For the first 6 months of life breastmilk is the only food that your baby needs to grow and be healthy. Your baby will also need a daily vitamin D supplement during their first year of life. Continue to breastfeed until your baby is two years old or more. The longer you breastfeed, the more benefits you and your baby get.
The Importance of Breastfeeding
- Breastmilk changes as your baby grows.
- Breastmilk is a mild laxative. This helps the newborn pass meconium. It also helps prevent jaundice.
- Breastfed babies have fewer bowel, breathing and ear problems.
- Breastmilk helps protect baby from heart disease, diabetes, some cancers and obesity later in life.
- Breastfeeding helps mom’s uterus return to pre-pregnancy size.
- Breastfeeding helps protect mom from osteoporosis, ovarian cancer, breast cancer and diabetes.
- Breastmilk has enough water for baby’s needs.
- Exclusive breastfeeding provides sufficient iron for the first six months. The iron in breastmilk is very easily absorbed by baby.
Skin-to-skin is a way of holding your baby. This position allows baby to stay warm and be calmed by being close to and smelling your skin, and being able to hear your heartbeat and breathing. It helps baby’s heart rate, breathing and blood sugar to become steady. Being skin-to-skin is good for mom. It lets mom bond with baby, feel more confident and relaxed, improves milk flow and milk supply, and also helps with a good latch (which means you are less likely to have sore nipples!). For skin to skin, undress baby down to his or her diaper. Lie back and rest baby upright on your bare chest – baby’s arms and head should be able to move easily. Partners and other support people can also hold baby skin-to-skin.
Supporting Breastfeeding Moms
Family and friends supporting breastfeeding moms makes breastfeeding easier. There are things you can do to help mom and baby learn to breastfeed well together:
- Learn as much about breastfeeding as you can. Knowing why it’s important and hearing from other moms who have breastfed what they did will make it easier for you to help mom.
- Find out where mom can go for help. That way, mom can get help as soon as possible if she needs it.
- Be positive. Mom might think she isn’t breastfeeding well or doesn’t have enough milk in the beginning.
- Help mom with the baby. Learn how to comfort baby, burp and change baby, take baby for walks and play with them, and also know signs that baby is ready to feed so that you can bring baby to mom.
- Let mom have privacy. Ask the new parents when they are ready to have visitors. Be supportive of them.
- Give mom time to relax. Suggest she go outside, take a nap, or spend a few hours doing something she enjoys by herself, and where she won’t be disturbed.
The more baby feeds at the breast the more milk mom will make.
Breastfeeding: Getting off to a Good Start
- Give baby the chance to latch himself or herself at the breast soon after birth.
- Sometime in the first hour, newborns are ready to latch and feed. Sometimes mom needs to express breastmilk and rub on baby’s lip if baby does not latch in the first few hours past birth. Latching early can prevent trouble later.
- Let baby lead the way. See “Baby-led latching”.
- Mom and baby should remain together in the same hospital room for the entire stay. Rooming-in day and night helps mom to learn baby’s cues and helps establish successful breastfeeding.
There are a number of behaviours newborns show to indicate that they are hungry. These include:
Feeding: the First Few Days
- Babies often have a long sleep after being born.
- Baby may feed but not for very long or very often.
- Baby is getting colostrum, the first milk.
- It is very high in carbohydrates, protein and immunities.
- Baby is getting lots of nutrition, even though it is a very small quantity.
- It protects baby against infection and it helps baby to pass the meconium from his or her bowel. Passing meconium helps decrease the risk of jaundice.
Days Two to Three:
- Baby is more awake and alert.
- Baby should feed very often, at least 8 feeds in 24 hours.
- Baby will still be getting colostrum.
- Let baby feed often. The breasts need lots of sucking to make milk.
- You may need to offer both breasts for the first little while.
Days Three to Five:
- For many women, the milk comes in.
- The breasts will be full. Feed often to prevent engorgement.
- Baby will have 8 or more feedings in 24 hours.
Day Six and After:
- Baby may feed from one breast only.
