Breastfeeding FAQs

How often should I nurse?

Feed your newborn whenever he or she show signs of hunger. A general guideline is to nurse around 8 to 12 times every 24 hours, or about every 2 to 3 hours. It's important to wake newborns to nurse at least every 3 hours until they are back to their birth weight. Once newborns have shown that they will demand enough milk to grow adequately, they will not need to be awakened to eat, and will often space out feedings as their hunger allows them. With time and patience, every mother-baby pair will develop their own schedule and feeding pattern.

How many months should I nurse?

The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) both recommend that mothers start breastfeeding as soon as possible after birth, ideally within the first hour. Research has shown that time skin-to-skin after delivery helps to encourage this. Both organizations encourage “breastfeeding-only” with no other supplements for healthy newborns for the first 6 months of life. At 6 months, your baby may slowly start having solid foods as well. But continue breastfeeding at least through the baby’s first birthday. After the first birthday, you and your baby can stop or continue breastfeeding as long as you want it to happen.

Is my baby getting enough milk?

There are a few ways to check if your baby is getting enough milk.

Latching on

You know your baby is getting milk if you hear gulping and swallowing sounds, not just sucking. Look for your baby steadily moving his or her jaw open and closed as another sign of proper “latching on.” If the latch is painful, it's important to ask for help from a lactation consultant or your healthcare provider. It could be a sign that your baby is not transferring milk from your breast well. Most of the time, this issue is common and can be easily managed with a little help.

Urine output and stool frequency

You can also tell how much milk your baby is getting by keeping track of your baby’s diapers. By the end of the first week of life:

  • Your baby should have about 1 wet diaper on day 1, and 2 wet diapers on day 2. This should increase each day by 1 more wet diaper, up to 6 wet diapers on day 6 and then about 6 wet diapers every day. The urine will be a pale yellow color, not dark yellow or orange. Wet diapers should stay around this amount as your breastfed baby gets older.

  • Your baby should have 3 or 4 stools per day that are at least a teaspoon in amount (not just smears). By the 4th day of life, the black-brown meconium early stool should start to transition to a greenish color, then within another day or two to a loose yellow stool with curds. This is a normal breastfed stool. It's not uncommon for a breastfed baby to pass stool after each feeding. In the second to fourth week of life, the number of stools can increase to about 5 per day. After 1 month, the number of stools usually lessens. It might be 1 or 2 a day. Some babies may have a day or days with no stool. In these cases, stool should be in larger amounts when passed.

Weight

It’s normal for your baby to lose some weight during the first 3 to 4 days of life. A baby might normally lose up to 7% to 10% of his or her birth weight during this time. Then your baby should start gaining again. By the end of the second week, he or she should be back to birth weight. In the weeks following this, he or she will gain about a half ounce to an ounce per day.

Does my baby need vitamins?

All breastfed infants should take 400 international units (IU) a day of vitamin D (infant formulation). Your healthcare provider may prescribe this or it may be purchased over the counter.  

When your baby is 6 months old, you may start to offer baby foods that contain iron. You should discuss the possible need for iron supplementation with your infant's healthcare provider.

What should I do if my breasts become swollen, tender, or sore?

These symptoms are most often because your breasts are too full of milk (engorged). This is common when your milk first comes in or if you are making more milk than your baby is drinking. This may cause swelling and make it harder for your baby to nurse. If this happens, try the following:

  • Keep nursing. This is a temporary condition. It gets better once you can get your baby to drink more milk. Be sure to breastfeed more often and let your baby feed until he or she is finished. Be sure to massage your breast while feeding to help the breast drain as fully as possible.

  • Express some milk before you breastfeed. Do this manually or with a breast pump. This will soften the darker area around the nipple (areola) so your baby can latch deeper to begin feeding.

  • Use a warm compress. This can be a towel or paper diaper soaked in warm water. Or take a warm shower before feeding. Some women have found that switching off between a cold compress and a warm one gives them relief. If you feel comfortable with this, you can try it too. If you use an ice pack, wrap it in a thin towel to protect your skin.

  • Take acetaminophen or ibuprofen for continued pain. The medicine is safe to take during breastfeeding.

If your nipples or breasts continue to hurt, call your healthcare provider. Nipple and breast problems are urgent and need to be looked at and treated as soon as possible.

When to seek medical advice

Unless your baby’s healthcare provider advises otherwise, call the provider right away if your baby has any of the following:

  • Fever (see Fever and children, below)

  • Repeated vomiting

  • Does not appear to be alert, refuses to nurse, or is sleeping too much, such as through feedings

  • Has signs of dehydration. These include fewer wet diapers than normal or no urine for 8 hours, or the urine appears dark. Or your baby has no tears when crying, “sunken eyes,” or dry mouth.

  • Is not gaining weight or losing weight

Call your own healthcare provider right away if you:

  • Have a fever of 100.4°F (38°C) or higher, or as directed by your provider

  • Have redness, warmth, pain, or unusual discharge from your breasts

  • Have such painful nipples and breasts that you want to stop nursing

  • Have a hard lump in your breast

  • Have lower belly (abdominal) pain or cramping when you are not breastfeeding

  • Have pain or burning when you pass urine

  • Have unexpected vaginal bleeding or foul-smelling discharge

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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