While breastfeeding isn’t the only option for feeding your baby, every mother has the potential to succeed and make it a wonderful experience. This article provides practical, helpful breastfeeding information to help improve breastfeeding rates in all women. 

A mother’s milk has just the right amount of fat, sugar, water, and protein that is needed for a baby’s growth and development. Most babies find it easier to digest breast milk than they do formula. Breast milk has antibodies in it to help protect infants from bacteria and viruses and to help them fight off infection and disease. Human milk straight from the breast is always sterile.

Breastfeeding saves time and money. You do not have to purchase, measure, and mix formula, and there are no bottles to warm in the middle of the night. Physical contact is important to newborns and can help them feel more secure, warm, and comforted. Nursing uses up extra calories, making it easier to lose the pounds gained from pregnancy. It also helps the uterus to get back to its original size more quickly and lessens any bleeding a woman may have after giving birth. Breastfeeding also may lower the risk of breast and ovarian cancer. 

One of the best things that only you can do is to breastfeed your baby for as long as possible. The longer a mom and baby breastfeed, the greater the benefits are for both mom and baby. The U.S. Surgeon General recommends that babies be fed with breast milk only – no formula – for the first six months of life. It is better to breastfeed for any amount of time than not. Solid foods can be added to your baby’s diet while you continue to breastfeed when your baby is four to six months old. For at least the first six months, breastfed babies don’t need supplements of water, juice, or other fluids. These can interfere with your milk supply if they are introduced during this time. 

Some women think that when they are sick, they should not breastfeed. But, most common illnesses, such as colds, flu, or diarrhea, can’t be passed through breast milk. In fact, when you are sick, your breast milk has antibodies in it. These antibodies help protect your baby from getting the same sickness. A few viruses can pass through breast milk. HIV, the virus that causes AIDS, is one of them. If you are HIV positive, speak to your doctor. 

Rarely, babies can be born with a genetic disorder called galactosemia in which they can’t tolerate breast milk because their bodies can’t break down the sugar galactose. Babies with classic galactosemia must be fed a special diet that is free of lactose and galactose. 

If you are breastfeeding, you should not smoke or take drugs. Illicit drugs, such as cocaine, PCP, heroin and marijuana can cause irritability, poor sleeping patterns, tremors, and vomiting. Babies can become addicted to these drugs. 

Sometimes a baby may have a reaction to something you eat, but this doesn’t mean your baby is allergic to your milk. Usually, if you have eaten a food throughout pregnancy, your baby has already become used to the flavor of this food. If you stop eating whatever is bothering your baby, the problem usually goes away on its own. It is possible for very common foods such as dairy, wheat, or citrus to cause a reaction.

Most medications have not been tested in nursing women. Most over-the-counter and prescription drugs, taken in moderation and only when needed, are thought to be safe. You should always check first with a health care provider before taking medicine. With some drugs, you can reduce the baby’s exposure by taking them just after nursing. Even mothers who must take daily medication for conditions such as epilepsy, diabetes, or high blood pressure may be able to breastfeed. While breastfeeding, if you become ill and have to take medication, tell your health care provider that you are breastfeeding. It may be possible to temporarily pump and discard your breast milk while taking the medication. During this time, you can use previously stored breast milk or formula to feed your baby, but by pumping and discarding your breast milk, you will be keeping your breast milk supply at a level to meet the baby’s needs when your treatment is over. 

Of course! Breast size is not related to the ability to produce milk for a baby. Breast size is determined by the amount of fatty tissue in the breast, not by the amount of milk. Most women, with all sizes of breasts, can make enough milk for their babies. 

When you breastfeed, your ovaries can stop releasing eggs (or ovulating), making it harder for you to get pregnant. Your periods can also stop. But, there are no guarantees that you will not get pregnant while you are nursing. The only way to make sure pregnancy does not occur is to use a method of birth control. The safest birth control pill to use when you are breastfeeding is a progesterone-only pill, sometimes called the “mini-pill.” Talk this over with your health care provider. Just because you are not menstruating, doesn’t mean you haven’t ovulated.

Not at all! Breastfeeding can be convenient no matter where you are because you don’t have to bring along feeding equipment like bottles, water, or formula. If you want to breastfeed in private, you usually can find a woman’s lounge or fitting room. If you want to go out without your baby, you can pump your milk beforehand and leave it for someone else to give your baby while you are gone. Pumping and storing breast milk is addressed later in this article.

