4
WHY BREASTFEEDING
IS IMPORTANT
Healthy babies and
mothers
7
FINDING SUPPORT
AND INFORMATION
Health professionals
by phone
10
BREASTFEEDING
MYTHS
common. Get the facts.
11
IS MADE
needs
HOW YOUR MILK
12
BREASTFEED
minute of life for
LEARNING TO
22
CHALLENGES
common problems
Tips for
COMMON
30
COMMON
QUESTIONS
and more
32
BREASTFEEDING
A BABY WITH
A HEALTH PROBLEM
35
BREASTFEEDING AND
SPECIAL SITUATIONS
38
BREASTFEEDING
IN PUBLIC
and about
39
PUMPING AND
STORING YOUR MILK
44
GOING BACK
TO WORK
employer about your
47
FITNESS
NUTRITION AND
49
HANDLING
STRESS
at bay
50
WEANING
YOUR BABY
your baby
53
TEAROUT TOOLS
TOOLS YOU CAN USE
page 42
page 54
IS IMPORTANT
BREASTFEEDING PROTECTS BABIES
YOUR FIRST MILK IS LIQUID GOLD.
and includes antibodies to protect your
page 20 to see
YOUR MILK CHANGES AS YOUR BABY GROWS.
and antibodies your baby needs for
FORMULA IS HARDER TO DIGEST.
BREASTMILK FIGHTS DISEASE.
•
Asthma•
•
•
Ear infections•
•
•
•
in preterm infants
•
Sudden infant death syndrome•
DID YOU KNOW?
page 30. To learn more
CAN BREASTFEEDING HELP ME LOSE WEIGHT?
WHY BREASTFEEDING IS RIGHT FOR YOU
LIFE CAN BE EASIER WHEN YOU BREASTFEED.
easier once you and your baby settle into
there are no bottles and nipples to
NOT BREASTFEEDING COSTS MONEY.
BREASTFEEDING KEEPS MOTHER AND BABY CLOSE. Physical contact is important to
BREASTFEEDING IS GOOD FOR THE MOTHER’S HEALTH, TOO.
BREASTFEEDING GLOSSARY
Nutrients
build tissue.
Antibodies
The gastrointestinal system is made up of the stomach and the
DURING AN EMERGENCY, SUCH AS A NATURAL DISASTER, BREASTFEEDING CAN SAVE YOUR BABY’S LIFE:
supply.
and diarrhea.
feed.
BREASTFEEDING IS GOOD FOR SOCIETY
breastfeed.
BREASTFEEDING SAVES LIVES.
infants could be prevented.
BREASTFEEDING SAVES MONEY.
infants. Breastfed infants usually need
FINDING SUPPORT AND
INFORMATION
and supplies.
HEALTH PROFESSIONALS WHO HELP WITH BREASTFEEDING
INTERNATIONAL BOARD CERTIFIED LACTATION
CONSULTANT (IBCLC). www.ilca.org
in your area.
CERTIFIED LACTATION COUNSELOR OR CERTIFIED BREASTFEEDING EDUCATOR.
counselors and educators have special
DOULA.
after the baby is born. Doulas that are
learn to breastfeed.
•
•
counselor. “Peer” means that the
•
– – –
•
Social media sites are popular
but do not rely on these resources for
instead.
WHAT YOUR PARTNER CAN DO
WIC PROGRAM
http://www.fns.usda. gov/wic/breastfeeding-promotion-and-support-wic
BUILDING A SUPPORT NETWORK
support persons can be involved in the
•
•
to be fed
•
•
•
•
Help around the house•
are at home
•
MYTHS
should also be an informed one.
MYTH: EVERYONE USES FORMULA.
. Research over the past
babies.
MYTH: FORMULA HAS MORE VITAMINS THAN BREASTMILK.
cannot match the nutrients and vitamins
only be passed from your body to your
recommended by the American Academy
MYTH: BREASTFEEDING MAKES YOUR BREASTS SAG.
also play a role.
