Advice from Lactation Consultants for New Moms
We asked our Lactation Consultants for some advice on the most commonly asked questions by new moms about breastfeeding.
- How long should I plan to breastfeed my baby?
- How often should I breastfeed my new baby?
- Can I drink alcohol while breastfeeding?
- Do I have to stop breastfeeding because I smoke?
- Are there any foods I should avoid while breastfeeding?
- Can I breastfeed while I am pregnant?
- Does breastfeeding hurt?
- Do I need to pump my breasts and if so, when?
- How long does breastmilk stay good in the freezer?
- How long does breastmilk stay good in the refrigerator?
- How long does breastmilk stay good at room temperature?
- I would love to breastfeed my baby during the day, and let my husband bottle feed at night while I sleep. Can we do this?
- How do I wean from breastfeeding?
- How do I clean my breast pump?
The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first 6 months of life with no additional foods or nutrients other than vitamin D drops. They recommend continuing to breastfeed, and adding solid foods, for at least the first 12 months. The World Health Organization recommends breastfeeding for up to 2 years or beyond.
In the beginning, newborns need to feed eight to twelve times in 24 hours in order to gain weight well and establish the milk supply. This may mean not waiting until your baby is crying to put them to the breast. Learning your baby’s early feeding cues, such as moving their eyes under their eyelids, lip smacking, bringing their hand to their mouth, will help you avoid the frustration of trying to latch a frantic newborn to the breast. It may be necessary in the early days to arouse your sleepy newborn to encourage them to feed. During the day, you may find it helpful to put your baby to the breast at more frequent intervals (every 2 to 2 ½ hours) so they will be more likely to go longer stretches at night. Most newborns, breast or bottlefed, will not sleep more than 4 to 5 hours at a stretch. Sometimes they will cluster feed (feeding every hour) before that longer stretch. Over time, once your infant is growing well, you will be able to move to a feeding on demand schedule.
Alcohol does pass through your breastmilk to your baby so you should avoid use of alcohol, especially in large amounts, while breastfeeding. Contrary to rumors, alcohol does not increase your supply. As it changes the taste of your milk, your baby may not feed as well and it may actually decrease your supply. An occasional drink will probably not harm your baby but avoiding breastfeeding for 2 hours afterwards is recommended by the US Department of Health and Human Services. The American Academy of Pediatrics advocates moderation as there are concerns about long-term repeated exposures of infants to alcohol in breastmilk.
This is a great time for you and your baby to quit smoking. Ask your health care provider for help. If you cannot, breastmilk still remains the ideal food for your baby. Avoid smoking around your baby. Wear a “smoking smock” when smoking (outdoors), and remove the smock and wash your face and hands afterwards to minimize your baby’s exposure to the chemicals smoking produces.
This advice is the same if you choose e-cigarettes or vaping, but less is known about the chemicals and their effects in these products.
For years, breastfeeding mothers were advised to restrict certain foods from their diet…spicy foods, beans, cabbage, onions, chocolate, etc. Research has shown, in most cases, this is unnecessary. Infants from cultures where spicy foods are the norm are no fussier. The foods you eat will actually help your infant develop a taste for the foods that are traditional to your culture or your family. All that being said, there are a few things to take into consideration. We no longer ban all chocolate while breastfeeding but do recommend no more than one pound of chocolate a day – an amount not advisable to anyone. Moderate consumption of caffeine (sodas, tea, coffee) should not affect your baby. Continue to avoid fish that are high in mercury (shark, swordfish, king mackerel, orange roughy, marlin, bigeye tuna, and tilefish). Mercury can cause damage to the nervous system in infants. Your health care provider may recommend eliminating certain foods from your diet such as dairy if your infant is showing signs of intolerance (rashes, spitting up, fussiness or blood in stools). Finally if there is a food that repeatedly seems to make your infant uncomfortable and it is not crucial to your diet consider eliminating it.
Can I breastfeed while I am pregnant?
In most cases, the answer to this question is yes but it is advisable to consult with your primary care provider or obstetrician as they know your medical history. If you have a history of preterm labor or miscarriage, it would be important to be aware of any uterine contractions that might result from nipple stimulation. Be aware of your body’s cues. Your supply may decrease and the taste of your milk may change after the first few months and this may lead your infant to wean him or herself. Keep in mind that the additional energy requirements of nursing and breastfeeding necessitate making sure you are getting added nutrition and rest.
In the first week or so, you may experience some nipple soreness as your infant learns to latch and you learn to support your baby. Your breasts may be full and tender as your milk supply is established. It is important to use a nipple butter frequently to keep your nipples healthy, Persistent nipple pain or cracked or bleeding nipples warrant a visit to a lactation consultant for evaluation of the feeding technique and latch. They may also have some advice to help you heal sore nipples. If breast fullness and pain continues, consult your lactation consultant or primary care provider to assist you with engorgement. Persistent deep breast pain accompanied by fever or chills should be brought to the attention of your OB or primary care provider as it may be an indication of mastitis – an infection of the breast.
For the first few weeks, if your infant is latching with minimal pain and gaining weight well, it is not necessary to pump…you are busy enough! Once breastfeeding is established, if you are planning to return to work or want to provide a bottle of expressed milk every now and then, you may want to start pumping. Pick a time of day directly after a feeding to pump for 10 to 15 minutes. Most women find that they have more milk in the morning but this may not be the most convenient time for them to pump. With consistency, your body will respond to what you are asking it to produce. If you will be working outside the home and pumping on a regular basis you may want to invest in a high quality double electric pump. This should be provided by your insurance company. Your lactation consultant can help you identify which pump suits your needs as well as offer advice to increase the effectiveness and efficiency of pumping.
How long does breastmilk stay good in the freezer?
6 months if in freezer section/pull out drawer (-5°C or 23°F).
12 months if in an upright or chest freezer (-20°C or -4°F).
Never refreeze thawed breastmilk.
Freshly Pumped Milk: 3-8 days at 4°C or 39°F.
Previously frozen, then thawed in refrigerator: 24 hours.
Previously frozen, then thawed in warm water: 4 hours.
Keep in the back of the refrigerator, not in the refrigerator door.
Freshly Pumped Milk: 5 hours at 25°C or 77°F.
Previously frozen, then thawed in refrigerator: 4 hours.
Previously frozen, then thawed in warm water: use right away.
Once the baby has sucked from the bottle it must be used within 30 minutes or discarded.
I would love to breastfeed my baby during the day, and let my husband bottle feed at night while I sleep. Can we do this?
This plan sounds like a wonderful division of labor. However, if the breasts go all night without stimulation before the infant is ready to sleep through the night, most women find a significant decrease in their milk supply. Your husband can help at night by answering your baby’s cries, bringing him or her to you and changing diapers thus minimizing your awake time.
When the time comes to wean your baby from breastfeeding, it is best to do it gradually. Drop one feeding at the breast at the same time of day every few days. Wear a supportive bra and use cold compresses for any engorgement that ensues. If your situation requires more rapid weaning or if you experience a great deal of engorgement, apply clean (washed with a small amount of soap and cool water), cool cabbage leaves directly to your breasts. As the leaves wilt, apply fresh ones. How this works is unknown but many mothers have found it to be extremely effective
How do I clean my breast pump?
Please refer to the following link for the most recent recommendations on breast pump cleaning: