Breastfeeding: What you need to know.

Babies were born to be breastfed.

breast milk
Breasfedding is best for the baby and the mother. The following is cited from, reflecting the opinion of the federal government regarding breastfeeding.

Benefits of breastfeeding for babies and mothers

Recent studies show that babies who are exclusively breastfed for 6 months are less likely to develop ear infections, diarrhea, and respiratory illnesses. They may also be less likely to develop childhood obesity. Breastfeeding delays the return of menstrual periods and may aid in spacing pregnancies.

Breastfeeding reduces the risk of breast and ovarian cancers.
Breastfeeding creates a strong bond between mother and child.
Breastfeeding mothers have increased self-esteem.

Benefits of breastfeeding for families

Breastfeeding saves the family budget hundreds of dollars.
Breastfeeding saves on health care costs.
Breastfeeding contributes to a more productive workforce.
Breastfeeding creates a healthier society

Tips for a smooth start to breastfeeding

Read about breastfeeding during your pregnancy so you will know what to do once your baby is in your arms.

Get good prenatal care to help assure that you carry your baby to term so he/she won't need special care.

Before you give birth, tell your health care provider about any previous breast surgery or injury. If your nipples appear flat or inverted, ask if it will affect how your baby latches on.

Talk to friends who have breastfed, or attend a breastfeeding support group (such as La Leche League) so you can meet other breastfeeding mothers.

Breastfeed your baby soon after delivery because the sucking instinct is very strong at this time.

Keep your baby in your hospital room with you so you can breastfeed often and get to know one another

If your baby stays in the nursery, tell the staff not to give your baby any infant formula or a pacifier. Ask them to bring your baby to you for feedings.

Expect your milk to increase a few days after a normal, uncomplicated birth.

Breastfeeding should not hurt. Ask for help if it is painful for you.

Breastfeed according to your baby's cues. Most newborn babies want to breastfeed about 8 to 12 times in 24 hours.

Breastfeeding is a learned process. Give your baby and yourself time to learn how to breastfeed.

Pat yourself on the back for giving the best to your baby!

Your breastfeeding questions answered

Does breastfeeding hurt?

Breastfeeding should not hurt. There may be some tenderness at first, but it should gradually go away as the days go by. To minimize soreness,your baby's mouth should be wide open, with as much of the areola (the darker area surrounding the nipple) in his or her mouth as possible. When your baby is breastfeeding effectively, it should be calming and comfortable for both of you. If breastfeeding becomes painful for you, seek help from someone who is knowledgeable about breastfeeding. See the Where to find help with breastfeeding

What foods do I need to eat?

Many cultures have suggestions about foods to eat or to avoid while breastfeeding. Eating such foods may make you or other family members more comfortable. However, research shows that a mother's milk is affected only slightly by the foods in her diet.

You may be thirstier and have a bigger appetite while you are breast-feeding. Drink enough non-caf-feinated beverages to keep from being thirsty. Making milk will use about 500 extra calories a day.

Women often try to improve their diets while they are pregnant. Continuing with an improved diet after your baby is born will help you stay healthy, which will help your mood and energy level. However, even if you don't always eat well, the quality of your milk won't change much. Your body adjusts to make sure your baby's milk supply is protected.

When should I start breastfeeding?

You should nurse your baby soon after birth, if possible, when your baby is awake and the sucking instinct is strong. At first, your breasts contain a kind of milk called "colostrum," which is thick and usually yellow or golden in color. Colostrum is gentle to your baby's stomach and it is full of antibodies to protect your baby from disease. Your milk supply will increase and the color will change to a bluish-white color during the next few days after your baby's birth.

How often will my baby breastfeed?

Newborns need to nurse frequently, at least every two hours, and not on a strict schedule. This stimulates your breasts to produce plenty of milk. Since human milk is more easily digested than formula, breastfed babies eat more frequently than bottle-fed babies do. Babies nurse less frequently as they get older and start solid foods.

How do I know my baby is getting enough milk?

You can tell your baby is getting enough milk by keeping track of the number of wet and dirty diapers. In the first few days, when your milk is low in volume and high in nutrients, your baby will have only 1 or 2 wet diapers a day. After your milk supply has increased, your baby should have 5 to 6 wet diapers and 3 to 4 dirty diapers every day. Consult your pediatrician if you are con cerned about your baby's weight gain.

