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Health Babies - Breastfeeding

Health Babies - Breastfeeding

Breastfeeding by Age

Questions about babies newborn to six months?
What position should I use to breastfeed my baby?
How do I know if my baby is getting enough?
Can I give my baby a bottle?
Questions about babies six months to one year?
Questions about nursing your toddler?
Questions about weaning?

Newborn to Six months 

Newborn to six months: get relaxed and comfortable and ask for help at the hospital.  Breast feeding should not hurt. Have faith in yourself! Breast feeding is a wonderful time to enjoy your baby and rest. Just be patient with baby and yourself and keep trying. 

Breastfeed your baby as soon as possible after birth - even during the first hour- and breastfeed at least every two hours. Colostrum is the first milk- it is thick, golden and comes in drops so as not to overfill your baby’s tiny tummy. Colostrum is very valuable for your baby. It provides antibodies against disease and also acts as a laxative to clean out the baby’s intestines. After colostrum has changed to mature milk by day 3 to 5 after birth, your baby will still nurse every 1 1/2 to 2 hours because the milk is easily digested and their tummies empty quickly. 

Colostrum changes to mature milk between day 3 and 5 after birth. Your breasts will become full. When the milk is not removed engorgement may occur.  The breasts swell and become painful, firm, and warm. The following suggestions may help to prevent engorgement and make it easier for the baby to latch.  Nurse often - 8 to 12 times in 24 hours

  • Use hot compresses on your breasts for 5 to 10 minutes to relieve swelling (disposable diapers work well) or take a warm shower
  • Gently massage your breasts during feedings and through out the day.
  • Don't use supplemental bottles for the baby
  • If you miss a feeding or baby only takes one breast, use hand expression or a pump to empty your milk
  • Use relaxing positions to nurse and don't forget to take good deep breaths - music may help too
  • If you are having trouble getting baby to latch check our free resource list for help
  • Nipple shields, supplemental bottles, and even pacifiers may prevent a good latch.
  • Engorgement subsides after 3 to 5 days. 

Begin with a correct position of the baby tummy to tummy with mom. There are several positions mom and baby can try out -take your time to find out what works for you!

cradle
football
cross_cradle
lying_down
tailor


(The American Academy of Pediatrics (AAP) recommends that infants do not sleep in bed with parents and/or other children to reduce the risk of Sudden Infant Death Syndrome (SIDS). For more information, see the full AAP document at :http://pediatrics.aappublications.org/content/128/5/e1341.full.pdf+html 

A correct latch of the baby’s mouth open wide, taking in nipple and areola will prevent soreness, empties the breast to feed the baby and encourages more milk to be produced by the breast. Holding the breast with one hand while holding the baby with the other hand and arm gives mom the control and support of the baby to position them at the breast 

Breastfeeding should not be painful. The most frequent reason for sore nipples is a poor latch, poor positioning or both. If it hurts, take the baby off by gently breaking the suction by putting your finger into their mouth. Don't pull the baby away while their mouth is closed on your nipple. Try again and make sure the baby is opening wide. 

Babies give hunger clues such as:

  • turning their head from side to side
  • putting a fist in their mouth
  • smacking their lips
  • don't wait until baby cries- this is usually a late sign of baby's hunger
  • don't let a newborn sleep longer then 3 hours- they need night time feedings as well 

You can tell if your baby is getting enough milk by listening for swallows while baby nurses. You can count wet and dirty diapers. After three or four days, you should get 5 to 6 wet diapers and 3 to 4 dirty diapers a day. A bowel movement the size of a quarter still counts as a dirty diaper. Also, a content, full baby will come off the breast spontaneously to end a feed. And don’t forget to burp the baby as well. 

Its is best to wait for your milk supply to be well established before you introduce a bottle-wait about 10 days to two weeks while exclusively breastfeeding to avoid nipple confusion and low milk production. The more you nurse, the more milk you produce. 

Breast milk is all your baby needs for the first 6 months even in hot weather. You don't need to give water, juice or any substitutes. New research has shown that waiting 6 months to introduce juice, cereal, and solids helps protect your baby from food allergies and from diseases the cause diarrhea.

As your baby gets older, they will go through growth spurts- the first one around 2 to 3 weeks. Growth spurts are times when baby needs more milk because they grow quickly in a short time. Nursing on demand satisfies baby and increases your milk production. You may notice the day after a growth spurt that the baby will sleep more and then nursing patterns return to normal.  Growth spurts occur every 3 to 4 weeks. 

At around 4-6 months baby’s bowel movements may change. It is normal for them to go less frequently- sometimes 5 or 6 days pass and then baby will have a large bowel movement.  

For more information about infant feeding, visit our page of helpful breastfeeding websites. 

 

Six months to a year: 

Babies are ready to start solids around six months. Signs of being ready for  solids are:

  • sitting up without support and holding their head up.
  • they are still hungry after nursing well.
  • being more social, reaching for your food, picking up objects, leaning forward and making chewing motions. 