- Baby may still want both breasts.
A Good Latch
You can tell baby has a good latch when baby’s mouth is wide open with flared lips around the nipple.
Baby-led latching is helpful right after birth, when baby is learning to breastfeed, when baby is not breastfeeding well, or when your nipples are sore.
- Sit comfortably with your back supported, leaning back.
- Hold baby on your bare chest between your breasts, so that his or her bare tummy is against yours.
- Baby will make a bobbing or pecking motion as they look for your breast.
- Support baby’s neck and shoulders with one hand, keeping the other hand on their bottom as they move towards your breast.
- When baby finds your nipple, they will push their chin into your breast, open their mouth and latch on to your breast.
- When baby is latched, you can adjust yours and baby’s position to make it more comfortable.
C or U Hold
Cupping your breast in your hand back away from the nipple, with your thumb and fingers on opposite sides creates what is called a “C” or a “U” hold depending on how you hold your breast. Be careful not to squeeze the breast as this interrupts the milk flow. This allows baby to latch deeply.
- Whatever feeding position you use, be comfortable.
- Hold baby so that he or she is on his or her side and baby’s tummy is against mother’s body. Baby’s head, neck and hips should be in a straight line. Baby’s nose should be in line with mother’s nipple.
- Bring baby toward the nipple. Tickle baby’s upper lips with the nipple. Baby should open his or her mouth wide, like a yawn. Wait for this big, open mouth before latching.
- Aim the nipple toward the roof of baby’s mouth. Gently push on baby’s shoulders to bring him or her onto the breast. When baby’s chin touches the breast, he or she will latch on.
- Check the latch. Baby’s chin will be pushed into your breast. Baby’s nose will be just touching your breast. Both of baby’s lips should be curled back. Baby’s lower jaw covers more of your breast than his or her upper jaw. This is called an asymmetrical latch or an off-centre latch. Most important, it should be comfortable.
- If you have pain, try two approaches:
1. Move baby’s position a bit to reduce pulling on your nipple.
2. Break suction by easing your finger into the corner of baby’s mouth. Take baby off. Start over.
Crying is a late sign that baby is hungry. Feeding will be easier if baby is fed on early feeding cues.
Positions for Breastfeeding
Use as many different positions as possible. Try to become comfortable with all of them. During the first few weeks, many mothers find the cross-cradle and football positions easier. After the first weeks, many women use the cradle and side-lying positions.
For all positions:
- Make sure you are comfortable.
- Use back support and pillows with your feet up, etc.
- Hold baby close to your body (baby’s tummy to mummy).
- Ensure a good latch.
- Baby’s head should be tipped back a little.
- Bring baby to you.
- Do not lean over to baby.
- Make sure baby is not pulling on your nipple.
Cross Cradle Position
- This position gives better control of baby’s head while you both are learning.
- Lay the baby with your arm along his or her back and your fingers gently supporting his or her head just behind the ears.
- Use a pillow if you need support. Tuck his or her arms out of the way. Babies put their hands in their mouths when hungry. You may need to swaddle baby.
- With your other hand, cup the breast, and touch the nipple to baby’s lips.
- Latch baby (see “A Good Latch”).
- Once baby latches, you can slide the free hand under baby to turn this position into a cradle position
- Lean back and relax.
- This position is easier for moms who’ve had a Caesarean Section. There is less pressure on the incision.
- Sit in a comfortable place.
- Lay 1 or 2 pillows beside you.
- Lay baby on the pillows. This will bring baby up to the level of the breast.
- Support baby’s back and head with your hand.
- Hold baby like a football.
- Latch baby (see “A Good Latch”).
- You may need another pillow once baby comes onto the breast.
- Sit back and relax.
- Hold baby across your lap, supported by one arm.
- The other hand cups the breast.
- Latch the baby (see “A Good Latch”).
- Once he or she settles, you will have one hand free for something else (a glass of water, telephone, books, the remote, etc).
- This position takes a little practice but is very helpful when mom is tired or sore.