Will I have to breastfeed in public? How do I manage that?

You don't have to breastfeed in public. Mothers often feel uncomfortable about it at first, but become more confident as they gain experience. Most of the time, other people don't even notice these mothers and babies because the baby is quiet and doesn't attract much attention. One way to gain confidence is to talk to other breastfeeding mothers about how they manage breastfeeding in public. Here are some ideas to try:

If your trip will be short, breastfeed just before leaving and right after you return home.

Find a women's lounge, a sitting area, or a public restroom (shopping malls and larger department stores often have women's lounges or dedicated nursing rooms).

Sit in your car while you feed your baby.

Go to a women's changing room in a clothing store.

Turn your chair so you are facing slightly away from other people. Ask your host if you can use another room if you are uncomfortable.

Use a baby sling, nursing cover, or blanket to cover your breast and your baby. Some women prefer to offer their milk in bottles while they are in public. It's best to avoid bottles in the early weeks so your baby can learn to breastfeed well.

Can I give my baby a pacifier if I breastfeed?

Most breastfeeding counselors recommend avoiding pacifiers for about the first month because they may interfere with your baby's ability to learn to breastfeed. After you and your baby have learned to breastfeed well, you may make your own decision about whether or not to offer a pacifier.

Can I still breastfeed if I go back to work or school?

Yes, you can! Breastfeeding keeps you connected to your baby, even when you are away. Employers and co-workers benefit because breastfeeding mothers need less time off for sick babies. Let your employer and/or human resources manager know that you plan to continue to breastfeed once you return to work. You should request a clean and private area where you can pump your milk. You can pump your milk during lunch or other breaks and refrigerate it or place it in a cooler for your baby to be fed later.

Take as much time off as possible, since it will help you get breastfeeding well established and also reduce the number of months you may need to pump your milk while you are at work. If your baby will need to drink your milk from a bottle while you are gone, it is a good idea to start offering a bottle when your baby is about 4 weeks old and is breastfeeding well. It's best to avoid bottles before 4 weeks while you and your baby are learning to breastfeed.

How much do breast pumps cost and what kind is best?

Breastfeeding mothers have many options when it comes to pumps. Effectiveness and prices vary. Manual pumps cost under $50. Electric pumps that include a carrying case and an insulated section for storing milk containers sell for over $200. Some pumps can be purchased at baby supply stores or general department stores, but most high-quality automatic pumps have to be purchased or rented from a lactation consultant at a local hospital, or from a breastfeeding organization. See Where to find help with breastfeeding on page 19 for more information.

Many mothers decide to purchase or rent pumps with the ability to pump both breasts at once -- especially working mothers. Double-pumping, as it is called, is faster and more effective, so a mother doesn't need as much time to pump.

Compared to the cost of not breastfeeding, which can be more than $300 a month, even a top-of-the-line pump is affordable. Ask for recommen dations from other mothers you know or from a breastfeeding counselor.

Should I give my baby water or cereal?

Your milk is all your baby will need for the first 6 months, even in hot weather. You don't need to give your baby water,juice or a breast milk substitute. Research shows that babies are healthier if other foods are delayed. A newborn baby's digestive system is very sensitive. Waiting 6 months helps protect your baby from food allergies and from dis eases that cause diarrhea. Solid foods may be given when your baby is about 6 months old.

I have heard that breastfed babies may not get enough vitamin D. What does this mean for my breastfed baby?

The American Academy of Pediatrics (AAP) published a statement in April 2003; saying that that some babies are at risk for vitamin D deficiency and rickets,the bone-softening disease caused by insufficient exposure to sunlight and/or inadequate vitamin D supplementation.

Sunlight can be a major source of vitamin D, but factors such as the latitude where you live, the amount of pigment in your baby's skin, your baby's amount of sun exposure, and the use of sunscreen products all affect how much vitamin D your baby's body can produce from sunlight.

The AAP recommends that all infants, including those who are exclusively breastfed and those who are fed formula, have a minimum intake of 200 International Units (IU) of vitamin D per day beginning during the first 2 months of life.

The AAP recommends that an intake of 200 IU of vitamin D per day be continued throughout childhood and adolescence. Vitamin D supplements for infants are available over the counter.

