Breastfeeding

Breastfeeding protects babies

  1. Early breast milk is liquid gold – Known as liquid gold, colostrum (coh-LOSS-trum) is the thick yellow first breast milk that you make during pregnancy and just after birth. This milk is very rich in nutrients and antibodies to protect your baby. Although your baby only gets a small amount of colostrum at each feeding, it matches the amount his or her tiny stomach can hold. (Visit How to know your baby is getting enough milk to see just how small your newborn’s tummy is!)
  2. Related information
     Did you know?

    While formula-feeding raises health risks in babies, it can also save lives. Very rarely, babies are born unable to tolerate milk of any kind. These babies must have soy formula. Formula may also be needed if the mother has certain health conditions and she does not have access to donor breast milk. To learn more about rare breastfeeding restrictions in the mother, visit the Breastfeeding a baby with health problems section. To learn more about donor milk banks, visit the Breastfeeding and special situations section.

    For health professionals
     Find more journal articles on breastfeeding.
  3. Your breast milk changes as your baby grows – Colostrum changes into what is called mature milk. By the third to fifth day after birth, this mature breast milk has just the right amount of fat, sugar, water, and protein to help your baby continue to grow. It is a thinner type of milk than colostrum, but it provides all of the nutrients and antibodies your baby needs.
  4. Breast milk is easier to digest – For most babies — especially premature babies — breast milk is easier to digest than formula. The proteins in formula are made from cow’s milk and it takes time for babies’ stomachs to adjust to digesting them.
  5. Breast milk fights disease – The cells, hormones, and antibodies in breast milk protect babies from illness. This protection is unique; formula cannot match the chemical makeup of human breast milk. In fact, among formula-fed babies, ear infections and diarrhea are more common. Formula-fed babies also have higher risks of:
    • Necrotizing (nek-roh-TEYE-zing) enterocolitis (en-TUR-oh-coh-lyt-iss), a disease that affects the gastrointestinal tract in preterm infants.
    • Lower respiratory infections
    • Asthma
    • Obesity
    • Type 2 diabetes
    Some research shows that breastfeeding can also reduce the risk of Type 1 diabetes, childhood leukemia, and atopic dermatitis (a type of skin rash) in babies. Breastfeeding has also been shown to lower the risk of SIDS (sudden infant death syndrome).

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Mothers benefit from breastfeeding

  1. Life can be easier when you breastfeed – Breastfeeding may take a little more effort than formula feeding at first. But it can make life easier once you and your baby settle into a good routine. Plus, when you breastfeed, there are no bottles and nipples to sterilize. You do not have to buy, measure, and mix formula. And there are no bottles to warm in the middle of the night! You can satisfy your baby’s hunger right away when breastfeeding.
  2. Breastfeeding can save money – Formula and feeding supplies can cost well over $1,500 each year, depending on how much your baby eats. Breastfed babies are also sick less often, which can lower health care costs.
  3. Breastfeeding can feel great – Physical contact is important to newborns. It can help them feel more secure, warm, and comforted. Mothers can benefit from this closeness, as well. Breastfeeding requires a mother to take some quiet relaxed time to bond. The skin-to-skin contact can boost the mother’s oxytocin (OKS-ee-TOH-suhn) levels. Oxytocin is a hormone that helps milk flow and can calm the mother.
  4. Breastfeeding can be good for the mother’s health, too – Breastfeeding is linked to a lower risk of these health problems in women:
    1. Type 2 diabetes
    2. Breast cancer
    3. Ovarian cancer
    4. Postpartum depression
    Experts are still looking at the effects of breastfeeding on osteoporosis and weight loss after birth. Many studies have reported greater weight loss for breastfeeding mothers than for those who don’t. But more research is needed to understand if a strong link exists.
  5. Mothers miss less work – Breastfeeding mothers miss fewer days from work because their infants are sick less often.

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Breastfeeding benefits society

The nation benefits overall when mothers breastfeed. Recent research shows that if 90 percent of families breastfed exclusively for 6 months, nearly 1,000 deaths among infants could be prevented. The United States would also save $13 billion per year — medical care costs are lower for fully breastfed infants than never-breastfed infants. Breastfed infants typically need fewer sick care visits, prescriptions, and hospitalizations.

Breastfeeding also contributes to a more productive workforce since mothers miss less work to care for sick infants. Employer medical costs are also lower.

Breastfeeding is also better for the environment. There is less trash and plastic waste compared to that produced by formula cans and bottle supplies.

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Breastfeeding during an emergency

When an emergency occurs, breastfeeding can save lives:

  • Breastfeeding protects babies from the risks of a contaminated water supply.
  • Breastfeeding can help protect against respiratory illnesses and diarrhea. These diseases can be fatal in populations displaced by disaster.
  • Breast milk is the right temperature for babies and helps to prevent hypothermia, when the body temperature drops too low.
  • Breast milk is readily available without needing other supplies.

    Finding support and information

    Molly from California says...

     

    I always knew I would breastfeed my children. When our daughter was born she started eating within the first hour. It was a little uncomfortable, but I figured it would go away with time. I found out ... (more)

    Read all the stories or share your own.

    Your Guide to Breastfeeding

    This free publication provides information and encouragement to women on breastfeeding. It explains the benefits for baby, mom, and society. It also provides frequently asked questions and answers about breastfeeding. It is available in English, Spanish, as well as in English for African American and American Indian and Alaska Native women.

  • Health professionals who help with breastfeeding
  • Mother-to-mother support
  • WIC program
  • More information on finding support and information
  • There are many sources of support available for breastfeeding mothers. You can seek help from different types of health professionals, organizations, and members of your own family. Under the Affordable Care Act (sometimes called "health care reform"), more and more women will have access to breastfeeding support without any out-of-pocket costs. And don't forget, friends who have successfully breastfed can be a great source of information and encouragement! You can also learn more in the following sections:

  • Breastfeeding advice videos
  • Share your story
  • Health professionals who help with breastfeeding

    Pediatricians, obstetricians, and certified nursemidwives can help you with breastfeeding. Other special breastfeeding professionals include:

  • International Board Certified Lactation Consultant (IBCLC) – Lactation consultants are credentialed breastfeeding professionals with the highest level of knowledge and skill in breastfeeding support. IBCLCs are experienced in helping mothers to breastfeed comfortably by helping with positioning, latch, and a wide range of breastfeeding concerns. Many IBCLCs are also nurses, doctors, speech therapists, dietitians, or other kinds of health professionals. Ask your hospital or birthing center for the name of a lactation consultant who can help you. Or, you can go to http://www.ilca.org to find an IBCLC in your area.
  • Breastfeeding Peer Counselor or Educator – A breastfeeding counselor can teach others about the benefits of breastfeeding and help women with basic breastfeeding challenges and questions. A "peer" means a person has breastfed her own baby and is available to help other mothers. Some breastfeeding educators have letters after their names like CLC (Certified Lactation Counselor) or CBE (Certified Breastfeeding Educator). Educators have special breastfeeding training but not as much as IBCLCs. These professionals still can be quite helpful.
  • Doula (DOO-la) – A doula is professionally trained and experienced in giving social support to birthing families during pregnancy, labor, and birth and at home during the first few days or weeks after birth. Those who are trained in breastfeeding can help you be more successful with breastfeeding after birth.
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    Mother-to-mother support

