Common Questions

Most likely, you’re fine! Studies show that only 1-5% of moms just don’t have what it takes to exclusively breastfeed their baby. That’s a pretty low percentage! Chances are that you will be able to meet your breastfeeding goals, whatever they may be. What often happens is that a mom questions her supply, so she supplements with a formula bottle or stored breastmilk. Less time spent at the breast will decrease supply and lead to more supplementation. Don’t shoot yourself in the foot! Trust your body.

Signs of a good feeding: Listen for swallows throughout the feed, look for relaxing fists, wet/poopy diapers, and an increase in weight and length. If you see these signs, your supply is doing great! There’s no need to measure exactly how much your little one is getting with every feed.

Things that DON’T represent your supply: The amount of milk you pump, the size of your breasts, and how much your baby takes in a bottle after a feed are NOT representative of your breastmilk supply! To address these points, some women just don’t respond well to breast pumps (I recommend getting sized for the correct flange size at bit.ly/LLbri), but their babies are transferring milk very well. Breast size has nothing to do with supply either. I like to think of size as storage capacity, meaning that moms with smaller breasts may feed for a shorter amount of time and more frequently to give their breasts time to refill. Lastly, a baby taking a bottle after being at the breast does not necessarily mean that your baby is not getting enough at the breast. Would you turn down free, fast-flowing milk from a bottle? Neither would your baby.

Here’s how much milk: By about day 3, your baby will work up to taking about 1 oz per feed. By one week, your baby will take in about 2 oz per feeding. Then around one month of age, your baby will take in about 2-5 oz per feeding, or about 25 ounces in 24 hours.

You don’t need to measure every feed: I know, you don’t have see-through breasts and don’t know exactly how much milk your baby is getting with every feeding. The good news is that it’s not necessary to measure every feeding! Instead, you can listen for swallows, look for relaxing fists, wet/poopy diapers, and weight/length gain at your pediatrician appointments.

Your baby is not a robot: I mentioned how much milk intake is normal, but know that each feeding will be different. Sometimes your baby will want a “snack” and other times a full “meal”. Don’t you do the same? When it comes to breastfeeding, it’s not just about getting calories to your baby. It’s about being close to mom and bonding with her. Some feeds may be short, others may be longer.

Why strict schedules may not work: Strict feeding schedules don’t work well with newborns. Think about how often throughout the day you grab a piece of gum or sip your water. Now imagine how you would feel if you went to grab a drink of water and someone told you no, it’s not the time for that. You wouldn’t feel very happy about being restricted, right? Your baby feels the same way! Try instead to feed on demand. Feeding on demand is the best thing you can do for a healthy supply. That means you should offer the breast to your baby often.

A good rule of thumb to follow: I know, I know, you want some exact numbers from me. Here’s a rule of thumb to follow when it comes to feeding schedules, but know that this is not set in stone and is more of a guideline. Breastfeed your baby at least every 2-3 hours, for at least 10-15 minutes on each breast. (And know that feeds could be much longer, especially for a newborn.) A minimum of 8 feeds in 24 hours is a good starting point, but at least 12 feeds in 24 hours is even better!

Offer frequently and a natural pattern will form: In the early days, plan to offer the breast frequently. From here you will find that you both naturally fall into a rhythm. This natural rhythm will help you anticipate when your baby’s next feeding will be, but remember that those times are not set in stone. After about 6 months of age, your baby may still feed every 2-3 hours, or she may take in larger quantities of milk 4-5 times per day. It just depends on the baby and the breastfeeding dynamics! Just be sure that from 6 to 12 months, you remember that breastmilk is still your baby’s main source of nutrition. A good rule to follow is breast first, solids second. After 1 year of age, there’s no set schedule at all! Just do what works best for you both.

