All About Breastfeeding

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Mastitis Treatment

Mastitis is a medical condition, which causes inflammation of the breast tissues. Usually, nursing mothers are affected by this condition, which may also occur in women who do not lactate. Such inflammation can be caused by various reasons, but the most common one is infection. Infection is mostly caused by bacteria (either from the baby’s mouth or from the mother’s skin), which may enter the breast tissues through cracked nipples or opening of milk ducts. Other causes are engorgement of the breast (filling of the breast with milk) and blocked milk ducts, which may sometimes lead to infection. It has been observed that, usually mastitis develops within the first six weeks of childbirth, but may occur at later stages too. In rare cases, males too develop this condition.

What are the Symptoms of Mastitis

The symptoms of mastitis may differ in intensity, according to the underlying cause. Most severe symptoms are caused by infection, which is characterized by swelling and redness of the breast. Sometimes, pus may come out of the nipple, and the temperature of the affected breast may also increase. Fever, shivers, nausea or vomiting, and muscle pain may also occur. A burning sensation may also develop while breastfeeding the baby. Mastitis due to infection affects one breast only, but in some cases, both the breasts may get affected. In case of engorgement, the breasts do not empty properly after feedings, and this results in accumulation of milk in the milk ducts. This makes the breasts swollen and sore. Usually, the condition affects both the breasts, and can be painful too. Blocked milk ducts affect only a part of the breast, which carries the blocked duct. The affected women may feel dull pain, but extreme cases may cause severe pain and flu-like symptoms. However, mastitis due to infection is the most severe among all.

How is Mastitis Treated

Mastitis treatment is decided according to the underlying cause and the intensity of the condition. According to health experts, breastfeeding has to be continued, even if there is an infection. Any bacteria in the breast milk will be destroyed by the baby’s digestive system. It is very important to seek medical attention at the earliest, to determine the exact cause of the condition, and to avoid complications. In case of non-infectious mastitis, the doctor may prescribe pain killers. The main requirement is draining the accumulated breast milk, which may otherwise lead to infection. Feed the baby frequently from the engorged breast and massage the affected area.

In case of blocked milk ducts, the affected part of the breast can become swollen and red, with a firm mass inside. This is a temporary condition, which may subside within a few days. However, it can lead to mastitis in some cases, as it develops infection. In order to avoid infection, feed the baby frequently, massage the area well, and apply warmth. Both the above said conditions – engorgement of the breast and blocked milk ducts, may lead to infection. Otherwise too, mastitis can be directly caused by infection of breasts.

In case of infection, oral antibiotics are administered for a stipulated period, along with painkillers. This antibiotic treatment is usually prescribed for simple mastitis. In case of acute mastitis, treatment is aimed at healing the abscess developed in the affected breast due to infection. It includes draining the abscess, which may take around one week to heal, oral antibiotics to eliminate the infection, and emptying the breast by feeding or pumping. If there is an abscess, the doctor may advise you to refrain from feeding the baby from the affected breast. Severe cases of breast infection and abscess may require surgery too.

As soon as you notice the symptoms, seek medical attention. You may also prevent this condition by frequently feeding your baby, ensuring that the breast is drained after each feeding, drinking lots of fluids, boosting your immune system with a balanced diet, and by practicing good personal hygiene.

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How to Increase Breast Milk Supply

A common worry of most mothers is whether they are producing enough milk for their babies. Breastfeeding is important for both the baby as well as the mother. It is extremely important for the baby as breast milk meets all its nutritional requirements, and also provides a number of immunological and developmental benefits that it carries throughout its life. The benefits for mothers include reduced risk of breast cancer and the uterus returning to its pre-pregnancy size. Milk production in a mother’s breast is nature’s way of providing for the newborn. With this fact in mind, it is only logical to understand that nursing the baby is the best way to ensure continuous and increased breast milk supply.

Go for Frequent Feeding: Try to breastfeed your baby more frequently. How frequent this should be depends upon the age of the child. However, if it is a one month old baby, try to feed it every two hours. Even if the baby is sleeping, wake it up for a feed.

Nurse Longer: Do not decide the feeding time of your baby on each breast. Let your baby finish feeding on one breast. When it seems satisfied, switch to the other side. This will help the baby drink the fat rich hindmilk which is supplied as a result of the milk-ejection reflex.

Feeding Techniques: There are some useful feeding techniques, which, if followed, helps in increasing breast milk. Try switch nursing. This works best for those babies who feed slowly or tend to fall asleep during feeds. As the name suggests, switch nursing refers to changing the breast offered to the baby. This should be done as soon as the baby enters the ‘comfort phase’ of sucking the mother’s milk or seems to drift into sleep. Quickly changing the breast at such moments would re-establish the baby’s interest in sucking the breast. This will ensure longer breastfeeding sessions, and hence, is an effective way of increasing supply naturally.

Massage Your Breasts: Baby feeding also helps in the massage of the mother’s breast. This increases breast milk production. Emulate this kneading action by massaging your breast while taking a shower or in the bath. Do this periodically throughout the day. This would signal to your body that the baby is feeding, and milk production would increase accordingly.

Diet: Studies suggest that nursing mothers require almost 500 calories extra everyday. So lactating women who are keen to go on a diet to lose the extra pounds that they gained during pregnancy, should be careful about what they eat and what they rule out of their menu. Lack of enough energy-rich food will leave them tired and in want of energy required for milk production. Avoid too much of caffeine. Although it stimulates milk production, it also stimulates the baby as it enters its system through the mother’s milk. Nursing mothers should also check their soda intake.

Fluid Intake: It is important for a nursing mother to keep herself hydrated. You don’t have to gulp down gallons of water. Just ensure that you have eight to ten glasses of water daily on an average. As long as your urine is clear and you do not suffer from constipation, everything is fine. Some even suggest that drinking milk would increase milk production in a lactating mother, However, no conclusive evidence about this correlation has yet been obtained. Drinking fresh juice should just be as effective as drinking milk as far as milk production in concerned.

Herbs: Although there is no scientific evidence to prove that herbs aid in increasing breast milk production, some herbs are believed to have such properties. Fenugreek might be the answer. Some women also have faith in milk thistle.

Other than these, using breastfeeding pumps, and proper rest and relaxation also ensures proper milk production in nursing mothers.

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Mastitis Symptoms

Mastitis is a type of inflammation in the body, where there is inflammation of the breast tissues that many women feel not just during breastfeeding, but at other times also. However, higher incidence is seen in nursing mothers, because of which it is also known as lactation mastitis. It occurs when a milk duct gets infected, leading to inflammation of the breast tissue, swelling, redness, tenderness, and pain. They are two types of mastitis―non-infectious and infectious mastitis. Non-infectious mastitis occurs when milk remains within the breast tissue and blocks the duct or tissue, and infectious mastitis is the one that is caused by bacteria. When bacteria enters the breast through a crack in the skin of the nipple and into the milk ducts, they multiply and infect the tissues around the duct, which are exhibited through some symptoms.

Symptoms
Mastitis usually occurs in only one breast, but when it occurs due to a Staph infection, it can affect both breasts. This condition often occurs in the early weeks of nursing, and can become very painful. That is why it is imperative to recognize its symptoms and immediately seek treatment to prevent it from turning chronic.

  • The infected breast feels swollen, tender, and very painful, which increases during nursing.
  • A burning sensation while breastfeeding.
  • The pain is accompanied by redness and soreness around the nipples.
  • If more than one duct is blocked, there might be a reduction in milk supply.
  • One may experience breast engorgement in the tissues.
  • Fatigue, tiredness, and a feeling of extreme emotional upheaval can also be experienced by nursing women.
  • Fever around 101 º F or higher, accompanied with chills.

Treatment Options
According to the Academy of Breastfeeding Medicine’s (ABM) Clinical Protocol for Mastitis, “If symptoms of mastitis are mild and have been present for less than 24 hours, conservative management (effective milk removal and supportive measures) may be sufficient. If symptoms are not improving within 12 to 24 hours, or if acutely ill, antibiotics should be started.” Early and prompt treatment will ensure that the nursing period is comfortable, so that the condition does not turn chronic, leading to future complications. The treatment is divided into medical help as well as a few home remedies.

Medical Treatment
The treatment and its course depends upon the number of blocked ducts and the severity. A doctor will mostly conduct a physical examination and take into consideration other symptoms. Antibiotics and pain relievers are generally prescribed to inhibit the spread of infection, reduce inflammation, and soothe the pain. Pain relievers generally include acetaminophen or ibuprofen. It is extremely essential that one completes the course, as this complication is quite prone to recur.

Home Remedies
A few important things to bear in mind while breastfeeding will not only help one improve this condition, but also ensure prevention. Breastfeed frequently and from both breasts, even the affected one. Keep the breasts clean before and after nursing, and swab them with warm water to get rid of any infection. A regular feed will relieve engorgement, as milk flow won’t get thicker and clog the ducts. You can also use a breast pump to completely empty the breasts, if necessary. Sleep on the back and not on the side of the affected breast, and take plenty of rest. A good breastfeeding diet and lots of water should also be consumed.