    Other breastfeeding mothers can be a great source of support. Mothers can share tips and offer one another encouragement. There are many ways you can connect with other breastfeeding mothers:

  • Ask your health care provider or hospital staff to recommend a support group.
  • Search your phone book or the Internet for a breastfeeding center near you. These centers may offer support groups.
  • Find a local La Leche League support group by visiting the organization's website at http://www.llli.org/.
  • Search the Internet for breastfeeding message boards and chats. (These resources can be great for sharing tips, but do not rely on websites for medical advice — talk to your health care provider.)
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    WIC program

    Food, nutrition counseling, and access to health services are provided to low-income women, infants, and children under the Special Supplemental Nutrition Program for Women, Infants, and Children. This program is popularly known as WIC (Women, Infants, and Children). Breastfeeding mothers supported by WIC may receive educational materials, peer counselor support, an enhanced food package, breast pumps, and other supplies.

    Breastfeeding mothers are also eligible to participate in WIC longer than non-breastfeeding mothers. Find contact information for your local WIC program or call the national WIC office at 703-305-2746.

    Learning to breastfeed

  • Keep in mind that breastfeeding is a learned skill. It requires patience and practice. For some women, the learning stages can be frustrating and uncomfortable. And some situations make breastfeeding even harder, such as babies born early or health problems in the mother. The good news is that it will get easier, and support for breastfeeding mothers is growing. Keep in mind that you make milk in response to your baby sucking at the breast. The more milk your baby removes from the breasts, the more milk you will make.

    Related information

  • Breastfeeding fact sheet – Find answers to common questions about breastfeeding
  • How breast milk is made


     

    Knowing how the breast works to produce milk can help you understand the breastfeeding process. The breast itself is a gland that is made up of several parts, including:

  • Glandular tissue – body tissue that makes and releases one or more substances for use in the body. Some glands make fluids that affect tissues or organs. Others make hormones or assist with blood production. In the breast, this tissue is involved in milk production.
  • Connective tissue – a type of body tissue that supports other tissues and binds them together. This tissue provides support in the breast.
  • Blood – fluid in the body made up of plasma, red and white blood cells, and platelets. Blood carries oxygen and nutrients to and waste materials away from all body tissues. In the breast, blood nourishes the breast tissue and provides nutrients needed for milk production.
  • Lymph – the almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. Lymph tissue in the breast helps remove waste.
  • Nerves – cells that are the building blocks of the nervous system (the system that records and transmits information chemically and electrically within a person). Nerve tissue in the breast makes breasts sensitive to touch, allowing the baby’s sucking to stimulate the let-down or milk-ejection reflex and milk production. Learn more about let-down reflex.
  • Fatty tissue – connective tissue that contains stored fat. It is also known as adipose tissue. Fatty tissue in the breast protects the breast from injury. Fatty tissue is what mostly affects the size of a woman’s breast. Breast size does not have an effect on the amount of milk or the quality of milk a woman makes.
  • Special cells inside your breasts make milk. These cells are called alveoli (al-VEE-uh-leye). When your breasts become fuller and tender during pregnancy, this is a sign that the alveoli are getting ready to work. Some women do not feel these changes in their breasts. Others may sense these changes after their baby is born.

    The alveoli make milk in response to the hormone prolactin (proh-LAK-tin). Prolactin rises when the baby suckles. Another hormone, oxytocin (oks-ee-TOH-suhn), causes small muscles around the cells to contract and move the milk through a series of small tubes called milk ducts. This moving of the milk is called let-down reflex. Learn more about let-down reflex.

    Oxytocin also causes the muscles of the uterus to contract during and after birth. This helps the uterus to get back to its original size. It also lessens any bleeding a woman may have after giving birth. The release of both prolactin and oxytocin may be responsible in part for a mother’s intense feeling of needing to be with her baby.

    What is a let-down reflex?

    A let-down reflex or milk ejection reflex is a conditioned reflex ejecting milk from the alveoli through the ducts to the sinuses of the breast and the nipple. This reflex makes it easier to breastfeed your baby. Let-down happens a few seconds to several minutes after you start breastfeeding your baby. It can happen a few times during a feeding, too. You may feel a tingle in your breast or you may feel a little uncomfortable. Keep in mind that some women don’t feel anything. Let-down can happen at other times, too, such as when you hear your baby cry or when you may just be thinking about your baby. If your milk lets down as more of a gush and it bothers your baby, try expressing some milk by hand before you start breastfeeding.

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    What you can do before you give birth

    What dad can do

    A woman who is thinking about how to feed her baby values her partner’s advice. A father’s approval and support of breastfeeding can boost the mother’s confidence and help her to overcome challenges. But supporting a woman’s choice to breastfeed is not the father’s only role. Although the bond between mother and baby is important, so is the bond between father and baby. Babies need cuddles and hugs from their dads, too! In fact, skin-to-skin contact helps baby and father bond much like it does for mother and baby.

    To prepare for breastfeeding, the most important thing you can do is have confidence in yourself. Committing to breastfeeding starts with the belief that you can do it!

    Other steps you can take to prepare for breastfeeding:

  • Get good prenatal care, which can help you avoid early delivery. Babies born too early often need special care, which can make breastfeeding harder.
  • Tell your health care provider about your plans to breastfeed, and ask if the place where you plan to deliver your baby has the staff and set-up to support successful breastfeeding. Some hospitals and birth centers have taken special steps to create the best possible environment for successful breastfeeding. They are called Baby-Friendly Hospitals and Birth Centers. Women who deliver in a baby-friendly facility are promised the information and support they need to breastfeed their infants.
  • Take a breastfeeding class. Pregnant women who learn about how to breastfeed are more likely to be successful than those who do not. Breastfeeding classes offer pregnant women and their partners the chance to prepare and ask questions before the baby’s arrival.
  • Ask your health care provider to recommend a lactation consultant. You can establish a relationship before the baby comes, or be ready if you need help after the baby is born.
  • Talk to your health care provider about your health. Discuss any breast surgery or injury you may have had. If you have depression or are taking medications, discuss treatment options that can work with breastfeeding.
  • Tell your health care provider that you would like to breastfeed your newborn baby as soon as possible after delivery. The sucking instinct is very strong within the first hour of life.
  • Talk to friends who have breastfed or consider joining a breastfeeding support group.
  • Talk to fathers, partners, and other family members about how they can help. Partners and family members can:
    • Support the breastfeeding relationship by being kind and encouraging.
    • Show their love and appreciation for all of the work that is put into breastfeeding.
    • Be good listeners when a mother needs to talk through breastfeeding concerns.
    • Make sure the mother has enough to drink and gets enough rest, help around the house, and take care of other children at home.
    • Give emotional nourishment to the child through playing and cuddling.
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    Tips for getting off to a good start

    After you have the baby, these steps can help you get off to a great start:

  • Breastfeed as soon as possible after birth.
  • Ask for an on-site lactation consultant to come help you.
  • Ask the staff not to give your baby other food or formula, unless it is medically necessary.
  • Allow your baby to stay in your hospital room all day and night so that you can breastfeed often. Or, ask the nurses to bring you your baby for feedings.
  • Try to avoid giving your baby any pacifiers or artificial nipples so that he or she gets used to latching onto just your breast.
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    Bringing your baby to the breast to latch

    Did you know?