Is it the right time?: Are you ready to start the weaning process? What about your baby? Think about the best timing for you both to wean and don’t feel pressured to do it right at one year of age. Did you know that the benefits of breastmilk extend past one year? The American Academy of Pediatrics recommends continuing breastfeeding until 2 years and beyond! As a side note, babies rarely self wean before 18 months of age. Anything below this age is more likely to be distracted nursing behavior and not early weaning. Remember that if your child is under 1 year of age, breastmilk is still their main source of nutrition and supplementation will be needed if you wean before that.

How to wean: If you find that weaning is necessary or desired, slow and steady is best. Weaning is not something that happens overnight! Start by dropping one feed (not the first in the morning, or right before bed — save those for last!). After a few days of that going well, drop one more feeding. If dropping one whole feeding is too much of a transition for your baby or your breasts, then start with slowly dropping the number of minutes in ONE feeding. Continue dropping minutes of that one feed, until it’s gone altogether, then move on to the next one.

Take care of your breasts: As you’re weaning, be familiar with your breasts and keep an eye out for any clogged ducts or hardened areas that may be forming. A clogged duct feels like a hardened area (about the size of a pea) right under your skin. When you catch clogged ducts early on, you can clear them out by gently massaging them down towards your nipple (think of it like a traffic jam from the clogged duct, all the way down to your nipple. That whole jammed lane needs to be massaged!). Do this gentle massage while are feeding/pumping, and also while in a warm shower. Warmth and vibration are helpful but be gentle with your breasts — we don’t want to do any damage! I like to describe it as using the same pressure as petting a cat.

Write down your top requirements: The best breast pump can be different from family to family. I recommend writing down a list of the top 3 things you want in a pump. Do you want it to be quiet because you will be pumping in the middle of an office? Or, do you want it to be portable because you won’t be able to sit down while you’re pumping? These things can help you narrow down your choices as you review your options.

What I look for in a pump: One of the most important factors to me is how good the suction is. It’s a bonus if it’s a closed system (which means that milk cannot back up into the pump and cause mold issues) and is quiet. I constantly hear praises regarding both of these qualifications with the Spectra pump. If it’s not covered by insurance, it’s fairly inexpensive.

Check with your insurance first: Under the Affordable Care Act, all insurance companies cover the cost (most cover 100% of the cost) of a breast pump. Depending on your insurance, the cost, ordering method, and options will be different. I recommend calling your insurance to see what your options are. Some companies will send the pump before your baby is born, so check sooner rather than later.

Dr. James McKenna: This doctor is the leading expert on co-sleeping and how to do it safely. He has an excellent website with FAQs on this topic but simply put, co-sleeping can be done very safely and breastfeeding moms can even get more rest at night when co-sleeping is practiced! (What mom doesn’t want more sleep?) Co-Sleeping FAQ

Side-lying position: Breastfeeding in the side-lying position is a secret weapon for more rest at night! It can be done with or without co-sleeping. If you don’t want to keep your baby in bed with you all night, then you can doze off in this position, switch to the other breast and then put your baby back into the bassinet next to your bed when you’re done. Another option is to keep your baby in bed with you all night! Preferences will be different from family to family, but the American Academy of Pediatrics recommends keeping your baby in the same room as you until 1 year of age. If you can’t make it until 1 year you can try for 6 months, but the reason for this is a decreased chance of Sudden Infant Death Syndrome. AAP recommendations

If you do co-sleep, follow this: There are some things to be careful about when it comes to co-sleeping. Do not co-sleep after smoking or drinking alcohol, while intoxicated or after taking medications that make you drowsy. Try and avoid loose blankets and bedding, especially near your baby’s face. Only co-sleep on a bed, and not on a couch where your baby could become wedged in.

Newborns are sleepy! Wouldn’t you want to drift off when near your mom, all warm and comfy? If your newborn is extra sleepy, change her diaper before a feed. You may want to leave her in just a diaper for the feeding! Even though being sleepy is common in newborns, there are some tips I have for you to feel confident that your little one is getting full feeds.

