Breastfeeding Tips from a Lactation Consultant

One of the earliest parenting decisions you’ll face is how to nourish your newborn baby. For an increasing number of women in the United States, that choice is to breastfeed. The benefits of breastfeeding for both mom and baby are well researched and widely recognized, and the CDC reports that breastfeeding rates have steadily increased in the United States over the last three decades. ^1,2,3

While it can be an intensely bonding and fulfilling experience for many, it’s also important to recognize and be open about the reality that breastfeeding can be really difficult at times.

It is not uncommon for women to struggle to initiate and sustain breastfeeding, and to have questions and concerns around topics like: is my baby getting all the nutrition he or she needs to thrive? One way to help calm those nerves is to know what to anticipate and be prepared with tips to help guide your breastfeeding journey.

“Food before 1 is just for fun.”

The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding – they mean breastmilk and breastmilk only - for about six months.⁴ Some babies will show great interest and signs of readiness for solid food before six months and others may not until 7-8 months.

After six months of exclusive breastfeeding, it’s recommended to continue breastfeeding while introducing complementary foods for at least 1 year or longer as mutually desired by mother and infant. Breastmilk or formula should be baby’s primary source of nutrition for the first year, with solid foods offered as a side dish.

Breastfeeding Tips

If you’re planning to breastfeed, here are some tips on what you can do to prepare before and after baby arrives:

Don’t be shy.

Reach out to local breastfeeding support groups (ex. La Leche League), research lactation consultants in your area, and connect with any friends that are nursing to see if you can observe other moms in action and build community around your breastfeeding goals.

Set up a dedicated space for breastfeeding at home!

Comfort will be key. If you intend to breastfeed, you’ll be very attached to this space, especially in the first few weeks.

Good items to have at your station are breastfeeding pillow(s), comfy chair/foot stool, water bottle, a charger/outlet, and a utility cart (there are so many cute DIYs online!) with any breastfeeding supplies like nipple care cream, pads or cloths, and spare pump parts. This can also double as a pumping station if you are bottle feeding.

So the baby’s here, and you planned to breastfeed – now what?

Know that it is normal to feel anxious or unprepared when it comes to breastfeeding, even with the best-laid pre/postpartum plans. Nursing doesn’t always come naturally, and each mom-baby dyad is unique.

Ask for help.

Lactation consultants can help set you up for success, literally and figuratively. They can evaluate your baby’s latch and help avoid the possibility of any injury to you. They may also check baby for any tongue or lip ties, show you different holds and positions to ensure maximum comfort while you nurse, and help set you up with a breast pump. They can see you through your breastfeeding journey from initiation to weaning, and can answer the questions you’ll inevitably have to help ease those breastfeeding jitters.

Keep your baby close.

The first hour after birth is crucial for breastfeeding initiation.⁵ Ask to have the baby skin to skin with you as soon and as much as possible after they’re born; remember, they also just went through a really intense experience that they’ll need to rest and recover from, and you want to latch them before they get snoozy and too difficult to rouse.

The sleepiness at breast may last those first few blurry days. Massage their little hands, stroke under their chin, and tickle their feet to keep them alert and focused on the very important task at breast.

A good latch is key.

Breastfeeding takes getting accustomed to, but it should not cause prolonged pain. If you’re experiencing pain or discomfort well after your baby initially gets on the breast, pain between feedings, and/or nipple skin damage, a poor latch is likely to blame.

Don’t be afraid to bring your baby in tight – you want them to have a good mouthful of breast tissue (areola, not just nipple) – and to be secure across your chest with your arm supporting their back and legs. A good latch avoids injury to mom and ensures that baby is effectively removing enough milk from the breasts.

Colostrum

Much of the fuss around skin to skin, latching, and breastfeeding initiation has to do with getting your baby its first doses of colostrum.

Liquid Gold

Colostrum is the first milk your body produces, and it packs a powerful nutritional and immunological punch for your baby. There’s not much of it, but it’s concentrated and nutrient dense – packed full of vitamins, minerals, proteins, and white blood cells that guard against infections and produce antibodies that line and protect the baby’s gastrointestinal tract.⁶ 

If you’re pumping or hand expressing, don’t let the small amounts you see deter you! Your baby’s stomach is only the size of a cherry on day one, so a little goes a very long way for getting your baby off to the best start possible.

Milk supply is all about demand.

No need to take an economics course to learn this concept – nursing mothers could write the book themselves. The more milk you remove from your breasts, the more your body will produce to match the demand. That’s why it’s so important to know, recognize, and follow your infant’s hunger and satiation cues. Save the scheduler for other tasks – breastfeeding should be done on infant demand until your supply is well-established.

So, does timing not matter at all?

It does, but don’t stress on a set schedule. Breastfeed or pump at least 8-12 times in a 24 hour period. That’s roughly about every 2-3 hours. Yes, it’s a round the clock job to start, but eventually you’ll settle in to a sustainable pattern that’s right for you and your baby.

Be patient.

It may take two to three months to build your milk supply. During that time, pumping or nursing will seem like it’s taken over your life. It’s hard work, but the rewards are plentiful.