    Some babies latch on right away and, for some, it takes more time.

    When awake, your baby will move his or her head back and forth, looking and feeling for the breast with his or her mouth and lips. The steps below can help you get your baby to “latch” on to the breast to start eating. Keep in mind that there is no one way to start breastfeeding. As long as the baby is latched on well, how you get there is up to you.

  • Hold your baby, wearing only a diaper, against your bare chest. Hold the baby upright with his or her head under your chin. Your baby will be comfortable in that cozy valley between your breasts. You can ask your partner or a nurse to place a blanket across your baby’s back and bring your bedcovers over you both. Your skin temperature will rise to warm your baby.
  • Support his or her neck and shoulders with one hand and hips with the other. He or she may move in an effort to find your breast.
  • Your baby’s head should be tilted back slightly to make it easy to suck and swallow. With his or her head back and mouth open, the tongue is naturally down and ready for the breast to go on top of it.
  • Allow your breast to hang naturally. When your baby feels it with his or her cheek, he or she may open his or her mouth wide and reach it up and over the nipple. You can also guide the baby to latch on as you see in the illustrations below.
  • At first, your baby’s nose will be lined up opposite your nipple. As his or her chin presses into your breast, his or her wide, open mouth will get a large mouthful of breast for a deep latch. Keep in mind that your baby can breathe at the breast. The nostrils flare to allow air in.
  • Do not put your hands on your baby’s head. As it tilts back, support your baby’s upper back and shoulders with the palm of your hand and pull your baby in close.
  • Getting your baby to latch

    1. Tickle the baby’s lips to encourage him or her to open wide.

    2. Pull your baby close so that the chin and lower jaw moves into your breast first.

    3. Watch the lower lip and aim it as far from base of nipple as possible, so the baby takes a large mouthful of breast.

    Click on the start button for a demonstration

     

    Text only version

    Signs of a good latch

    Did you know?

    A good latch is important for your baby to breastfeed effectively and for your comfort. During the early days of breastfeeding, it can take time and patience for your baby to latch on well.

  • The latch feels comfortable to you, without hurting or pinching. How it feels is more important than how it looks.
  • Your baby’s chest is against your body and he or she does not have to turn his or her head while drinking.
  • You see little or no areola, depending on the size of your areola and the size of your baby’s mouth. If areola is showing, you will see more above your baby’s lip and less below.
  • When your baby is positioned well, his or her mouth will be filled with breast.
  • The tongue is cupped under the breast, although you might not see it.
  • You hear or see your baby swallow. Some babies swallow so quietly, a pause in their breathing may be the only sign of swallowing.
  • You see the baby’s ears “wiggle” slightly.
  • Your baby’s lips turn out like fish lips, not in. You may not even be able to see the bottom lip.
  • Your baby’s chin touches your breast.
  • Help with latch problems

    Are you in pain? Many moms report that their breasts can be tender at first until both they and their baby find comfortable breastfeeding positions and a good latch. Once you have done this, breastfeeding should be comfortable. If it hurts, your baby may be sucking on only the nipple. Gently break your baby’s suction to your breast by placing a clean finger in the corner of your baby’s mouth and try again. Also, your nipple should not look flat or compressed when it comes out of your baby’s mouth. It should look round and long, or the same shape as it was before the feeding.

    Are you or your baby frustrated? Take a short break and hold your baby in an upright position. Try holding him or her between your breasts skin-to-skin. Talk, sing, or provide your finger for sucking for comfort. Try to breastfeed again in a little while. Or, the baby may start moving to the breast on his or her own from this position.

    Does your baby have a weak suck, or make only tiny suckling movements? Break your baby’s suction and try again. He or she may not have a deep enough latch to remove the milk from your breast. Talk with a lactation consultant or pediatrician if your baby’s suck feels weak or if you are not sure he or she is getting enough milk. Rarely, a health problem causes the weak suck.

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    How often should I breastfeed? How long should feedings be?

    Early and often! Breastfeed as soon as possible after birth, then breastfeed at least 8 to 12 times every 24 hours to make plenty of milk for your baby. This means that in the first few days after birth, your baby will likely need to breastfeed about every hour or two in the daytime and a couple of times at night. Healthy babies develop their own feeding schedules. Follow your baby’s cues for when he or she is ready to eat.

    Feedings may be 15 to 20 minutes or longer per breast. But there is no set time. Your baby will let you know when he or she is finished. If you are worried that your baby is not eating enough, talk to your baby’s doctor. Use our Feeding Chart (PDF, 110 KB) to write down when your baby wants to eat.

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    Breastfeeding holds

    Some moms find that the following positions are helpful ways to get comfortable and support their babies in finding a good latch. You also can use pillows under your arms, elbows, neck, or back to give you added comfort and support. Keep in mind that what works well for one feeding may not work well for the next. Keep trying different positions until you are comfortable.

    Cradle hold – An easy, common hold that is comfortable for most mothers and babies. Hold your baby with his or her head on your forearm and his or her whole body facing yours.

    Cross cradle or transitional hold – Useful for premature babies or babies with a weak suck because it gives extra head support and may help babies stay latched. Hold your baby along the opposite arm from the breast you are using. Support your baby’s head with the palm of your hand at the base of his or her neck.

    Clutch or “football” hold – Useful for mothers who had a c-section and mothers with large breasts, flat or inverted nipples, or a strong letdown reflex. It is also helpful for babies who prefer to be more upright. This hold allows you to better see and control your baby’s head, and keep the baby away from a c-section incision. Hold your baby at your side, lying on his or her back, with his or her head at the level of your nipple. Support baby’s head with the palm of your hand at the base of the head. (The baby is placed almost under the arm.)

    Side-lying position – Useful for mothers who had a c-section or to help any mother get extra rest while the baby breastfeeds. Lie on your side with your baby facing you. Pull your baby close so your baby faces your body.