Hand expression: If you have already tried all that you can do to keep your sleepy newborn awake, hand expression is going to be your secret weapon! It’s an excellent way to get breastmilk to your baby (especially sleepy newborns) until they can latch on and transfer the milk themselves. You can hand express your breast milk into a simple spoon or medicine cup, and then put it straight into your baby’s mouth! Your baby will swallow that colostrum (or breastmilk) and perk up enough to try at the breast again. It doesn’t mean that you will be spoon feeding your newborn forever, so no worries there. Here’s a video to show you exactly how: Hand Expression Video

Breast compressions: This is my best advice for you because hand expression helps keep the milk flowing to remind your baby that it’s feeding time. Hand expression can be done through the entire feed to get more milk to your little one. To do hand expression, hold your breast with a “C” shaped hand. Bring your thumb and fingers together to compress your breast tissue and hold it there for about 10-15 seconds. After that, rotate your hand to reach your other milk glands and then compress and hold again. This shouldn’t be painful! If it is, be sure to not be tugging your breast tissue forward and compress with less pressure.

Hand pumps are not a complete necessity, but can be very helpful for many families! There are two main options: the Haakaa and a manual breast pump. These are both alternatives to an electric double breast pump that come in handy, for different situations. Some families may not find much use for these two options, while others use them daily.

Haakaa hand pump: The Haakaa is a silicone hand pump that uses suction to stay on your breast. When you breastfeed, your milk “lets down” on both breasts at the same time. Since you only breastfeed on one breast at a time (unless you have twins!), many moms find that they leak on the other breast into a breast pad which is all wasted milk. They find that they can instead attach something such as a Haakaa to catch those letdowns, which helps to beef up their freezer stash of breastmilk. This milk may be a bit higher in foremilk, but overall will be fine to feed a mainly breastfed baby. One downside to the Haakaa is that for moms with oversupply, it can remove enough milk to increase supply further.

Manual breast pump: Manual pumps are simple, quick, convenient and don’t require electricity to work. They are powered by your hand power! For that reason, they are great for emergent situations. Manual breast pumps are also very portable, making them easy to use on the go. Manual pumps can be handy for starting a let-down before bringing the baby to your breast. The downside to these is that a lot of pumping can be tiring for your hands.

Not all lactation consultants are made equal: First, it’s important to understand that anyone can be a self-proclaimed “lactation consultant”, without any sort of formal training. Even between those that have been formally trained and certified, there is a difference between a CLC (Certified Lactation Counselor) and an IBCLC (International Board Certified Lactation Consultant). When looking for breastfeeding help, consider that IBCLC’s have passed the highest level of training that the lactation field offers. Not all of your nurses and healthcare providers have this high level of certification!

Toe-curling pain?: This is a great sign that you need some hands-on help. There is a big difference between the soreness that naturally happens as your nipples are transitioning to this new sensation of breastfeeding and toe-curling pain. That level of pain requires a closer look at your babies latch before any fancy nipple creams can even start the healing process. Bleeding, blisters and breakdown are NOT a “normal” part of breastfeeding. Most importantly to remember, it’s better to get help sooner rather than later!

Overall support- Every mom has her own breastfeeding goals. One of the biggest deciding factors on whether or not she meets her goals is support. Moms NEED good, quality support. Working closely with an IBCLC Lactation Consultant can be one of the best support people you have.

What is going on?: In the days following giving birth, your breasts can start to feel hard, full and tender. This is called engorgement and it starts around days 3 to 5, just as your milk is starting to come in with more volume. Did you know that this engorgement can even extend into your armpits? After those first few days of your baby receiving colostrum (that sticky, yellow first milk), your baby’s stomach grows to fit about one ounce (around 3 days old). Engorgement can last up to about two weeks postpartum, but I am going to explain how to manage it best.

Don’t restrict feeds: When your breasts are full and sore, you may be tempted to avoid feeding time. It turns out that the best thing you can do is to feed frequently! Keep that milk moving, because the milk that stays stuck can become clogged ducts and possibly mastitis. Give your breasts some love by applying warmth for up to 20 minutes before a feed, and then cold for up to 20 minutes after a feed.