Start slowly with solids. Nurse your baby first to make sure they get the best food possible- moms milk! Solid foods are "in addition" to breast milk. Start with only a teaspoon of rice cereal diluted with a tablespoon or so of breast milk or formula. Baby may sit in a high chair or someone’s lap. Use a small spoon and put it inside the baby’s lips so she can suck on the food. The first few attempts will be messy. The baby’s tongue will thrust and push the food out and it takes time for them to learn to move the food to the back of their throat to swallow it. Learning to eat solids is a gradual process.  As the baby’s desire for more food increases, you can add more. Try one new food at a time, waiting about a week between new foods. If they develop an allergy or become upset, you will know what food to eliminate. Other foods to introduce are strained, pureed, mashed cooked vegetables, fruit, meat and mashed beans. The American Academy of Pediatrics recommends exclusive breast feeding for the first six months with no additional solids. A further recommendation is breast feeding for a year or longer so far as mom and baby agrees. 

Food allergies may occur during the first year.  Avoid egg whites, nuts, strawberries, shellfish, and peanuts. Citrus fruits (oranges, lemons and grapefruit) may cause allergies, as well as kiwi, soy products (including soy milk and tofu). Cow milk and products including cheeses, yogurt and ice cream may trigger allergies. It is important to seek your doctor’s advice on starting these foods if there is a family history of food allergies. 

To avoid choking, do not offer hot dogs, hard candies, popcorn, whole grapes, nuts and seeds, large chunks of any food, and peanut butter. 

Honey or corn syrup should not be given to children under a year because they carry a risk of botulism.

 

Breastfeeding Your Toddler

The American Academy of Pediatrics currently recommends that "Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child."  The World Health Organization (WHO) and UNICEF recommend that babies be breastfed for at least two years. WHO reports that the world average for breastfeeding is 4.2 years. 

Nursing beyond the first year (also known as extended breastfeeding) is normal, healthy, and common in many countries.  Depending on where you live, extended breastfeeding may mean putting up with comments and disapproving stares. If you're bothered by unsolicited comments and stares, you might find it easier to nurse your child at home before heading out to the store or the park. Some moms find it more acceptable to nurse at set times during the day — like in the morning, before naps, or before bed — and teach their toddlers to drink from a cup during meals and snacks. 

Nursing an older baby is completely different than nursing a younger one. The older baby is far more efficient and has less need to use you as a pacifier.   A toddler will nurse less often, maybe every four or five hours. They will climb on your lap, nurse a few minutes for thirst or comfort and then jump down and return to playing. There will be longer sessions of nursing that typically occur at bed and nap times.  Though typically they are to busy exploring the world around them to sit still for a long nursing session.   

Breastfeeding can be an important source of reassurance and emotional support for your toddler. The strong connection your child feels with you while nursing will foster independence, not make him overly dependent or clingy. Our culture tends to believe that pushing children away will help them develop independence. In fact, the opposite is true. Forcing a child to stop nursing before he's developmentally ready won't necessarily create a more confident child; rather, it could make him cling more. 

If you don't care what people think or say, then have some snappy responses ready when someone asks you the inevitable question: "Is she still nursing?" Sometimes a simple "yes" is the best conversation stopper. Or, the next time you're nursing in public and someone asks, "Are you ever going to stop breastfeeding?" say, "Yes, in about ten minutes." 

There are significant emotional and physical benefits to extended nursing, though, so don't let others pressure you to stop. You need to do what feels right for you and your child. Breast milk still provides immunities, vitamins, enzymes and fats needed for brain development. 

In fact, studies have shown that breastfeeding toddlers get sick less often than their peers.  If your child is sick, breast milk may be the only thing he can keep down. It also provides them with immunities allowing them to heal faster. You'll feel better too, knowing that you're helping him fight off the illness.

 

Weaning

Worldwide most babies wean between 2 to 4 years of age. Ideally, your baby will nurse until he outgrows the need. This can be called natural or baby-led weaning. Depending on your approach, weaning can be done gradually over several weeks or more abruptly. 

Abrupt weaning should be avoided for the sake of both you and your baby. When you suddenly stop nursing, your breasts may become engorged and you could develop a breast infection or abscess. The sudden weaning may also cause a sharp drop in hormone levels, which may trigger the onset of depression. Keep your health care provider informed of your breastfeeding transition to help avoid major complications. 

Abrupt weaning is hard on the child as well. Nursing is not just a source of food; it is a source of comfort and security. Weaning gradually lets you substitute in new behaviors, to substitute the loss of closeness, while still feeling your love and security. 

There are medical reasons to wean abruptly; though you need to be sure there are no other alternatives.  When you doctor tells you the medication you are on is incompatible with breastfeeding, you need to be your own advocate. Ask him if there are compatible options available. There are resource books available that can tell your doctor just how safe the medication is for the baby, how long it stays in your breast milk and how much is transferred into your milk. Many doctors don’t take time to look this information up and will err on the side of caution. This causes many women to wean unnecessarily.  You may wish to seek a second opinion from a lactation consultant or a breastfeeding friendly doctor, rather than wean abruptly. 

For temporary situations, you may want to express or pump your milk.  It is for just these types of situations that it is recommended you have a 3 to 5 day supply of breast milk stored in your freezer. Using the pump will allow you to keep your milk supply, while taking your medications. A good quality electric breast pump is best for this purpose. Your body still receives signals that there is a need to produce breast milk allowing you to begin nursing again when things return to normal.