Breastfeeding and Lactation Support Common Questions

Is the baby getting enough milk?
It is normal to wonder if the baby is getting enough milk. Signs that the baby is getting enough milk include:

• The baby having a deep latch that is comfortable.
• A calm baby after feeding.
• A change in the color and number of baby’s stool. Meconium is the first sticky, black substance that your baby passes. Stools change to a mustard color, runny and seedy texture once you have a larger supply of milk.
• One to two wet and dirty diapers the first 24 hours is normal. Newborns will feed in short frequent burst sometimes every hour.
• By 3 to 5 days after delivery, with frequent feedings, the amount of milk will increase. At this stage, the baby should have at least 6 wet diapers and 3 to 4 dirty diapers in 24 hours.

Will Dad and my family feel left out if I breastfeed?
Fathers, families, and friends are an important part of mothers support team. Sometimes, however, they may express that they feel left out when a mother decides to breastfeed. Be sure to include the family in discussing the importance of breastfeeding so they can support your decision to provide breast milk. There are many ways these important people can help in baby’s care.

• “Kangaroo Care”, is an excellent way for Daddy to feel close to his new baby. There are many benefits for the baby from “Kangaroo Care” including better regulation of temperature, better oxygen levels, better blood sugar levels, and stimulation of senses that help nerve and brain development.
• At home, important support people can help ensure mother’s rest and recover well. Helping with older siblings is a very important job. Also, family and friends can help with baby care jobs such as bathing, dressing, burping and diapering.
• For mothers who decide to pump and collect breast milk for their baby, fathers and other family members can fill in labels for mother’s milk storage containers. They can help by cleaning breast pump parts and encourage pumping at regular times. While mother rest or are doing other necessary things in their life, fathers, grandparents, aunts and siblings can feed the baby the milk you collect.

Will breastfeeding hurt?
Breastfeeding should not hurt! There may be some nipple tenderness the first couple of days until the nipples adjust. Mothers will feel some tugging on the breast when the baby latches on initially. Any discomfort should go away within a minute or two.

Most complaints of pain while breastfeeding relate to how the baby is attached, also called “latched on." Most of the time an uncomfortable latch can be quickly and easily taken care of. A lactation consultant will help find a comfortable position and teach mothers how to help the baby “latch on”.

I don’t have any milk. What now?
Many women think they don’t have enough milk. But, mothers make milk starting in the fourth month of pregnancy. Newborns stomachs are the size of a marble at birth - one teaspoonful (5 ml). Mothers have enough colostrum to fill their baby’s stomach as soon as he or she arrives. Do not over fill a baby by offering early feedings of formula. This may delay mother’s milk from “coming in” and decrease the amount of milk she make later.

Is it normal to be uncomfortable with the idea of putting my baby to my breast?

• Some women are not sure they will be comfortable with breastfeeding. It can be intimidating the first time. Please discuss this concern with your patients.
• Some women choose to collect breast milk by pumping as an alternative to nursing at the breast. They will need a good pump if they plan to regularly pump breast milk.
• Some women worry about their privacy and being able to breastfeed discreetly especially while in the hospital with staff and visitors coming and going. Ask us and support people to help mother to have quiet, private times with her baby so she can get off to a good start.

Are my breasts too small for breastfeeding?
Breasts and nipples come in many shapes and sizes. The size of the breasts or nipples does not determine success in breastfeeding. Most women, even with very small breasts, are able to produce enough milk for their baby. Even if the nipples are flat or inverted, mothers can successfully breastfeed their baby.

What do I do if I tried and could not make enough milk?

• Many women have tried to breastfeed only to find that their milk supply was too small to satisfy their baby. This is usually because of early and frequent use of formula before the breasts develop the cells needed to make large volumes of milk.
• Breastfeeding early and frequently ensures a good milk supply. If the baby is not able to be placed to the breast, frequently emptying the breast, early pumping and using a breast pump at the baby’s bedside can help boost mother’s milk supply. Also, frequently holding the baby skin-to-skin increases mother’s milk supply.
• Most mothers pump only drops of milk for the first few days. This is normal.
• Many things – such as high blood pressure, premature labor, medications, and Cesarean birth can delay “coming in” of mother’s milk.
• Many things can temporarily decrease milk supply: illness, hormone changes, stress, having a setback in a baby’s condition, and especially lack of frequent emptying of the breast.
• If you think milk supply is low, be sure to call our certified lactation consultants for ways to increase milk supply. I have to go back to work so it is better not to start breastfeeding.Today, many women return to work soon after giving birth. Ask our lactation consultants for information about preparing to go back to work and how to approach employers about helping mothers continue to breastfeed after returning to work. Continuing breastfeeding can be a benefit to mothers, babies and employers.
• Having access to a breast pump when mothers return to work makes it possible to breastfeed as long as she want.
• Remember, providing any amount of breast milk for the baby is beneficial for mother and baby, no matter how long she breastfeeds. Even if she decides to stop breastfeeding before returning to work, every drop counts in giving the baby a healthy start.

Are the medications I'm taking safe for my baby?
Most medications are safe for babies when you breastfeed. A physician or lactation consultant can help identify any medications that might cause potential problems with breastfeeding. IMPORTANT: Counsel mothers to talk to their healthcare provider and lactation consultant after going home before taking any new medications while breastfeeding.

I had breast surgery...can I still breastfeed?
Some types of breast surgery can interfere with a women’s ability to breastfeed. It is best to discuss the individual surgery with the doctor and lactation consultant to know if she is able to breastfeed. In most cases, breastfeeding the baby is the best way to know if she is able to produce milk.

Will my breasts leak?
It is true that a nursing mother’s milk will "let down" sometimes when she is not nursing, for example, even when she hears someone else’s baby cry. Applying gentle pressure to the nipples usually stops the flow of milk. She can protect her clothing by wearing disposable or washable breast pads inside her bra. These should be changed when they become wet. Leaking becomes less common as time goes on.