When should I wean my baby?

It is recommended that babies be exclusively breastfed for the first six months. You may continue to breastfeed through the first year of life and longer if you and your baby wish

How can I encourage my partner's support for breastfeeding?

Prepare your partner in advance and explain that you need support. Highlight the important benefits of breastfeeding and be sure to emphasize how much money you'll save, too. Not breastfeeding can cost over $300 a month when you include the cost of increased medical bills -- money that could be used for food, housing costs, savings, or a vacation. Point out to your partner that breastfeeding will give your child the best start in life, with effects that last well into childhood and adulthood. If your partner seems jealous of the closeness between you and your baby, suggest other ways for him to be close to your baby, such as talking or singing to the baby, giving a bath, or by simply sitting with you and your baby to enjoy the special mood that breastfeeding creates.

Can I breastfeed if I smoke or drink alcohol?

In their most recent statement on the subject, the American Academy of Pediatrics announced that newer research seems to show that the beneficial effects of breastfeeding outweigh the negative effects from the mother's smoking. For example, babies who are exposed to second-hand smoke have a higher rate of upper respiratory infections, but breastfeeding helps protect babies from these illnesses. It is always better to quit smoking. If you can't quit, try cutting down during the time you are breastfeeding. You and your baby will both be healthier.

Light drinking by a breastfeeding mother has not been found to be harmful to a breastfeeding baby. Larger amounts of alcohol may make your baby sleepy or dizzy and may affect his or her growth over time.

Can I breastfeed if I need to take prescription medication?

Always check with your healthcare provider before taking any medication. Most medications pass into your milk in small amounts. If you take medication for a chronic condition, such as hypertension, diabetes or asthma, your medication may already have been studied in breast-feeding women, so you should be able to find information to help you make an informed decision with the help of your health care provider. Newer medications and medications for rare disorders may have less information available. The American Academy of Pediatrics has information about many prescription and over-the-counter medications posted on their web site at:

Why does the U.S. Department of Health and Human Services care about breastfeeding?

Breastfeeding is a public health issue -- it directly contributes to improved health of mothers and babies. Research shows that babies bene fit from breastfeeding because it is a cost-effective, low-tech way of reducing infant illness, hospitalization, and mortality, particularly for low birth-weight and pre-term babies.

Healthier babies grow up to be healthier adults. Research shows that babies who are exclusively breastfed for 6 months are less likely to develop ear infections, diarrhea, and respiratory illnesses. They may also be less likely to develop childhood obesity.

A recent evaluation of research on breastfeeding and breast cancer showed that the more months a woman breastfeeds the less likely she is to develop breast cancer. Researchers estimated that women in countries like the US could reduce their risk of breast cancer by 4.3% for each 12 months spent breastfeeding.

Why don't more women breastfeed their babies?

The results of recent focus groups done by the U.S. Department of Health and Human Services' Office on Women's Health suggest some reasons.

Women believe that breast-feeding hurts, either from hearing of others' experiences or because of their own expe rience with a previous baby, and women worry that their milk will not be as beneficial if their diet is poor, if they smoke, or if they drink alcohol. Research has shown that the overall benefits of breast-feeding outweigh the negative effects of moderate smoking, drinking, and eating non-healthy foods.

Other factors make a difference in breastfeeding rates, too. For instance, the focus group results show that many women believe that breastfeeding is difficult to balance with working outside the home. Also, many of us did not grow up around women who breastfed, so we did not learn about breastfeeding from our mothers and other relatives. Some of us do not have access to prenatal care, which may lead to low birth weight and premature birth -- factors that may make breastfeeding more difficult. And women sometimes go through an entire pregnancy without receiving any information on breastfeeding. Learning about breastfeeding should be a standard part of your prenatal care.

Why should I talk to my doctor or health care provider about breastfeeding?

Talking to your health care provider will help you learn his or her views on breastfeeding and find out what kind of support for breastfeeding she/he offers. Most pediatricians in the United States agree that human milk is superior for infant feeding. Your health care provider or your child's pediatrician should offer you accurate, easy-to-understand breast-feeding information. Some clinics and doctors' offices offer the services of a board certified lactation consult ant to help with breastfeeding. See the section on page 22 for questions to ask at your next doctor or health care provider visit.