Common Breastfeeding Questions

Growth Spurts
What is a growth spurt?
  • Your baby wants to nurse more often than usual for a few days – this is normal
  • You may feel like she is nursing “all the time” and more fussy than usual
  • Growth spurts usually happen around 2 weeks, 6 weeks & 3 months of age
  • The 2-week growth spurt often happens at the same time that your breasts begin to feel less full. Don’t worry – you still have milk – and you can make plenty more if you keep breastfeeding.
  • Growth spurts last for a few days. After the growth spurt, breastfeeding returns to normal
What should I do?
  • Let your baby nurse as often as she wants. This will quickly boost your milk supply and your baby’s nursing pattern will return to normal sooner.
  • Don’t wait for your breasts to feel full between feedings. They are never completely empty. Let your baby keep nursing and switching sides until she is satisfied.
  • Don’t give your baby formula. Count diapers so you know baby is getting enough milk.
  • Don’t worry about housework for a few days, and eat simple meals.
  • Create a ‘nursing station’ with everything you need close by:
    For you – water, healthy snacks, cell phone, TV remote, books, or magazines
    For older children – snacks, books, special toys, or DVDs that are used when the baby is nursing

Many mothers find that breastfeeding gets much easier after the 6-week growth spurt!

Cluster Feeding
What is cluster feeding? 
  • Cluster feeding is when your baby nurses several times close together
  • It is normal for young babies to cluster feed, especially in the evenings. For example, your baby might want to nurse at 5:00 pm, and again at 5:40 pm, and again at 6:20 pm, and again at 7:00 pm.
  • After cluster feeding, most babies settle down for a nice, long nap
But do I have enough milk? 

Yes, if your breastfed baby is gaining enough weight, you know you have enough milk!

Many moms wonder how their breasts could have time to ‘fill up’ between feedings.

  • The good news is… the breasts make milk fastest when the baby has just breastfed.
  • This milk is rich and high in calories, even though there may be just a small amount.
What can I do to make cluster feeding easier?
  • Set up a ‘nursing station’ with snacks, water, phone, magazines, or the TV remote close by
  • Prepare simple evening meals that can be eaten with one hand
  • Take advantage of the baby’s long nap to get some good sleep

Remember – breastfeeding gets easier as your baby gets older and is not growing so fast.

Engorgement
What is engorgement?
  • Your breasts feel very full and heavy. They may feel hot, hard or painful.
  • Engorgement usually occurs in the first week after the baby is born
  • Engorgement can also occur later on, if you go longer than usual between feedings
How to prevent engorgement
  • Breastfeed your baby frequently, at least 10 times in 24 hours, right from the day he is born
  • Even though you don’t have much milk at first, it’s important to let your baby suck frequently
How to treat engorgement 

1.     If your breasts feel like a bag of marbles, you probably need to help the milk flow. You can:

  • Take a warm shower or use warm, moist washcloths on the breasts before nursing
  • Express a little milk before nursing to soften the areola (darker area)
  • Massage the breast during feedings to help the milk flow
  • If your baby is not able to latch on well, express your milk by hand or with a pump every 2-3 hours
  • Use cool compresses or ice packs (a bag of frozen peas wrapped in a cloth works well) on the breasts to help relieve pain and swelling between feedings

2.   If your breast feels like an overfilled water balloon, and you also have swollen hands or ankles, it may be hard for your baby to latch on. You can:

Try Reverse Pressure Softening before latching your baby.

 