MYTH: IF YOUR BREASTS ARE TOO SMALL, YOU CAN’T BREASTFEED.
MYTH: IF YOUR BREASTS ARE TOO LARGE OR YOU’RE PLUS SIZE, YOU CAN’T BREASTFEED.
MYTH: YOU WON’T BE ABLE TO MAKE ENOUGH MILK.
MYTH: BREASTFEEDING SPOILS A CHILD.
baby to be attached to his or her mother
MYTH: BREASTFEEDING HURTS.
page 14 to learn more.
on page 4.
HOW YOUR MILK
IS MADE
ALVEOLI CELLS:
AREOLA:
LOBES:
MILK DUCTS:
the breast to the nipple/areola area
NIPPLE:
The breasts often become fuller and
Areola
Nipple
Alveoli cells
TO BREASTFEED
three years.
•
•
Breastfeed as soon as possible after•
•
necessary.
•
can breastfeed often.
•
PREPARE FOR BREASTFEEDING BEFORE YOU GIVE BIRTH
GET GOOD PRENATAL CARE
avoid early delivery. Babies born too early
TELL YOUR DOCTOR ABOUT YOUR PLANS TO BREASTFEED
create the best possible environment for
TAKE A BREASTFEEDING CLASS.
ASK YOUR DOCTOR TO RECOMMEND A LACTATION CONSULTANT. You can establish a
have support ready after the baby is born.
TALK TO YOUR DOCTOR ABOUT YOUR HEALTH. Discuss
TELL YOUR DOCTOR THAT YOU WOULD LIKE TO BREASTFEED AS SOON AS POSSIBLE AFTER DELIVERY.
TALK TO FRIENDS WHO HAVE BREASTFED
GET THE ITEMS YOU WILL NEED FOR BREASTFEEDING
HOW OFTEN SHOULD I BREASTFEED?
FOLLOW YOUR BABY’S LEAD
of frustration for you and your baby. One
to you.
CREATE A CALM ENVIRONMENT FIRST.
HOLD YOUR BABY SKINTOSKIN. Hold your
LET YOUR BABY LEAD
SUPPORT YOUR BABY, BUT DON’T FORCE THE LATCH. Support his head and shoulders as he searches for your breast. Avoid the temptation to help him latch on.
ALLOW YOUR BREAST TO HANG NATURALLY
and reach up and over the nipple. As she presses her chin into the breast and
HOW LONG SHOULD FEEDINGS BE?
breast. They may be shorter or
GETTING YOUR BABY TO LATCH
Pull your baby close so that the chin and
SOME BABIES LATCH ON RIGHT AWAY, AND FOR SOME IT TAKES MORE TIME.
and she said he had developed a perfect latch. She called us the miracle mom
SIGNS OF A GOOD LATCH
•
The latch feels comfortable to you•
body. She does not have to turn her
•
•
•
see it.
•
HELP WITH LATCH PROBLEMS
ARE YOU IN PAIN? ARE YOU OR YOUR BABY FRUSTRATED?
DOES YOUR BABY HAVE A WEAK SUCK OR MAKE ONLY TINY SUCKLING MOVEMENTS?
by a health problem.
COULD YOUR BABY BE TONGUETIED?
A GOOD LATCH
BREASTFEEDING HOLDS
CLUTCH OR “FOOTBALL” HOLD: useful if you
his or her head at the level of your nipple.
palm of your hand at the base of his or her head.
CROSSCRADLE OR TRANSITIONAL HOLD: useful for
support and may help the baby stay
hand.
CRADLE HOLD:
is comfortable for most mothers and
head on your forearm and his or her
LAIDBACK HOLD (STRADDLE HOLD): a more
to your breast. As your baby searches for
SIDELYING POSITION: useful if you have had
TIPS FOR MAKING IT WORK
LEARN YOUR BABY’S HUNGER SIGNS.
alert and active. They may put their
for the baby to latch if he is upset. Over
FOLLOW YOUR BABY’S LEAD.
KEEP YOUR BABY CLOSE TO YOU.
