Texts on this page are from La Leche League International (LLLI) and published under its kind concession.
How often should I nurse my baby?
Every baby is different! Due to individual differences, healthy full-term babies may breastfeed as often as every hour or as infrequently as every four hours and thrive, according to LLLI Breastfeeding Answer Book (BAB) Third Revised Edition, page 26. Daily breastfeeding patterns will vary from baby to baby and from day to day.
Many mothers are surprised at how quickly and easily human milk is digested (often within 90 minutes of the last feeding). Rather than watching the clock it is recommended that a mother watch for signs that her newborn is hungry, such as the rooting reflex, chewing/sucking on hands or fingers, or crying.
Mothers can follow their baby's lead in how often to breastfeed, as long as their baby is getting enough. See the FAQ on how to tell your baby is getting enough milk or the articles in our Web resource page on milk supply issues. Breastfed babies regulate themselves; they take what they need at each feeding, and from each breast. The American Academy of Pediatrics recommends that healthy, full-term newborns should breastfeed eight to twelve times in each 24-hour period. This equates to feedings two to three hours apart.
Thus, if your baby is not breastfeeding at least eight to twelve times in a 24-hour period in the early weeks, you may need to wake your baby to breastfeed more often. You can find an information sheet on "Tips for Rousing the Sleepy Newborn" in the LLLI Online Store, or it may be available from your local Leader. It is important that you rouse your baby for feeding as necessary so your baby will gain properly.
Some mothers are concerned when their baby wants to breastfeed more often than every two hours. "During the early months, many babies do what is called 'cluster feeding;' spacing feedings closer together at certain times of the day (typically during the evening) and going longer between feedings at other times" (BAB, p. 36). This variability in frequency is normal. Moreover, many breastfeeding problems -- including those attributed to "too much milk" or "not enough milk" -- are resolved with more frequent nursing.
Babies who breastfeed frequently (as long as they are latched on correctly) tend to get plenty of milk because their mothers' milk supplies have been boosted by the frequent stimulation. Research now shows that restricting the amount of time at the breast and extending the time between feedings can reduce not only a mother's milk supply, but also the fat content of her milk -- resulting in a hungry, crying baby.
As babies grow and their stomachs become larger, they naturally begin to go longer between feedings and develop more regular feeding patterns. Growth spurts may disrupt the more regular feeding patterns, but they are usually short lived.
How can I tell if my baby is getting enough milk?
This may be the most asked question for La Leche League Leaders. It is understandable, since breasts are neither see-through nor marked off in ounces. Thank goodness there are other signs that indicate baby is getting enough milk.
Typically during the first few days, while the baby is receiving mother's thick, immunity-boosting colostrum, he will wet only one or two diapers per day.
Once mother's milk comes in, usually on the third or fourth day, the baby should begin to have 6-8 wet cloth diapers (5-6 wet disposable diapers) per day. (An easy way to feel the weight of a wet disposable diaper is to pour 2-4 tablespoons of water in a dry diaper.)
In addition, most young babies will have at least two to five bowel movements every 24 hours for the first several months, although some babies will switch to less frequent but large bowel movements at about 6 weeks.
A baby that is sleeping rather than feeding every 2-3 hours or is generally lethargic may need to be assessed by a health care provider to make sure that he is adequately hydrated.
These are additional important signs that indicate your baby is receiving enough milk:
•The baby nurses frequently averaging at least 8-12 feedings per 24-hour period.
•The baby is allowed to determine the length of the feeding, which may be 10 to 20 minutes per breast or longer.
•Baby's swallowing sounds are audible as he is breastfeeding.
•The baby should gain at least 4-7 ounces per week after the fourth day of life.
•The baby will be alert and active, appear healthy, have good color, firm skin, and will be growing in length and head circumference.
The physical act of breastfeeding is more than the quantity of milk that is supplied, as you will find once you hold your baby in your arms. Breastfeeding is warmth, nutrition, and mother's love all rolled into one. Understanding and appreciating the signs of knowing when your baby is getting enough to eat is the one of the most important things a new mother can learn. If you have any concerns regarding your baby, they should be addressed with your health care practitioner.
