For something that is as natural as breastfeeding…it can be tricky to navigate.
Over the past few years as I have immersed myself in the breastfeeding world, there are questions that I see time and time again.
While I certainly don’t mind addressing these questions, I thought it would be helpful to put together a little “Breastfeeding FAQ” page with all these common questions – and answers – in one place.
Please keep in mind that you should always work with an International Board Certified Lactation Consultant (IBCLC) and/or pediatrician for concerns in relation to your specific child. This FAQ is not meant to replace that of a medical professional.
When will my milk come in?
Breast milk typically comes in on between 48 hours and five days.
First-time mothers often have their milk come in a little slower than mothers who have had other children.
Having a c-section to delay your milk coming in. However, the sooner you are able to be with your child and latch, the better. More family-centric c-sections that are available these days have helped improve the amount of time it takes for milk to come in.
You can help it come in faster by nursing on-demand/latching frequently and doing lots of skin to skin. Related Reading: When Does Milk Come in? Secrets to Establishing Milk Supply
When should I start pumping?
If your baby cannot latch and breastfeed, isn’t able to breastfeed as normal, or you are choosing to exclusively pump, you should start pumping immediately after birth. However, if you are planning to primarily breastfeed from the breast (even if you are going back to work), it is not recommended to start pumping until 4-6 weeks after you have given birth. This recommendation is to allow the body to naturally regulate the supply to what baby needs. Pumping too frequently during this time period can cause an oversupply – which is not a good thing!If you are having to go back to work at six weeks, I would suggest starting two weeks before you go back. This will give you plenty of time to get enough for the first day back, as well as a 2-3 day emergency supply. Related Reading: Breastfeeding and Work – Tips for the Pumping Mom
How much should I give my baby in a bottle?
The recommendation that most breastfeeding professionals settle on is about 1-1.25 ounces per hour, and ideally not going longer than four hours between feeds. This article gives great information on the ounce per hour rule. It’s important to remember that breast milk is different than formula. From the ages of 1-6 month, the total amount baby needs in a 24 hour period really doesn’t change (and is about 24-30 ounces per 24 hours). By giving smaller bottles more frequently, it makes it easier for mom to keep up with her supply and baby not getting overfed.
Is my baby eating enough?
Most mothers who are exclusively breastfeeding can’t help but ask themselves this – and it’s totally understandable. Breasts don’t have ounce markers like bottles!In general, you can look for the following signs to indicate your baby is getting enough to eat:–Relaxed after nursing–Gulping sounds regularly during nursing sessions–Normal weight gain –Adequate diaper output (keep in mind that the number of poopy diapers a breastfed baby has each day can lessen after about six weeks). –Breasts feel softer after feeding–Baby is alert and meeting developmental milestonesYou can do a weighted feeding to determine how much baby transfers. However, keep in mind that these have their limits. One weighted feed doesn’t give a good picture of the whole day – these are best when done over the course of 24 hours. With permission and guidance from an IBCLC, you can do weighted feeds at home. The majority of people do not need to do this, but it can be helpful. I find the Hatch Baby Grow scale to be the best option for consistent, at home weighings.
Why is my baby eating so frequently?
Cluster feeding is very common for breastfed babies – especially in the beginning and during growth spurts.
We’ve been taught that babies should eat on a schedule from the start and only every three hours – however, this isn’t really how breastfeeding works. A baby generally will nurse more if they need your body to make more.
Here is a great article on when cluster feeding is normal
– and when it’s a cause for concern.
My baby isn’t having poopy diapers – is something wrong?
During the first 4-6 weeks, it’s expected for a breastfed baby to have multiple bowel movements a day. If they are not having many or any at all, it is a cause for concern. While there are certainly breastfed babies who may have less and be an exception, if your child has stopped having bowel movements before this age, it’s worth investigating with a doctor or IBCLC. After six weeks, breast milk tends to lose its laxative effect, and it can be completely normal to go multiple days (up to about a week or so) without a bowel movement IF baby doesn’t seem uncomfortable and is having adequate weight gain.
When will my period return?
This is the million-dollar question! For women who are exclusively breastfeeding every 2-3 hours and baby isn’t sleeping through the night, you typically won’t see it return until that schedule changes. There are some women this won’t be the case for, but it is pretty typical. If you feed with bottles or supplement at all, go longer periods without nursing (especially at night), it wouldn’t be abnormal for it to return earlier. Keep in mind that you will likely ovulate before your first postpartum period, so if you plan to use breastfeeding as birth control, be familiar with tracking ovulation. There are some women who will not have a period at all until their baby is almost or completely weaned. It’s impossible to know if that will be you!