How to soften your breasts: There are a few different ways to soften your breasts through the use of your hands. Hand expression, breast massages, and reverse pressure softening are all excellent ways to put those hands to work and increase your comfort. Reverse pressure softening is done by laying down, lining your fingers in a circle around your nipple (on your areola) and gently pressing down towards your chest wall. This method is especially helpful if your areola is swollen from getting a lot of IV fluids while you labored. During the engorgement phase, I prefer these three hands-on methods more so than a breast pump,because pumps tend to pull all that extracellular fluid forward and make it harder for milk to come out. Hand Expression Video Breast Massage Video

The first 3-4 weeks: The first 3-4 weeks after birth is not the time to stress about building your stash of breast milk! That time is best spent focusing on practicing your latch and feeding your baby on demand. Those two things alone will be a full-time job! If you want or need to pump during that time, great! Just store that milk and don’t worry about doing anything extra.

Pump once a day: After 3-4 weeks, you can ease into one pumping session a day. Many moms notice that they pump more milk first thing in the morning. If that time is not convenient for you, choose a time that is! Whatever time may be, try to pump about 1 hour after your baby feeds so your breasts have time to refill with breast milk.

Make it convenient: Storing milk while breastfeeding your baby is double duty, so it’s important to make the process as convenient as possible. Some moms find it convenient to build up a stash by using their Haakaa during feeds. Others set up their breast pump in one common area in their house. Every time they walk by their breast pump, they will stop and pump — even if it’s just for a few minutes.

There are laws to protect you: Did you know that there are laws that protect breastfeeding in the workplace? The Fair Labor Standards Act (FLSA) provides basic accommodation standards for breastfeeding mothers at work. FLSA applies to most hourly employees, so check with your HR department to see if these laws apply to you. This act protects your time to pump milk at work in a private space that is not a bathroom. There are more details to this act that can be found here: FLSA details

Set up a pumping station: While setting up and taking down your breast pump only takes a few minutes, those minutes add up throughout the workday. A more efficient option is to set up your breast pump in one set spot and leave it there for the day. While a pumping station may not be possible for everyone, it can be a real time-saver for those with short breaks. One last time-saving hack? You can keep one breast pump at work and another at home to simplify the whole process.

If you’re getting any pushback: If you find that you aren’t getting the support you need to pump at work, have a conversation with your supervisor and coworkers. Remind them that emptying your breasts every 2-3 hours is vital to maintaining your milk supply. Remind them that providing your baby with breastmilk will result in fewer sick days for your little one, which means fewer work days missed for you.

Normal weight gain- Gaining weight is an important piece of the breastfeeding puzzle. Following the growth curve is an important indicator of getting enough milk at the breast. It doesn’t matter if your baby is in the 99th percentile or the 3rd percentile. At some point, genetics have to kick in! From about 4 days to 4 months, your baby will gain around 5-7 ounces per week. This is the time where weight gain is most closely watched.

Breast Milk first, formula second: Sometimes circumstances call for supplementation. That can be for short term use, to get a baby back on track with weight gain, or more long term use. Either way, families will often have stored breastmilk on hand and wonder if they should supplement with that, or if formula is better. The best rule of thumb to follow is to give your breastmilk first, and formula second when you don’t have breastmilk on hand. The important part is the number of ounces going into your baby. Formula is not more nutrient-dense or superior to your breastmilk.

True low supply- The truth is that most moms have what it takes to exclusively breastfeed their baby, although there are circumstances where formula can come in handy. For moms that aren’t able to produce enough breast milk, formula can be a real lifesaver. Examples of this could include a health history of PCOS, adoptive situations, and induced lactation. An alternative to formula is donor milk, from either a milk bank or a local trusted mom.

Drinking water is so important, for so many different reasons! Your baby will get what she needs through your breastmilk (no worries there) but it may be at the expense of you! Drink water to protect yourself.