Remember that your baby is not used
AVOID NIPPLE CONFUSION.
doctor has told you to use them because
the breast.
MAKE SURE YOUR BABY SLEEPS SAFELY AND CLOSE BY. Have your baby sleep in a crib or
bassinet in your bedroom so that you can
VITAMIN D
page 30.
MAKING PLENTY OF MILK
HOW LONG SHOULD I BREASTFEED?
Association.
WHAT WILL HAPPEN WITH YOUR MILK, YOUR BABY, AND YOU IN THE FIRST FEW WEEKS
TIME MILK BABY YOU (MOM)
BIRTH
baby early protection
time to breastfeed your baby.
FIRST 12–24 HOURS
You may not see the
your baby needs and in
Be sure to rest.
NEXT 3–5 DAYS
breastfed babies do not eat on a schedule.
Your breasts may feel
can use disposable or cloth pads in your bra
FIRST 4–6 WEEKS
continues.
time and may be further apart.
HOW TO KNOW YOUR BABY IS GETTING ENOUGH MILK
old.
ounce each day.
•
•
•
periods.
•
•
Your breasts may feel softer after you feed your baby.HOW MUCH DO BABIES TYPICALLY EAT?
especially in the early days. Once
TYPICAL NUMBER OF WET DIAPERS AND BOWEL MOVEMENTS IN A BABY’S FIRST WEEK
(IT IS FINE IF YOUR BABY HAS MORE)
1 DAY = 24 HOURS
BABY’S AGE NUMBER OF WET DIAPERS NUMBER OF BOWEL MOVEMENTS COLOR AND TEXTURE OF BOWEL MOVEMENTS
DAY 1 1
DAY 2 2 3
DAY 3 5–6
6–8 cloth
3
DAY 4 6 3
DAY 5 6 3
DAY 6 6 3
CHALLENGES
But remember that you are not alone. problems.
CHALLENGE: SORE NIPPLES
once you and your baby have found a
WHAT YOU CAN DO
•
page 14 for•
•
you breastfeed.
•
•
Get help from your doctor ornot use these products. Your doctor
best for you and your baby.
•
nipples.
•
disposable pads you can place in
•
Avoid harsh soaps or ointments that your nipples and breasts clean.•
CHALLENGE: LOW MILK SUPPLY
concerned.
page 20.
THERE MAY BE TIMES WHEN YOU THINK YOUR SUPPLY IS LOW, BUT IT IS ACTUALLY JUST FINE.
•
•
WHAT YOU CAN DO
•
•
Breastfeed often and let your baby•
stops.
•
formula or cereal in addition to your
uncomfortable for you and your baby.
WHAT YOU CAN DO
•
Breastfeed on one side for each•
before you are ready to breastfeed on
to relieve some of the pressure. You also can use a cold compress or
page 18
•
Burp your baby often if he or sheCHALLENGE: STRONG LETDOWN REFLEX
WHAT YOU CAN DO
•
•
•
CHALLENGE: ENGORGEMENT
and painful. You also may have breast
page 26
important to try to prevent it before this
CHALLENGE: ENGORGEMENT (CONT.)
WHAT YOU CAN DO
•
•
•
•
•
•
•
Use cold compresses on your breast pain.•
baby breastfed at home. Be sure to not let more than four hours pass
•
•
•
of the nipple and help your baby latch. Try one of the holds in the
pain. You may need to repeat each
SIX ENGORGEMENT HOLDS*:
1. 2.
place them on each side of the nipple.
3.
4. 5.
nipple.
CHALLENGE: PLUGGED DUCT
the breast. You should not have a fever or other symptoms.
duct does not drain properly. Pressure
breast at a time.
WHAT YOU CAN DO
•
•
•
the nipple.•
area.•
•
•
CHALLENGE: BREAST INFECTION (MASTITIS)
•
•
Nausea•
•
•
other family members have a cold or the
SEE YOUR DOCTOR RIGHT AWAY IF:
•
•
•
• Your symptoms came on severely and suddenly.
