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Breastfeeding FAQ

The minutes following childbirth is often a blur of emotions and activity so it's important to inform your doctor before delivery if you intend to breastfeed. Also, your partner should remind hospital staff that you do not want your baby to be given a pacifier or supplemental feeding without a medical reason. If you can, breastfeed within an hour of birth to take advantage of your baby's sucking instinct, which is strong immediately following delivery. The following are other frequently asked questions women and their partners have about breastfeeding. For questions involving physical pain or frustrations associated with breastfeeding, refer to the technique page.

What is the father's role in breastfeeding?
It is a fortunate baby that has a close, loving relationship with both of his parents! Babies need lots of physical contact, and when not breastfeeding, a father's loving arms are a wonderful place for his baby to be. Fathers need to spend time with their babies in order to get to know them better and get 'tuned in' to their needs. Watch for cues that baby is ready for some fathering interaction. A hungry baby won't be at all interested in playing, but once baby has nursed his fill, dad can take over. Try letting your full breastfed baby lie on her father's chest. Rocking baby on the father's shoulder is often a favorite activity. Many fathers find rewarding times with baby by showing the baby this big, wide world we live in!

The support of a baby's father can help the breastfeeding relationship succeed. The father can head off discouragement, deflect negative comments from friends and relatives, help calm a fussy baby and bring the new mother food and drink while she is breastfeeding. Most importantly the baby's father can remind the new mother that breastfeeding is one of the most important things she can do to get their baby off to a good start in life.

Especially in the first few weeks, when lack of sleep and hormonal changes can sometimes make new mothers waver in their determination to breastfeed, a father who suggests, "let's try that one more time," or who reminds his partner that, "they say babies space out their feedings after the three week growth spurt," can be invaluable. A father who brings pillows for help in positioning a newborn or who brings a telephone so that the mother can call a supportive friend is truly helping to feed his child!

How long should a feeding last?
How long a feeding lasts is best determined by your baby. A newborn may nurse 12 or more times a day for 15 to 45 minutes each session. Infants nurse most vigorously on the first breast, so start on the opposite side the next time. You'll know he's getting enough to eat if your breasts feel softer after nursing and he wets six to eight diapers and passes several seedy yellow stools a day. (Many breastfed newborns have a bowel movement after every feeding.) If you're concerned about whether your baby is getting enough to eat, call your physician.

What is colostrum? How does it benefit my baby?
Colostrum is the first milk your breasts produce in the early days of breastfeeding. This special milk is low in fat, and high in carbohydrates, protein, and antibodies to help keep your baby healthy. It is extremely easy to digest, and is therefore the perfect first food for your baby. It is low in volume 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 lighter in color. In those first few days it is extremely important to breastfeed your newborn at least 9-12 times in 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.

Later, when you are producing mature milk for your baby, the concentrations of the antibodies in the milk will be lower, but your baby will be taking in much higher volumes of milk. 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 long should a mother breastfeed?
Breastfeed on demand, as soon as your baby shows hunger cues such as increased alertness or making sucking motions. Feed for as long as your baby desires.

In terms of weeks, months, years, a mother and her baby should breastfeed for as long as they wish to breastfeed. The American Academy of Pediatrics currently recommends that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired. As solids are introduced, usually around the middle of the first year, your baby will shift his primary source of nutrition from your milk to other foods.

All the benefits of human milk--including nutritional and health--continue for as long as your baby receives your milk. In fact, as your baby takes less human milk, these advantages are condensed into what milk is produced. Many of the health benefits of human milk are dose related, that is, the longer the baby receives human milk, the greater are the benefits.

How can I tell if my baby is getting enough milk?
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.

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