- Mom lies down on her side.
- Baby lies beside mom.
- Turn baby to his or her side. Baby should be facing mom’s breast.
- Latch baby (see “A Good Latch”).
- Please refer to “Babies and Sleep” if you plan to nap while nursing.
Signs that Baby is Ready To Feed
- Baby moves his or her arms and legs.
- Baby brings his or her hands to his or her mouth.
- Baby makes sucking motions with mouth.
- Baby has rapid eye movements under lids.
- Baby roots (looks for nipple).
- Baby tries to latch.
- Baby has tightly closed hands, like fists.
- Baby sticks his or her tongue out and licks his or her lips.
Signs that Baby is Getting Milk
- When the milk starts to flow:
- Baby opens jaw. This is when baby sucks.
- Baby pauses. This is when his or her mouth is filling with milk.
- Baby closes jaw. This is when baby swallows and breathes.
- You can see the big movement of the jaw right up to baby’s temples.
- You may hear a soft gulp with swallows from
- 3 to 4 days after the birth.
- Mom’s breasts will feel softer after a feed than before. This lets you know baby is removing milk.
Signs that Baby is Full
- Baby releases the nipple.
- Baby does not show interest if offered the breast again.
- Baby pushes away.
- Baby falls asleep.
- Baby has open, relaxed hands and arms.
How Much, How Often, How Long
- Newborn babies have tiny tummies. They need to eat frequently.
- Feedings will not be evenly spaced. It may be half an hour between feeds one time and 3 hours the next time. Some feedings may last an hour and others 5 minutes. This is normal.
- Baby should feed at least 8 times in a 24 hour period.
- Watch for cues that your baby is hungry and needs to eat (see Feeding Cues).
- If baby lost a lot of weight in hospital or is not gaining well, he or she will need to feed more often.
- Offer the first breast until baby is no longer interested. Baby will get both foremilk (thirst-quenching) and hindmilk (filling). Offer the second breast if baby still is not full. Between breasts is a good time to change baby’s diaper.
- In the first 2 weeks, offer both breasts at every feeding.
- As baby gets the hang of breastfeeding, he or she will be easier to latch and feed.
- Continue with demand feedings. You will need to feed your baby at least 8 times in 24 hours and babies feed both during the daytime and at night.
- The way babies suck on a pacifier is different from the way they suck at the breast. While you baby is learning to breastfeed she might find it difficult to go from breast to pacifier and back again.
- Pacifier use can lead to a decrease in breastmilk and an increase in babies getting ear infections and having dental problems later on.
- See section “Tips to Help you and Baby Cope” if you need to soothe baby.
- If you decide to use a pacifier, only give it to your baby for a short time after she has fed. Some babies never use a pacifier.
- Every so often baby will have a growth spurt (see “Growth and Development”).
- Baby will feed more frequently for about 2 days.
- This stimulates the breasts to make more milk.
- You may think that he or she is not satisfied.
- In a day or two, your breasts will catch up with baby’s appetite.
Expressing/Pumping and Storing Breastmilk
You can also pump and or hand express your breastmilk if you are separated from baby or to increase your flow. Remember a baby feeding at the breast is more effective than expressing or pumping milk.
- You may want to hand express for many reasons: as an alternative to pumping, to provide a drop of breastmilk to help baby latch, or to release some breastmilk to relieve engorgement.
- Choose a comfortable place where you can be relaxed.
- May be helpful to warm breast with a cloth or by having a shower.
- Gently massage the breast all over.
- Cup your breast in one hand. Hold the container for the milk in the other.
- Press the hand cupping your breast firmly toward your ribs.
- Pressing firmly, slide your thumb and forefinger toward the areola.
- Stop just at the edge of the areola.
- It may be a few moments before you see any milk.
- You may get only drops at first.
- You will eventually get a stream of milk.
- Hand expression is a skill and requires practice.
- There are a wide variety of manual and electric pumps available in different price ranges.
- A manual pump is good for occasional use.
- An electric pump is better for frequent use, such as if you are pumping once or twice a day.