CHALLENGE: FUNGAL INFECTIONS
nipples or in your breast. This type of
Candida Candida
healthy by the natural bacteria in our
Candida
•
Nipple soreness that lasts more than•
nipples
•
•
Achy breasts•
WHAT YOU CAN DO•
often.•
•
•
•
•
or toys your baby puts in her
•
Boil all breast pump parts that touch•
each other.
CHALLENGE: NURSING STRIKE
This usually does not mean that the baby
babies may just become fussy at the
breast entirely.
•
sore
•
•
•
in routine
•
•
•
•
reaction if the baby has bitten her
•
•
especially if your baby is unhappy. Be
WHAT YOU CAN DO
•
the baby used to breastfeed to avoid
CHALLENGE: INVERTED, FLAT, OR VERY LARGE NIPPLES
must latch on to both the nipple and the
WHAT YOU CAN DO
•
consultant if you are concerned about your nipples.
•
pull your nipples out. You also can use a special device that pulls out
nipples.
QUESTIONS
SHOULD I SUPPLEMENT WITH FORMULA?
DOES MY BABY NEED CEREAL OR WATER?
the baby cereal may cause your baby to
IS IT OKAY FOR MY BABY TO USE A PACIFIER?
DOES MY BABY NEED MORE VITAMIN D?
baby still needs vitamin D supplements.
D from the food they eat.
IS IT SAFE TO SMOKE, DRINK, OR USE DRUGS?
because it can help protect your baby
and tremors.
CAN I TAKE MEDICINES IF I AM BREASTFEEDING?
or pharmacist about medicines you are
medicines. This includes prescription
and dietary or herbal supplements.
have on the breastfed baby.
of medicines on breastfed babies. The
https://toxnet.nlm. nih.gov/newtoxnet/lactmed.htm. You can print out the information you
pharmacist to discuss.
CAN I BREASTFEED IF I AM SICK?
page 5 to learn about
•
page 37 for more
•
•
•
antimetabolites•
WILL MY PARTNER BE JEALOUS IF I BREASTFEED?reasons to breastfeed. Remind your
is convenient and comfortable. Be sure
can cost you money. Your partner can
DO I HAVE TO RESTRICT MY SEX LIFE WHILE BREASTFEEDING?
comfortable for you and your partner if
•
DO I STILL NEED BIRTH CONTROL IF I AM BREASTFEEDING?
delay the return of normal ovulation
doctor birth control choices that you can
I HEARD THAT BREASTMILK CAN HAVE TOXINS IN IT FROM THE ENVIRONMENT. IS IT STILL SAFE FOR MY BABY?
pollutants. Remember that your baby
or chemicals.
DOES MY BREASTFED BABY NEED VACCINES? IS IT SAFE FOR ME TO GET A VACCINE WHEN I’M BREASTFEEDING? Yes. Vaccines are very important to
also help your baby respond better to
can help relieve pain and soothe an upset baby.
WHAT SHOULD I DO IF MY BABY BITES ME?
•
Gently press your baby to your open her mouth more to breathe.•
limits.•
already.•
WHAT DO I DO IF MY BABY KEEPS CRYING?WITH A HEALTH PROBLEM
Some health problems in babies can
your baby needs — even more so if your
baby cannot breastfeed directly from
Some common health problems in
JAUNDICE
bilirubin. Bilirubin is found in the blood but usually only in very small amounts.
build up faster than it can be removed from the intestinal tract. Jaundice can
and third day of life. The jaundice usually
not harmful.
Some breastfed babies develop jaundice
removed from the body easily.
treatment options and let the
REFLUX DISEASE
Some babies have a condition called
tube in the throat. Some symptoms of
•
•
•
discomfort
•
pain
•
•
•
•
of these symptoms and not have GERD.
these symptoms have a severe case of
COLIC
breastfed babies may be sensitive to a
hernia or some type of illness.
PREMATURE OR LOW BIRTH WEIGHT
SOME BABIES CAN BREASTFEED RIGHT AWAY.