Plugged Ducts & Mastitis
What are plugged ducts and what should I do if I get one? 
  • A little plug of thickened milk may prevent the milk from draining from one part of the breast. That part of the breast feels hard and swollen.
  • Keep nursing – breastfeed at least every 2 hours
  • Use warm washcloths on the breast or take a warm shower/bath before each feeding
  • Always start on the side with the plugged duct
  • Position the baby’s chin close to the sore spot
  • Massage the breast while the baby is nursing
  • Drink lots of fluids
  • Get more rest – put off errands and housework for a few days
  • Avoid tight bras or clothing
What is a breast infection and how is it treated?
  • The breast feels sore and looks red – you have a high fever and feel like you have the flu.
  • If this occurs, continue nursing frequently and contact your doctor for treatment
  • Try to rest as much as possible
Fussy Baby
Tummy Troubles
  • Feed your baby as soon as he shows signs of hunger, such as turning towards the breast or sucking on his fingers. Don’t wait till he is crying.
  • If baby seems gassy, try lying him tummy-down along your forearm and support his head in the crook of your elbow. This puts a little pressure on his tummy and helps to get rid of gas.
  • To see if baby needs to burp, hold him upright against your chest and shoulder and rub his back.
  • If your baby fusses when you lie him down after feedings, try holding him in the burping position for 10 -15 minutes so that his full stomach has a chance to empty.
Other Discomforts
  • Change diapers as soon as they get wet or dirty. Ask doctor about rashes.
  • If baby seems most fussy in the evenings, try carrying him more during the day. A safe cloth baby carrier can help. Check out these safety tips.
  • Some babies get overstimulated. Turn down the TV, radio, and bright lights. Limit the number of people who handle the baby. Take baby for a walk outside to help him calm down. Learn more about overstimulation.
  • Contact your doctor if you suspect that your baby may have an illness.

This video explains normal baby behavior, including fussy behavior, and gives examples of how to handle it.

 

Biting

Babies may “bite” or clamp down on the breast with their gums for a variety of reasons:

  • If your baby is teething, his gums may be swollen and painful. Offer him something cold to chew on (like a chilled, wet washcloth) or rub his swollen gums with your clean finger before breastfeeding.
  • If your milk supply is low, your baby may clamp down to try to get the milk to flow. You can nurse or pump more often to build up your supply.
  • If your baby is anxious, try nursing in a quiet room.
  • If your baby is bored, he may want you to pay more attention to him while he is nursing. Give him cuddles, smiles, and kisses when he nurses without biting.
  • If your baby clamps down on the breast towards the end of a feeding when he is falling asleep, slip your finger gently between his gums and take him off the breast as soon as you notice the breast starting to slip out of his mouth.

Most biting is just temporary and weaning is not necessary.

Breastfeeding in Public
Breastfeeding in public is normal.

 

California Civil Code Section 43.3 states that a mother may breastfeed her child in any location, public or private, where the mother and child are authorized to be present.

If your right to breastfeeding public is denied, you can call the toll-free Nursing in Public Hotline (855-NIP-FREE). You will be asked to record a message, and an experienced volunteer mom will help you understand what your rights are and suggest ways to handle the situation. All personal information will be kept private.

Learn more about the hotline. Find more resources online here.

Breastfeeding Strikes

Breastfeeding strikes occur suddenly, usually between 3 – 8 months, for many reasons

  • Pain from teething, an ear infection, sore throat or cold
  • Baby feels stressed while breastfeeding – mom may be upset or distracted
  • Mom reacted strongly or shouted unexpectedly while baby was breastfeeding
  • Change in routine – mom returned to work, has lots of visitors, or is using a new lotion
  • Sometimes there is no obvious reason

It may take 2 – 4 days for a baby to start back to breastfeeding

  • Be patient & relax. Cuddling and skin-to-skin contact may help baby feel more relaxed.
  • Gently offer breast whenever baby shows hunger signs, without trying to force him to breastfeed.
  • Try offering the breast when the baby is sleeping or very sleepy.
  • Vary nursing positions (try offering the breast while walking or rocking, or holding baby upright).
  • Limit noise and distractions during feedings.
  • Try feeding your expressed milk with a cup or spoon instead of a bottle.
  • Keep up your milk supply by pumping every 3 – 4 hours.

Nursing strikes rarely lead to weaning. With time, your baby will return to the breast.

Hand Expression
This video shows how to do hand expression. Here are some tips for hand expression.
Nipple Shields
Why might I use a nipple shield?
  • To help your baby stay latched onto the breast if she has a weak suck
  • To help your baby latch on if your nipple is flat or inverted
  • To encourage your baby to switch to breastfeeding if she is used to the feel of a bottle nipple

It’s best to work with a lactation consultant to determine whether you need a nipple shield and to show you how to use it. 