- Try to get the best quality pump you can afford.
- If baby is unable to breastfeed, for example premature, a hospital grade electric pump may be necessary. This option requires a kit to be purchased.
- Your pump will come with detailed directions for use. Every pump is different.
- Pumping is a skill and requires practice.
- Choose a comfortable place where you can be relaxed.
- May be helpful to warm breast with a cloth or by having a shower.
- Look at your baby or a picture of baby.
The guidelines for storing breastmilk are below. If your baby is premature or sick, different guidelines need to be used. Talk to your health-care provider.
- Use containers washed in hot, soapy water, then rinsed well. You can also use plastic bags made for food or breastmilk.
- Cool the fresh breastmilk in the refrigerator.
- Add the cooled milk to a container of already frozen milk.
- Freeze in small amounts from 2 to 4 ounces to prevent waste.
- The milk will expand as it freezes. Leave some room in the container for this.
- If using screw-top containers, do not tighten caps until milk is completely frozen.
- Label each container with date.
Thawing and Using Breastmilk
- Hold the closed container under cool, running water until milk is thawed or thaw in the fridge for 8-12 hours.
- Breastmilk separates, smells and tastes different when thawed. This is normal.
- Swirl the container to mix the breastmilk, do not shake.
- Warm thawed breastmilk by putting the container in warm water.
- You can use a small cup or spoon to feed your baby expressed breastmilk
Do not use a microwave to thaw or heat breastmilk. This will destroy vitamin C and the valuable immunities in breastmilk.
Vitamin D and Breastfed Infants
- Babies need vitamin D for healthy growth and development. It helps them build strong, healthy bones and teeth.
- In Canada, we do not get enough sunlight from October to April to make vitamin D.
- Most vitamin D comes from having our skin exposed to sunlight.
- Health Canada recommends all breastfed, healthy, term babies should get 10 ug (400 IU) of vitamin D every day from birth.
- Give vitamin D for as long as your baby receives breast milk.
- You can buy vitamin D drops at your local pharmacy. Always follow the instructions on the package for how to give the vitamin safely.
Breastmilk Storage Guidelines
|Room Temperature||Cooler with 3 frozen Ice Packs||Refrigerator||Self-Contained Refrigerator Freezer Unit||
|Freshly expressed breastmilk||Max 4 hours at 66-72°F
|24 hours at 59°F (15°C)||3-5 days at 32-39°F (0°C)||
|6-12 months at 0°F (-19°C)|
|Thawed breastmilk (previously frozen)||Do not store||Do not store||
|Never refreeze thawed milk||Never refreeze thawed milk|
Troubleshooting – Making Breastfeeding Easy
Baby will not wake, or goes back to sleep when put to breast. To wake the baby:
- Remove all of baby’s clothes except for the diaper. Baby will stay warm enough cuddled skin-to-skin with mom.
- Rub baby’s head, back, tummy and feet.
- Change position or talk to baby.
- Using a cool (not cold) cloth on baby’s face.
- Try expressing to get a let down. This may help baby become interested.
- Use breast compressions while baby is feeding to wake baby and increase milk intake.
- Almost all women report some nipple pain in the first week or two of breastfeeding.
- It is normal for some pain just as baby latches. This should last only a few seconds.
- Pain that lasts through the whole feeding is not normal.
- Any breakdown of skin (cracks, scabs, etc.) means that there is a problem.
- Most often, this is caused by an incorrect position or shallow latch, which can put unwanted pressure on the nipple.
- Small corrections can make a big difference.
- You may need help in figuring out just what to change. Talk to your breastfeeding support person for help.
- Applying a drop of expressed breastmilk to the nipple and letting it air dry or using an anhydrous lanolin nipple cream is soothing and helps healing. You do not need to wash it off before the next feeding.
- This occurs when the mature milk comes in, about 3-5 days after birth.
- It is a combination of full milk glands and swelling of the breast tissue.
- You can prevent it by feeding baby frequently.
- Simple treatment with cold compresses.