Yes! You can do it! Breastfeeding keeps you connected to your baby even when you are away. Employers and co-workers benefit because breastfeeding moms often need less time off for sick babies. More and more women are breastfeeding when they return to work. Many companies sell effective breast pumps and storage containers for your milk. Many employers are willing to set up special rooms for mothers who pump. After you have your baby, try to take as much time off as possible, since it helps you get breastfeeding well established and also reduces the number of months you may need to pump your milk while you are at work. 

Let your employer and/or human resources manager know that you plan to continue breastfeeding once you return to work. Before you return to work, or even before you have your baby, start talking with your employer about breastfeeding. Don’t be shy about requesting a clean and private area where you can pump your milk. All you need is a chair, a small table, and an outlet if you are using an electric pump. Many electric pumps also can run on batteries. You can lock the door and place a small sign on it that asks for some privacy. You can pump your breast milk during lunch or other breaks. 

If your employer is NOT aware of state laws that to allow you to breastfeed at your job, share the documents from the website below. Under these laws, your employer is required to set up a space for you to breastfeed and/or allow paid/unpaid time for breastfeeding employees. To see if your state has a breastfeeding law for employers, go to ncsl.org/research/health/breastfeeding-state-laws.aspx.

You can breastfeed discreetly in public by wearing clothes that allow easy access to your breasts, such as button down shirts. By draping a receiving blanket over your baby and your breast, most people won’t even realize that you are breastfeeding. It’s helpful to nurse before your baby becomes fussy so that you can get into a comfortable position to nurse. You also can purchase a nursing cover or baby sling for added discretion. Many stores have women’s lounges or dressing rooms if you want to slip into one of those to breastfeed. 

You can prevent the most common challenges or problems by following the three most important tips about breastfeeding: 

Some mothers initially experience tenderness that disappears as the days go by. Breastfeeding shouldn’t hurt once that tenderness has passed. Your breasts and nipples are designed to deliver milk to your baby. When your baby is breastfeeding effectively, it should be calming and comfortable for both of you. If breastfeeding becomes painful for you, seek help from a breastfeeding specialist or a lactation consultant. 

If your baby is latched on and positioned properly, you should not feel pain. The baby’s mouth should be wide open, with as much of the areola as far back into his/her mouth as possible. The baby should never nurse on the nipple only. If it hurts, take the baby off of your breast and try again. The baby may not be latched on right. Break your baby’s suction to your breast by gently placing your finger in the corner of his/her mouth, and reposition your baby. You and the baby should be facing each other, tummy to tummy. If you feel pain, the baby is not latched onto your breast properly. 

Most breastfeeding counselors recommend avoiding bottle nipples or pacifiers for about the first month because they cause nipple confusion. The baby’s mouth sucks differently on an artificial nipple. After you and your baby have learned to breastfeed well, you can introduce artificial nipples when feeding the baby some expressed breastmilk in a bottle, or with a pacifier, if you choose.

In the first few days when you’re in the hospital, your baby should stay with you in your room if there are no complications with the delivery or with your baby’s health. The baby will be sleepy. Don’t expect the baby to wake you up when he or she is hungry. You will have to wake the baby every two to three hours to feed. At first you will be feeding your baby colostrum, called ‘first milk,’ which is a thick yellowish milk, rich in nutrients. Even though it looks like only a small amount, this is the only food your baby needs. In the beginning, you can expect your baby to lose some weight. This is very normal and is not from breastfeeding; the baby is balancing fluids. 

You can tell your baby is getting enough milk by keeping track of the number of wet and dirty diapers. In the first few days, when your milk is low in volume and high in nutrients, your baby will have only 1 or 2 wet diapers a day. After your milk supply has increased, your baby should have 5 to 6 wet diapers and 3 to 4 dirty diapers every day. Consult your pediatrician if you are concerned about your baby’s weight gain. 

If you prepare him in advance, your partner should not be jealous. Explain that you need support. You can explain the important benefits of breastfeeding. Be sure to emphasize the cost savings. Formula can cost over $300 a month. Breastfeeding gives a good start in life with benefits that can last well into childhood. There are plenty of other ways to care for the baby besides feeding.

Breastfeeding is a unique experience for each woman and her baby, and each woman has to find her own routine, setting, and positions that work best. Today, many mothers return to jobs outside of their homes after their babies are born, and the breastfeeding routine that they’ve set up while on maternity leave has to change. Many women continue to breastfeed successfully though with the help of a breast pump. Whether you choose to stay at home to care for your baby or choose to return to a job outside your home, here are some tips about breastfeeding and pumping to make breastfeeding easier and safe for you and your baby.