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    Tips for making it work

  • Learn your baby’s hunger signs – When babies are hungry, they become more alert and active. They may put their hands or fists to their mouths, make sucking motions with their mouth, or turn their heads looking for the breast. If anything touches the baby’s cheek — such as a hand — the baby may turn towards this hand, ready to eat. This sign of hunger is called rooting. Offer your breast when your baby shows rooting signs. Crying can be a late sign of hunger and it may be harder to latch once the baby is upset. Over time, you will be able to learn your baby’s cues for when to start feeding.
  • Follow your baby’s lead – Make sure you are both comfortable and follow your baby’s lead after he or she is latched on well. Some babies take both breasts at each feeding. Other babies only take one breast at a feeding. Help your baby finish the first breast, as long as he or she is still sucking and swallowing. This will ensure the baby gets the “hind” milk — the fattier milk at the end of a feeding. Your baby will let go of the breast when he or she is finished, and often falls asleep. Offer the other breast if he or she seems to want more.
  • Keep your baby close to you – Remember that your baby is not used to this new world and needs to be held very close to his or her mother. Being skin-to-skin helps babies cry less and stabilizes the baby’s heart and breathing rates.
  • Avoid nipple confusion – Avoid using pacifiers, bottles, and supplements of infant formula in the first few weeks unless there is a medical reason to do so. If supplementation is needed, try to give expressed breast milk first. But it’s best just to feed at the breast. This will help you make milk and keep your baby from getting confused while learning to breastfeed.
  • Sleep safely and close by – Have your baby sleep in a crib or bassinet in your room, so that you can breastfeed more easily at night. Sharing a room with parents is linked to a lower risk of SIDS (sudden infant death syndrome).
  • Know when to wake the baby – In the early weeks after birth, you should wake your baby to feed if 4 hours have passed since the beginning of the last feeding. Some tips for waking the baby include:
    • Changing your baby’s diaper
    • Placing your baby skin-to-skin
    • Massaging your baby’s back, abdomen, and legs
    If your baby is falling asleep at the breast during most feedings, talk to the baby’s doctor about a weight check. Also, see a lactation consultant to make sure the baby is latching on well.
  • First 12-24 hoursYour baby will drink about 1 teaspoon of colostrum at each feeding. You may or may not see the colostrum, but it has what the baby needs and in the right amount.It is normal for the baby to sleep heavily. Labor and delivery are hard work! Some babies like to nuzzle and may be too sleepy to latch well at first. Feedings may be short and disorganized. As your baby wakes up, take advantage of your baby’s strong instinct to suck and feed every 1-2 hours. Many babies like to eat or lick, pause, savor, doze, then eat again.You will be tired, too. Be sure to rest.

    Next 3-5 daysYour white milk comes in. It is normal for it to have a yellow or golden tint first. Talk to a doctor and lactation consultant if your milk is not yet in.Your baby will feed a lot (this helps your breasts make plenty of milk), at least 8-12 times or more in 24 hours. Very young breastfed babies don’t eat on a schedule. Because breast milk is more easily digested than formula, breastfed babies eat more often than formula-fed babies. It is okay if your baby eats every 2-3 hours for several hours, then sleeps for 3-4 hours. Feedings may take about 15-20 minutes on each side. The baby’s sucking rhythm will be slow and long. You might hear gulping.Your breasts may feel full and leak. (You can use disposable or cloth pads in your bra to help with leaking.)

    The first 4-6 weeksWhite breast milk continues.Your baby will likely be better at breastfeeding and have a larger stomach to hold more milk. Feedings may take less time and will be farther apart.Your body gets used to breastfeeding so your breasts will be softer and the leaking may slow down.

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    How to know your baby is getting enough milk

    Many babies, but not all, lose a small amount of weight in the first days after birth. Your baby’s doctor will check his or her weight at your first visit after you leave the hospital. Make sure to visit your baby’s doctor within three to five days after birth and then again at two to three weeks of age for check-ups.

    You can tell if your baby is getting plenty of milk if he or she is mostly content and gaining weight steadily after the first week of age. From birth to three months, typical weight gain is two-thirds to one ounce each day.

    Other signs that your baby is getting plenty of milk:

  • He or she is passing enough clear or pale yellow urine, and it’s not deep yellow or orange (see the chart below).
  • He or she has enough bowel movements (see the chart below).
  • He or she switches between short sleeping periods and wakeful, alert periods.
  • He or she is satisfied and content after feedings.
  • Your breasts feel softer after you feed your baby.
  • Talk to your baby’s doctor if you are worried that your baby is not eating enough.

    How much do babies typically eat?

    A newborn’s tummy is very small, especially in the early days. Once breastfeeding is established, exclusively breastfed babies from 1 to 6 months of age take in between 19 and 30 ounces per day. If you breastfeed 8 times per day, the baby would eat around 3 ounces per feeding. Older babies will take less breastmilk as other food is introduced. Every baby is different, though.

    The newborn tummy

    HazelnutWalnut


    At birth, the baby’s stomach can comfortably digest what would fit in a hazelnut (about 1-2 teaspoons). In the first week, the baby’s stomach grows to hold about 2 ounces or what would fit in a walnut.

    Minimum number of wet diapers and bowel movements in a baby's first week
    (it is fine if your baby has more) 1 day = 24 hours

    Baby's ageNumber of wet diapersNumber of bowel movementsColor and texture of bowel movements

    Day 1 (first 24 hours after birth)1The first one usually occurs within 8 hours after birthThick, tarry, and black

    Day 223Thick, tarry, and black

    Day 35-63Looser greenish to yellow (color may vary)

    Day 463Yellow, soft, and watery

    Day 563Loose and seedy, yellow color

    Day 663Loose and seedy, yellow color

    Day 763Larger amounts of loose and seedy, yellow color

     

    Diaper Checklist (PDF, 325 KB) – Print a blank worksheet to keep track of wet diapers and bowel movements

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    How long should I breastfeed?

    Many leading health organizations recommend that most infants breastfeed for at least 12 months, with exclusive breastfeeding for the first six months. This means that babies are not given any foods or liquids other than breast milk for the first six months. These recommendations are supported by organizations including the American Academy of Pediatrics, American Academy of Family Physicians, American Congress of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Dietetic Association, and American Public Health Association.

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    More information on Learning to breastfeedMaking plenty of milk

    Your breasts will easily make and supply milk directly in response to your baby’s needs. The more often and effectively a baby breastfeeds, the more milk will be made. Babies are trying to double their weight in a few short months, and their tummies are small, so they need many feedings to grow and to be healthy.

    Most mothers can make plenty of milk for their baby. If you think you have a low milk supply, talk to a lactation consultant. Visit the Finding support and information section for other types of health professionals who can help you.

    What will happen with you, your baby, and your milk in the first few weeks

    TimeMilkThe babyYou (Mom)

    BirthYour body makes colostrum (a rich, thick, yellowish milk) in small amounts. It gives your baby a healthy dose of early protection against diseases.Will probably be awake in the first hour after birth. This is a good time to breastfeed your baby.You will be tired and excited.