- Using cold, washed, green cabbage leaves inside the bra (20 minutes at a time, up to 3 times a day) also helps.
- It can be difficult to have a good latch when you are engorged.
- Express a little breastmilk to soften the nipple to help get a better latch.
- Focus on good latch and draining the breast.
Thrush is a yeast infection. This is found in baby’s mouth and often on mom’s nipples and may cause pain or discomfort. Baby may have thrush if:
- There are white spots or coating of the tongue that doesn’t wash off.
- The inside of baby’s lips have a ‘mother of pearl’ appearance.
- Please see your health-care provider for treatment options. Thrush will not clear up on its own.
Breastfeeding and Tongue-tie
The medical term for tongue-tie is ankyloglossia. It is a relatively common problem. The tongue is anchored to the floor of the mouth by a thin, vertical piece of tissue, called the frenulum. For most people, it is attached at about the middle of the tongue. For children with tongue-tie, the frenulum may go all the way to the tip of the tongue, or it may be very short or thick.
Signs of Tongue-tie:
- Nipple pain and cracks.
- After feeding, the end of the nipple looks like the end of a fresh tube of lipstick.
- There is a whitish stripe across the nipple after feeding.
- Baby loses suction while feeding and sucks air.
- Baby’s mouth makes a clicking sound while feeding.
- Baby cannot stick out his or her tongue past the lips.
- The tip of baby’s tongue cannot touch the roof of the mouth.
- Baby cannot move his or her tongue sideways.
- The tip of baby’s tongue may look flat or square instead of pointy.
- The tip of baby’s tongue may be notched or heart-shaped.
- Baby does not gain weight well (good weight gain is 4-12 ounces, or 120 to 320 grams, per week).
If you are concerned about tongue-tie, consult your health-care provider or lactation consultant.
Weaning Your Baby
How to Wean from the Breast
- It is better to spread weaning from the breast over more than three weeks.
- Replace one feeding at a time. Start with the feeding that your baby is least interested in.
- You may feel full for a few days. This is a signal for your breasts to make less milk. If you have pain, use the comfort tips for engorgement.
- After 4 or 5 days, replace another feeding.
- As your baby nurses less often, your milk supply will decrease.
- To makes things easier on you, pump or express only enough milk to relieve soreness.
- Your favorite feeding time is usually the last one to replace.
Medications/Drugs and Breastfeeding
A lot of drugs are safe while breastfeeding. Most are no risk to infants. A few drugs are not safe. Please talk with your health-care provider, pharmacist or lactation consultant about the safety of any drug you need to take.
Alcohol is transferred through breastmilk. It can affect your baby’s development, and lower the amount of milk you make. It is best if you choose no alcohol while you are breastfeeding. If you choose to have a drink, it is best not to breastfeed for at least 2 hours per drink.
- Motherisk has more information on drinking while breastfeeding www.motherisk.org, or call 1-877-439-3744
- Breastfeeding women should avoid all street drugs
- They affect the mother’s ability to care for baby.
- Drugs can pass through the breastmilk. If you have any questions about drugs that you may use and are breastfeeding, please contact Motherisk at 1-877-439-2744 or at www.motherisk.org
- Nicotine is a stimulant that is transferred to baby in breastmilk.
- It can cause irritability in your baby.
- Nicotine can decrease milk production and ejection and may cause poor weight gain.
- Breastfeeding is the healthiest choice for your baby even if you smoke.
- Anyone who smokes should be encouraged to smoke outside and away from baby.
Nicotine levels are the highest right after smoking. To decrease the effects of smoking on your baby:
- Breastfeed before you smoke or use nicotine replacement therapy (NRT).
- Remove the clothing you wore when smoking and wash your hands before holding or caring for baby.
You may get an antibiotic to take for up to 14 days to treat the infection. The antibiotic usually given for mastitis is safe for baby. You can and should continue breastfeeding even if you need medication.
If you have any of these symptoms, please call your health-care provider for treatment.
Not Enough Milk?