Before your baby is born, it is helpful to know what type of nipples you have. A flat nipple lies flat against the areola (the darker circular area around the nipple) instead of protruding outward like a normal nipple. Inverted nipples seem pushed inward to the areola. Both flat nipples and inverted nipples can make correct latch-on more challenging for your baby since they are not easy for the baby to grab in his or her mouth. One solution is to wear a breast shell (a round plastic shell that fits around your breast) in your bra to create some pressure around the nipple to help it protrude for easier latch-on. You can also wear the shell while breastfeeding to help your baby get the nipple in his or her mouth.

Before the birth of your baby, know what medications you are taking or may have to take after the birth and how they will affect your baby through your breast milk. Talk with your health care provider about their safety and about possible alternative treatments that won’t affect the baby. 

Fathers and other special support persons can be involved in the breastfeeding experience. Breastfeeding is more than a way to feed a baby; it becomes a lifestyle. While no one but the baby’s mother can provide breast milk, it is helpful for the mother and the baby if the father or support person encourages this healthy relationship. Fathers or support persons play a major role in the breastfeeding experience by being sensitive and supportive. They can encourage breastfeeding when the mother is feeling tired or discouraged. They can affirm their love, approval, and appreciation for the mother’s work and time that she puts into breastfeeding. They also can be good listeners and provide understanding to the mother’s and baby’s needs to accommodate breastfeeding in the home or when traveling. All of this support helps the mother feel better about herself and proud that she is giving her baby the best. Many people also feel warmth, love, and relaxation just from sitting next to mother and baby during breastfeeding. Fathers and support persons also can help when the mother begins to wean the baby from breastfeeding by giving emotional nourishment to the child through playing, cuddling, and giving a bottle or cup. 

Whether you return to work or stay at home, having an effective pump is helpful. You can use it to help relieve engorgement especially when your milk supply first comes in or for when you need to be away from your baby for any amount of time, such as an evening out with your partner. If you have to temporarily take medication that may harm your baby, you can pump and discard your milk during this time. 

Under the Patient Protection and Affordable Care Act, breastfeeding services and supplies are covered without cost sharing in health plans starting August 1, 2012. Compare various styles of breast pumps at babygearlab.com/Breast-Pump-Reviews

It is recommended to introduce your baby to a bottle when he or she is around four weeks old. Otherwise, the baby might not accept the bottle later on. Once your baby is comfortable taking a bottle, it is a good idea to have dad or another family member offer a bottle of pumped breast milk on a regular basis so the baby remembers the practice. 

It’s a good idea to line your work schedule with your feeding pattern at home about two weeks before you return to work. During the hours you will be at work, offer the baby a bottle of formula or pumped breastmilk. Try to find time to pump at the same time you expect to pump at work. During the off-work hours, continue to breastfeed, skin-to-skin. This gets your breasts ‘on schedule.’ On the weekends or days off, breastfeed throughout the day to build up your supply.

It is important to know the guidelines for storing breast milk properly so that you always give your baby fresh milk. Any container used to store milk should be sterile. When freezing milk, always try to leave an inch or so from the top of the container for the milk to expand. After pumping your milk, label the storage container. Always use the oldest dated milk first. Breast milk can be stored in the following ways: 

It is helpful to freeze the milk in small amounts, such as two to four ounces, so there is less waste and you can choose the amount of milk depending on the baby’s hunger. 

You can store breast milk in bottles that fit directly onto your breast pump. After pumping, simply remove the pumping tubing, cover with the bottle lid, label the milk, and put it in the refrigerator. Many breast pump carrying cases also come with built-in, cooler-type compartments for storing ice packs and freshly pumped bottles of milk. If used correctly, these work until you can get home to store the milk in the refrigerator or freezer. 

Research is conflicting about the advantages and disadvantages of storing milk in glass versus plastic. Glass bottles or containers are best for freezing breast milk because it offers the most protection from contamination. The second choice is clear, hard plastic, and last choice is the cloudy hard plastic containers. Wait to tighten the caps or lids until the milk is completely frozen. 

If you want to freeze your breast milk in bags, you can purchase storage bags that fit directly onto your breast pump. They are pre-sterilized, thick, have an area for labeling, and seal easily. After pumping, simply remove the pumping tubing, fold the bag over, making sure all air is out and seal it. Other storage bags can be used in the kind of bottle that uses disposable liners so there is no need to transfer the milk. 

