Caring for Your Baby: The Basics

Breastfeeding: Strategies for Success

Mother's milk is natures perfect baby food, but breastfeeding doesn't necessarily come naturally. Most women can benefit from at least some coaching to help things go more smoothly. Here are some resources that can make things a little easier.
More moms are learning about the importance of breastfeeding. In fact, nearly 4 out of 5 moms in the United States breastfeed their babies – the highest it’s been in 20 years.

Breastmilk is the best food for most babies during the first year of life. Studies show that children who are breastfed have fewer ear infections, lower respiratory infections, and urinary tract infections than children who receive formula. Breastfed babies are also less likely to develop childhood obesity, which is a growing epidemic in the United States.

It’s especially important for babies to have breastmilk during the first few months of life. While formula includes key vitamins for your baby’s health, breastmilk provides certain nutrients, antibodies and proteins that can protect your baby from common illnesses to help her grow stronger.

All babies need to have enough vitamin D to help prevent a bone-weakening disease called rickets. Breastfed babies need multivitamin drops containing vitamin D starting in the first few days of life. Some breastfed babies may also need iron.

Remember – breastfeeding is a natural skill, but it’s also a learned skilled. Be patient and give yourself (and your baby) time to master this new ability.

If You’re Not Sure
Even if you’re unsure about breastfeeding, you may want to give it a try while in the hospital. Your body is better able to make milk immediately after giving birth.

If you begin breastfeeding and decide to stop, you can always switch to formula. But if you start with formula, switching to breastmilk later can be hard or even impossible.

How to Breastfeed Your Baby

Breastfed newborns need to eat 8 to 12 times in 24 hours (about once every 2 to 3 hours). Here's how to breastfeed your baby:

  • Sit up and hold your baby with his tummy touching your tummy.
  • Cup your breast and tickle his lip with your nipple.
  • When he opens his mouth, firmly bring him to your breast. Your baby has to have at least 1/2 inch of your areola (the darker skin around the nipple) in his mouth to start milk flowing. If your nipples hurt or are cracked or bleeding, the baby may not latch on correctly.
  • Talk to your health care provider if you need help.

Clothes for Comfort
Several companies sell breastfeeding clothes with flaps or hidden slits to make breastfeeding discreet. These are convenient, but any two-piece outfit with a shirt that pulls up (rather than unbuttons) can work well.

Once your baby is latched on to your breast, you can settle the shirt hem so that little or no breast shows. Practice in front of a mirror until you feel confident. If you are particularly shy, a vest, poncho or sweater can provide additional coverage from the side.

Breast Pumps
Mothers who are returning to work or school usually need a breast pump. How often you’ll need to pump milk depends on whether you’re feeding your baby only breastmilk or if you’re switching between breastmilk and formula. Since you won't know in advance how often you'll need to pump, it's usually best to obtain a pump after the baby is born.

There are a variety of pumps available. Women who pump infrequently often prefer manual pumps, while working women commonly like electric double pumps. A lactation consultant can help you evaluate your needs and choose wisely.

Shop around until you find the pump that works best for you. You will also need bags or bottles to store pumped breastmilk (also called "expressed breastmilk").

Prices for breast pumps vary depending on their features. Be sure to compare costs. Some health insurance companies help pay for a breast pump. Find out if your insurance covers the purchase of a breast pump.

You may also want to think about renting a breast pump. For many families, this is a cost-effective solution. Talk to your health provider or hospital staff for more information about where to rent a pump.

Reusing a friend’s pump is safe as long as you buy new accessories (tubing, storage bags, bottles, nipples). Talk to your health care provider if you’re interested in this option.

Breastfeeding at Work
If you’re planning to return to work, you may want to continue feeding your baby breastmilk. Before you begin your maternity leave, find out if there is a lactation policy or benefit in place. Helping you to continue breastfeeding your baby is in an employer's best interest, as mothers of breastfed babies miss fewer days from work because their babies are sick less often.

Ask if your employer will give you a private place and time to express milk. Talk to your boss about working from home a few days a week or easing back into work part-time.

You will probably need to pump two to three times in a full-time workday, for about 10 to 15 minutes each time. Most working women find an electric double breast pump easy to use and most efficient.

Your child care provider should support you and your baby  by feeding her expressed breastmilk—and by welcoming you to feed your baby during the workday.

Storing Breastmilk
Expressed breastmilk can be kept in the refrigerator or freezer. Write the date on the container before you freeze or refrigerate it.

You can store breastmilk for up to three months in a freezer that has a separate door. If you have a freezer compartment inside a refrigerator, store the milk for no more than two weeks. This is because refrigerator doors get opened and closed more frequently than doors for separate freezers. If you keep your refrigerator between 32-39°F, you can keep breastmilk in the fridge for up to eight days.

To warm the breastmilk, place the bottle under running hot water or in a bowl of warm water. Shake the bottle and then test the temperature of the milk on the back of your hand. Always taste or smell breastmilk before giving it to your baby, just to make sure it’s okay.

Breastfeeding and Sleeping
Be careful about falling asleep when you breastfeed. This can pose a suffocation risk for your baby.

What You Can Do

  • Find a health care provider for you and your baby that supports breastfeeding.
  • Take a breastfeeding class before you give birth. Ask your health care provider, a lactation consultant (an expert in breastfeeding), the La Leche League, or a childbirth educator for information about classes in your area.
  • Find out if the birthing facility where you will deliver is committed to breastfeeding.
  • Tell nurses in the hospital that you want to breastfeed. Don’t let them give your baby formula.
  • Ask to see the lactation consultant while you are in the hospital to help answer any questions you have.
  • Ask that your baby room with you while in the hospital so that you can breastfeed him when he wants to eat.
  • Find someone who has enjoyed breastfeeding. Ask her for advice and information.
  • Get help and comfort from your partner.
  • Find a breastfeeding support group in your area. La Leche League offers such help; call (800)-LA LECHE.
  • Learn about breastfeeding from books and DVDs. Your local library probably has some good resources. 
  • If you are taking any medications, talk to your health care provider about whether they are safe for your baby as you breastfeed. The U.S. Centers for Disease Control and Prevention has helpful information about medications and breastfeeding.

Resources on the Web
gotmom.org, a breastfeeding Web site sponsored by the American College of Nurse Midwives

American Academy of Pediatrics

International Lactation Consultant Association

La Leche League International

Breastfeeding.com, an online community of mothers and nursing professionals

February 2010

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