Some things can help you prepare for breastfeeding:
- Get regular prenatal care to help you avoid preterm birth.
- Tell your doctor you plan to breastfeed and ask what support the facility you plan to deliver in offers to help you breastfeed after birth.
- Take a breastfeeding class.
- Ask your doctor to connect you with a lactation consultant, who can teach you breastfeeding basics and help you if have issues.
- Talk to your doctor about any health conditions you have or medications you take that could interfere with breastfeeding.
- Tell your doctor and hospital health care providers that you want to breastfeed as soon as possible after delivery.
- Talk to friends who breastfeed or join a support group for breastfeeding.
- Stock up on the supplies you need for breastfeeding, such as nursing bras and other items.
The following tips, known as the ABCs of breastfeeding, will help you and your baby get comfortable with the process:
- Awareness. Watch for your baby’s signs of hunger, and breastfeed whenever your baby is hungry. This is called “on-demand” feeding. In the first few weeks, you may be nursing 8-12 times every 24 hours. Hungry infants move their hands toward their mouths, make sucking noises or mouth movements, or move toward your breast. Don’t wait for your baby to cry. That’s a sign they are too hungry.
- Be patient. Breastfeed as long as your baby wants to nurse each time. Don’t hurry your infant through feedings. Infants typically breastfeed for 10-20 minutes on each breast.
- Comfort. This is key. Relax while breastfeeding, and your milk is more likely to “let down” and flow. Get yourself comfortable with pillows as needed to support your arms, head, and neck, and a footrest to support your feet and legs before you begin to breastfeed.
Are There Medical Considerations With Breastfeeding?
In a few situations, nursing could cause a baby harm. You should not breastfeed if:
- You are HIV-positive. You can pass the HIV to your infant through breast milk.
- You have active, untreated tuberculosis.
- You’re receiving chemotherapy for cancer.
- You’re using an illegal drug, such as cocaine or marijuana.
- Your baby has a rare condition called galactosemia and cannot tolerate the natural sugar, called galactose, in breast milk.
- You’re taking certain prescription medications, such as some drugs for migraine headaches, Parkinson’s disease, or arthritis.
Talk with your doctor before starting to breastfeed if you’re taking prescription drugs of any kind. Your doctor can help you make an informed decision based on your particular medication.
Having a cold or flu should not prevent you from breastfeeding. Breast milk won’t give your baby the illness and may even give antibodies to your baby to help fight off the illness.
Also, the AAP suggests that infants should be exclusively breastfed starting at 4 months of age, and infants who are partially breastfed and receive more than half of their daily feedings as human milk, should be supplemented with oral iron. This should continue until foods with iron, such as iron-fortified cereals, are introduced into the diet. The AAP recommends checking iron levels in all children at age 1.
Discuss supplementation of both iron and vitamin D with your pediatrician. Your doctor can guide you on recommendations about the proper amounts for both you and your baby, when to start, and how often the supplements should be taken.
Common Breastfeeding Challenges
There are some common concerns or challenges that you could face when breastfeeding. They include:
- Sore nipples. You can expect some soreness in the first weeks of breastfeeding. Make sure your baby latches on correctly, and use one finger to break the suction of your baby’s mouth after each feeding. That will help prevent sore nipples. If you still get sore, be sure you nurse with each breast fully enough to empty the milk ducts. If you don’t, your breasts can become engorged, swollen, and painful. Holding ice or a bag of frozen peas against sore nipples can temporarily ease discomfort. Keeping your nipples dry and letting them “air dry” between feedings helps, too. Your baby tends to suck more actively at the start. So begin feedings with the less-sore nipple.
- Dry, cracked nipples. Avoid soaps, perfumed creams, or lotions with alcohol in them, which can make nipples even more dry and cracked. You can gently apply pure lanolin to your nipples after a feeding, but be sure you gently wash the lanolin off before breastfeeding again. Changing your bra pads often will help your nipples stay dry. If possible, only use cotton bra pads.
- Worries about producing enough milk. A general rule of thumb is that a baby who’s wetting six to eight diapers a day is most likely getting enough milk. Never give your infant plain water. Your body needs the frequent, regular demand of your baby’s nursing to keep producing milk. Some women mistakenly think they can’t breastfeed or produce enough milk if they have small breasts. But small-breasted women can make milk just as well as large-breasted women. Good nutrition, plenty of rest, and staying well-hydrated all help, too.
- Pumping and storing milk. You can get breast milk by hand or pump it with a breast pump. It may take a few days or weeks for your baby to get used to breast milk in a bottle, so begin practicing early if you’re going back to work. Breast milk can be safely used within 2 days if it’s stored in a refrigerator. You can freeze breast milk for up to 6 months. Don’t warm up or thaw frozen breast milk in a microwave. That will destroy some of its immune-boosting qualities, and it can cause fatty portions of the breast milk to become super hot. Thaw breast milk in the refrigerator or a bowl of warm water instead.
- Inverted nipples. An inverted nipple doesn’t poke forward when you pinch the areola, which is the dark skin around the nipple. A lactation consultant can give you tips that allow women with inverted nipples to breastfeed successfully.
- Breast engorgement. Breast fullness is natural and healthy. It happens as your breasts become full of milk, staying soft and pliable. But breast engorgement means the blood vessels in your breast have become congested. This traps fluid in your breasts and makes them feel hard, painful, and swollen. Alternate heat and cold, for instance, use ice packs and hot showers, to relieve mild symptoms. It can also help to release your milk by hand or use a breast pump.
- Blocked ducts. A single sore spot on your breast, which may be red and hot, can signal a plugged milk duct. This can often be relieved by warm compresses and gentle massage over the area to release the blockage. More frequent nursing can also help.
- Breast infection (mastitis). This occasionally happens when bacteria enter the breast, often through a cracked nipple after breastfeeding. If you have a sore area on your breast along with flu-like symptoms, fever, and fatigue, call your doctor. Antibiotics are usually needed to clear up a breast infection, but you can most likely continue to breastfeed while you have the infection and take antibiotics. To relieve breast tenderness, apply moist heat to the sore area four times a day for 15-20 minutes each time.
- Stress. Being overly anxious or stressed can interfere with your let-down reflex. That’s your body’s natural release of milk into the milk ducts. It’s triggered by hormones released when your baby nurses. It can also be triggered just by hearing your baby cry or thinking about your baby. Stay as relaxed and calm as possible before and during nursing. It can help your milk let down and flow more easily. That, in turn, can help calm and relax your infant.
- Premature babies may not be able to breastfeed right away. In some cases, parents can release breast milk and feed it through a bottle or feeding tube.
- Warning signs. Breastfeeding is a natural, healthy process. But call your doctor if:
- Your breasts become unusually red, swollen, hard, or sore.
- You have an unusual discharge or bleeding from your nipples.
- You’re concerned your baby isn’t gaining weight or getting enough milk.
Where Can I Get Help With Breastfeeding?
Images of parents breastfeeding their babies make it look simple, but many people need some help and coaching. It can come from a nurse, doctor, family member, or friend, and it helps new parents get over possible bumps in the road.
Reach out to friends, family, and your doctor with any questions you may have. Most likely, others in your life have had those same questions.
When to Stop Breastfeeding
Deciding when to stop breastfeeding is a personal decision. The AAP recommends feeding your baby only breastmilk for the first 6 months. Once you begin to introduce solid foods, the AAP advises continuing to nurse for the next year and a half, if this is desirable for both you and your baby.
But some new parents may want to stop nursing earlier. You may choose to stop breastfeeding if you’re returning to work, pregnant with another baby, or seeking more independence. Whatever your reason, deciding to stop breastfeeding is always your choice.
It can be easier to stop breastfeeding if your child initiates the weaning process. Some parents begin by transitioning their baby to bottle-feeding first. Once you begin to introduce other foods to your baby, they may naturally turn away from breastfeeding around their first birthday. If your baby is eating three solid meals a day, they’re likely getting the nutritional content they need from solid foods alone.
Weaning can be an emotional process for both you and your baby. Take extra time to cuddle your baby to make sure you still have all the skin-to-skin contact you had while nursing.
Talk with your health care provider if you have questions about when you can stop nursing.