Breastfeeding 101

Over the weekend I joined a new mom group hoping to make some mommy friends. It is a great group and I love the people in it. I noticed that a lot of the first time moms to be had a lot of questions about breastfeeding. I knew what a lot of the answers were, but I couldn’t find a post that really spoke to the experience of breastfeeding as a whole without breaking it down into a listicle type article (Top 10 Tips for Breastfeeding). When I looked back into my archives, even I had only done the list without giving new mamas what to really expect.

With this post, I hope to change that and demystify some of what is going to happen when you start breastfeeding and the resources available to you.

Before we really get into it, I want to say that while I breastfeed my daughter for 18 months (10 months exclusively), I am firmly in the “fed is best” camp. Not everyone can or should breastfeed.

This article is to give you an idea of what you might be in for if you choose to breastfeed. It is not meant to be commentary that this is the only, or even preferred, way to go. I would also like to note that everyone’s breastfeeding experience is a little different, so expect your breastfeeding experience to vary from mine.

And finally, I am neither a doctor nor a lactation consultant. Everything in this article is based on experience and extensive research I have done. If you have any questions or concerns, ask your doctor.

So, without further ado,

What is breastfeeding like in the beginning?

When you first start breastfeeding, your boobs get really sore. Your body hasn’t done this before and it is trying to figure out how much milk the baby needs and when the baby needs it.

There are times when you will produce too much milk and become painfully engorged, and times when you won’t have produced much at all when the baby needs it. It takes a few weeks for your body and the baby to synch up on the milk production front. Once you are synched, you should not become painfully engorged again unless you are off-pattern.

Some women only leak milk at the beginning when they are still trying to synch up with the baby, others leak milk the whole time they are breastfeeding. So it is important to get some high-quality breast pads to soak up the milk. As an advocate for all things renewable, I prefer reusable breast pads. I bought one set and I will be able to use them for when I breastfeed all of my little ones.

After the general soreness of your boobs figuring this milk production thing out, your nipples will hurt. They will hurt because they are being stretched by full milk ducts, pulled on by pumps, and suckled by a hungry baby. Friction is your enemy and you will end up with chapped, painful nipples in those first few weeks. But good news! Once you hone in on a care routine, your nipples won’t be so sore.

Bottom line: the first couple of months are really difficult. You are in pretty consistent discomfort, and as the only person who can feed the baby, you won’t be getting much sleep. Once you push through that first couple of months, it generally gets easier.

What do I need to get before the baby arrives?

If you plan to breastfeed, you are going to need some things to protect your boobs and make breastfeeding easier. Some of these items are beneficial even if you don’t wind up breastfeeding in the end. You should get:

• Boppy or other nursing pillow- you will use a nursing pillow constantly. These pillows are designed to support the baby as you hold them. In those first few weeks, do not be surprised if you are holding baby 8-10 hours per day. That is a lot of strain on your arm without support. Even if you are on the fence about breastfeeding, this pillow will come in handy.
• Breast pads- every free goodie bag you get will have some complimentary single-use breast pads. Stash two in the diaper bag (just in case) and use the rest when you go out those first few weeks. As you get close to using them up, you will know if you want to do something reusable or if you want to stick with the single-use pads. The cost for the single-use pads can add up, so if you are planning to breastfeed for a year or more, I would go with a reusable option which will save money in the long run.
• Nursing tanks- Those first few weeks after birth, you are going to feel like crap. You won’t want to wear a bra, and you will only have the energy to lounge under your new baby like a big human pillow. That is okay. Enjoy the cuddles. Even if you don’t breastfeed, a light cotton tank with a shelf bra is perfect for lounging. Seriously, I’m done breastfeeding and I still wear those tanks to bed. They are so comfortable.
• A breast pump- Insurance in the US is now required to provide a breast pump to new mothers. Call your insurance and find out what you need to do to claim your pump. Usually, you only need to provide a copy of a prescription from your doctor for the pump (they have a standard form). Then call the local hospital you plan on delivering at to find out what they use. Whatever pump you pick, choose the same brand as the hospital. Why? Because you will get a set of pump parts at the hospital when you deliver, and if you have the same brand of pump? Free pump parts that work with your pump, so now you have two sets! That means washing pump parts half as many times throughout the day!
• The clearest bottle of olive oil you can find- Friction is your enemy, so you need a lubricant to protect you both from baby’s sucking and from the pump. You could get some more expensive oils, like vitamin e oil, but olive oil has been used for this exact purpose for centuries and it works wonders. Just put a little on your nipples before feeding and it will protect you from chafing. Choose a lighter olive oil because they have the least amount of flavor. A small bottle of oil will last you most of a year, and any that is left over when you are done is great for cooking so nothing goes to waste.
• Nipple butter- After you are done with the latch, everyone and their mother will suggest you put lanolin on your nipples. I don’t recommend lanolin. It did nothing to prevent chapping and it gave my baby gas. I recommend finding a high-quality nipple butter. They melt right into your skin and keep your nipples soft and healthy. This was my favorite, but you could also make your own.
• Bottles- No matter how you feed your baby, you are going to need bottles. If you don’t have a way for someone to take over a feeding or two you are going to go mad. If you plan to exclusively breastfeed, you could use the bottles you get for free from various gift bags. I recommend choosing the type of bottle you want and then picking up a starter pack. A quick note: when choosing bottles choose something that has a similar boob radius and nipple shape to you. Then get the binkies that go with that bottle set. Keeping everything similar will help reduce nipple confusion. And glass bottles last longer than plastic.
• A bottle brush- You need a way to clean bottles and pump parts.
• A package of formula- you can get a starter kit of formula for free from the big formula companies. Do it. The first few days when your milk is coming in, you may not have enough milk for the baby when they need it. FED IS BEST! Babies have died from thirst/starvation because moms have refused to supplement until their milk comes in. If your baby is constantly crying and rooting, you may need to supplement. That is okay. Just keep at it and it will even out soon. It is also good to have a backup in case you need to be put on meds for something and have to pump and dump.

Is it better to breastfeed and then also pump simultaneously?

In the beginning, your milk is still trying to come in. If you pump before the baby latches, you risk not having enough milk for the baby. Instead of pumping before, pump shortly after the baby is done drinking. This will encourage your milk to come in faster and increase your milk supply.

Once your milk comes in, you should start to switch to pumping before baby drinks. The baby is much more efficient in extracting milk than any mechanical pump could ever be. So pumping first insures you get all the way to empty. Emptying out the supply is great for your boobs.

There are also some silicone manual pumps that can suction on to your free boob while breastfeeding. It is common for the unoccupied boob to let down at the same time as the one baby is latched onto. If you are one of the people who experience this, getting one of those pumps will be a lifesaver while you breastfeed.

When do babies stop breast feeding?

The WHO recommends being exclusively breast/ formula-fed until 6 months. After that, they recommend the baby receive some breastmilk until at least the age of 2.

Of course, that is not always realistic. In America, it is common for parents to stop breastfeeding at or around 6 months, but really children need milk in some form for longer than that. If you are going to stop breastfeeding at 6 months, you should supplement food with formula.

I advocate for starting to wean when the baby is ready. There will come a point when the baby is really interested in your food. They start reaching for it when you bring it to your mouth, they try to pull it off your plate. Give them your food. Babies cant eat honey or salt, but everything else is fair game. Introduce adult food slowly so you know if they are allergic to anything. The biggest benefit of this method is you skip purees entirely and don’t have to feed the baby. You can all eat at the same time. It is glorious.

If you want me to do a post on baby-led weaning, let me know in the comments below.

How often does a baby have to be breastfed? Does it depend on the baby?

Most newborns need to eat every 2-3 hours.

There are times when they will need to eat more often, and times when they will sleep through a feeding. The key is to make sure you are getting 8-10 wet diapers a day. Less than that and your baby might be dehydrated.

Furthermore, newborns cannot eat too much. They don’t understand how. They eat when they are hungry until they are full, that’s it. So don’t worry your baby is eating “too much” because that isn’t possible.

How long does breast milk last in the freezer?

Check out this article from the CDC on proper breast milk storage. There are even handy charts to put on your fridge.

How do I store breast milk?

The big pump companies make bags to store your breastmilk in the freezer. They are expensive and they hold way too much milk.

I just stored the milk in 2-4 ounce increments in snack bags. I would leave the bags in the door of the freezer overnight so they would freeze into stick-shapes, and then I would stack them all in a gallon-sized freezer bag to protect them from freezer burn.