EVEN IF YOUR BABY IS BORN PREMATURELY AND YOU ARE NOT ABLE TO BREASTFEED AT FIRST, YOUR BABY CAN STILL BENEFIT FROM YOUR MILK. YOU CAN:
•
in the hospital as soon as you are able.
•
insurance plans must cover breast
you are able to rent an electric pump or a manual pump.
•
•
once your baby is ready to breastfeed
BREASTFEEDING AND
SPECIAL SITUATIONS
TWINS OR MULTIPLES
of multiples and their babies are the same as for all mothers and babies —
more than one baby may seem
successfully breastfeed more than one
SEEKING SUPPORT
Reach out to other moms of multiples
•
–
www.llli.org/faq/twins.html
– Mothering Multiples: Breastfeeding
and Caring for Twins or More!
•
•
can rent a breast pump if the babies are born early.
MAKING ENOUGH MILK
•
birth is helpful for multiples the
•
•
page 20.
•
their eyes.
Jen, Charleston, South Carolina
• page 20
• page 22
BREASTFEEDING AFTER BREAST SURGERY
implants usually breastfeed successfully.
as possible.
ADOPTION AND INDUCING LACTATION
breastfeed their babies and can do it
physical action. The stimulation of the
and a lactation consultant. They can
baby arrives and start to breastfeed then.
system or a lactation aid to ensure your
same time.
USING MILK FROM DONOR BANKS
•
–
– Your baby has other health problems.
–
–
–
some therapies may mean only a
•
to parents of babies in need. This is
has not been tested in a lab such as at a
IN PUBLIC
Some mothers feel uncomfortable
•
such as the American Academy of
the best choice for the health of a mother and her baby. You can see
www.ncsl.org/research/ health/breastfeeding-state-laws. aspx.
your choice to breastfeed your baby.
•
•
around your shoulders.
•
comforted and close to you. But be
•
•
•
in a booth.
becomes fussy so that you have time to
comfortable.
out and about. You should be proud of
PUMPING AND STORING
YOUR MILK
PUMPING YOUR BREASTMILK
and your pump parts and bottles are clean.
•
•
your breasts.
•
•
Gently rub your nipples.WAYS TO EXPRESS YOUR MILK BY HAND OR PUMP
TYPE HOW IT WORKS WHAT’S INVOLVED AVERAGE COST
HAND
EXPRESSION You use your hand to massage and compress your breast to remove milk.
•
Requires practice, skill, and coordination•
Gets easier with practice, and can be as fast as pumping•
Good if you are seldom away from your baby or you need an option that is always with you. But all moms should learn how to hand express. Watch a video at http://med.stanford.edu/ newborns/professional-education/breastfeeding/hand-expressing-milk.htmlFree
MANUAL
PUMP You use your hand and wrist to operate a hand-held device to pump the milk.
•
Requires practice, skill, and coordination•
Useful for occasional pumping if you are away from your baby only once in a while•
May put you at higher risk of breast infection$30 to $50
ELECTRIC BREAST PUMP
Runs on battery or plugs into an electrical outlet.
•
Can be easier for some moms•
Can pump one breast at a time or both breasts at the same time•
Double pumping may collect more milk in less time, which is helpful if you are going back to work or school full-time•
Need a place to clean and store the equipment between uses$150 to more than $250
You can rent an electric pump from a lactation consultant at a local hospital or from a breastfeeding organization. This type of pump works well for creating a milk supply when a new baby can’t feed at the breast. Mothers who struggled with
these pumps work well for them.
health insurance plan must cover the cost
rental or a new one for you to keep. Your plan may provide guidance on whether the covered pump is manual or electric, how long the coverage of a rented pump lasts, and when they’ll provide the pump.
Learn more about your breastfeeding
STORING YOUR BREASTMILK
AFTER EACH PUMPING
•
care provider.
•
not recommended — this can cause
•
TIPS FOR FREEZING MILK
•
•
Try to leave an inch or so from the•
door.
TIPS FOR THAWING AND WARMING UP MILK
•
•
temperature. Some moms serve it cold.