    Common breastfeeding challenges

  • Sore nipples
  • Low milk supply
  • Oversupply of milk
  • Engorgement
  • Plugged ducts
  • Breast infection (mastitis)
  • Fungal infections
  • Nursing strike
  • Inverted, flat, or very large nipples
  • Breastfeeding a baby with health problems
  • Breastfeeding and special situations
  • More information on common breastfeeding challenges
  • Breastfeeding can be challenging at times, especially in the early days. But it is important to remember that you are not alone. Lactation consultants are trained to help you find ways to make breastfeeding work for you. And while many women are faced with one or more of the challenges listed here, many women do not struggle at all! Also, many women may have certain problems with one baby that they don’t have with their second or third babies. Read on for ways to troubleshoot problems.

    Sore nipples

    Many moms report that nipples can be tender at first. Breastfeeding should be comfortable once you have found some positions that work and a good latch is established. Yet it is possible to still have pain from an abrasion you already have. You may also have pain if your baby is sucking on only the nipple.

    Related information

  • Breastfeeding fact sheet – Find answers to common questions about breastfeeding
  • Ask for help!

    Ask a lactation consultant for help to improve your baby’s latch. Talk to your doctor if your pain does not go away or if you suddenly get sore nipples after several weeks of pain-free breastfeeding. Sore nipples may lead to a breast infection, which needs to be treated by a doctor.

    What you can do

  • A good latch is key, so visit the Bringing your baby to the breast to latch section for detailed instructions. If your baby is sucking only on the nipple, gently break your baby’s suction to your breast by placing a clean finger in the corner of your baby’s mouth and try again. (Your nipple should not look flat or compressed when it comes out of your baby’s mouth. It should look round and long, or the same shape as it was before the feeding.)
  • If you find yourself wanting to delay feedings because of pain, get help from a lactation consultant. Delaying feedings can cause more pain and harm your supply.
  • Try changing positions each time you breastfeed. This puts the pressure on a different part of the breast.
  • After breastfeeding, express a few drops of milk and gently rub it on your nipples with clean hands. Human milk has natural healing properties and emollients that soothe. Also try letting your nipples air-dry after feeding, or wear a soft cotton shirt.
  • If you are thinking about using creams, hydrogel pads, or a nipple shield, get help from a health care provider first.
  • Avoid wearing bras or clothes that are too tight and put pressure on your nipples.
  • Change nursing pads often to avoid trapping in moisture.
  • Avoid using soap or ointments that contain astringents or other chemicals on your nipples. Make sure to avoid products that must be removed before breastfeeding. Washing with clean water is all that is needed to keep your nipples and breasts clean.
  • If you have very sore nipples, you can ask your doctor about using non-aspirin pain relievers.
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    Low milk supply

    Ask for help!

    Let your baby’s doctor know if you think the baby is not getting enough milk.

    Most mothers can make plenty of milk for their babies. But many mothers are concerned about having enough.

    Checking your baby’s weight and growth is the best way to make sure he or she is getting enough milk. Let the doctor know if you are concerned. For more ways to tell if your baby is getting enough milk, visit the How to know your baby is getting enough milk section.

    There may be times when you think your supply is low, but it is actually just fine:

  • When your baby is around 6 weeks to 2 months old, your breasts may no longer feel full. This is normal. At the same time, your baby may nurse for only five minutes at a time. This can mean that you and baby are just adjusting to the breastfeeding process — and getting good at it!
  • Growth spurts can cause your baby to want to nurse longer and more often. These growth spurts can happen around 2 to 3 weeks, 6 weeks, and 3 months of age. They can also happen at any time. Don’t be alarmed that your supply is too low to satisfy your baby. Follow your baby’s lead — nursing more and more often will help build up your milk supply. Once your supply increases, you will likely be back to your usual routine.
  • What you can do

  • Make sure your baby is latched on and positioned well.
  • Breastfeed often and let your baby decide when to end the feeding.
  • Offer both breasts at each feeding. Have your baby stay at the first breast as long as he or she is still sucking and swallowing. Offer the second breast when the baby slows down or stops.
  • Try to avoid giving your baby formula or cereal as it may lead to less interest in breast milk. This will decrease your milk supply. Your baby doesn’t need solid foods until he or she is at least 6 months old. If you need to supplement the baby’s feedings, try using a spoon, cup, or a dropper.
  • Limit or stop pacifier use while trying the above tips at the same time.
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    Oversupply of milk

    Ask for help!

    Ask a lactation consultant for help if you are unable to manage an oversupply of milk on your own.

    Some mothers are concerned about having an oversupply of milk. Having an overfull breast can make feedings stressful and uncomfortable for both mother and baby.

    What you can do

  • Breastfeed on one side for each feeding. Continue to offer that same side for at least two hours until the next full feeding, gradually increasing the length of time per feeding.
  • If the other breast feels unbearably full before you are ready to breastfeed on it, hand express for a few moments to relieve some of the pressure. You can also use a cold compress or washcloth to reduce discomfort and swelling.
  • Feed your baby before he or she becomes overly hungry to prevent aggressive sucking. (Learn about hunger signs in the Tips for making it work section.)
  • Try positions that don’t allow the force of gravity to help as much with milk ejection, such as the side-lying position or the football hold. (See the Breastfeeding holds section for illustrations of these positions.)
  • Burp your baby frequently if he or she is gassy.
  • Some women have a strong milk ejection reflex or let-down. This can happen along with an oversupply of milk. If you have a rush of milk, try the following:

  • Hold your nipple between your forefinger and middle finger or with the side of your hand to lightly compress milk ducts to reduce the force of the milk ejection.
  • If baby chokes or sputters, unlatch him or her and let the excess milk spray into a towel or cloth.
  • Allow your baby to come on and off the breast at will.
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    Engorgement

    Ask for help!

    Ask your lactation consultant or doctor for help if the engorgement lasts for two days or more.

    It is normal for your breasts to become larger, heavier, and a little tender when they begin making more milk. Sometimes this fullness may turn into engorgement, when your breasts feel very hard and painful. 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. It usually happens during the third to fifth day after birth, but it can happen at any time.

    Engorgement can lead to plugged ducts or a breast infection, so it is important to try to prevent it before this happens. If treated properly, engorgement should resolve.

    What you can do

  • Breastfeed often after birth, allowing the baby to feed as long as he or she likes, as long as he or she is latched on well and sucking effectively. In the early weeks after birth, you should wake your baby to feed if four hours have passed since the beginning of the last feeding.
  • Work with a lactation consultant to improve the baby’s latch.
  • Breastfeed often on the affected side to remove the milk, keep it moving freely, and prevent the breast from becoming overly full.
  • Avoid overusing pacifiers and using bottles to supplement feedings.
  • Hand express or pump a little milk to first soften the breast, areola, and nipple before breastfeeding.
  • Massage the breast.
  • Use cold compresses in between feedings to help ease pain.
  • If you are returning to work, try to pump your milk on the same schedule that the baby breastfed at home. Or, you can pump at least every four hours.
  • Get enough rest, proper nutrition, and fluids.
  • Wear a well-fitting, supportive bra that is not too tight.
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    Plugged ducts

    Ask for help!

    If your plugged duct doesn’t loosen up, ask for help from a lactation consultant. Plugged ducts can lead to a breast infection.