My Supply Dropped With My Period!
It is very common for women to see a drop in supply when their period returns – typically it will be in the days leading up to, and it will gradually get better. The good news is, this is typically temporary. It can just be frustrating! The best thing you can do is stay hydrated, nurse baby as much as they want (even if it seems like they are constantly at the breast), and be patient. There is some evidence that suggests taking calcium and magnesium together can help combat supply issues during your period. Please see this Kelly Mom article for dosage information – but always consult with your doctor first!
How much should I be pumping?
If you are exclusively pumping, you should pump every 2-3 hours, or as much as baby is eating.
If you pump in addition to nursing, you should always pump whenever a bottle is given instead of breastfeeding. If you are trying to get some extra freezer supply, the best time to pump is in the morning – usually about 15-30 minutes after your first nursing session.
It’s a common misconception that you HAVE to pump in order to breastfeed. This is not true!
If you have no reason to pump and baby is growing well from breastfeeding alone, don’t feel like you have to pump. I pumped a grand total of two times with my oldest child, and I breastfed him until he was nearly two.
How can I increase my supply?
This will depend a lot on why you want to increase your supply. It’s first important to know what “normal” supply is. The body is designed to make just enough for baby – not a huge surplus. Oversupplies are not the goal!If baby is feeding directly from the breast, growing as expected, meeting milestones, and having enough diapers – you do not need to increase your supply. Many mothers look at pump output as well to see if they need to increase supply – average output for a mother who is pumping in addition to nursing is .25-2 ounces per session. For a mother who is pumping in place of a nursing session, about an ounce an hour from the last time you nursed/pumped is expected. Many women experience an oversupply in the beginning and worry when that drops (or, better put, when their supply regulates). If you are experiencing a true low milk supply problem, the best thing you can do is work with an IBCLC to troubleshoot. There are some medications that can be prescribed, but this should be a last resort. In general, the best antidote for low supply is increased stimulation to the breast. Here are a few other general tips: –Make sure baby is nursing (or you are pumping) every couple of –hours. –Avoid a stringent schedule that may restrict a baby’s ability to naturally increase your supply. –Power pumping is a great way to mimic a growth spurt. Pump for 10 minutes on, 10 minutes off for an hour. Do not pay attention to how much you get – the action of pumping like this will likely help supply within three days. –If baby is eating solids, make sure they haven’t taken over for the main source of nutrition. Breast milk should be offered FIRST before any meals throughout the first year. For more advice on how to increase supply, please read this post – How to Increase Breast Milk Production
Why am I pumping less?
As mentioned in the previous question, average output for a breastfeeding mother is .25-2 ounces when done in addition to breastfeeding (so within -0-2 hours after the last feed). For a replacement feed, you can expect about one ounce an hour since the last time you nursed or pumped. It can be difficult to see mothers who are pumping TONS of ounces, but it is important to keep in mind that this is the exception – not the rule. Some mothers will see a decrease in pump output during the latter half of the year. This does not mean your breastfeeding journey is over! This is a great article that discusses the “six-month slump” and how to combat it. Additional Reading: 25 of the Best Breastfeeding Tips for Moms
Cold, flu and allergy remedies while breastfeeding
Unfortunately, there are not a ton of medications for cold, flu and allergies that you should use during breastfeeding. I’m just going to direct you to this helpful guide on Kelly Mom!
Can I use X medication while breastfeeding?
The good news is, there are very few medications that you truly cannot use during breastfeeding – and if it’s not recommended, there is typically an alternative. Unfortunately, a lot of mothers are given poor advice to discontinue breastfeeding for certain medications that are fine – typically because of lack of education or fear of lawsuits. I would suggest always contacting the Infant Risk hotline for any concerns – they are the true experts on all things breastfeeding and medications.
Should I/Can I introduce a pacifier?
There’s a lot of debate on this, and honestly, I probably am less stringent about this than others in the breastfeeding community.
However, the recommendation is to not introduce artificial nipples – including pacifiers – until breastfeeding is well-established.
The main concern is that a mother will miss her child’s hunger cues by just giving them a pacifier rather than feeding on demand.
In my experience, I have given a pacifier from the beginning and had no issues. But the “official” response would be to wait for a few weeks.
Here is a great article about breastfeeding and pacifiers
that you might want to read.
How can I stay awake while breastfeeding?
It’s so easy to feel like you are going to fall asleep every time you go to breastfeed – especially during those middle of the night feeds. Here are some great suggestions for staying awake while breastfeeding.
