Nursing changes as your baby grows. Here's how to adapt.
The first days and weeks of breastfeeding often boil down to sheer survival: getting your baby to latch onto (and stay on!) your breast; functioning on what often feels like mere minutes of sleep; and willing yourself to keep going if you're having problems.
Yet at some point down the road, when you and your baby have made it through the getting-to-know-each-other period, you're likely to have different questions and concerns.
Here's a look at some of the breastfeeding issues you're likely to face throughout the first year.
I've heard that getting a proper latch is essential for successful breastfeeding. Is it really that important?
Yes, it's that important. If you don't have a proper latch, your baby may not get enough milk, and you could develop sore and cracked nipples. Following are tips from Corky Harvey, R.N., M.S., I.B.C.L.C., co-owner of The Pump Station stores in Southern California, on how to get it right (click here for step-by-step photos):
- Position your baby so he is lying on his side, his belly flush against yours.
- Prop up the baby with a pillow and hold him up to your breast; don't lean over toward him.
- Using your free hand, place your thumb and fingers around your areola (the dark area surrounding the nipple).
- Tilt your baby's head back slightly and gently touch him with your nipple just above his upper lip.
- When his mouth is open wide, scoop your breast into his mouth. Place his lower jaw on first, well behind the nipple.
- Tilt his head forward, placing his upper jaw deeply on the breast. Make sure he takes the entire nipple and at least 1½ inches of the areola in his mouth.
How can I tell if my baby is getting enough milk?
This is one of the most common questions among breastfeeding moms, because unlike with a bottle, you just can't tell how much milk your baby is getting. To make sure you're both on the right track, your pediatrician will monitor his weight closely, especially for the first several weeks.
In the meantime, pay attention to his diapers: He should have six to eight wet ones and at least two "seedy," mustard- colored stools daily by the time he's 7 days old. Also keep this in mind: "As long as your baby is gaining weight consistently and his diapers show that he is eating enough, you can assume that he's getting plenty of milk," says Jeanette Panchula, R.N., P.H.N., I.B.C.L.C., a lactation consultant at the Solano County Department of Public Health and the California Department of Public Health's Maternal, Child and Adolescent Health division. If you're still concerned, schedule a weight check with your pediatrician.
I'm going back to my full-time job in a few weeks and want to keep breastfeeding. How do I handle pumping?
First off, alert your employer about your plans so that you can work together to find the best place for you to pump. "It will help things go more smoothly if you can figure out where and when you will pump before you actually get back to work," Panchula says. You should have begun pumping when your baby was 3 weeks or 4 weeks old, both to get him used to taking a bottle and so you'll have a supply of breast milk stored in the freezer. If you haven't started, get going!
Since you'll be returning to work full time, you'll probably want to rent or buy a double electric pump because it expresses both breasts at once and therefore cuts down on pumping time. (For some great models, see "Nursing" in our Buyer's Guide) When you return to work, try to pump as often—and at about the same times—as your baby normally nurses.
I'd like to have an occasional glass of wine. How long do I need to wait after drinking before nursing my baby?
In general, the alcohol from one drink—8 ounces of beer, 6 ounces of wine or one shot of hard alcohol—tends to be metabolized (and thus absent from your milk) within two to three hours, at which time it's safe to nurse your baby. But a better guideline is this: As long as you're feeling any effects from the alcohol, even if you are just a bit tipsy or giddy, don't put your baby to the breast. Want to be even more sure? Try MilkScreen, a home test for alcohol in breast milk (milkscreen.com).
I've heard that breastfed babies usually take longer to sleep through the night. Should my son be doing this yet?
First, keep in mind that "sleeping through the night" at this age actually means five or six hours, not eight or nine. Second, every baby is different. Some will start sleeping through at 3 months old; others won't until much later. "Babies sleep through the night when they're ready, whether or not they're breastfed," Panchula says.
That said, because breast milk is digested so completely and more quickly than formula, breastfed babies do tend to eat—and therefore wake—more frequently than formula-fed babies. (Tip: Don't look at the clock! Feed the baby whenever he's hungry, day or night.)
My baby seems ready for solids. How and when should I introduce them?
"Breast milk still is the most important part of your baby's diet at this age, so breastfeed right before you offer cereal or other foods," says Debi Page Ferrarello, R.N., M.S., I.B.C.L.C., director of family education and lactation at Penn Medicine at the University of Pennsylvania Health System.
When you do offer solids, start with rice cereal and gradually add a cooked or mashed fruit or vegetable. (Many pediatricians believe it's fine to start with a finely puréed fruit or vegetable, or even meat; check with your doc to see what she recommends.) Be sure to wait three to five days before introducing a different food so you can trace the cause of any allergic reaction.
Can I take birth-control pills if I'm breastfeeding?
"Yes. But opt for a progestin-only 'mini-pill,' since pills containing estrogen can decrease milk supply," Ferrarello says. Depo-Provera—an injection given every three months— is another progestin-only contraceptive that is safe to use while breastfeeding; wait six weeks after childbirth before beginning use.
I keep getting clogged milk ducts. What causes them, and what can I do to treat them?
"One of the risk factors for clogged ducts is a change in a baby's feeding pattern," Ferrarello says. "If your baby is nursing less frequently because he's eating more solids, milk 'stasis'— when milk sits in the breast—can occur and cause the ducts to clog." The best way to treat clogged ducts is by nursing or pumping often from the affected breast, applying warm compresses, and getting plenty of fluids and rest. If you have a fever or flulike symptoms, see your doctor; you may have mastitis, an infection that often requires antibiotics.
My baby keeps biting me! How can I make him stop?
Take him off the breast as soon as he starts to bite, say, "No biting!" and keep him off the breast until the next feeding. Also be alert: Biting usually happens toward the end of a feeding, so if you can tell that your baby is almost finished nursing, remove him from the breast before he clamps down.
My baby often seems uninterested in nursing. Is this normal?
"This is completely normal at this age," Harvey says. "Babies are curious about their world and really start to explore now." Your budding toddler may be distracted by every noise he hears, which causes him to pull away from the breast; or he may be crawling, in which case he really wants to explore. While this might be a frustrating time for you, it should pass; it typically doesn't mean that the baby is ready to wean.
My baby is eating more solids. How many times a day should he be nursing?
"A minimum of four times a day is what we expect," Harvey says. "A baby this age should be getting about 16 to 20 ounces of breast milk daily." At the end of the first year, half of a baby's calories should be coming from breast milk.
I'm not sure I'm ready to wean. Are there any good reasons to breastfeed for longer than a year?
There are many reasons to continue nursing, but one of the best is your baby's health: Breast milk continues not only to protect him from many illnesses, but it also will help him recover more quickly if he does get sick. "As long as your baby is drinking breast milk, he's getting all the immunological benefits nursing provides," Harvey says.
But there's more. "A nursing mother and her infant have a special bond, and there is no reason any woman should be in a hurry to give it up," Harvey adds. "As long as she and the baby are happy, there is no reason to wean."