How much? An easy rule of thumb is to drink half your body weight in ounces each day. That’s a great place to start.

Keep water stocked in your normal nursing spot: Start getting into the habit of sipping water while you breastfeed your baby. If it’s always within an arm’s reach, then you will be more likely to drink throughout the day!

5/5/5 rule: The 5/5/5 rule states that you can safely store your breastmilk for about 5 months in the freezer, 5 days in the fridge and 5 hours at room temperature. Have a deep freezer? You can store your breast milk for one year! So to break things down further: If you know you will be using your breastmilk at the next feeding, just keep it on your counter! If you know you won’t be needing your freshly pumping breastmilk in the next 5 days, then put it straight into your freezer.

Include the date it was pumped- Get into the habit of writing the date that you pumped that breast milk onto its storage container. This will allow you to use up the oldest milk first to minimize waste.

Store it flat, for storage sake, in containers of 2-5 oz: Did you know that babies from 1-6 months old take in the same amount of breastmilk? That amount is about 2-5 ounces per feed. Based on that, try and store your breastmilk in containers no larger than 2-5 ounces. That will make it easy to thaw out one feeding at a time. Once the milk is thawed, it needs to be used within 24 hours, so smartly stored amounts will ensure less wasted milk. It’s always a sad day when breast milk has to be thrown away! Pro tip: use expired or spoiled milk for a milk bath! Just add enough to your baby’s bathwater to make the water cloudy. It’s excellent for the skin.

Plan ahead- It’s best to thaw milk in the fridge, so plan when possible. For example, if you are going to work the next day, pull out the breast milk that you will be taking to your caregiver the night before. Try and use your oldest dated milk first. Think first in, first out. Thawed milk should be used within 24 hours, so plan accordingly.

Avoid microwaves: Warming milk in the microwave can break down the good nutrients and also create hot spots. Instead, warm it up by running the container under warm water or setting it in a bowl of warm water. You can also consider purchasing a bottle warmer, especially if you are planning to thaw large amounts at a time. Did you know that you can feed your baby breast milk straight from the fridge? It can even be at room temperature. Just know that it may take some getting used to from your baby since it’s not the same temperature as when it comes straight from your breast.

Test the milk on your wrist: After you’ve thawed and prepared your baby’s breastmilk, be sure to always check the temperature on your wrist before feeding it to your baby. Swirl the milk to mix in fat that may have separated, and bon appetit to your baby!

Deeper latch- When it comes to painful breastfeeding, first look at the baby’s latch. A shallow latch leads to breakdown, bleeding, and blisters. A deep latch means that your baby has as much breast tissue in her mouth as possible. Remember it’s called BREASTfeeding and not nipple feeding. If you already have some breakdown on your nipples, try a different breastfeeding position to give those sore spots a break. With any breastfeeding position that you choose, you can lean back and put your baby on top of you, so that gravity is on your side. Getting a deep latch, every single feeding is so important for avoiding pain.

Take it a day at a time- Don’t give up on a hard day! If taking it one day at a time is too much, then take it one feeding at a time. Care for your nipples. Keep them clean and get a good nipple cream. Did you know that breast milk can be healing for your nipples? Hand express a drop after feeding and rub in all of those good antibodies.

Get help! Did you work on getting a deeper latch, but you are still having toe-curling pain? There may be something deeper going on. If you have recurrent clogged ducts, color changes in your nipple, deep shooting pain, or severe nipple damage that won’t heal, you need a closer look! Work with an IBCLC and your healthcare professional to get to the root of the problem. It’s better to get help sooner rather than later!

I know I’m a Lactation Consultant but…- here’s the truth: If breastfeeding is ruining your life, don’t do it! YOU are an important piece of the breastfeeding puzzle. Your mental health and wellbeing are so important. Choosing to stop breastfeeding is always an option and remember that every drop of breastmilk that you gave your baby was significant.