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

    What you can do

  • Breastfeed often on the affected side, as often as every two hours. This helps loosen the plug, and keeps the milk moving freely.
  • Massage the area, starting behind the sore spot. Use your fingers in a circular motion and massage toward the nipple.
  • Use a warm compress on the sore area.
  • Get extra sleep or relax with your feet up to help speed healing. Often a plugged duct is the first sign that a mother is doing too much.
  • Wear a well-fitting supportive bra that is not too tight, since this can constrict milk ducts. Consider trying a bra without underwire.
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    Breast infection (mastitis)

    Ask for help!

    Ask your doctor for help if you do not feel better within 24 hours of trying these tips, if you have a fever, or if your symptoms worsen. You might need medicine. See your doctor right away if:

  • You have a breast infection in which both breasts look affected
  • There is pus or blood in the milk
  • You have red streaks near the area
  • Your symptoms came on severely and suddenly

  • Even if you are taking medicine, continue to breastfeed during treatment. This is best for both you and your baby. Ask a lactation consultant for help if needed.

    Mastitis (mast-EYE-tiss) is soreness or a lump in the breast that can be 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 may feel warm or hot to the touch and appear pink or red. A breast infection can occur when other family members have a cold or the flu. It usually only occurs in one breast. It is not always easy to tell the difference between a breast infection and a plugged duct because both have similar symptoms and can improve within 24 to 48 hours. Most breast infections that do not improve on their own within this time period need to be treated with medicine given by a doctor. (Learn more about medicines and breastfeeding in our Breastfeeding fact sheet.)

    What you can do

  • Breastfeed often on the affected side, as often as every two hours. This keeps the milk moving freely, and keeps the breast from becoming overly full.
  • Massage the area, starting behind the sore spot. Use your fingers in a circular motion and massage toward the nipple.
  • Apply heat to the sore area with a warm compress.
  • Get extra sleep or relax with your feet up to help speed healing. Often a breast infection is the first sign that a mother is doing too much and becoming overly tired.
  • Wear a well-fitting supportive bra that is not too tight, since this can constrict milk ducts.


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    Fungal infections

    Ask for help!

    If you or your baby has symptoms of a fungal infection, call both your doctor and your baby’s doctor so you can be correctly diagnosed and treated at the same time. This will help prevent passing the infection to each other.

    A fungal infection, also called a yeast infection or thrush, 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 exists in our bodies and is kept at healthy levels by the natural bacteria in our bodies. When the natural balance of bacteria is upset, Candida can overgrow, causing an infection.

    A key sign of a fungal infection is if you develop sore nipples that last more than a few days, even after you make sure your baby has a good latch. Or, you may suddenly get sore nipples after several weeks of pain-free breastfeeding. Some other signs of a fungal infection include pink, flaky, shiny, itchy or cracked nipples, or deep pink and blistered nipples. You also could have achy breasts or shooting pains deep in the breast during or after feedings.

    Causes of thrush include:

  • Thrush in your baby’s mouth, which can pass to you
  • An overly moist environment on your skin or nipples that are sore or cracked
  • Antibiotics or steroids
  • A chronic illness like HIV, diabetes, or anemia
  • Thrush in a baby’s mouth appears as little white spots on the inside of the cheeks, gums, or tongue. Many babies with thrush refuse to nurse, or are gassy or cranky. A baby’s fungal infection can also appear as a diaper rash that looks like small red dots around a main rash. This rash will not go away by using regular diaper rash creams.

    What you can do

    Fungal infections may take several weeks to cure, so it is important to follow these tips to avoid spreading the infection:

  • Change disposable nursing pads often.
  • Wash any towels or clothing that comes in contact with the yeast in very hot water (above 122°F).
  • Wear a clean bra every day.
  • Wash your hands often, and wash your baby’s hands often — especially if he or she sucks on his or her fingers.
  • Put pacifiers, bottle nipples, or toys your baby puts in his or her mouth in a pot of water and bring it to a roaring boil daily. After one week of treatment, discard pacifiers and nipples and buy new ones.
  • Boil daily all breast pump parts that touch the milk.
  • Make sure other family members are free of thrush or other fungal infections. If they have symptoms, make sure they get treated.
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    Nursing strike

    Ask for help!

    Ask for help if your baby is having a nursing strike to ensure that your baby gets enough milk. The doctor can check your baby’s weight gain.

    A nursing “strike” is when your baby has been breastfeeding well for months, and then suddenly begins to refuse the breast. A nursing strike can mean that your baby is trying to let you know that something is wrong. This does not usually mean that the baby is ready to wean. Not all babies will react the same to the different situations that can cause a nursing strike. Some babies will continue to breastfeed without a problem. Others may just become fussy at the breast, and others will refuse the breast entirely. Some of the major causes of a nursing strike include:

  • Mouth pain from teething, a fungal infection like thrush, or a cold sore
  • An ear infection, which causes pain while sucking
  • Pain from a certain breastfeeding position, either from an injury on the baby’s body or from soreness from an immunization
  • Being upset about a long separation from the mother or a major change in routine
  • Being distracted while breastfeeding — becoming interested in other things around him or her
  • A cold or stuffy nose that makes breathing while breastfeeding difficult
  • Reduced milk supply from supplementing with bottles or overuse of a pacifier
  • Responding to the mother’s strong reaction if the baby has bitten her
  • Being upset about hearing arguing or people talking in a harsh voice while breastfeeding
  • Reacting to stress, overstimulation, or having been repeatedly put off when wanting to breastfeed
  • If your baby is on a nursing strike, it is normal to feel frustrated and upset, especially if your baby is unhappy. It is important not to feel guilty or think that you have done something wrong. Keep in mind that your breasts may become uncomfortable as the milk builds up.

    What you can do

  • Try to express your milk on the same schedule as the baby used to breastfeed to avoid engorgement and plugged ducts.
  • Try another feeding method temporarily to give your baby your milk, such as a cup, dropper, or spoon.
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    Inverted, flat, or very large nipples

    Ask for help!

    Ask for help if you have questions about your nipple shape or type, especially if your baby is having trouble latching well.

    Some women have nipples that turn inward instead of protruding, or that are flat and do not protrude. Nipples can also sometimes be flattened temporarily due to engorgement or swelling while breastfeeding. Inverted or flat nipples can sometimes make it harder to breastfeed. But remember that for breastfeeding to work, your baby has to latch on to both the nipple and the breast, so even inverted nipples can work just fine. Often, flat and inverted nipples will protrude more over time, as the baby sucks more.

    Very large nipples can make it hard for the baby to get enough of the areola into his or her mouth to compress the milk ducts and get enough milk.