If you do need to increase your milk supply after keeping track of wet diapers, bowel movements and weight gain, there are several options you can try to increase your milk supply. See our FAQ on "Increasing Your Milk Supply" and refer to our Web resource page on milk supply issues or further information. Keep in touch with your health care provider if your baby is not gaining well or is losing weight. In most cases, improved breastfeeding techniques will quickly resolve the situation, but occasionally, weight gain may indicate a health problem.
What is colostrum? How does it benefit my baby?
Your breasts produce colostrum beginning during pregnancy and continuing through the early days of breastfeeding. This special milk is yellow to orange in color and thick and sticky. It is low in fat, and high in carbohydrates, protein, and antibodies to help keep your baby healthy. Colostrum is extremely easy to digest, and is therefore the perfect first food for your baby. It is low in volume (measurable in teaspoons rather than ounces), but high in concentrated nutrition for the newborn. Colostrum has a laxative effect on the baby, helping him pass his early stools, which aids in the excretion of excess bilirubin and helps prevent jaundice.
When your baby is breastfed early and often, your breasts will begin producing mature milk around the third or fourth day after birth. Your milk will then increase in volume and will generally begin to appear thinner and whiter (more opaque) in color. In those first few days it is extremely important to breastfeed your newborn at least 8-12 times each 24 hours, and more often is even better. This allows your baby to get all the benefits of the colostrum and also stimulates production of a plentiful supply of mature milk. Frequent breastfeeding also helps prevent engorgement.
Your colostrum provides not only perfect nutrition tailored to the needs of your newborn, but also large amounts of living cells which will defend your baby against many harmful agents. The concentration of immune factors is much higher in colostrum than in mature milk.
Colostrum actually works as a natural and 100% safe vaccine. It contains large quantities of an antibody called secretory immunoglobulin A (IgA) which is a new substance to the newborn. Before your baby was born, he received the benefit of another antibody, called IgG, through your placenta. IgG worked through the baby's circulatory system, but IgA protects the baby in the places most likely to come under attack from germs, namely the mucous membranes in the throat, lungs, and intestines.
Colostrum has an especially important role to play in the baby's gastrointestinal tract. A newborn's intestines are very permeable. Colostrum seals the holes by "painting" the gastrointestinal tract with a barrier which mostly prevents foreign substances from penetrating and possibly sensitizing a baby to foods the mother has eaten.
Colostrum also contains high concentrations of leukocytes, protective white cells which can destroy disease-causing bacteria and viruses.
The colostrum gradually changes to mature milk during the first two weeks after birth. During this transition, the concentrations of the antibodies in your milk decrease, but your milk volume greatly increases. The disease-fighting properties of human milk do not disappear with the colostrum. In fact, as long as your baby receives your milk, he will receive immunological protection against many different viruses and bacteria.
How do I position my baby to breastfeed?
Note: For clarity, we are referring to baby as "he" and mother as "she."
During the early weeks optimal positioning is especially important. When you and your baby are well positioned, your nipples stay healthy and your baby can feed most efficiently. Concern about sore nipples is a common reason that mothers contact La Leche League. Proper positioning helps eliminate many cases of sore nipples.
You may have noticed this is a long FAQ. Be assured that breastfeeding has been successfully accomplished by mothers and babies for centuries. However, like other seemingly simple tasks, it takes a lot of words to describe. LLL Leaders are experienced in guiding mothers through the positioning process. If you feel overwhelmed by preparing to breastfeed your baby, contact your local Leader for information and support. She will be happy to simplify matters for you.
Basic Steps for Optimal Positioning
1. Position yourself comfortably with back support, pillows supporting your arms and in your lap and your feet supported by a footrest or a telephone book.
2. Position baby close to you, with his hips flexed, so that he does not have to turn his head to reach your breast. His mouth and nose should be facing your nipple. If possible, ask your helper to hand you the baby once you are comfortable. (See "Going Beyond the Basics" for details.)