It is normal for cold breast milk to separate into two parts, what looks like cream and then a lighter colored milk. Some human milk also varies in color and can be bluish, yellowish, or brownish. Just gently shake the milk before feeding to mix it back together. 

Breast milk doesn’t take long to thaw or warm up. Never place a bottle or bag of breast milk directly in the microwave. Milk doesn’t heat uniformly in the microwave, so you won’t have control over the temperature and could burn your baby. Instead, hold the bottle or frozen bag of milk under cool and then warm water for a few minutes. If warm running water is not available, you can heat water on the stove. Remove the pan from the heat and place the container into the warm water. Never warm the container directly on the stove. Shake the milk and then test it on your wrist to see if it’s warm enough for your baby. Once frozen milk is thawed, it can be refrigerated, but not refrozen. 

You don’t have to buy a new wardrobe to breastfeed. While no extravagant breastfeeding clothing is necessary, you should try to wear clothing that makes breastfeeding and pumping easier. Wearing jumpers or one-piece dresses are difficult. Try a blouse or two-piece outfits. Nursing bras and nursing clothes, like blouses that have hidden openings near your chest, are available but are not necessary. 

You can buy disposable or cloth breastfeeding pads to line your bra. These help prevent any leaking from soaking through your blouse. The disposable pads can be thrown away, and the cloth pads can be tossed in the washing machine and used again. 

If you want to breastfeed your baby in public, you can use a receiving blanket or a breastfeeding blanket that discreetly covers your chest and your baby’s upper body. 

Some women breastfeed without problems, but for many women, minor problems may arise especially if it is their first time breastfeeding. The good news is that most problems can be overcome with a little help and support. More serious problems may require you to see your health care provider, and it is important to know the warning signs for these situations. The following section discusses some of the most common problems that can pose a challenge to breastfeeding and some solutions to overcome them. 

Poor latch-on and positioning are the major causes of sore nipples because the baby is not getting enough of the areola into his or her mouth and is sucking mostly on the nipple. If you have sore nipples, you are more likely to postpone feedings because of the pain, but this can lead to your breasts becoming overly full or engorged, which can then lead to plugged milk ducts in the breast. If your baby is latched on correctly and sucking effectively, your baby should be able to nurse as long as he/she likes without causing any pain. Remember: It shouldn’t hurt! 

Solutions:

Important: If you still have sore nipples after following the above tips, you may need to see someone who is trained in teaching breastfeeding, like a lactation consultant or peer counselor. See the Where to Go for Help section for more information. 

Anything that reduces the amount of time your baby is at your breast or postpones regular nursing can cause overly full or engorged breasts. A breastfeeding mother usually feels a normal fullness (a slight heaviness that is not painful) in her breasts, especially in the first couple of days when her milk comes in, but overly full or engorged breasts can be very painful and feel very hard. You also may have breast swelling, tenderness, warmth, redness, throbbing and flattening of the nipple. Engorgement sometimes also causes a low-grade fever and can be confused with a breast infection. Engorgement is the result of the milk building up and usually happens during the third to fifth day after birth. All of the following can contribute to engorgement: 

Engorgement can lead to plugged ducts or breast infection, so it is important to prevent it before this happens. If treated properly, engorgement should only usually last for one to two days. 

Solutions: 

Important: Contact your health care provider if your engorgement lasts for more than two days even after treating it.

It is common for many women to have a plugged duct in the breast during the period she breastfeeds. A plugged milk duct feels tender, sore, or like a lump in the breast. It is not accompanied by a fever or other symptoms. It happens when a milk duct does not properly drain, becomes inflamed, pressure builds up behind the plug, and surrounding tissue becomes inflamed. A plugged duct usually only occurs in one breast. 

A breast infection (mastitis), on the other hand, is soreness or a lump in the breast that is accompanied by a fever and/or flu-like symptoms, such as feeling run down or very achy. Some women with a breast infection also have nausea and vomiting. You also may have yellowish discharge from the nipple that looks like colostrum or the breasts feel warm or hot to the touch. A breast infection can occur when other family members have a cold or the flu and, like a plugged duct, it usually only occurs in one breast. 

The treatment for plugged ducts and breast infections is similar:

Important: If you do not feel better within 24 hours of trying these steps and you still have a fever or your symptoms worsen, call your health care provider. You may need an antibiotic. Also, if you have a breast infection in which both breasts look affected or there is pus or blood in the milk, red streaks near the area, or your symptoms came on severe and suddenly, see your health care provider right away. 