    What you can do

  • Talk to your doctor or a lactation consultant if you are concerned about your nipples.
  • You can use your fingers to try and pull your nipples out. There are also special devices designed to pull out inverted or temporarily flattened nipples.
  • The latch for babies of mothers with very large nipples will improve with time as the baby grows. In some cases, it might take several weeks to get the baby to latch well. But if a mother has a good milk supply, her baby will get enough milk even with a poor latch.
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    Breastfeeding a baby with health problems

    There are some health problems in babies that can make it harder to breastfeed. Yet breast milk and early breastfeeding are still best for the health of both you and your baby — even more so if your baby is premature or sick. Even if your baby cannot breastfeed directly from you, it’s best to express or pump your milk and give it to your baby with a cup or dropper.

    Some common health problems in babies are listed below.

    Jaundice

    Ask for help!

    If your baby develops jaundice once at home, let your baby’s doctor know. Discuss treatment options and let the doctor know that you do not want to interrupt breastfeeding if at all possible.

    Jaundice is caused by an excess of bilirubin, a substance that is in the blood usually in very small amounts. In the newborn period, bilirubin can build up faster than it can be removed from the intestinal track. Jaundice can appear as a yellowing of the skin and eyes. It affects most newborns to some degree, appearing between the second and third day of life. The jaundice usually clears up by two weeks of age and is not harmful.

    Two types of jaundice can affect breastfed infants — breastfeeding jaundice and breast milk jaundice.

  • Breastfeeding jaundice can occur when a breastfeeding baby is not getting enough breast milk. This can happen either because of breastfeeding challenges or because the mother’s milk hasn’t yet come in. This is not caused by a problem with the breast milk itself.
  • Breast milk jaundice may be caused by substances in the mother’s milk that prevents bilirubin from being excreted from the body. Such jaundice appears in some healthy, breastfed babies after about one week of age. It may last for a month or more and it is usually not harmful.
  • Your baby’s doctor may monitor your baby’s bilirubin level with blood tests. Jaundice is best treated by breastfeeding more frequently or for longer periods of time. It is crucial to have a health care provider help you make sure the baby is latching on and removing milk well. This is usually all that is needed for the infant’s body to rid itself of excess bilirubin.

    Some babies will also need phototherapy — treatment with a special light. This light helps break down bilirubin into a form that can be removed from the body easily. If you are having trouble latching your baby to the breast, it is important that you pump or hand express to ensure a good milk supply. The same is true if the baby needs formula for a short time — pumping or hand expressing will make sure the baby has enough milk when you return to breastfeeding.

    It is important to keep in mind that breastfeeding is best for your baby. Even if your baby experiences jaundice, this is not something that you caused. Your health care providers can help you make sure that your baby is eating well and that the jaundice goes away.

    Reflux disease

    Ask for help!

    See your baby’s doctor if he or she spits up after every feeding and has any of the other symptoms mentioned here. If your baby has GERD, it is important to continue breastfeeding. Breast milk is more easily digested than infant formula.

    Some babies have a condition called gastroesophageal (GASS-troh-uh-SOF-uh-JEE-uhl) reflux disease (GERD), which occurs when the muscle at the opening of the stomach opens at the wrong times. This allows milk and food to come back up into the esophagus, the tube in the throat. Some symptoms of GERD can include:

  • Severe spitting up, or spitting up after every feeding or hours after eating
  • Projectile vomiting, where the milk shoots out of the mouth
  • Inconsolable crying as if in discomfort
  • Arching of the back as if in severe pain
  • Refusal to eat or pulling away from the breast during feeding
  • Waking up often at night
  • Slow weight gain
  • Gagging or choking, or problems swallowing
  • Many healthy babies might have some of these symptoms and not have GERD. But there are babies who might only have a few of these symptoms and have a severe case of GERD. Not all babies with GERD spit up or vomit. More severe cases of GERD may need to be treated with medication if the baby refuses to nurse, gains weight poorly or is losing weight, or has periods of gagging or choking.

    Cleft palate and cleft lip

    Ask for help!

    If your baby is born with a cleft palate or cleft lip, talk with a lactation consultant in the hospital. Breast milk is still best for your baby’s health.

    Cleft palate and cleft lip are some of the most common birth defects that happen as a baby is developing in the womb. A cleft, or opening, in either the palate or lip can happen together or separately and both can be corrected through surgery. Both conditions can prevent babies from forming a good seal around the nipple and areola with his or her mouth, or effectively remove milk from the breast. A mother can try different breastfeeding positions and use her thumb or breast to help fill in the opening left by the lip to form a seal around the breast.

    Right after birth, a mother whose baby has a cleft palate can try to breastfeed her baby. She can also start expressing her milk right away to keep up her supply. Even if her baby can’t latch on well to her breast, the baby can be fed breast milk by cup. In some hospitals, babies with cleft palate are fitted with a mouthpiece called an obturator that fits into the cleft and seals it for easier feeding. The baby should be able to exclusively breastfeed after his or her surgery.

    Premature and/or low birth weight

    Did you know?

    If you leave the hospital before your baby, you can express milk for the hospital staff to give the baby by feeding tube.

    Premature birth is when a baby is born before 37 weeks gestation. Prematurity often will mean that the baby is born at a low birth weight, defined as less than five and a half pounds. Low birth weight can also be caused by malnourishment in the mother. Arriving early or being small can make for a tough adjustment, especially if the baby has to stay in the hospital for extra care. But keep in mind that breast milk has been shown to help premature babies grow and ward off illness.

    Most babies who are low birth weight but born after 37 weeks (full term) can begin breastfeeding right away. They will need more skin-to-skin contact with mom and dad to help keep them warm. These smaller babies may also need more frequent feedings, and they may get sleepier during those feedings.

    Many babies born prematurely are often not able to breastfeed at first, but they do benefit from expressed milk. You can express colostrum by hand or pump as soon as you can in the hospital. You can talk to the hospital staff about renting a hospital grade electric pump. Call your insurance company or local WIC Office to find out if you can get reimbursed for this type of pump. You will need to express milk as often as you would have breastfed, so around 8 times per a 24-hour period.

    Once your baby is ready to breastfeed directly, skin-to-skin contact can be very calming and a great start to your first feeding. Be sure to work with a lactation consultant on proper latch and positioning. Many mothers of premature babies find the cross cradle hold helpful. (See the Breastfeeding holds section for an illustration.) It may take some time for you and the baby to get into a good routine.

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    Breastfeeding and special situations

    Twins or multiples

    Did you know?

    Many twin and multiple babies are smaller or born premature. Please see the Premature and/or low birth weight section for other tips for caring for these babies. Also, talk with a lactation consultant about more ways you can successfully breastfeed.

    Did you know?

    Many breastfeeding basics are the same for twins or multiples as they are for one baby. Learn more about these important topics:

  • How to know your babies are getting enough milk
  • How to troubleshoot common breastfeeding challenges
  • Ways to keep milk supply up
  • The benefits of human milk to mothers of multiples and their babies are the same as for all mothers and babies — possibly greater, since many multiples are born early. But the idea may seem overwhelming! Yet many of these moms find breastfeeding easier than other feeding methods because there is nothing to prepare. Many mothers have overcome challenges to successfully breastfeed twins and more even after going back to work.

