Breastfeeding Info for Families

The skin on the breast becomes more elastic and the nipple and areola may become darker in color. Tiny raised bumps known as Montgomery glands on the areola secrete oil that cleanses and lubricates the nipple, keeping it soft and pliable. It also has a scent that the baby uses to locate the breast. You cannot smell it but your baby will be able to, especially right after the birth. Do not remove this oil with soaps or other drying agents such as alcohol or witch hazel. Some women may experience slight leaking from the nipples towards the end of their pregnancy. 

Most people notice an increase in breast size during pregnancy.  This is because the mammary glands are preparing to make milk.  Swelling and tenderness are signs that the breast is changing. The amount of breast change will vary between women. If there is very little or no breast change during pregnancy, it is important to discuss it with your lactation consultant or health care provider.

Your breasts are producing colostrum during the 2nd trimester of pregnancy.  

The size and shape of your breasts have nothing to do with how much milk you will make.  Women of all sizes, with large or small breasts, can successfully breastfeed.

Breastfeeding your baby, like any new skill, may take some time and practice.  If you are are feeling unsure about breastfeeding, you are not alone.  Ask for help in the hospital or contact your WIC office to ask questions.

Breastfeed your baby as soon as possible after birth.  Colostrum is the first milk your body makes - it is thick, golden and comes in drops so as not to overfill your baby's tiny tummy.  It provides many nutrients and antibodies to protect your baby from infections.  It also acts as a laxative to clean out and strengthen your baby's digestive system.  

Transitional milk comes a few days later.  You may notice that your breasts become fuller and that your milk slowly changes to a bluish-white color.  Your milk is changing to meet your baby's needs!  Nursing often, removing milk and relieving engorgement will help with milk production.

After about 10-15 days after birth, you start making mature milk.  The nutrients are still changing to meet your baby's needs!  Try to let your baby empty your first breast before switching to the other breast during a feeding.  This will help your baby get the right mix of nutrients at each feeding.

Here are some other helpful tips:

• Use warm compresses on your breasts for 5 to 10 minutes to relieve swelling or take a warm shower.
• Gently massage your breasts during feedings and throughout the day.
• If you miss a feeding or baby only takes one breast, use hand expression or a pump to empty your milk.
• If you are having trouble getting baby to latch check or have any questions about breastfeeding, contact a Community Breastfeeding Resource.

As your baby gets older, they will go through growth spurts - the first one is around 2 to 3 weeks. Growth spurts are times when baby needs more milk because they grow quickly in a short time. Nursing on demand satisfies baby and increases your milk production. You may notice the day after a growth spurt that the baby will sleep more and then nursing patterns return to normal. Growth spurts occur every 3 to 4 weeks.

At around 4 to 6 months baby's stooling patterns may change. It is normal for them to go less frequently sometimes 5 or 6 days pass and then baby will have a large bowel movement.

There are many ways to position yourself and hold your baby while breastfeeding.  What's most important is figuring out what works for you and your baby. You may even decide to use different positions for each feeding or on different sides.  Learn more about the different positions at USDA WIC Breastfeeding Support.  No matter what position you choose, always position baby to your nipple height, rather than leaning over your baby.  That will make breastfeeding more comfortable your you and help your baby get a good latch.

The American Academy of Pediatrics (AAP) recommends that infants do not sleep in bed with parents and/or other children to reduce the risk of Sudden Infant Death Syndrome (SIDS). For more information, visit the Michigan Department of Health and Human Services page. 

It doesn't take much to fill up your baby.  At birth, your baby's tummy is no bigger than a toy marble.  By day 10, your baby's stomach grows to the size of a ping-pong ball.  Alot of people have questions about making enough milk.  Its one of the most commonly asked questions by most moms!!

Babies give hunger cues such as:

• Turning their head from side to side
• Opening and closing their mouth
• Moving their a fist to their mouth
• Sucking on hands or smacking their lips

Many people think crying is the only sign that their baby is hungry.  But this is actually a sign of distress and a late sign of hunger.  Once baby is crying, it can be harder to get baby to latch.  

• Remember that babies need night time feedings too.

You can tell if your baby is getting enough milk by listening for swallows while baby nurses. You can also count wet and dirty diapers. After three or four days, baby should have about 5 to 6 wet or dirty diapers.  The dirty diapers of a breastfed baby are often yellow-ish in color and look different than the diapers of a formula fed baby.  Other signs of fullness are:

• Baby releases from your breast
• Baby relaxes their body and opens their fists

TIP:  Your baby helps you make milk by suckling and removing milk from your breast.  The more milk your baby drinks, the more milk your body will make. Frequent breastfeeding or milk removal (8-12 times or more every 24 hours), especially in the first few days and weeks of baby's life, helps you make a good supply.