How come my baby is waking up?
Infant sleep is a very interesting and hotly debated topic – and it’s not one I love. I don’t even allow much discussion in my breastfeeding support group because of that. The bottom line is that babies wake for various reasons – and often it is to nurse. There is nothing wrong with your child if they are waking for night feeds past six months. I love this article about why older babies wake to nurse at night. I always tell people that the one thing you can be sure of during the first year is that sleep rarely stays the same. I see mothers devastated that their child who once slept through the night is having trouble sleeping – but rest assured (pun intended), your baby is not abnormal. They could be going through a growth spurt, a wonder week, etc. Additional Reading: Gentle Ways to Help Your Baby Sleep Through the Night
When should I introduce solids?
According to the AAP and the WHO, breast milk or formula should ideally be the only source of nutrition for a baby for the first six months of life. Babies who are given complementary foods earlier than that tend to wean earlier and mothers often report lower breast milk supply. The recommendation used to be four months, so many pediatricians haven’t kept up with the current recommendations and given that suggestion, which can be confusing. Solids should not be given to increase weight gain or to help baby sleep through the night. Here is a great resource with all the current recommendations and research regarding the introduction of solids to breastfed babies – Starting Solids from Kelly Mom. Additional Reading: Tips for Introducing Solids
I’m having surgery – do I have to stop breastfeeding?
In most situations, the only discontinuation of breastfeeding a mother will have to do when having surgery is during the surgery itself. Mom can usually resume breastfeeding after she is awake enough to nurse. A lot of moms are advised to pump and dump for 24 hours, however, this is typically just done out of an abundance of caution. The most current recommendations and research does not typically support that. For more information, please read this article.
Mastitis and Clogged Ducts
These are two conditions that all breastfeeding mothers dread the potential of.
Mastitis is an infection of the breast, and it causes flu like symptoms. It is often accompanied by a red, warm spot somewhere on the breast. It can start from a clogged duct that doesn’t get remedied or from an infection that enters the breast through tears or cuts.
If you suspect Mastitis at all, please call your medical provider immediately.
Clogged ducts occur when milk hasn’t been properly emptied from the breast. These are most common when a mother’s supply is regulating and may not have milk emptied properly.
You can pump to get rid of clogged ducts, but be careful not to overpump, as that can make the problem worse.
Additional Reading: Surviving the Boob Flu
What is paced feeding?
This is the ideal way to feed a breastfed baby a bottle! It mimics the act of breastfeeding and will give you the best opportunity to avoid a bottle preference. It’s important to recognize that the processes of breastfeeding and bottle feeding are very different. When feeding from the breast, the baby has to work to get the milk out. They have to take natural pauses. They are more easily able to tell when they are full. When feeding from a bottle, if the milk is coming out, they will typically keep eating it – especially if it’s coming from a fast flow nipple and it’s propped up. This is a survival mechanism to avoid drowning from the milk. When milk comes out so fast, it can be difficult for a baby to tell when they are full. Paced feeding adds in natural pauses and allows baby to figure out when they are full a little easier. When combined with a slow flow nipple, this is the best practice for feeding a bottle. Here is my favorite Paced Feeding video. Additional Reading: How to Bottlefeed a Breastfed Baby
My doctor has brought up supplementing – what should I do?
Being told you need to supplement can be a devastating thing for any mother. However, there are definite situations where it is warranted and needed for the baby’s well-being – and there’s no shame in that!When given the suggestion to supplement, the first thing you should do is meet with an IBCLC who can properly evaluate how breastfeeding is going, whether your supply is adequate, how baby is transferring, etc.
Should I build a freezer stash?
A lot of women see pictures on Facebook of women with freezers filled to the brim with breast milk.
If there’s one thing you should take away from this, it’s this – this is not a requirement. Nor is it the norm. These women either have massive oversupplies or are exclusive pumpers – and more often than not, the milk gets donated or goes to waste.
So don’t feel like you have to have a freezer full of milk in order to be successful. If you do – that’s just great. But don’t make yourself depressed thinking otherwise.
Even for mothers going back to work, it is recommended to have a 2-3 day freezer supply for emergencies, plus enough for your first day back (based on the 1-1.25 ounces per hour rule).
One easy way to extra milk without a lot of extra effort is to get a silicone suction pump, such as the Haaka
. This is really helpful in the beginning when you have more of a surplus of milk, and you just use it on the opposite breast that you are nursing on.
What kind of birth control can I use while breastfeeding?