However you store your breast milk, be sure to label it with the time it was pumped, the date, and how much is in the container. If you are sick when you pumped a batch, it is helpful to label the bag with the illness or symptoms you had at that time. The antibodies in that batch of milk will help a child with those same symptoms. So if your baby is sick, you can give them milk that will help them get better.

If you are in a situation where you should pump and dump, freeze the milk into cubes in an ice cube tray and then transfer the cubes to a freezer bag. The cubes of discard milk can then be used in baths when the baby has a rash. The breastmilk will help ease the itchiness and irritation. Every time I have given my daughter a milk bath when she had a rash, it was gone by the following morning. Don’t discard any milk, it is all useful!

If there is milk left after a bottle feeding, can I reuse it?

The obvious and safe answer is no.

Once a bottle touches the baby’s lips, they have injected bacteria into the milk that might cause it to sour. Obviously, your breast milk is not pasteurized and will go bad faster than regular milk. That is why you need to be careful about how you store and use your pumped milk. You don’t want to make the baby sick.

However, I have reused milk with my daughter in very specific circumstances. If she left a significant amount of milk (like if she only drank an ounce when given 4 or 5) and I knew I could use it in the next 3-4 hours, I would combine it with fresh milk and save it in the fridge for the next feeding.

Any leftover milk from that second feeding would be discarded regardless of how much was left. I only did this as we were getting close to weaning, I would never recommend doing this with a newborn. Reusing milk is playing with safety, so I would not recommend it as a matter of course.

Verdict: it is not recommended to reuse breast milk.

What is the best way to defrost breast milk?

If you store your milk in bags, it will defrost easily in about an hour or two on the counter at room temperature. If you need to defrost faster, putting the bag of milk in some room temperature water will speed up your defrost time (you may need to change the water a few times).

Sticks of milk that will fit in a bottle can be heated in warm water of a bottle heater.

What is a good affordable breast pump?

The Affordable Care Act mandates that breast pumps are fully covered by insurance. Talk to your insurance about what they need to give you a pump.

My insurance required that I send them a prescription from my doctor for a pump at the 6-month mark, which is pretty standard. If you wind up having a preemie, you can have the insurance overnight you the pump.

I highly recommend buying the same brand of pump as the hospital you are delivering at. In the hospital, they will help you find the right-sized flange, and give you a set of pump parts for their brand of pump. If you have the same brand of pump, then those parts will be usable with your pump and you will not have to figure everything out again. Plus you’ll have a second set of parts.

How do I avoid mastitis?

Mastitis happens when your milk ducts get infected. You are at an increased risk of infection if your milk ducts get blocked. Prevention is key here. It is much easier to prevent blocked ducts than it is to unblock a duct.

To prevent blocked ducts: get enough sleep, drink more water (and other fluids) than you think is possible, and make sure you fully let down every time you feed the baby/ pump.

If you have a blocked duct try the following in this order:

1. Drink a big glass of water
2. Take a nap/ get more sleep
3. Use a hot compress
4. Massage the boob/ nipple to clear the blockage
5. Use the baby to clear the blockage (pump first and then latch so the baby sucks out the blockage)
6. Try to go a little longer than usual between feedings/ pumping to build up pressure and then repeat all the steps
7. If you cant clear the blockage, you may need to go to the doctor. A red, swollen boob with a blockage that can’t clear has probably progressed to mastitis.

When should I call my doctor or lactation consultant?

In the first few weeks after birth, you will have a lot of questions and a number of issues. This is normal. Most hospitals include 3-4 lactation consultations in the cost of giving birth. You don’t need to use them all in the hospital before you go home.

Call your lactation consultant if you are in pain, are having problems with the baby latching, or are concerned the baby isn’t able to suck out enough milk. They are also fantastic resources for nursing bras and supplies to unblock clogged ducts.

Call your doctor if you suspect mastitis or thrush, or the baby is showing signs of distress. If you have any concerns about the baby’s health or your health, it doesn’t hurt to drop your doctor a line.

Do I still need to take my prenatal vitamin?

Yes.

You may actually need to take more than one.

