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1. How often should I breastfeed?

   Babies need to be breastfed frequently and until satisfied. This may mean breastfeeding eight to 12 times a day or more for about 15 to 20 minutes at each breast. Let your baby determine the feeding schedule (otherwise known as nursing on demand). Watch for early signs of hunger, which include:

   • Increased alertness or activity
   • Mouthing or putting hands to mouth
   • Rooting (moving his/her head in search of your nipple)
     
     

2. How long should I breastfeed?

   Babies should be fed with breast milk only—no formula—for the first six months of life. It's important to continue breastfeeding for as long as you can, ideally until your baby is one year old or beyond. The longer you breastfeed, the greater the health benefits for you and your baby.

3. How do I know if my baby is getting enough milk?

   Many mothers worry about whether their babies are getting enough milk. An easy way to gauge whether your baby is getting enough is to pay attention to his/her weight and the number of wet and dirty diapers. This may include:

   • Consistently gaining weight after the first three to seven days after birth. Babies often lose some of their weight (7 to 10 percent) within the first week.
   • Six to eight wet diapers and three to four yellow, seedy bowel movements by day five.
     
     

4. What is colostrum?

   Colostrum, also called "first milk," is a thick, yellowish fluid that helps your newborn's digestive system grow and function. Even though it looks like a small amount, this is the only food your baby needs until your milk supply comes in, usually within five days of giving birth. Colostrum is rich in nutrients and provides protection against infectious diseases.

5. How do I know if my baby has latched on properly?

   If your baby has latched on correctly, he/she should have your entire nipple and most of the areola (the dark skin around your nipple) well into his/her mouth. Make sure your baby's whole body is turned toward your breast, not just his/her head. Try positioning a pillow just below your breasts to ensure the baby is resting comfortably at the same level as your nipple. Your baby's suckling should be even, and you will hear his/her swallows.

6. Should breastfeeding be painful?

   No. Although you may experience some discomfort and tenderness during the first few days, breastfeeding shouldn't be painful. You may feel the slightest tug. If breastfeeding hurts or you have flu-like symptoms (fever, chills, feeling run down), contact your health care provider.

7. What is a lactation consultant?

   Lactation consultants are professionals who are trained to help mothers who want to breastfeed their babies. Most hospitals and clinics have lactation consultants on staff to help new moms learn how to nurse. They can provide encouragement and assist moms and babies with latching difficulties, painful nursing and other issues that may interfere with efforts to breastfeed. To find a lactation consultant near you, visit www.laleche.org.

8. What is the let-down reflex?

   You may experience a tingling or tightening sensation as your milk lets down and fills your breasts. This reflex means your milk is ready to flow. This sometimes occurs in response to your baby's cry or when a feeding is overdue.

9. How can I maintain my milk supply?

   Your milk supply will respond to your baby's needs—the more your baby suckles, the more milk will be produced. If you're concerned about your milk production, increase the number of feedings a day. Other steps to take include:

   • Pumping when you return to work or plan to be away from your baby for an extended period of time
   • Getting plenty of rest
   • Eating a nutritious diet with plenty of calcium
   • Delaying introducing formula or solid foods until six months of age at the earliest
     
     

10. Are there foods or medications that I should discontinue while breastfeeding?

    Pay attention to foods that might bother your baby. If you notice a pattern, avoid the food for a few days and then reintroduce it to see what happens. Most mothers who eat a balanced diet and don't have a history of allergies, won't need to restrict the foods they eat, except for a few things. Caffeine and alcohol can get into your milk, so limit their intake. You should also avoid certain kinds of fish and shellfish high in mercury; these include shark, swordfish, king mackerel and tilefish. You can safely eat up to 12 ounces (two servings) a week of fish and shellfish low in mercury, including shrimp, canned light tuna, salmon, pollock, clams, haddock, trout and catfish. Some medications may be harmful to your baby if they pass into your milk. Be sure to check with your health care provider about which foods, beverages and medications are safe for you and your baby.

11. Can I continue breastfeeding when I return to work?

    Yes. A growing number of new moms are returning to work and can continue breastfeeding thanks to breast pumps and storage containers, as well as policies that encourage workplaces to be supportive of nursing. Pumping can help you maintain your breast milk supply and keep you connected to your baby, even when you are away. Employers benefit because breastfeeding moms often need less time off for sick babies.

12. How long can I use stored milk?

    The following are some guidelines for freshly expressed breast milk storage:

    • At room temperature (66-72°F) for up to four hours
    • In a refrigerator (32-39°F) for five to seven days
    • In a cooler with freezer ice packs (59°F) for 24 hours
    • In a self-contained freezer unit for three to four months
    • In a deep-freezer (0°F) for six to 12 months

13. What are the most recent guidelines for pregnant and breastfeeding mothers about eating seafood?

    Some fish contain high levels of mercury that can harm your baby's developing nervous system if eaten regularly. However, a recent federally funded report released by the Institute of Medicine (IOM) showed that the heart benefits of seafood outweigh the risks. The report showed that omega-3 fatty acids found in fish promote healthy vision and brain development in infants whose mothers consume seafood while they are pregnant or nursing.

    So does this mean you should eat fish or not? The answer is you should eat fish, but you should make sure it's the right kind. Guidelines issued jointly in 2004 by the U.S. Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) noted that pregnant women can safely eat up to 12 ounces (about two servings) a week of a variety of cooked fish and shellfish with lower levels of mercury, such as shrimp, clams, oysters, salmon, catfish, crab, haddock and trout. If you choose tuna, stay away from albacore, or white tuna, which contains higher levels of mercury than canned tuna. The FDA and EPA also recommend that women of childbearing age, pregnant women and breastfeeding women not eat shark, swordfish, king mackerel or tilefish, which have high levels of mercury. In addition, they recommend that you check local advisories about the safety of fish caught by family and friends in your local lakes, rivers and coastal areas. If no advice is available, eat up to six ounces (one average serving) per week of fish you catch from local waters, but don't consume any other fish during that week. And as always, talk with your health care professional about the risks of eating fish and shellfish while breastfeeding. For more information, visit the FDA's food safety Web site at www.cfsan.fda.gov/seafood1.html.