How do I stop using a nipple shield?
  • Your baby may need the shield for a few days, weeks, or months
  • Premature babies may need to use a shield at least until they reach their due date
  • Encourage your baby to breastfeed without the shield by holding him skin-to-skin
  • Nurse with the shield at the start of feedings and then see if he will latch on without it
  • Try nursing without the shield at different times of day to see what works best for your baby
  • Keep track of your baby’s weight gain and diaper count to be sure your baby is getting enough milk without the nipple shield 

Learn more about nipple shields.

 

Breast Implants
How do breast implants affect breastfeeding?
  • Many women who have breast implants are able to fully breastfeed their baby
  • Breastfeeding will not harm your implants
  • Women with breast implants may experience a little extra discomfort if they get engorged
  • The type of implant surgery may affect how much milk you can make. If you have nipple sensation and your breasts grew in size during pregnancy, you have a good chance of making plenty of milk.
What should I do if I have breast implants and want to breastfeed?
  • It’s a good idea to talk with a breastfeeding counselor before your baby is born to discuss your individual situation
  • Breastfeed frequently in the early days so that your breasts do not become painfully full
  • To help your breasts make as much milk as possible, breastfeed very frequently during the early weeks – at least 10 times in 24 hours
  • Have your baby’s weight checked at least weekly during the first 2 months
  • If breastfeeding gets off to a slow start, or your baby has trouble latching on, it’s important to ask for help right away
Weaning
When and how do I wean my baby?
  • The American Academy of Pediatrics recommends breastfeeding at least a year or longer
  • Go slowly, so your baby does not feel rejected, and you do not get engorged
  • If you want to wean gradually, don’t offer the breast, but don’t refuse it when your baby wants it
  • If you want to wean more quickly, replace one feeding every few days with formula or a snack
  • Bedtime is a difficult time for babies to give up nursing, so don’t start with this feeding
  • A family member can distract or feed the baby a snack/cup/bottle to replace nursing
  • Give your baby lots of extra cuddling to make up for the loss of the comfort of nursing
What changes should I expect while weaning by baby?
  • You will get your period back, if you haven’t already
  • Your breasts will take a few months to return to their pre-pregnancy size
  • Your baby may still wake at night for various reasons – teething, colds, loneliness
  • Your baby will still need to be held a lot and will still need a lot of your attention
  • If weaning is happening too fast for the baby to adjust, she may become clingy or fussy. It’s OK to wait until she’s a little older and then try again.
Returning to Work/School
Leaving Your Baby Can Be Difficult
Build up a good milk supply before returning to work
  • For the first 3 – 4 weeks, just focus on establishing your milk supply by breastfeeding frequently
  • Once you have a good milk supply, pump once or twice a day, and save the milk in the freezer
  • Once your baby is breastfeeding well, offer a small amount of expressed milk in a bottle so your baby gets used to taking a bottle
  • Once you return to work, your milk supply may dip during the week. Breastfeed frequently when you are at home to build up your milk supply again.

You can also access information online: 

Toolkit for returning to work or school

Mother-to-mother advice for moms working outside the home and breastfeeding

Resources for employers and information about legislation

Maternity Leave Educational Tool

Ways to find the time and space to pump in a variety of work settings

Ask your WIC counselor for more information about working and breastfeeding. You may be eligible for a WIC pump to help you continue to breastfeed after returning to work or school.

Are you covered under State Disability Insurance?

You may be able to take Paid Family Leave (PFL) to stay home and bond with your new baby!

This Fact Sheet explains PFL
Find PFL Brochures in various languages
How to FILE A DI/PFL CLAIM

Medications & Breastfeeding

Many medications are safe to take during breastfeeding, but it is always important to check with your doctor first, even for pver the counter medications. Here are some ways to get more information:

  1. Mother to Baby (CTIS): You or your doctor can contact Mother to Baby for professional advice about the safety of medications and other products, such as alcohol or cigarettes, during breastfeeding.
  1. Infant Risk Center : You or your doctor can contact the Infant Risk Center for information about the risk of medications and other products during breastfeeding. Long-distance phone call Monday-Friday 8am-5pm Central Time: 806-352-2519

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