The milk is pulling the same nutrients from you to feed to the little one as it was before they were born. But now they need higher and higher quantities of those nutrients. It is not uncommon around 4 or 5 months for the mother or baby to start becoming anemic because of the baby’s sudden iron cravings.

By the time I was done pumping at 15 months, I was taking 4 prenatal a day. Listen to your body and continue to feed it nutritious foods and supplement it with vitamins. Both you and your baby need them.

What if baby doesn’t latch?

Talk to your lactation consultant and see if you can fix the problem. If you can’t, you have a difficult decision to make.

My daughter could not latch. Her mouth was much smaller than my nipple when she was born, and by the time she was big enough to latch she wasn’t interested and found it frustrating. Because she was a preemie, I committed to pumping every meal for her for over a year. In that time she managed to latch exactly 3 times. I have pictures of all of them.

I’m not going to lie: pumping was hard. I was pumping for over 8 hours a day on average to keep up with her seemingly unquenchable thirst. But you don’t have to pump. If the child cannot latch for some reason, formula feeding is a good option too. Do what is right for your family.

I am currently trying to breastfeed and it hurts a lot. What do I do?

In the beginning, breastfeeding should be uncomfortable but not painful. If you are at tears-of-frustration crying because it hurts so much you might have to stop, then something is wrong. Contact your lactation consultant and let them help you fix it. The latch could be off, the baby could be sucking too hard, you could be allergic to your nipple cream. Whatever is happening, they will know how to fix it. So pack up your pump and the baby and pay them a visit.

If you have tried everything and it still hurts after a decent try, there is no shame in switching to formula. Your child will be fine, promise.

How do I clean and sterilize pump parts and bottles?

When you go home from the hospital, take home as many of those grey plastic buckets they use to corral tools as you can. Those buckets are perfect for washing pump and bottle parts. Put the parts in them with some dish soap and warm water. Then use a bottle brush to wash them and leave them to dry.

Once every couple of days, sterilize the parts using vinegar and water. Let the parts soak in the vinegar solution for at least ten minutes. Then wash them as normal.

When our daughter first came home, we would sterilize the parts every day. As she got older we would space out the sterilizations more and more. By the time we stopped, we were sterilizing things once or twice a week.

If I decide breastfeeding is working for my family, what else should I get?

Nursing bras- I would not get any nursing bras until you have had the baby. Your size is likely to change between carrying the baby and having it. Lactation consultants typically have a vast array of nursing bras they can sell you. Get fitted by your lactation consultant and work together to find the right bra for you. Trying to do it on your own will cost you money as you find bras that you thought would fit, but don’t.

• Extra pump parts- pump parts are going to break, get lost, or wear out. The last thing you want is to sit down to pump only to find a broken part you don’t have a replacement for. Have an extra set of all your pump parts on hand including the hoses.
• A manual pump- they make these wonderful silicone hand pumps that will actually suction to your breast. Those are fantastic for catching an unlatched boob’s let down. They are also small and easily portable, so you can throw them in a bag when you go out with your friends. Make sure you get one with a lid so you can store the milk and not worry about it spilling when you set the pump down. Seriously, they spill so easily.
• Nipple care items- there are silicone gel patches meant to soothe raw nipples and cups to give your nipples air. There are medicated patches meant to pull out a clog in a duct, and heating pads designed to fit in your bra. Talk to your lactation consultant or do a quick search on healing products for breastfeeding. A lot of them are fantastic.
• Snacks- when breastfeeding you need to eat when the baby eats. That means you need a lot of quick snacks stashed all over. You will be hungry, so find some healthy snacks that you enjoy and stash them in places where you are likely to breastfeed the baby. Make sure to drink enough water too.

Is there anything else I should know?

Regardless of if you choose to breastfeed or bottle-feed, the very first milk you produce as a mom is vital for your baby. If you only feed/ pump that first time, you have already set your baby up well. That first milk you produce as a mom is full of your antibodies. You are literally giving your little one an immune system. If you can give the child at least that one feeding, you are doing great. If you can’t, that is okay too.

You are doing what is best for your baby, your body, and your mental health. Do not let anyone shame you for your feeding choices. They don’t know you, can’t know your journey, and you are doing the right thing (whatever that looks like) for your family.

You take good care of that baby, mama. It will all be okay.

If you have any questions I didn’t answer, leave them in the comments below and I will answer them!

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