Take it one step at a time: Think about your original breastfeeding goal. Was it to breastfeed for 3 months? 6 months? 1 year? Does that goal feel impossibly far away right now? Of course it does, because you’re looking too far down the road at the result. Instead, chop that goal up and just take it one day at a time. If that’s too much right now, take it one feeding at a time. In the meantime, get some good support in your life. Take a mental health day. If you’re feeling overwhelming negative thoughts during letdown or have a history of abuse, an IBCLC and good support can help you either work through those issues or start the weaning process. (Just because we promote breastfeeding doesn’t mean that we haven’t helped hundreds of moms through the weaning process, for whatever reason!)

It’s not all or nothing: Sometimes we tend to think that it has to be 100% breastfeeding or 100% bottle feeding, or 100% breastmilk or 100% formula. It turns out that many families chose to do a mix of these options. This all or nothing mentality doesn’t always serve us, so get creative and do what works best for your family.

Breastfeeding takes work, bottles don’t: Your baby is smart! She will figure out quickly that time at the breast takes a bit of work while a bottle is free, fast, and flowing. The beautiful thing about breastfeeding is that since it does take some work, feedings are “paced.” This means that your baby is in control of taking how much milk she wants. She can easily stop when she’s full since she’s eating at a slower pace. Think about times when you ate your meal quickly. Wasn’t it easy to overeat? It’s the same with fast-flowing milk.

Paced bottle feeding and breast compressions: If you would like to transition back to breastfeeding or do a mix of breast and bottle feeding, then these two things are going to be very important. Paced bottle feeding means that we are slowing down the fast flow to more closely mimic breastfeeding so that your baby won’t get as frustrated when coming back to your breast. The breast compressions will also be helpful because it helps get more milk to your baby while she’s breastfeeding. See how to do both here: Paced Bottle Feeding Breast Compressions

Be patient: The difference between a bottle and a breast are very different in so many ways. It can be a big transition to go from one to the other. It is rarely something that happens quickly, usually requiring baby steps. Sometimes a nipple shield can be a useful tool to help ease that transition. It’s a silicone covering that goes over your nipples and will feel similar to a bottle nipple in your baby’s mouth. I highly suggest working with an IBCLC when using or introducing a nipple shield in any way.

Get a good start! The first few days after birth, your breastmilk production completely relies on milk being removed from your breast. As you transition from colostrum (that first milk) to your full milk volume, your baby’s stomach size will also be growing to hold more milk. Putting your baby to breast frequently will signal the transition to more milk volume sooner. This stimulation is key. Try and feed your baby 12+ times in 24 hours for a better start. If you’re separated from your baby, pump, hand express, or do breast massage 12+ times in 24 hours.

Relax! Oxytocin is the hormone needed for your milk to “let-down”, or exit your breast. Your body releases this hormone when your baby stimulates your nipples. Stress is the opposite of oxytocin. Think of stress and oxytocin, or milk let down, as opposites on a teeter-totter. If one is high, the other is low. So sit back, relax your shoulder, take a deep breath and let the milk flow.

Water, sleep, self care- Staying hydrated is an important protection for you. You don’t need to drown yourself in water — drink half your body weight in ounces. Sleep when your baby sleeps, avoid extra stress, and accept help from others. Do something you love that’s just for you.

Form + Function- While you may be tempted to snap a pic of the underside of your baby’s tongue and post it to a mommy group to ask for opinions, I would advise against it. When it comes to restriction under the tongue, how it looks is not the only thing that matters. Instead, we look at form and function. How your baby’s tongue functions at the breast is just as important! If your baby is transferring milk well and you aren’t having any pain, there may be no need to have a procedure done.

A trained IBCLC can help- If you’re feeling pain, seeing nipple breakdown, or your little one is not gaining weight well, I suggest working with an IBCLC who is trained on tongue ties. Unfortunately, most healthcare professionals are not trained on managing tongue ties. It’s not that your pediatrician doesn’t care — he or she just has so many other things to be educated on, and tongue ties are so specialized. An IBCLC can help you navigate the best path.