Many women think they do not have enough milk for baby. Almost all women have enough milk to feed a baby for many months.
If you are worried about not having enough milk:
- Talk to a Public Health Nurse or lactation consultant as soon as possible
- Spend more time skin-to-skin with baby.
- Make sure baby has a good latch.
- Alternating breast massage and compression during feeding can help improve milk flow and and get milk removed from the breast. It can also keep baby interested in feeding.
- Express or pump a little after each feeding to further increase supply.
- Avoid using artificial nipples so baby will stimulate the breast.
- Be aware that some medications, including low-dose birth control pills reduce milk supply for some women. If you are taking any medication or herbal product, talk to your healthcare provider.
Baby still hungry?
It is normal for baby to want more milk at times when he/she is going through faster periods of growth called growth spurts. Growth spurts are common at 3 weeks, 6 weeks and 6 months of age. For the first six months, handle hunger by feeding your baby more often, not by adding infant cereals or other new foods. Your baby’s body isn’t ready for solids until six months of age. Giving solids before six months will not make your baby sleep through the night.
Herbs for Increasing Milk Supply
Women have used many different herbs to increase their milk supply. The best-known ones are fenugreek and blessed thistle.
- Before using any of these, remember that herbal does not always mean safe.
- Talk to the staff at the health food store or pharmacy where you buy herbal products.
Medication for Increasing Milk Supply
Domperidone is a medication that is used to treat nausea, vomiting and bloating. It also increases milk supply. It requires a prescription. Please talk to your health-care provider for further information.
Ameda (online), 2014
Best Start, 2014
Breastfeeding Basics (online), 2015
Breastfeeding, Inc. (online), 2011
Fraser Health (online), 2016
Haldimand- Norfolk Health Unit Fact Sheets (online), 2015
La Leche League Canada (online), 2016
Mayo Clinic (online), 2015
Medela (online), 2016
Motherisk (online), 2016
For Fathers of Breastfeeding Babies
- Your support for breastfeeding can help decide how long mom will breastfeed.
- When the going gets tough, dad can be the best person to say, “Let’s keep going.”
- Other people may have negative comments. You can head off friends and family who are not helpful.
- Help mom find a place to feed baby while you are out. Just sitting beside her helps with privacy.
- Tell mom that what she is doing is important to you. She may feel overwhelmed during the first few weeks of breastfeeding.
- Be aware of her feelings and keep a positive attitude.
- Skin-to-skin contact is very important for baby to get to know you. Refer to the “Skin-to-skin” section.
- Remember, the more often the baby is breastfed, the more milk mother will produce, and the more she will believe she can do this.
- Involve yourself with the care of your baby.
- Bring the baby to your partner for feedings.
- Assist and learn with your partner about the first feedings.
- Massage her neck and back to help with relaxation while breastfeeding.
- Burp your baby.
- Offer mom a healthy snack or drink while she is feeding baby.
- Be there while your partner breastfeeds, lean close and talk to your partner and baby.
- Hold, carry, bath, diaper, massage, cuddle, soothe, play, talk and read to baby.
- Take baby for a walk in stroller or carrier.
- Help keep the household running smoothly.
- Encourage mom to rest or go out for a while.
- Hold baby on your bare chest and let baby fall asleep in your arms!
It is Common for Moms to Have Baby Blues
- New mothers experience a variety of feelings after the birth.
- Their bodies and feelings are changing fast.
- If mom seems sad or teary a lot, she may have baby blues.
- If you are concerned, encourage her to see her health-care provider.
Becoming a Dad
- Breastfeeding is not a barrier to your having a special relationship with your baby.
- Your role as a father is important, both in the care of your baby and in the nurturing of your partner.
- When baby is older, you will be his or her favorite playmate.
Take Care of Yourself, Too
- Try to balance work, play and family needs.
- You may feel overwhelmed. Talk about it with your partner.
- Help set priorities for preparing meals, doing household chores, etc.
- As new parents, each of you needs to look after your own physical, emotional and spiritual needs.
March of Dimes (online), 2016