Breast-Feeding
Home Treatment
Learning how to breast-feed
In the first few days after delivery, breast-feed your baby every 1 to 3 hours even if you have to wake your baby. Frequent breast-feeding increases your prolactin levels, which stimulates your breasts to produce more milk.
You can help prevent and solve many problems when you become familiar with basic breast-feeding techniques, such as proper latch-on
and feeding positions. The basic breast-feeding positions include:
Alternate which breast you start with at each feeding. Also use a different position frequently. At first, you may change the hold you use each time you feed your baby. These practices help ensure that all areas of your breast empty well during the feeding. Using different positions and alternating breasts for each feeding may help to prevent sore nipples or blocked milk ducts.
Women who have had a cesarean delivery may prefer positions in which the baby doesn't rest on the abdomen, such as the side-lying position or the football hold.
The first few weeks of breast-feeding can be challenging because of the changes to your body and routine. With preparation and support, you can learn the skills necessary to breast-feed successfully.
Treating early minor problems
Minor problems are common during breast-feeding. Most breast-feeding challenges can be solved at home with help from your doctor or lactation consultant as needed. These types of problems often include:
- Breast engorgement, which can cause painful breasts and flattened nipples, making it difficult for a baby to latch on for feeding. Gently massage your breasts and express or pump some milk to soften your nipple and areola before breast-feeding. This will help your baby latch deeper onto your breast, past your nipple and onto your areola. Wearing a supportive, well-fitting bra also may help, and applying cold compresses to your breasts occasionally after breast-feeding may reduce swelling and pain. For more information, see the topic Breast Engorgement.
- Sore or cracked nipples. You can help relieve the pain from sore or cracked nipples by rubbing a few drops of breast milk on the nipple and areola and allowing letting it dry completely. Try using a hair dryer on a low, cool setting to help your nipples dry more quickly. It may also help to apply pure lanolin cream on your nipples.
- Blocked milk ducts and mastitis. Blocked milk ducts may cause a painful lump in the breast. Untreated blocked milk ducts can lead to an infection, which will require a visit to your doctor. Massage the affected area toward the nipple before breast-feeding and during feeding. This simple measure can help release the milk plug. Also, this is one time you should always feed your baby on the affected side first. Your baby is usually more eager at the start of a feeding. The stronger sucking force helps empty the breast and unblock the duct.
- Poor let-down. Practice relaxation techniques; breast-feed in comfortable, quiet, and familiar spots; eat properly; and drink plenty of fluids. Your doctor may prescribe oxytocin if your let-down does not improve within a few days of starting breast-feeding.
- Breast milk leaking. Your let-down reflex may be stimulated unintentionally. Be prepared by using absorbent pads that you change frequently. You can use washable or disposable pads, but do not use pads that have a plastic backing.
- Low milk supply. More frequent breast-feeding usually helps increase your milk supply within 48 hours. You can also try pumping both breasts for 10 to 15 minutes each after you have just fed your baby. You should notice an increase in your milk supply after 2 to 4 days of the extra pumping. Other factors sometimes affect milk production; however, it is rare to have a true milk deficiency. Contact a lactation consultant if you think your milk supply is too low.
You usually can take acetaminophen (such as Tylenol) and ibuprofen (such as Advil) while breast-feeding to help relieve discomfort from some of these problems. However, talk to your doctor before taking any medication (prescription or nonprescription).
If problems persist or symptoms are severe, talk to your doctor. For problems related to technique or positioning, you also can talk to or visit a lactation consultant.
Breast infections are treated with prescription medications and home treatment measures. Infections that sometimes occur with breast-feeding include:
- A yeast infection, which may affect you and your baby. The baby often has white patches in his or her mouth (thrush) or a diaper rash, while your nipples may be extremely sore. You may also experience stabbing pains in your breast, especially as you start to breast-feed and in between feedings. You and your baby must both be treated with medication for a yeast infection.
- Mastitis, which may cause a fever, flu-like symptoms, and pain in the breast with an inflamed, red, dimpled, or swollen area. An untreated infection may lead to an abscess, which can cause a firm, often painful mass in the breast. For more information, see the topic Mastitis.
Established breast-feeding
After you have established a routine, breast-feeding becomes easier. However, you may face situations that can periodically present challenges to your normal breast-feeding routine such as storing breast milk. These situations include:
- Returning to work outside the home. Plan ahead and think about how you can successfully incorporate breast-feeding into your work schedule.
- Teething. When your baby's primary teeth start to come in, usually between 6 and 12 months of age, you both have to make a few adjustments. Your baby may have a temporary loss of appetite because his or her mouth is sore. Teething babies may bite the breast, not knowing that it causes pain. Usually, a firm "no" and a stern expression are enough to control this behavior. It may also help to stop breast-feeding when your baby is finished actively eating and then give him or her cold teething items to chew on.
