done eating and/or playing at the breast. ESPECIALLY, if he bites. Keep it simple. Just remove the baby from the breast. Try not to yell or scare him with harsh scolding if he bites. This may make him afraid to go back to the breast.



17) IS IT POSSIBLE TO LOSE WEIGHT/GAIN WEIGHT WHILE BREASTFEEDING?

Studies have shown that breastfeeding women, on average, burn about 500 more calories more per day. Therefore, most breastfeeding women do lose weight faster. Some women can actually have a hard time even maintaining a healthy weight due to such drastic weight loss. This is rare, but if you notice that you are experiencing this, just increase your daily caloric intake with healthy calories. Yet, while it is quite common for women to lose weight while breastfeeding, this is not the case for ALL women. There are some theories out there saying that breastfeeding women may have a harder time burning off simple carbohydrates. But, that is just a theory. Whether you are one of the many lucky women who see easy weight loss due to breastfeeding or not, just remember that breastfeeding is very important to the health of your baby and to YOU! If you are not seeing weight loss due to breastfeeding, do not get discouraged! Eating healthy and exercise are very good for you and your family, but stopping breastfeeding prior to the AAP recommendations is not! Your body has just spent 9 months changing while making a baby, give it some time to go back. Do not be hard on yourself and enjoy your breastfeeding, whether you are experiencing rapid weight loss or not. You will not be breastfeeding forever, but you will cherish it forever! :o) If you are concerned about your weight loss or lack there of, it wouldn't hurt to seek the advice of a professional.











I will add more as I think of them or as I get more feedback from all of you. And if you notice that any of my advice is wrong or lacking in any way, please don't hesitate to add a comment. Thank you in advance and I hope this helps to reduce some of the same questions being asked several times.