Frequently Asked Questions
It is recommended to breastfeed on demand and follow babies cues, but this should equate to 8-12 times in a 24 hour period. Breast milk is easily digested so newborns are hungry often. It is also important for frequent feedings to stimulate your milk production in the beginning. As babies get older they will start to go closer to 2-3 hours between feedings. Newborns should not go more than 4 hours including overnight feedings. You want to count the length of time between feedings from the time your baby begins to nurse to when the baby begins to nurse again.
Understanding hunger cues will be extremely important in knowing if your baby is actually hungry as well as monitoring feeding times/diaper output. Babies can be fussy for many other reasons besides hunger. Signs a baby is actually hungry can include bringing hands to their face, rooting, making sucking noises, sucking their hands or fingers, and clenching of the fists/arms. Crying is a late hunger cue, so it is important to feed during early cues. Understanding stomach size and how much a baby should be getting will help mom understand.
Breast milk is typically discussed in three stages: colostrum, transitional breast milk, and mature breast milk. This is also called Lactogenesis I, II, and III. Colostrum is what your body makes from mid pregnancy to birth. Your breastmilk transitions once your placenta is birthed until 20-30 hours after birth and this is transitional breast milk. Once your milk is fully transitioned usually by one week postpartum this is mature breast milk. During these stages your baby is given exactly what your baby needs.
Milk removal will be controlled by the baby’s appetite. The more demand, milk removal that is occurring the more supply that will be produced. You breast milk contains a protein called FIL and its role is to slow milk production down when FIL is present and speeds up production when FIL is not present. This is why milk removal and emptying of breasts is so important. More frequent feeds/pumps will help.
The breastfeeding process starts mid way through pregnancy when your body begins to make your fire milk, colostrum. Colostrum is a thick yellow fluid that is a concentrated source of antibodies, protein, fat. During pregnancy you have high levels of prolactin and progesterone to keep milk supply low (Lactogenesis I). With the birth of your placenta, your progesterone levels drop drastically allowing for the transition of the next stage of your milk over the next 2-3 days(Lactogenesis II). Up until this point your breast milk was driven by hormones but now it will be driven by supply and demand (Lactogenesis III).
Breast milk whether through nursing or pumping gives your baby a great start. Some of the benefits to breastfeeding for the mom are the release of oxytocin which helps your uterus return to pre-pregnancy size, decreased risk of breast and ovarian cancer, and may help lose weight as you burn more calories. Babies benefit from breast milk as they are provided with ideal nutrients, antibodies to fight off infections and promote healthy weight gain in your baby.
This is the biggest question of all. First is to check output, consider weight gain, and is your baby content and growing. See our diaper guide to see if your baby is having enough output. Whatever goes in must come out. Baby should have at least 6 wet diapers in a 24 hour period by day 6 of life. Next you can do a weighted feed where you weigh the baby, nurse and then weight your baby again. The difference between the weights is approximately how much your baby transferred. Checking to see if your baby is growing appropriately and content is also another way to see if you are making enough milk. Your baby should reach birth weight by 2 weeks and double birth weight by 6 months. This should be about 4-8 ounces weight gain a week. If you have any further concerns please reach out for an appointment.
Cross cradle, side lying, and football hold are three great positions to start with when working on getting the hang on things. Some more advanced holds are upright nursing, laid back nursing, nursing in a carrier, and rugby hold. Check out our graphic on positions to see how to perform each hold.
Breast milk is alive so it changes its properties to meet baby’s needs so you do not need to change the amount of milk from 2 weeks on. During the first two weeks your baby will get less because of their stomach size. From 2 weeks on, the baby will take 1-1.25 ounce an hour. See our stomach sizing chart to better understand.
A nursing strike can be super frustrating if your baby is rejecting the breast. Offering the breast every feed while maintaining your milk supply with pumping will be crucial while you get through this period. Trying to change up the position can be helpful. Make sure your baby is not frustrated while trying to nurse. You may need to stop, calm your baby down and then try again. Trying to offer your baby the breast before your baby is due can be helpful, so your baby is not too hungry. Lots of skin to skin in between can be helpful. Hand expressing a little milk on your breast to entice your baby to nursing is another trick. Also make sure there is nothing anatomically going on that could be causing this.
Sometimes baby nurses what feels like all day long. 8-12 times a day is minimum and your baby may want to nurse more often. Most of the time it is normal as your baby is doing what he/she needs to in order to support you in making plenty of milk, boost brain development, and grow and be content. Cluster feeding while normal can be tiring, but do know it does not last forever. If you feel there is an issue with supply or transfer please see the FAQ on how to know if my baby is getting enough or one of our lactation providers can see you.
During the newborn period a nursing session should last between 20-40 minutes. Newborns are extra sleepy so sometimes the extra time is needed along with a lot of patience. As your baby gets older and more proficient an average session should last 15-30 minutes.
First sign of a good latch is a comfortable, pain free latch. Sometimes it can be uncomfortable in the first 30 seconds, but after then should not be painful. You also want to make sure your baby’s chest and stomach rest against your body so that your baby’s head is straight. You want your baby’s chin to touch your breast and your baby’s mouth should open wide around the breast, not just the nipple. You should also see and hear baby swallowing. Seeing that baby is growing and satisfied is also indicative of a good latch.
The first few days it is recommended to hand pump as it is more efficient with the drops of colostrum. You can double pump for 10-15 minutes per session for additional stimulation. Once your milk supply is established it is recommended to pump 15-30 minutes on average or 2-5 minutes after the last drop. It is better to pump both sides at the same time if possible.
There are many things to consider when choosing the best breast pump for you. Open or closed system, battery or no battery, hands free option, tote option, and hospital grade or hospital strength. You will want to consider what your use will be with the breast pump; going back to work, exclusively pumping, or occasional date night. Adjust-ability is a key feature where you can adjust suction strength and cycles to mimic the baby as close as possible. Our lactation providers can help you determine which pump is best for you if you need additional support.
Durable Medical Equipment (DME) companies provide breast pumps to moms through their insurance. You can go to aeroflowbreastpumps.com/qualify and input your insurance information for verification. Once your benefits have been confirmed you can pick out a pump to meet your needs and it will get shipped to you.
Most insurances cover a breast pump through your benefits. As lactation providers we recommend all moms getting a breast pump even if it is not your plan to pump, so that in case it is needed for any reason you have it on hand and ready to use.
You can store your breastmilk on the counter if you are going to use the milk within 4 hours. You can store your breastmilk in the fridge if you are going to use the milk within 4-7 days. You can store your breastmilk in the freezer if you are going to use the milk within 6 months in the fridge/freezer combo or within 12 months if in a deep freezer.