In general, you should avoid any birth control that has estrogen. This can significantly drop, alter, or even diminish your supply. Because of this, your options are limited to the mini pill, the copper IUD, condoms, or natural family planning. The Mirena is supposed to be okay for breastfeeding mothers – but be aware that there is some circumstantial evidence from mothers whose supplies disappeared overnight with it. Breastfeeding can be used in conjunction with natural family planning, but there are very strict requirements in order for it to work. This is called the Lactational Amenorrhea Method (LAM). You can click here to learn more about this. Just continuing to breastfeed is not enough to protect pregnancy. Click here to learn more about breastfeeding and birth control.
Help! My baby won’t take a bottle!
It can be so frustrating when your child won’t take a bottle – and you need them to!
There will be some babies who just won’t take them – but in general, with a little coaxing, most babies will.
If you are going back to work, try and start introducing a bottle a few weeks before you go back. It’s important to follow proper bottle-feeding protocol for breastfed babies, but most babies will take to a bottle pretty well.
When you have a baby who is a little more stubborn, you may need to try different bottles, nipples, temperatures, and even environments. Many mothers find that someone else has to offer the bottle.
In no situation should you withhold food from the baby to get them to take a bottle.
If your baby is over six months, you can try using a sippy cup or straw as an alternative method.
Additional Reading: The Best Bottles for Breastfed Babies
What formula should I supplement with?
If you decided to supplement with artificial milk, you have a lot of options – and it can be overwhelming.
Unless your child has some kind of allergy that requires a specific type of formula – most formula is pretty similar in ingredients. I would suggest starting with the Member’s Choice or Kirkland brands – which are basically the same as Similac, etc.
If you want something with cleaner ingredients, there are plenty of organic and non-GMO options. Holle Formula and HiPP are the two that I would suggest looking into first. Baby’s Only is also very popular.
My provider says I have to send more milk – what do I do?
When this happens, it’s important to have a sit-down discussion to talk about why they are wanting more milk, what they do to soothe baby, and how they are feeding the baby. Unfortunately, not all providers are trained in proper breastfeeding protocol and feeding. When talking with them, I would discuss the following:–How do they feed the bottle? Ask them to demonstrate to ensure paced feeding. –Make sure they are using a very slow flow nipple. This does not need to change with age or size. –Ask them if giving a bottle is their first resort when baby starts crying–Ask them to give smaller bottles, closer together. Ideally, baby will be eating every 2-3 hours. –If you have determined baby is going through a growth spurt, temporarily increase milk by .25-.5 ounces per feed but make sure they know that it is temporary. –This is a great guide to determine how much expressed milk baby needs–Share this information with the care provider.
Oh boy – this is always a fun topic, and it’s not one I can really address a ton right now.
Not all children will bite, but when they do, it can make breastfeeding very challenging.
Here are a few tips:
–Immediately unlatch the child from the breast
–Firmly tell them no anytime they do it
–Make sure baby has a good latch. A baby who is latched well shouldn’t generally bite
–If baby is biting a lot, you can temporarily make an effort to remove them from the breast as soon as they actively stop swallowing to prevent bites.
It is a myth that you have to wean because a child has teeth. Some women do because they cannot get the biting under control – but it’s perfectly fine to nurse once your child sprouts teeth!
Additional Reading – When Baby Bites
and Is Your Breastfeeding Baby Biting? Here’s What You Should Do.
Bottle Nipple Size – What should I use?
One of the biggest things I see when it comes to bottle preference is simply using too large of a bottle nipple. In general, a mother’s nipple size isn’t gong to change – so neither should the bottle! You should always use the smallest nipple size that your child can tolerate. I know plenty of parents who have their child using a preemie nipple throughout the first year. I haven’t seen very many situations where a child *needs* to be on a size 2 or 3 nipple – it’s more often for the convenience of the person giving the bottle.
Milk Storage Guidelines
I feel like every time this question is asked, there are a million different answers!For the sake of this article, I will be citing the information available from the CDC. You are always encouraged to discuss things with your IBCLC or doctor. You should always store breast milk in breast milk storage bags or clean, food-grade containers made of glass or plastic that have a tight-fitting lid. You should never store breast milk in plastic bags that have not been specifically designed for breast milk. Here are the CDC recommendations for storage. When storing in the fridge, keep at the back of the fridge. In the freezer, it’s best to avoid freezing in the door.
Well, I hope that this was helpful. Please let me know if you have any additional questions below. Again, remember that this article is not meant to substitute the advice of a qualified IBCLC or medical provider.