If you are still unsure about your milk supply or if there are concerns about your baby's growth, its a good idea to seek support from a lactation specialist, WIC office and/or health care provider.  At Monroe WIC we have a BREASTFEEDING WARMLINE (734-240-7901) that you can call anytime day/night and leave a voicemail with your question(s).  A Lactation Specialist will call you back to help you talk through your concerns and direct you to additional resources if needed.

It can take a few weeks for you and your baby to feel happy and confident with breastfeeding.  Its is best if you can wait for your milk supply to be well established before introducing baby to a bottle.  Holding off on bottles for about two weeks while baby is learning to breastfeed helps to avoid nipple confusion and low milk production. The more you nurse, the more milk you produce.

If a health care provider recommends for baby to have supplementary feedings, you can ask them for "breastfeeding friendly" ways to do this.  

Babies are ready to start solids around six months. Signs of being ready for solids are:

• Sitting up without support and holding their head up.
• They are still hungry after nursing well.
• Being more social, reaching for your food, picking up objects, leaning forward, and making chewing motions.

Start slowly with solids. Nurse your baby first to make sure they get the best food possible mom's milk! Solid foods are in addition to breast milk. Start with only a teaspoon of rice cereal diluted with a tablespoon or so of breast milk or formula. The baby may sit in a high chair or on someone's lap. Use a small spoon and put it inside the baby's lips so she can suck on the food. The first few attempts will be messy. The baby's tongue will thrust and push the food out and it takes time for them to learn to move the food to the back of their throat to swallow it. Learning to eat solids is a gradual process. As the baby's desire for more food increases, you can add more.

Try one new food at a time, waiting about a week between new foods. If they develop an allergy or become upset, you will know what food to eliminate. Other foods to introduce are strained, pureed, mashed cooked vegetables, fruit, meat, and mashed beans. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months with no additional solids. A further recommendation is breastfeeding for a year or longer so far as mom and baby agree.

Nursing beyond the first year (also known as extended breastfeeding) is normal, healthy, and common in many countries. 

Nursing an older baby is completely different than nursing a younger one. The older baby is far more efficient and has less need to use you as a pacifier. A toddler will nurse less often, maybe every four or five hours. They will climb on your lap, nurse a few minutes for thirst or comfort and then jump down and return to playing. There will be longer sessions of nursing that typically occur at bed and nap times. Though typically they are to busy exploring the world around them to sit still for a long nursing session.

Breastfeeding can be an important source of reassurance and emotional support for your toddler. The strong connection your child feels with you while nursing will foster independence as they grow.

There are significant emotional and physical benefits to extended nursing.  Also, breast milk provides concentrated immunities, vitamins, enzymes and fats that are needed for brain development.

• Caffeine: Caffeine should be limited to 2 servings or less per day.  Caffeine is found in coffee, soft drinks, tea, some medications and chocolate. If your baby seems unusually fussy or wakeful you may want assess how much caffeine you are consuming.
• Artificial Sweeteners: There is not evidence that artificial sweeteners are harmful when breastfeeding. Of course, there is one exception to this rule for mothers of infants with Phenylketonuria (PKU) as aspartame contains phenylalanine. In general it is always a good idea to keep food additives to a minimum.
• Supplement and Herbs: Some supplements can affect milk supply or interact with other medications you might be taking.  Its best to speak with your doctor or Lactation Specialist about any supplements you are taking.

A nutritious diet is very important after you have a baby for many reasons. Your body needs vitamins and minerals to heal properly after delivery. Although it is important to eat well postpartum, your breast milk always maintains a high nutritional quality even if your diet is less than adequate. No special diet or foods are necessary, but mothers should try to eat a balanced, varied diet to remain healthy and energetic.

While breastfeeding a baby, you will need to consume approximately 300 to 500 extra calories a day.  There are several important nutrition factors to consider when breastfeeding. Here are some helpful nutritional guidelines:

• Calcium: Calcium is very important to everyone but especially when pregnant or breastfeeding because studies have shown that calcium is drawn out of your bones during pregnancy and lactation. Most women should have 2 to 4 servings of milk or dairy per day. Some good sources of calcium include yogurt, milk, cheese, broccoli, watercress, oranges, almonds, tofu, and dark leafy greens.
• Iron: Iron is important during pregnancy and postpartum. A lack of iron in your blood can cause you to feel weak, lightheaded, tired, have a loss of appetite, or be more likely to get colds and flu. Continuing to take your prenatal vitamins will help keep your iron levels up but the best way to have enough iron in your blood is to eat foods that are high in iron. Here is a list of foods- red meat, lamb, turkey, chicken, pork and fish, kidney beans, dried beans and peas, whole grain breads and iron-fortified cereals, greens, broccoli, baked potato with skin, raisins, and dried fruit. High vitamin C foods/beverages along with high iron foods help your body absorb iron easier, so drink a glass of 100% fruit juice with your meal.
• Folic Acid: Folic acid is very important if you could potentially become pregnant. Folic acid is a B-vitamin when taken one month before conception and throughout the first trimester reduces the risk of neural tube defects. The recommended amount of folic acid is 400 micrograms daily which can be consumed in a vitamin supplement or by eating foods high in folic acid. Breakfast cereals are especially high in folic acid, many contain 100% of the daily value, enriched pasta, rice, breads, flour and other grains have been fortified with folic acid. Fruits, green leafy vegetables, dried beans and legumes also contain folic acid.
• Vitamins: It is recommended that breastfeeding women continue to take prenatal vitamins. Eating lots of fruits and vegetables will also help you get all the vitamins and minerals you need. Vitamin D is important to your baby's bone growth. It is recommended that ALL infants and children have a minimum daily intake of 400 IU of Vitamin D beginning soon after birth. Discuss questions and concerns about Vitamin D with your baby's doctor. Vitamin D is found in fish, milk, eggs and butter.

• Fluids:  Its important to drink plenty of fluids while breastfeeding.  Oxytocin released in breastfeeding triggers your thirst; this is your body's way to making sure that you are getting enough water to produce breast milk.  While being slightly dehydrated may not affect breast milk production, it can influence your mood, amount of energy and skin health.  

• Medications/Drugs: Many medications are compatible with breastfeeding, but you should consult your doctor and/or lactation consultant when taking over-the-counter or prescription drugs. Medications and Mother's Milk: A Manual of Lactational Pharmacology  by Dr. Thomas Hale Ph.D., is a current researched source used by Hospital Newborn Nurseries and Lactation Consultants for validating the safety of medications while breastfeeding. Dr. Hale's manual is updated every two years and is offered in a parent's version and online. Street drugs are illegal and unsafe. Street drugs are not compatible with breastfeeding.
• Alcohol: Since alcohol has been found to pass into human milk and can interfere with the milk ejection reflex, alcohol consumption should be avoided while breastfeeding. An occasional drink, not exceeding two ounces of alcohol, may be safe, but you should consult your health care provider about the associated risks. Amounts exceeding two ounces should definitely be avoided. One occasional glass of wine or one beer is generally acceptable, but not more. Many mothers often report that a few sips of beer stimulated a letdown reflex of their milk, but too much will inhibit it. Brewers Yeast, a component of beer can also be taken as a supplement when let-down and milk supply is diminished. There is no research evidence documenting of the yeast's effect on milk supply. Breast pumping and discarding breast milk is recommended when alcohol is consumed beyond the limits stated above.
• Smoking: Regardless of feeding method (breastfeeding or infant formula), maternal smoking is a risk factor for sudden infant death syndrome (SIDS) and other health conditions. Mothers who use tobacco or e-cigarettes should be encouraged to quit; however, breastfeeding provides numerous health benefits and breast milk remains the recommended food for an infant.

Worldwide most babies wean between 2 to 4 years of age. Ideally, your baby will nurse until he outgrows the need. This can be called natural or baby-led weaning. Depending on your approach, weaning can be done gradually over several weeks or more abruptly.

Abrupt weaning should be avoided for the sake of both you and your baby. When you suddenly stop nursing, your breasts may become engorged and you could develop a breast infection or abscess. The sudden weaning may also cause a sharp drop in hormone levels, which may trigger the onset of depression. Keep your health care provider informed of your breastfeeding transition to help avoid major complications.

Abrupt weaning is hard on the child as well. Nursing is not just a source of food; it is a source of comfort and security. 

There may be medical reasons to wean abruptly; though its always a good idea to ask if there are "breastfeeding friendly" options to achieve the medical care needed.  Lactation Consultants have extensive medical training and may be able to offer personalized guidance to help.

Your loved ones are probably excited to meet the baby.  There are many ways they can start bonding with the baby and support you with breastfeeding.  Its a good idea to talk with your friends and family about your decision to breastfeed your baby.  

Here are just a few ideas for those supporting a breastfeeding mom:

• Before baby comes, learn the basics of breastfeeding.
• Consider taking a breastfeeding class together.
• At the hospital, focus on skin-to-skin time for both mom and support people.  This is a great way to soothe and bond with baby.
• At the hospital, remind the staff that you have chosen breastfeeding.  If there are questions or concerns, ask the staff and learn together.  
• At home, help with baby care.  Partners can help soothe, bathe, change diapers, dress and burp the baby.   
• At home, partners can help with house chores.
• Above all, acknowledging that breastfeeding can be hard at times and letting your partner know how proud you are of them can make a big difference.