- Illness. When your baby has a minor illness, such as a cold or flu, continue breast-feeding. Breast milk is still the best nourishment. If your baby is unable to eat as usual, use a breast pump to express milk at your regular feeding times. However, make sure your baby does not become dehydrated. Sometimes a sick baby will cup-feed breast milk if he or she won't take the breast. Be sure to take your baby to a doctor if symptoms continue or become worse. For more information, see the When to Call a Doctor section of this topic.
- Digestive problems. Some babies develop a cow's milk protein sensitivity. If this occurs, stop milk and dairy products in your diet. Talk to your doctor about when to reintroduce these foods into your diet.
- Travel. Plan ahead to include times and places for breast-feeding your baby or pumping your breasts.
Other factors that can affect breast-feeding include:
- Your approach to weight loss while breast-feeding. Weight loss should be gradual and not compromise your health or your baby's health. Focus on eating a balanced diet that includes enough calories.
- Your activity and rest. Getting exercise and adequate rest are both important for your recovery from pregnancy and for optimal breast-feeding.
- Your support. Although the first 2 weeks of breast-feeding usually are the most challenging, you may have other times when you need extra help. Have people you can contact, such as friends and family who have breast-fed or a lactation consultant. Other support is available through local hospitals or clinics and support organizations, such as La Leche League. For more information, see the Other Places to Get Help section of this topic.
Also, consider the following while you are breast-feeding:
- It can take time to resume a sexual relationship with your partner. Use birth control methods if you want to lower your pregnancy risk. Women who are breast-feeding can still become pregnant.
- Be careful about being exposed to poisonous substances while breast-feeding.
Special circumstances and breast-feeding
- Breast-feeding during pregnancy can be continued unless you are at risk for preterm labor. You will have special dietary needs to address and possibly more noticeable fatigue and nausea.
- Breast-feeding multiple-birth infants is possible but can be physically and emotionally challenging.
- Breast-feeding both a newborn and an older child is possible. However, the youngest should have priority. This is critical during the first few days, when your newborn needs your colostrum.
- Supplementation is sometimes needed for healthy babies, such as when the mother does not eat meat or dairy products, or they do not live in an area with fluoridated water. A daily supplement of at least 200 IU of vitamin D is now recommended to be given to all babies, including those who are exclusively breast-fed, beginning before 2 months of age.15
- Relactation, which is stimulating your body to again produce breast milk and start breast-feeding or taking measures to stimulate your body to produce breast milk when you have not been pregnant recently (such as for an adopted baby). Although relactation is difficult, your chances of success increase if you have previously breast-fed.
- Cup-feeding your baby may be recommended if your baby is unwilling or unable to feed from the breast or requires supplementation. This technique may be used for both premature and full-term infants. It may be tried as an alternative to bottle-feeding (which may interfere with breast-feeding later) or to inserting a feeding tube in a baby's stomach.
Weaning
It is best for you and your baby if you continue breast-feeding for a full year. If you continue to breast-feed beyond 1 year, your baby will continue to benefit. After the first year, look for signs that your baby is ready to wean. Talk to your doctor if you have questions about weaning.
Whenever you decide to wean, keep in mind the following:
- Suddenly stopping breast-feeding may be harder for both you and your baby than a gradual decrease in feeding frequency.
- If you stop breast-feeding before your baby is 12 months old, gradually introduce a formula. It may take some time to find the formula that is best for your baby.
- If you stop breast-feeding when your baby is between 6 and 12 months of age, talk to your doctor about how to incorporate an appropriate diet. For example, you may need fewer formula feedings and more cereals; or your baby may be able to use a non-spill cup instead of a bottle.
- The longer you breast-feed, the fewer side effects you will feel from weaning (such as engorgement). Home treatment to reduce discomfort caused by weaning includes applying cold compresses on the breasts, hand expressing
- Your baby may show a few signs of readiness and still not respond to your attempts to wean. If this is the case, try feeding your baby in a dimly lit, quiet, and private place. This may make your baby lose interest because it is an environment that lacks stimulation and interaction, which is often what he or she seeks when breast-feeding or bottle-feeding.
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| Author: | Kathe Gallagher, MSW | Last Updated: May 10, 2007 |
| Medical Review: | Kathleen Romito, MD - Family Medicine Joy Melnikow, MD, MPH - Family Medicine | |
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| Topic Overview | |
Health Tools  | |
| What Is Normal | |
| Common Concerns | |
| Routine Checkups | |
| When To Call a Doctor | |
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| Other Places To Get Help | |
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