Frenotomy? Body work? Leave it alone? There are a few different options when breastfeeding isn’t going quite right even after working for a good latch. Chiropractors, craniosacral therapists, pediatric dentists, IBCLC’s, and more are all part of the healthcare team that can help you and your little one get back on track to meeting your breastfeeding goals.

The best time to learn is BEFORE baby comes: Yes, pregnancy is the best time to learn about breastfeeding. Many moms assume that breastfeeding is a natural process and will just happen after delivery, but that’s not the best time to learn a brand new skill.

Take a quality prenatal breastfeeding class: If possible, schedule a breastfeeding class during the last half of your pregnancy. This will help set that base knowledge that you can continue building after your baby is born. These classes are even better when your spouse or support person can attend with you!

Set yourself up for success: Have a plan in place for after your baby is born. Think of it as a birth plan, but specific to breastfeeding. Do you want to do one hour of skin to skin after birth? Do you want to exclusively breastfeed? Do you want to room-in with your baby during your stay? All of these are great topics to include in your plan. Plan by having meals in place. Hire a housecleaner with all the money that you will be saving by breastfeeding! Good support is the most important thing when it comes to meeting your personal breastfeeding goals.

Hunger Cues: Did you know that the earliest sign of hunger is your baby opening her eyes and turning her head from side to side? Feed your baby when you see these early hunger cues. On the other hand, crying is a late sign of hunger.

Hands are fists?: Your baby’s hands tell you a lot about hunger. Tight fists, up near your baby’s face say: “feed me!” You will notice that as the feed goes on, her fists will slowly start to open and her arms will relax downwards. That milk drunk look is telling you “I’m full!”

Breastfeeding is also for comfort: Remember that breastfeeding is not just about getting calories. Instead, it’s also about being close to mom. Your chest is your baby’s happy place where she feels safe. It’s a familiar area that she would like to stay close to at all times. Try and aim for after at least 10-15 minutes of good active sucking on each breast. After that, if your baby falls asleep you can offer the breast again. But if she just falls back to sleep, go ahead and give her some other comfort techniques like skin to skin time or swaddling.

Contact vs toe-curling pain- In short, breastfeeding should never be a toe-curling, painful experience, though soreness is normal. After delivery, mom begins to adapt to the new sensation of her baby coming in contact with her nipples every couple of hours. While soreness is normal, know that bleeding, breakdown, and blisters are npt.

Fix the latch- A good rule of thumb is the 30-second rule. When your baby first latches, know that some initial soreness is normal. If things aren’t feeling right after 30 seconds, do not hesitate to unlatch and try again. Unlatch your baby by breaking the suction first. It may take 30 tries to get a good deep latch! A good latch should not be painful.

Take care of your nipples- Keep your nipples clean and protected with creams, breast pads, and a deep latch. Change out your breast pads when they become soaked. Apply nipple cream after every feed and be sure to cover your breasts so they aren’t rubbing against your shirt with every move. If things aren’t feeling right even after applying nipple cream, get help from an IBCLC.

Don’t restrict foods, right off the bat: Many families wonder what food groups should be avoided while breastfeeding. The truth is that most babies do just fine with their mom eating a well-balanced diet of all foods. Ideally, we want to keep breastfeeding as convenient as possible. Instead of focusing on restriction, eating in moderation is a better way. For example, you may not want to drink 6 cups of coffee in one sitting. Instead, you may want to drink 1-2 cups of coffee.

From mouth to breast milk: The time it takes for food and drinks to affect your breast milk differs from person to person and depends on how quickly the food is digested.
4-6 hours is average, but the timeframe could be shorter or much longer.

Food Elimination Diet: If you suspect one food item to be causing trouble, or if you have a family history of a specific allergy, you may want to try an elimination diet. It is best to cut out one food item at a time for a full 2-3 weeks. That way, you can pinpoint exactly what’s causing the problem and try to avoid it in the future. Try and keep a food journal during this process to watch for trends.