How do I know if baby is getting enough?

Is there anything more anxiety-inducing than thinking your baby isn’t getting the nourishment they need from you? Before you allow the doubts to creep in and derail your breastfeeding goals, read ahead for some clues:

What goes in, must come out.

Wet and dirty diapers are your number one indicator that baby is hydrated and nourished. If you never imagined yourself searching for diaper output infographics, well, welcome to the glamours of motherhood.

In the first month of life, baby’s diapers should be monitored carefully and any output tracked. Those dirty and wet diapers are indicators of whether your baby is healthy and getting enough breastmilk.

Ask for weight checks and try weighted feeds. With weighted feeds, your baby will be weighed pre- and post-feed and you’ll have assurance of how many ounces of milk they’ve consumed.

Look for cues as your baby is feeding.

Do you hear audible swallowing and see smooth, sustained, rhythmic suckling action? (Note: clicking noises or an irregular sucking pattern can indicate that there is an issue with the latch and should be investigated further). Does baby seem satisfied and satiated when they come off the breast?  

These tips can all serve as clues and assurances that your baby is getting all they need from you.  Take a deep breath and trust yourself, your body, and your baby to know what needs to get done.

Avoid formula

If your aim is to exclusively breastfeed, formula will only fill your baby’s tummy and leave them less motivated to nurse. Your supply will dip as a result of the decreased milk removal, and you may find yourself trapped in a cycle where your baby removes less milk, your body makes less milk, you have to rely more on formula, and eventually your milk supply dwindles. If you are concerned you have a low milk supply and your baby is not getting enough nutrition, you can work with your physician on supplementing your breast milk with baby formula, if necessary.

Keep in mind: your milk supply is dictated by how often you breastfeed or pump.

Breastfeeding vs. Bottle Feeding

If you are struggling with breastfeeding, your baby will still benefit greatly from receiving your breastmilk from a bottle. While breastfeeding’s got its advantages, breastmilk doesn’t have to be consumed directly from the source. Pump that precious milk and bottle-feed if that’s what works for you.

Pumping Tips

The same principles as breastfeeding apply to pumping. You need to remove milk to produce milk, so establish a pumping routine (at least one pump session every 2-3 hours), start building a small stash, and bottle feed your baby on demand.

The right equipment will set you up for success.

A hospital-grade, double-electric breast pump is the gold standard for exclusive pumping. Get yourself a hand-free pumping bra (or DIY by cutting slits in the cups of an old bra), and have extra sets of pump parts and bottles on hand.

Breast milk storage bags for your pumped milk are key; label them with the date and store for future use. Make sure to follow established guidelines for safely storing and freezing breastmilk.

Fit matters

A good breast pump flange fit is as important as a good latch. Wearing the right size flange for you will avoid injury and optimize milk expression. You’ll know you have a good fit when the nipple is able to move freely while pumping without rubbing against the sides of the flange – little to no areola should be pulled in to the flange while pumping.

You are not the number of ounces you pump.

Don’t stress on the amount of milk you pump! Set aside the time you need to complete an entire pump cycle and achieve a let-down or two. Cover the collection bottles with socks if you’re hung up on the amount you are pumping, and use the time as an excuse to kick back, relax, and snuggle or scroll through photos of your adorable newborn.

Foods to Avoid While Breastfeeding

Here’s good news: very few, if any.

Breastfeeding and balancing a newborn can be challenging enough. Don’t make it unnecessarily complicated and difficult on yourself by eliminating foods from your diet unless there’s some medical indication to do so. If you notice a pattern of change in baby’s mood/health after you consume certain foods (ex. colic, rash, excessive spitting up/vomiting, fussiness that isn’t soothed by nursing, etc.) consult your doctor to identify and troubleshoot any dietary issues.

Baby food sensitivities or allergies to breastmilk due to food mom consumes aren’t as common as you may have been led to believe. In the rare instances they do happen, cow’s milk proteins that make their way into mom’s milk from dairy consumption may be to blame.⁷

Breastfeeding is nutritionally and energetically demanding.

Aside from any noticeable issues, enjoy the foods you normally would, and focus most on properly nourishing and hydrating yourself.

Keep in mind that lactating women have different nutrient needs when breastfeeding than when pregnant⁸ and a postnatal vitamin can help fills those needs.

Benefits of Breastfeeding

Breastmilk has the right balance of nutrients for your baby, it is easier to digest than infant formula, and it contains antibodies to boost baby’s immune system. Breastfed babies benefit from a decreased risk of infection, SIDS, and allergies.⁹

Simply put, your breast milk is custom-made for your baby – there simply isn’t an infant formula that can be manufactured exactly like it.^10.11

Breast milk is an amazing living fluid. 

It is filled with protective germ killing cells and the composition constantly changes to meet your baby’s developmental needs as your baby grows.^10,11

Did you know?

When you get sick, white blood cells develop and appear in your breast milk to protect your baby. When your baby gets sick, the germs transferred to you from baby’s mouth via breastfeeding prompt your body to produce antibodies to boost your baby’s immunity.¹¹ Talk about being intricately linked and bonded.