GUIDE TO STORING FRESH BREASTMILK FOR USE WITH HEALTHY FULLTERM INFANTS
PLACE TEMPERATURE HOW LONG THINGS TO KNOW
COUNTERTOP,
TABLE Room temp
REFRIGERATOR
FREEZER
DEEP FREEZER
GUIDE TO STORING THAWED BREASTMILK
ROOM TEMPERATURE
(60°F TO 85°F) REFRIGERATOR (39°F OR COLDER) ANY FREEZERS
THAWED BREASTMILK
Source: American Academy of Pediatrics
TO WORK
DURING YOUR MATERNITY LEAVE
•
you recover from childbirth and
•
pump may be the best method for
close. See pages 39 to 43 for more
•
•
care provider about your desire to
need their support.
BACK AT WORK
•
•
over lunch.
•
you both time to reconnect before
GET A QUALITY BREAST PUMP
page 40 for more information on types of breast
FIND A PRIVATE PLACE TO EXPRESS MILK
private area you can use. You may be able
The room should be private and secure
should also have an electrical outlet if
toilet stall.
DURING THE DAY?
page 20
PUMPING TIPS
•
•
•
Gently rub your nipples.•
•
your baby.
STORING YOUR MILK
YOUR BUSINESS CAN TAKE EASY STEPS TO SUPPORT BREASTFEEDING!
SUPPORTING NURSING MOMS AT WORK: EMPLOYER SOLUTIONS
www.womenshealth.gov/breastfeeding/employer-solutions/ index.php
by industry.
THE BUSINESS CASE FOR BREASTFEEDING
NUTRITION
AND FITNESS
HEALTHY EATING
There are no foods you need to avoid.
and love.
that some foods cause stomach upset in
foods to see if your baby feels better and
•
•
•
does not cause a problem for most
•
a supplement. Vitamin and mineral supplements should not
need a multivitamin and mineral supplement.
•
See page 30 for information onTIPS FOR HEALTHY EATING
Tips Nutrition Education Series” at
CAN A BABY BE ALLERGIC TO BREASTMILK?
•
mucus or blood
•
•
•
•
•
better results.
VEGAN DIETS
FITNESS
HANDLING
STRESS
conditions.
breastfeed can be stressful. But it is
themselves. Try to listen to your body so
your health.
RELAX.
you and your baby. Use this time to bond
SLEEP.
SURROUND YOURSELF WITH SUPPORTIVE PEOPLE.
GET MOVING.
Physical activity improves your mood.
DON’T DEAL WITH STRESS IN UNHEALTHY WAYS.
unhealthy to overeat in response to stress.
GET HELP FROM A PROFESSIONAL IF YOU NEED IT.
help promote sleep. But not all medicines
to your doctor or pharmacist before
YOUR BABY
suddenly can be physically painful for you and emotionally hard on you and your baby.
WHEN TO WEAN YOUR BABY
.
The American Academy of Pediatrics
•
•
•
as both you and your baby are comfortable. Some mothers and babies continue to nurse into
the toddler years and beyond.
been found of developmental harm
•
•
•
many medicines are safe for both baby and mother.
5
HOW TO TELL WHEN YOUR CHILD IS READY TO WEAN
earlier than is normal due to separation
page 28.
NURSING SESSIONS HAPPEN LESS OFTEN.
FORMULA WHEN I WEAN?
IF YOUR BABY IS OLDER THAN 1 YEAR
HOW TO WEAN YOUR BABY
are some reasons you may have to stop
and even perhaps before you planned to
•
your breasts or pump a tiny amount if your breasts become uncomfortable.
•
younger
than 1 year older
than 1 year
•
•
close to you.
•
•
try a car ride or let your partner do the bedtime routine.
•
hard emotionally on both of you.
•
for you. Try these tips to ease discomfort.
•
•
Do not bind your breasts. Thisinfection.
•
any herbal remedies or alternative
you and your baby.
•
place the leaves in your bra over your breasts and under the arms if
often as needed for comfort.
