Breast Feeding Q&A - Remaining Healthy

Why should I breastfeed?
Here are just some of the many good reasons why a woman should breastfeed her baby:

How long do I need to breastfeed?
The U.S. Surgeon General recommends that babies be fed with breast milk only - no formula - for the first 6 months of life. It is better to breastfeed for 6 months and best to breastfeed for 12 months.

Newborns need to nurse often, at least every 2 hours, and not on any strict schedule. This will stimulate the mother's breasts to produce plenty of milk. Breastfed babies eat more frequently than bottle-fed babies do. This is because breast milk is easier to digest than formula. Solid foods can be introduced when the baby is 4 to 6 months old. Breastfed babies don't need supplements of water. These can interfere with a mother's milk supply if they are introduced in the early months. ^ top

Is there any time when a woman should not breastfeed?
Some women think that when they are sick, they should not breastfeed. But, most common illnesses, such as colds, flu, or diarrhea, can't be passed through breast milk. In fact, if a mother is sick, her breast milk will have antibodies in it. These antibodies will help protect her baby from getting the same sickness.

A few viruses can pass through breast milk. HIV, the virus that causes AIDS, is one of them. Women who are HIV positive should not breastfeed.

Sometimes a baby can be born with a condition called primary lactase deficiency or with galactosemia in which they can't tolerate breast milk. This is because their bodies can't break down lactose, a sugar found in the milk of humans and animals. Symptoms include diarrhea and vomiting. Babies with severe galactosemia may have liver problems, malnutrition, or mental retardation. Babies with these conditions must be fed formula that comes from plants, such as soy milk or a special galactose-free formula.

Nursing mothers should not smoke or take drugs. Some drugs, such as cocaine and PCP, can make the baby high. Other drugs, such as heroin and marijuana can cause irritability, poor sleeping patterns, tremors, and vomiting. Babies can become addicted to these drugs.

Sometimes a baby may have a reaction to something the mother eats (like spicy foods). This doesn't mean the baby is allergic to the mother's milk. If the mother stops eating whatever is bothering her baby, the problem usually goes away on its own.

Is it safe to take medications while breastfeeding?
Most medications have not been tested in nursing women. No one knows exactly how a given drug will affect a breastfed child. Most over-the-counter and prescription drugs, taken in moderation and only when needed, are thought to be safe. You should always check first with a health care provider before taking medicine. With some drugs, you can reduce the baby's exposure by taking them just after nursing or before the child sleeps. Even mothers who must take daily medication for conditions such as epilepsy, diabetes, or high blood pressure may be able to breastfeed.

Can I breastfeed if my breasts are small?
Of course! Breast size is not related to the ability to produce milk for a baby. Breast size is determined by the amount of fatty tissue in the breast, not by the amount of milk. Most women, with all sizes of breasts, can make enough milk for their babies.

Will breastfeeding keep me from getting pregnant?
When a woman breastfeeds, her ovaries can stop releasing eggs (or ovulating), making it harder for her to get pregnant. A woman's periods can also stop. But, there are not guarantees that a woman will not get pregnant while she is nursing. The only way to make sure pregnancy does not occur is to use a method of birth control. Most birth control pills are not safe to use when a woman is nursing. The only safe birth control pill to use is the "mini-pill." Talk with your health care provider about what birth control method is best for you to use while nursing.

Will breastfeeding tie me to my home?
Not at all! Breastfeeding can be convenient no matter where you are because you don't have to bring along feeding equipment like bottles, water, or formula. Your baby is all you need. Even if you want to breastfeed in private, you usually can find a woman's lounge or fitting room. If you want to go out without your baby, you can pump your milk beforehand, and leave it for someone else to give your baby while you are gone.

Can I still breastfeed when I go back to work?
With careful planning, you can still breastfeed when you go back to work. If her job allows, a new mother can pump her breast milk a few times during the day and refrigerate or freeze it for the baby to take in a bottle later. Or, some women nurse at night and on weekends and give their babies daytime bottles of formula. A mother's milk production can adapt to this type of schedule.

If your job does not have a lactation program, ask your supervisor or Human Resources department to arrange for your needs. Working mothers who breastfeed need a private, clean space where they can pump milk, a storage place for the milk, and breaks during the day when they can pump milk. ^ top

How much do breastfeeding pumps cost and what kind will I need?
Breast pumps range in price from under $50 (manual/hand pump or battery powered pumps) to several hundred dollars (electrical and hospital grade pumps). If you're only going to be away from your baby a few hours a week, then you can purchase a hand pump, or one of the less expensive ones. If you're going back to work, it is worth investing in a good quality electric pump. You can purchase these from some retail stores or online, but most are available for purchase or rent through lactation consultants, at local hospitals, or from a breastfeeding organization.

How can I breastfeed discreetly in public?
You can breastfeed discreetly in public by wearing clothes that allow easy access to your breasts, such as button down shirts. By draping a receiving blanket over your baby and your breast, most people won't even realize that you are breastfeeding. It's helpful to nurse the baby before he/she becomes fussy so that you can get into a comfortable position to nurse. You also can purchase a nursing cover or baby sling for added discretion. Many stores have women's lounges or dressing rooms, if you want to slip into one of those to breastfeed.

If I decide to breastfeed, is there a right way to do so?
There are several tips for making breastfeeding a good experience for both mother and baby. However, you can prevent the most common challenges or problems by following the three most important tips about breastfeeding:

Does breastfeeding hurt?
Breastfeeding SHOULD NOT hurt. If your baby is latched on and positioned properly, you should not feel pain. The baby's mouth should be wide open, with as much of the areola as far back into his/her mouth as possible. This minimizes soreness for the mother. The baby SHOULD NOT nurse on the nipple only. If you feel pain, the baby is not latched onto your breast properly.

Can I give my baby a pacifier if I breastfeed?
Pacifiers and other artificial nipples (like bottles) should not be introduced until your baby has established feeding at your breast - when the baby is 4 to 6 weeks old. Artificial nipples and pacifiers require a different sucking pattern than breastfeeding. The baby is likely to become confused about how to suck at the breast and how to suck from an artificial nipple. ^ top

How do I know that my baby is getting enough milk from breastfeeding?
Babies have different eating and diaper habits. But, the common signs that babies are getting enough milk are:

Will my partner be jealous if I breastfeed?
If you prepare him in advance, your partner should not be jealous. Explain that you need his support. You can tell him the important benefits of breastfeeding. Tell him he won't make bottles, so he'll get more rest. Be sure to emphasize how much money he'll save too. Tell him it will cost over $300 a month to pay for formula - money that could go to bills, savings, or a vacation. You can tell him that breastfeeding will give his child the best start at life, with benefits that can last well into childhood. He can help with changing and burping the baby, sharing chores and by simply sitting with you and the baby to enjoy the special mood that breastfeeding creates.

For More Information...
You can find out more about breastfeeding by contacting the National Women's Health Information Center (800-994-WOMAN (9662)) or the following organizations:

*This information was adapted from: "Breastfeeding Best Bet for Babies" by Rebecca D. Williams, in the FDA Consumer, October 1995; from the Department of Health and Human Services' Office on Women's Health's, 2000 Blueprint for Action on Breastfeeding, and the African-American Breastfeeding Alliance, Inc's and the Office on Women's Health's An Easy Guide to Breastfeeding for African-American Women. ^ top