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Reviewed by the Faculty of Harvard Medical School

Frequently Asked Questions About Breastfeeding

Breastfeeding is the most natural way to feed your baby — but that doesn't mean it's always easy. There can be a lot to learn, especially for first-time moms. Here are answers to questions frequently asked by mothers and their partners. If you have any concerns, you should discuss them with your health care professional.

Will I be able to make enough milk to meet my baby's needs? Can the milk dry up?

Most mothers produce more than enough milk for their baby. If your infant has latched on to your breast correctly and is allowed to nurse as often and as long as he wishes, then your breast will be stimulated to produce the hormones necessary to make milk. In rare cases, either because of trouble with latching or a maternal health problem, enough milk isn't made. If your baby isn't wetting at least six diapers over 24 hours and pooping regularly, if he seems fussy after feeding or your breasts don't seem full, call your health care professional.

Is it normal for my breast to hurt while I nurse?

You should only feel a tugging sensation if the baby is latched on to the breast correctly. Attention to positioning is vital to prevent soreness. There may be tenderness initially, but this is temporary. Putting breast milk on the nipple after nursing and alternating positions at the breast will help relieve the tenderness. If you begin to feel pain after the nursing has been going well, contact your health care professional.

Does my baby need extra water in hot weather?

No! Breast milk provides all of the water an infant needs.

Should I wash my nipples with soapy water before I breastfeed my baby?

Wash the breast area with plain water while bathing. The tiny glands on the areola secrete a fluid that keeps the skin of the nipple and areola intact and helps prevent infection. Mothers should not remove this by vigorous scrubbing with soap or creams and lotions. These products can mask or remove the scent of your body and breast milk, which the infant uses as a way to locate the breast.

Do I need to time feedings and always offer both breasts at a feeding?

Breastfeeding is a baby-led activity. Therefore, the baby will tell you quite clearly by coming off the breast that he is finished. The baby should finish feeding at one breast before being offered the other breast. It is important that your baby feeds long enough on each breast because the quality of the milk changes during a feeding, with higher amounts of some important nutrients later during the feeding. In the beginning of the feeding the breast milk can be higher in lactose (a sugar normally found in milk). High-lactose milk moves through the bowel quickly, causing discomfort that may result in fussiness and crying. Later in the feeding, milk is much higher in fat. High-fat milk is absorbed more slowly, allowing time for the hormones that stimulate digestion and feelings of satisfaction to work. The fat also provides more than 50 percent of the milk's caloric value and contains the fatty acids that are important for brain growth and visual development. The fatty acid also contributes to the softer consistency and milder odor of baby's stools.

Isn't formula just as good as breast milk?

No! The formula is not custom made for your baby, whereas your breast milk provides the antibodies, living cells, enzymes and hormones your infant needs. There are other reasons that breastfeeding is preferred over formula-feeding: Formula-feeding does not provide the same level of physical contact that mother and baby experience through breast-feeding. Increased interaction has been shown to improve mother-child bonding and enhance intellectual development in the child.

If I get sick, should I stop nursing?

With very few exceptions, continuing to nurse protects the baby. You have developed antibodies, which are passed onto the baby in the breast milk. If breastfed infants do get ill, they are less sick and recover faster because of the antibodies in the milk. Even if you have a breast infection or abscess, you can still nurse the baby with that breast. The milk is not "bad," and you need to keep the milk flowing in the infected breast to heal faster.

I take a prescription medication. Should I stop nursing?

You should always check with your baby's health care professional before you take any medication, but there are very few medications, prescription or otherwise, that cannot be taken while nursing.

Should I avoid certain foods and beverages? Do I need to drink a lot of milk to make milk?

Nursing mothers need to eat a balanced diet and usually do not need to avoid any foods. If there is a family history of food allergy, or if the baby's health care provider feels that the baby is showing signs of allergy (such as fussiness with feeding, vomiting, blood in the stool, rashes or poor weight gain), the mother may be asked to avoid foods likely to cause allergy, such as dairy, nuts, wheat or eggs. While it's OK to have a cup of coffee, it's best to limit caffeine intake as it can make the baby irritable when it gets into breast milk. Alcohol also gets into breast milk, and its intake should be limited as well.

You don't need to drink milk to make milk. You do, however, need to drink plenty of fluids to ensure your supply of milk and keep you from getting dehydrated yourself. Water is the beverage of choice — keep a bottle with you at all times.

Can breast implants or breast-reduction surgery prevent me from breastfeeding my baby?

There has been no evidence that breast implants with silicone are harmful to the breastfeeding infant. Mothers who have had reduction surgery often are able to nurse their babies but some do not make enough milk and need to use a supplementation device while breastfeeding.

My breasts are small. Can I breastfeed my baby?

The size of the breast does not determine whether the mother will be able to nurse her baby. Mothers with smaller breasts may find their babies need to nurse more frequently, but if the mother allows the infant to nurse as often as desired, the mother's breast will make a sufficient supply of milk.

Is it OK for my baby to formula-feed while I'm resting in the hospital after delivery?

Offering bottles during the first few weeks and especially during the first few days of life can make breastfeeding more difficult. If a healthy nursing baby is given formula, then the mother's milk supply decreases, as suckling stimulates the hormones necessary for milk production. Using a bottle also can cause a problem with nipple confusion. The way a baby sucks at the breast is different from the way she sucks a rubber nipple. Some nursing infants have a great deal of difficulty going back to the breast after just one bottle. Supplementing with formula also can cause the mother's breasts to get engorged, which is painful. It is better to limit visitors so that you can rest, rather than send the baby to the nursery.

I've been told there's no harm in feeding my baby formula every once in a while. Is this true?

Although infant formula is generally safe and nutritionally complete for babies, there may be some physical risks associated with formula-feeding. For example, some babies may develop an allergy or intolerance to infant formula. Recent studies also suggest that giving even a small amount of formula may lessen some of the benefits of exclusive breastfeeding. Using formula, especially during the first few weeks of life, can interfere with the mother's milk supply.

I have inverted nipples. Can my baby breastfeed?

Infants can learn to nurse well on nipples that are inverted or flat. For women with inverted or flat nipples, there is a device called a shell that may assist in releasing and elongating the nipple. The shell is worn inside the bra during the day. If you have inverted nipples, you should definitely talk to a lactation consultant — before the baby is born, if possible.

What is nipple confusion?

Nipple confusion occurs when infants have difficulty going back to the breast after receiving bottles before breastfeeding was well established. Nursing from a bottle can be easier than nursing from the breast. Because milk flows faster from a rubber nipple than the mother's nipple, the baby does not need to open his mouth wide when using a bottle. When the baby then breastfeeds, he may latch on to the tip of the breast nipple only, and not get much milk. The baby also may have a tendency to spit out his mother's nipple because of the different sucking pattern on a rubber nipple. Although not all infants get nipple confusion, it is best to avoid using a bottle for the first four to six weeks while you and your baby are learning to breastfeed.

What changes to my breasts can I expect while I'm pregnant and while I'm breastfeeding?

During pregnancy your breasts and nipples may change in size and color. These changes are a healthy sign that your body is preparing for feeding your baby. The skin stretches and becomes more pliable to accommodate the growing milk-making cells and ducts in the breast. The nipples and areolas will darken, which helps the baby to identify the breast when he is first learning to nurse.

Last updated October 18, 2010