3. Support your breast so it is not pressing on your baby's chin. Your baby's chin should drive into your breast. (See "Breast Support Techniques" below for descriptions.)
4. Attach or latch baby onto your breast. Encourage him to open his mouth wide and pull him close by supporting his back (rather than the back of his head) so that his chin drives into your breast. His nose will be touching your breast. Your hand forms a "second neck" for your baby. (See "Is My Baby Latched on Well" below for further information.)
5. Enjoy! If you are feeling pain, detach baby gently and try again.
These steps may need to be repeated frequently during the early weeks. You and your baby will find a technique that works for you after some practice.
What do I have to do to prepare my breasts for breastfeeding? I have heard things like "roughing them up" is a good way to prepare them so they won't hurt.
There is very little you need to do to prepare your breasts for breastfeeding.
"Roughing up" the nipples by rubbing them with a towel is no longer recommended. It has been found that doing so can remove the protective substances produced by the breast during pregnancy and afterwards. Instead, you might want to try some gentle breast massage. This can help you become more comfortable handling your breasts, and may also be useful later on if you need to express your milk. Information on breast massage can be found in the book THE WOMANLY ART OF BREASTFEEDING, available from LLL Groups or from the LLL catalog.
It is a good idea to check for flat or inverted nipples while you are pregnant, as this can sometimes make it a bit more difficult for a baby to latch on to the nipple correctly. You can speak to your local LLL Leader (before your baby is born) about how to check for inverted nipples and how to deal with them. But these are rare, so don't worry if you know they are not inverted. Your doctor could tell you also.
It's possible that you have heard that breastfeeding will make your nipples sore. In most cases, sore nipples are caused by poor positioning or improper latch.
Lotions are generally not necessary. Your nipples are already producing what they need for their protection. If you have a skin condition such as psoriasis or eczema, you may wish to ask your dermatologist what you can use. Be sure to tell the doctor you will be breastfeeding, as that can make a difference in the type of treatment prescribed. Also, do not use soap on your breasts, as this can dry them out. When you bathe or shower, rinsing with clear water is fine. If your nipples are very dry, you may wish to apply a lubricant.
Cracked and bleeding nipples are not a normal sign of breastfeeding. Breastfeeding is not meant to be painful - if it is, you need to find out why, and correct it. The main cause of sore nipples is improper positioning. The baby should be face to nipple, and tummy to tummy with you. The baby's chin should be just below the nipple, and the baby needs to open wide to take in a good mouthful.
You might want to attend LLL meetings in your area before your baby is born, or at least contact the Leader for your area. LLL meetings are a mother-to-mother sharing of ideas, information, and encouragement. It can be very helpful to see other mothers breastfeeding. As well, each Group has a lending library of books on breastfeeding, pregnancy and childbirth, nutrition, and parenting. Check out the section of our Web site entitled Finding a Local LLL Group.
Our collection of Web resources contains more helpful information on preparing to breastfeed that may be helpful to you.
If breastfeeding is so natural, why doesn't it seem to come naturally?
That's a good question! Before your baby arrives, it seems like all you need to do is put the baby to the breast, let him or her attach, and away you go. But in reality, it's not always so simple.
True, some babies do just go right to the breast, and never experience any problems. But many of us need some help. In times gone by, before the 20th century, when every mother breastfed and families weren't so mobile, you'd turn to your mother, grandmother, or aunt for breastfeeding help. Unfortunately, today we've lost that breastfeeding community. That's where La Leche League steps in to fill the gap. Pick up a copy of the WOMANLY ART OF BREASTFEEDING, our breastfeeding guide. Breastfeeding really is a learned art.
If you're pregnant, try to think beyond the labor and birth of your baby, to the months of breastfeeding ahead of you. While you're pregnant is a good time to prepare, by going to several La Leche League meetings. It will help you build your support network
Have some of your friends said, "I tried breastfeeding, but it didn't work; it was painful; I didn't have enough milk; I leaked too much; my baby didn't seem satisfied, etc.?" Try an LLL meeting, and meet Leaders and mothers who are breastfeeding or who have successfully breastfed their babies. If you can't make it to a meeting, consider an online chat meeting, or getting to know the Leaders and mothers on our Mother-to-Mother support forums. Ask questions and read about the experiences of others. Our collection of articles and other resources on preparing to breastfeed will also reassure you.
A little preparation will reap long-term benefits! Learn what is a normal newborn behavior and what is a potential problem (for example, the "good" baby who sleeps all the time, and isn't waking to feed).
Breastfeeding is one of the most important things you can do for your baby. If you are pregnant, or a new mother experiencing difficulties, give a Leader a call, and consider attending a meeting. You'll be glad you did. LLL members are warm, intelligent women, dedicated to learning to be the best they can for their babies and growing families.
Will I Spoil My Baby by Holding/Nursing Him So Often?
Mothers throughout history have always known, and research now shows, that babies are happiest, healthiest, and smartest, if they are kept in close contact with their mother or another family member most of the time. Asleep or awake, happy or sad, babies like to feel and smell your warm embrace. Research shows babies grow faster and learn about their world more readily when up on mother's level. There's more for the baby to see when he is with you while you go about your daily business than when lying flat in a crib or carriage. Babies cry much less and expend less energy that way. Many newborns sleep more deeply when held against your body. This type of approach is very respectful of your baby's feelings, and is sometimes called "attachment parenting."
To get more done while keeping baby close, save your arms by getting a baby sling. More versatile than the front pack, these over-the-shoulder carriers are nice because you can easily and discreetly breastfeed while wearing one, and the baby can be held in many different positions (facing in or out, cradle position, on the hip), up to 30 pounds. They are available through some LLL groups, NEW BEGINNINGS, and some baby supply stores. Many premature babies can benefit from this kind of care, if they are strong enough. Skin-to-skin contact is preferred, inside the parent's clothing. This is called "kangaroo care." LLL experience shows that children parented this way become quite secure and independent as they grow. They learn to trust their world, and other human beings, and feel "right" inside. These early feelings of love, security, and respect will become patterned in your child's mind and will be what he/she looks for when ready to form adult relationships. It all starts with you!
Nursing a baby "on demand," or by request, not only assures you a bountiful milk supply (the more a baby suckles, the more milk you make), it also makes you available to comfort your child, soothe a pain, or simply provide the human contact your baby needs. His mouth is the most sensitive area of his body, and sucking feels so good to him. Unlike a pacifier (dummy), which can fall on the floor and get dirty, your nipples are always safe. No need to watch the clock; watch what your baby is telling you. He may be thirsty, want a snack, or a full course meal.
Pacifiers can cause nipple confusion in some babies, but may be useful in some situations. Proceed with caution, if you use one.
Caring for a crying baby at night can be one of the most challenging aspects of being a new parent, especially if friends or relatives tell you that picking up or nursing your baby every time he/she cries will spoil the baby. Some people may tell you the baby needs to learn "self-comforting" at night so that he/she can go back to sleep without you. Although so-called "sleep training" may work for some families, many mothers have found that they prefer or they feel more comfortable to respond to baby's cries, no matter what time of day or night they hear them.
For many of us, keeping our babies close to us all night, whether in our bed or in a crib or bassinet next to the bed, is the best way to meet our babies' needs while disrupting our own sleep as little as possible. For more comments about babies and sleeping, see the FAQ "When Will My Baby Sleep Through the Night?"
Here's a "what if?" question that sometimes helps mothers trust their hearts and stop worrying about spoiling their babies. Imagine you were scared or sad enough to start crying. What if another adult you loved knew you were crying, but refused to hug you, reminding you that you'd had a hug just an hour ago? You would probably stop crying eventually on your own, but wouldn't you feel better if that other adult had comforted you when you needed it?
To learn more and support LLLI, visit www.LLLI.org.