Even if you need an antibiotic, continuing to breastfeed during treatment is best for both you and your baby. Most antibiotics do not affect your baby through your breast milk. 

Thrush (yeast) is a fungal infection that can form on your nipples or in your breast because it thrives on milk. The infection forms from an overgrowth of the candida organism. Candida usually exists in our bodies and is kept at healthy levels by the natural bacteria in our bodies. However, when the natural balance of bacteria is upset, candida can overgrow, causing an infection. Things that can cause thrush include having an overly moist environment on your skin or nipples that are sore or cracked, taking antibiotics or birth control pills, having a diet that contains large amounts of sugar or foods with yeast, or having a chronic illness like HIV infection, diabetes, or anemia. 

If you have sore nipples that last more than a few days even after you make sure your baby’s latch and positioning is correct or you suddenly get sore nipples after several weeks of unpainful nursing, you could have thrush. Other signs of thrush include itching, flaking and drying skin, or tender or pink skin. The infection also can form in the baby’s mouth from having contact with your nipples and appears as little white spots on the inside of the cheeks, gums, or tongue. It also can appear as a diaper rash as small red dots around a rash on your baby that won’t go away by using regular diaper rash ointments. 

Solutions: 

A nursing strike is when your baby has been nursing well for months, then suddenly loses interest in breastfeeding and refuses the breast. A nursing strike can mean several things are happening with your baby and that she or he is trying to communicate with you to let you know that something is wrong. Not all babies react equally to different situations that can cause a nursing strike. Some continue to breastfeed without a problem, others may just become fussy at the breast, and others refuse the breast entirely. Some of the major causes of a nursing strike include: 

If your baby is on a nursing strike, it is normal to feel frustrated and upset, especially if your baby is unhappy. Your breasts also may become uncomfortable as the milk builds up. It is important not to feel guilty or that you have done something wrong. 

Solutions: 

Some babies are born with conditions that may interfere with or make breastfeeding more difficult. However, in all of the following cases, breastfeeding is still best for the baby to thrive. 

Jaundice is a condition that is common in many newborns. It appears as a yellowing of the skin and eyes and is caused by an excess of bilirubin, a yellow pigment that is a product in the blood. All babies are born with extra red blood cells that undergo a process of being broken down and eliminated from the body. Bilirubin levels in the blood can be high because of higher production of it in a newborn, an increased ability of the newborn intestine to absorb it, and a limited ability of the newborn liver to handle large amounts of it. Many cases of jaundice do not need to be treated—a health care provider carefully monitor the baby’s bilirubin levels. Sometimes infants have to be temporarily separated from the mother to receive special treatment with phototherapy. In these cases, breastfeeding may be discouraged and supplements or other fluids may be given to the baby. However, the American Academy of Pediatrics discourages stopping breastfeeding in jaundiced babies and suggests continuing frequent breastfeeding, even during treatment. If your baby is jaundiced or develops jaundice, let the health care provider know that you do not want to interrupt nursing if possible. 

It is not unusual for babies spit up after nursing. Usually, babies can spit up and show no other signs of illness, and the spitting up disappears as the baby’s digestive system matures. As long as the baby has six to eight wet diapers in a 24-hour period (under six weeks of age), and your baby is gaining weight (at least 4 ounces a week) you can be assured your baby is getting enough milk. 

Some babies have a condition called gastroesophageal reflux (GER), which occurs when the muscle at the opening of the stomach opens at the wrong times, allowing milk and food to come back up into the esophagus (the tube in the throat). Symptoms of GER can include: 

Many healthy babies might have some of these symptoms and not have GER. But there are babies who might only have a few of these symptoms and have a severe case of GER. Not all babies with GER spit up or vomit.

If your baby spits up after every feeding and any of the other symptoms mentioned above, it is best to see your health care provider so your baby can be correctly diagnosed. Other than GER, your baby could have another condition that needs treatment. If there are no other signs of illness, your baby could just be sensitive to a food in your diet or a medication he/she’s receiving. If your baby has GER, it is important to try to continue to breastfeed since breast milk still is more easily digested than formula. Try smaller, more frequent feedings, thorough burping, and putting the baby in an upright position during and after feedings. 

If you need more information on breastfeeding or extra help with a breastfeeding challenge, don’t get discouraged! There are many people and organizations that want to help you have a successful and happy breastfeeding experience. The following organizations are the most recognized national organizations that provide valuable information on or support for breastfeeding.