    Being prepared

    It will help to learn as much as you can about breastfeeding during your pregnancy. You can:

  • Take a breastfeeding class.
  • Find Internet and print resources for parents of multiples.
  • Join a support group for parents of multiples through your health care provider, hospital, local breastfeeding center, or La Leche League International.
  • Let your health care provider and family members know that you plan to breastfeed.
  • Keep in mind that even if your babies need to spend time in the NICU (neonatal intensive care unit), breastfeeding is still possible, with some adjustments.
  • Find a lactation consultant with multiples experience before the babies are born so that you know where to turn for help. Ask her where you can rent a breast pump if the babies are born early.
  • Making enough milk

    Most mothers are able to make plenty of milk for twins. Many mothers fully breastfeed or provide milk for triplets or quadruplets. Keep these tips in mind:

  • Breastfeeding soon after birth and often is helpful for multiples the same way it is for one baby. The more milk that is effectively removed, the more milk a mother’s body will make.
  • If the babies are born early, double pumping often will help the mother make more milk.
  • The doctor’s weight checks can tell you if your babies are getting enough breast milk. For other signs that your babies are getting enough breast milk, see the How to know your baby is getting enough milk section.
  • It helps to have each baby feed from both breasts. You can “assign” a breast to each baby for a feeding and switch at the next feeding. Or, you can assign a breast to each baby for a day and switch the next day. Switching breasts helps keep milk production up if one baby isn’t eating as well for a bit. It also gives babies a different view to stimulate their eyes.
  • Breastfeeding positions

    Breastfeeding twins and more may take practice, but you and your babies can find your ideal positions and routine. Keep trying different positions until you find ones that work for you. For some mothers and babies, breastfeeding twins at the same time works well. Others find individual feedings to work better. Still others find that it depends on the time — you may feed one baby at a time at night and feed two babies at the same time during the day. Lastly, as your babies grow, you may find that you need to change your feeding routine.

    Below are some positions that may work for you:

  • Double clutch (“football”) — Place both babies in the clutch hold. You will need pillows at your side (and maybe one on your lap) and you will place the babies on the pillows with their legs going toward the back of the chair or couch. If you are placing the babies in front of you, try to keep their whole bodies turned toward you, their chests against your chest. Their bodies must not be facing up. This is very important to help prevent nipple pain and to make sure that the babies are getting enough milk.
  • Cradle-clutch combination — Place one baby (usually the easiest to latch or stay latched) in the cradle position and then position the second baby in the clutch position.
  • Double cradle — Place the babies in front of you with their legs overlapping, making an X across your lap.
  • Partial breastfeeding

    Even though full, direct breastfeeding is ideal, many mothers of multiples feed their babies breast milk or some formula by bottles at times. It is important to work with your doctor, your baby’s doctor, and a lactation consultant to figure out what works best for your family.

    Breastfeeding during pregnancy

    Breastfeeding during your next pregnancy is not a risk to either the breastfeeding toddler or to the new developing baby. If you are having some problems in your pregnancy such as uterine pain or bleeding, a history of preterm labor or problems gaining weight during pregnancy, your doctor may advise you to wean. Some women also choose to wean at this time because they have nipple soreness caused by pregnancy hormones, are nauseous, or find that their growing bellies make breastfeeding uncomfortable. Your toddler also may decide to wean on his own because of changes in the amount and flavor of your milk. He or she will need additional food and drink because you will likely make less milk during pregnancy.

    If you keep nursing your toddler after your baby is born, you can feed your newborn first to ensure he or she gets the colostrum. Once your milk production increases a few days after birth you can decide how to best meet everyone’s needs, especially the new baby’s needs for you and your milk. You may want to ask your partner to help you by taking care of one child while you are breastfeeding. Also, you will have a need for more fluids, healthy foods, and rest because you are taking care of yourself and two small children.

    Breastfeeding after breast surgery

    How much milk you can produce depends on how your surgery was done and where your incisions are, and the reasons for your surgery. Women who have had incisions in the fold under the breasts are less likely to have problems making milk than women who have had incisions around or across the areola, which can cut into milk ducts and nerves. Women who have had breast implants usually breastfeed successfully. If you ever had surgery on your breasts for any reason, talk with a lactation consultant. If you are planning breast surgery, talk with your surgeon about ways he or she can preserve as much of the breast tissue and milk ducts as possible.

    Adoption and inducing lactation

    Many mothers who adopt want to breastfeed their babies and can do it successfully with some help. Many will need to supplement their breast milk with donated breast milk from a milk bank or infant formula, but some adoptive mothers can breastfeed exclusively, especially if they have been pregnant before. Lactation is a hormonal response to a physical action, and so the stimulation of the baby nursing causes the body to see a need for and produce milk. The more the baby nurses, the more a woman’s body will produce milk.

    If you are adopting and want to breastfeed, talk with both your doctor and a lactation consultant. They can help you decide the best way to try to establish a milk supply for your new baby. You might be able to prepare by pumping every three hours around the clock for two to three weeks before your baby arrives, or you can wait until the baby arrives and start to breastfeed then. Devices such as a supplemental nursing system (SNS) or a lactation aid can help ensure that your baby gets enough nutrition and that your breasts are stimulated to produce milk at the same time.

    Using milk from donor banks

    If you can’t breastfeed and still want to give your baby human milk, the best and only safe place to go is to a human milk bank. You should never feed your baby breast milk that you get directly from another woman or through the Internet. A human milk bank can dispense donor human milk to you if you have a prescription from your doctor. Many steps are taken to ensure the milk is safe. Donor human milk provides the same precious nutrition and disease fighting properties as your own breast milk.

    If your baby was born premature or has other health problems, he or she may need donated milk not only for health, but also for survival. Your baby may also need donated milk if she or he:

  • Can’t tolerate formula
  • Has severe allergies
  • Isn’t thriving on formula
  • You can find a human milk bank through the Human Milk Banking Association of North America (HMBANA). HMBANA is a multidisciplinary group of health care providers that promotes, protects, and supports donor milk banking. HMBANA is the only professional membership association for milk banks in Canada, Mexico and the United States and as such sets the standards and guidelines for donor milk banking for those areas. You can also contact HMBANA if you would like to donate breast milk.

    To find out if your insurance will cover the cost of the milk, call your insurance company or ask your doctor. If your insurance company does not cover the cost of the milk, talk with the milk bank to find out how payment can be made later on, or how to get help with the payments. A milk bank will never deny donor milk to a baby in need if they have the supply.

     

  • Keep track of your baby’s wet diapers and dirty diapers to make sure he or she is getting enough milk. (Try our Diaper Checklist (PDF, 325 KB).)
  • Keep offering your breast to the baby. If the baby is frustrated, stop and try again later. You can also try when the baby is sleeping or very sleepy.
  • Try various breastfeeding positions, with your bare skin next to your baby’s bare skin.
  • Focus on the baby with all of your attention and comfort him or her with extra touching and cuddling.
  • Try breastfeeding while rocking and in a quiet room free of distractions.