The benefits of breastfeeding are lifelong.

The live bacteria from breastmilk that colonizes your baby’s gut when you exclusively breastfeed can confer lifelong benefits by helping develop baby’s resistance to conditions such as diabetes and metabolic syndrome.⁹  

Breastfeeding vs. Formula

Sometimes breastfeeding doesn’t work out, and that can be difficult to accept. It is important to not feel guilty about formula feeding – you are doing your best to feed your baby.

Infant formula is designed to match the nutritional profile of human breast milk and will provide infants the nutrients they need to grow and develop. It will fill the void when breastfeeding isn’t an option, and you can still develop good bonding and closeness to your baby.

Every drop of breastmilk counts.

Remember - every minute, day, week, or month day you spent breastfeeding is a victory and worth celebrating.

When and How to Stop Breastfeeding 

There is no known age where breastmilk is considered nutritionally insignificant for children.  Your baby will eventually transition to solid foods to meet nutritional needs, but breastfeeding doesn’t lose its benefits at a set date or point in time.

The World Health Organization recommends exclusive breastfeeding up to six months of age with continued breastfeeding along with appropriate foods up to 2 years of age or beyond.¹² The choice of when to wean is up to you - breastfeed as long is mutually desirable for both you and your baby.

When it’s time to wean

Go about weaning gently and slowly to steadily decrease your supply and avoid complications like clogged ducts, engorgement, and/or mastitis. Enlist the help of your breast pump to pump a little “off the top,” but don’t empty your breasts, as that will only signal to your body to continue producing more and maintain your current supply.

Weaning to end your breastfeeding journey can be an emotional time for both you and your baby, so give yourself grace and time to reflect and be proud of all you’ve accomplished.

Breastfeeding Club

We’d want and expect breastfeeding to be intuitive. We were made for this after all, right? The glossy photos of doting moms with their content babies sharing intimate nursing moments would have you believe there’s something odd or wrong with you for having breastfeeding struggles.

The reality is that whether you’re a first-time mom or breastfeeding veteran, each mother-baby dyad is unique and faces its own breastfeeding challenges and triumphs throughout the journey. Breastfeeding tips, some patience and resolution, and a strong support system are invaluable for setting yourself up for breastfeeding success. Set small goals and targets for yourself and your baby and celebrate every single moment.

This information is only for educational purposes and is not medical advice or intended as a recommendation of any specific products. Consult your health care provider for more information.

References:

1. “U.S. Breastfeeding Rates Continue to Rise.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 31 July 2013, cdc.gov/media/releases/2013/p0731-breastfeeding-rates.html.
2. McDowell, Margaret M., et al. “Breastfeeding in the United States: Findings from the National Health and Nutrition Examination Survey, 1999-2006.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 6 Nov. 2015, cdc.gov/nchs/products/databriefs/db05.htm.
3. “Breastfeeding Among U.S. Children Born 2010–2017, CDC National Immunization Survey.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 10 Dec. 2020, cdc.gov/breastfeeding/data/nis_data/results.html.
4. “Breastfeeding and the Use of Human Milk.” PEDIATRICS, vol. 129, no. 3, 2012, doi:10.1542/peds.2011-3552.
5. “Early Initiation of Breastfeeding to Promote Exclusive Breastfeeding.” World Health Organization, World Health Organization, 11 Feb. 2019, who.int/elena/titles/early_breastfeeding/en/.
6. Godhia, Meena, and Neesah Patel. “Colostrum - ITS COMPOSITION, Benefits as A Nutraceutical : A Review.” Current Research in Nutrition and Food Science Journal, vol. 1, no. 1, 2013, pp. 37–47., doi:10.12944/crnfsj.1.1.04.
7. “ABM Clinical PROTOCOL #24: ALLERGIC Proctocolitis in the Exclusively Breastfed Infant.” Breastfeeding Medicine, vol. 6, no. 6, 2011, pp. 435–440., doi:10.1089/bfm.2011.9977.
8. Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. “Meeting Maternal Nutrient Needs during Lactation.” Nutrition During Lactation., U.S. National Library of Medicine, 1 Jan. 1991, ncbi.nlm.nih.gov/books/NBK235579/.
9. Dieterich, Christine M et al. “Breastfeeding and health outcomes for the mother-infant dyad.” Pediatric clinics of North America vol. 60,1 (2013): 31-48. doi:10.1016/j.pcl.2012.09.010
10. Ballard, Olivia, and Ardythe L Morrow. “Human milk composition: nutrients and bioactive factors.” Pediatric clinics of North America vol. 60,1 (2013): 49-74. doi:10.1016/j.pcl.2012.10.002
11. Witkowska-Zimny, Malgorzata, and Ewa Kaminska-El-Hassan. “Cells of human breast milk.” Cellular & molecular biology letters vol. 22 11. 13 Jul. 2017, doi:10.1186/s11658-017-0042-4
12. “Breastfeeding.” World Health Organization, World Health Organization, who.int/health-topics/breastfeeding#tab=tab_2.

Written by Banafsheh Amini, MAS, IBCLC.