Good support: A good support person in your life can make meeting your breastfeeding goals easier. They can be given a clear list of responsibilities to help take the pressure off of you such as changing diapers, burping the baby, getting snacks and water for mom, babywearing, hiring a housecleaner, coordinating meals, and more!

Breast compressions and side-lying position: Breast compressions can help your baby get more breast milk while breastfeeding. These can speed things up, especially with sleepy newborns! The side-lying position can also be done for exhausted, tired mamas (isn’t that us all?). When safely done, a mom can sleep and rest while also feeding the baby. An IBCLC can help you master these two things. Breast Compressions Side-Lying Position

It gets better! The first 3-4 weeks are tricky for nearly every family. If you can get through the first month or so of breastfeeding, that’s when things start to get easier. Feedings will no longer last one hour, and you will have gotten better at latching your baby well on the first try. You can do this!

During your pregnancy, discuss with your OBGYN or Midwife what your local options are for breastfeeding support.  Many practitioners will recommend breastfeeding classes you can take prior to the arrival of your baby.  After delivery, most hospitals will have lactation consultants on staff that are able to visit you during your hospital stay. Be sure to find out what your hospital offers before delivery.  The Affordable Care Act requires that all new insurance plans provide breastfeeding support and supplies.  Call your insurance company to see what is available to you.  You can also check Lactation Network , Simplifed or contact your local WIC office for additional insurance covered lactation support options.

Call your insurance company to see what lactation support options are available on your insurance plan.  The Affordable Care Act requires that all new insurance plans provide breastfeeding support and supplies.  You can also check Lactation Network , Simplifed or contact your local WIC office for additional insurance covered lactation support options. There are also many free options for breastfeeding support such as La Leche League or your local hospital is likely to have a free breastfeeding support group.

Yes! Breastfeeding may look different after a breast lift and reduction, and with careful planning and preparation you will become closer to meeting your breastfeeding goals. Finding a community of parents who are experiencing the same challenges can help lead you to success.  BFAR is a breastfeeding facebook support group specifically for woman or transgender males looking for support after breast reduction or lift.  Defining your Own Success: Breastfeeding After Breast Reduction Surgery is another great resource to help guide you through these challenges.

Prior to surgery, discuss your desire to breastfeed in the future, and your options for how the surgery will be done. There has been some promising research showing surgeons using a technique that is able to preserve the column of the subareolar parenchyma, the lactating part of the gland under the areola, which can increase the likelihood of breast milk production. Here is a systematic review of observational studies on the impact of breast reduction surgery on breastfeeding.

After surgery, the condition of the milk ducts and the capability of the nerves to stimulate the release of milk are vital in determining the success of milk production. With time, the human body is capable of regenerating milk ducts and nerves through a process called recanalization and reinnervation.

This decision is up to you. Please know that every drop of breastmilk matters.  The Iowa Extension Service reports that just one teaspoon of breastmilk (5mls) has 3,000,000 germ-killing cells in it. A teaspoon a day, still provides all the benefits of breast milk. 

Plan ahead! If possible meet with an IBCLC prior to delivery or take a breastfeeding class.  Milk production is based on milk removal, so the more milk that is removed, the more you will make. In order to provide extra stimulation, you can start pumping immediately after delivery.  At each feeding, breastfeed your baby first, and use a hospital grade breast pump afterwards. Keep in mind that you may not see any breast milk removed while pumping, that is ok, it is the stimulation of the nipple that will help increase the breast milk production as your mature milk will come in between day 3-5 from delivery.  Another way to help increase milk production is through hand expression.  Remember, breastfeeding after a breast reduction or lift may look different than expected.  Breastfeeding is not always about nutrition, you can always put your baby to breast for comfort and bonding. If supplementation is needed there are at-breast-supplementers available to you such as an SNS or Lact-aid.