If the related symptoms appear, they should not be ignored, as when untreated and unchecked, it can turn into an abscess which would require surgical draining. Motherhood and nursing would be an enjoyable experience only if you can learn to manage the complications associated with it as well.

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Fenugreek for Lactation

Fenugreek is an ancient herb, which has been used since ages for its medicinal properties. It comes handy in treating a number of ailments as well. This herb was accorded a higher position by Hippocrates, as well as the Greek and Roman physicians. It is referred to as ‘Trigonella foenum-graecum L.‘ It aids in lactation, therefore it is often given to lactating women. The fenugreek plant is a herb native herb to the Mediterranean region. However, now it is widely grown in Egypt, Morocco, India, and also England. It is used in Greek, Roman, and Egyptian cuisine widely. A fenugreek plant grows up to two feet in height and blooms in the summer. Fenugreek is actually the small stony seeds in the pod. Its plant is similar to a bean plant and the seeds are yellowish brown in color. The seeds are hard and angular or oblong. These seeds have a deep furrow, due to which the seed splits into two. It is available as a whole, dried seed or in the powder form as well. This powder is dull yellow in color and is made after roasting the fenugreek seeds. When these seeds are powdered, it gives off a spicy smell. It has a powerfully aromatic and bittersweet taste. The after taste of fenugreek is bitter and is similar to that of celery.

Fenugreek for Lactation

Scientists are unable to answer the question as to, how does fenugreek help in lactation? It is probably due to the hormone precursors present in it, which boost breast milk production. It has been observed that the milk production increases in about 24 to 72 hours after consumption of this seed. It is said that milk production increases by 900% after consumption of fenugreek. At times, an automatic drain pump is required to drain out excess milk, which was not consumed by the baby. Research has established the fact that it has helped a majority of lactating mothers, but there are cases in which there is no effect after its usage.

Its another benefits is that, even after a woman stops taking fenugreek seeds, the milk production does not reduce. It remains the same, but the mother will have to maintain the adequate milk supply by breast stimulation.

This seed is approved by the FDA, therefore, it safe for consumption. Boil a cup of water and add ½ teaspoon of fenugreek to the water. Bring it to a boil and then let it steep for 15 minutes. Let the water cool down to room temperature. After the water comes to room temperature drink the water and chew the seeds. You will have to consume this mixture twice a day, ideally once in the morning and once in the evening. There are some women who do like its taste, and they can use it in tea. But, the effect of using fenugreek in tea is not similar to consuming it directly. These days, its capsules are also available in the market and the dosage of these capsules vary from one brand to another. However, most of the brands suggest three capsules a day.

Some women also complain of maple-like smell in their urine and sweat, after the consumption of this seed. There are some who complain that their babies urine also displays the same smell. Diarrhea can be caused by fenugreek in some women, but reducing the dosage or stopping the herb totally helps to prevent such a condition.

Lactating women who have been administered insulin, have noted that there was a decrease in their insulin dose after they started consuming fenugreek. This is because fenugreek lowers the blood sugar level. It may reduce asthma symptoms in some women.

Although its consumption is considered safe option for lactating women, it is important to consult your physician before starting its consumption. There are chances that it can have adverse effect on some women. Therefore, it is better to consume it under medical supervision.

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Breastfeeding and Alcohol Consumption

Life is difficult for an expectant mother, before her child arrives. Yet, having a baby is much more difficult post delivery, because the mother has to make many changes to her diet, routine, and life. Though this adjustment is already heavy due to the baby’s added responsibility, it becomes worse when there are people telling her to do this and not do that. This article is for her benefit, so she’s armed with all the knowledge related to breastfeeding and alcohol consumption. Get to know all the pros and cons of alcohol and nursing before you decide on what you must do.

The High-Profile Debate

Many experts vary on this high-profile debate on breastfeeding and alcohol consumption. Let me summarize what a few of these experts have to say about this.

  • The American Academy of Pediatrics Committee on Drugs classifies alcohol (ethanol) as a “Maternal Medication Usually Compatible with Breastfeeding”.
  • Some experts are staunchly opposed to alcohol intake before the baby is weaned off breast milk, no matter how small the quantities.
  • Hale (2002) voices the opinions of many experts when it says that drinking can be done (in moderation) if the nursing is done 2 to 3 hours after the woman stops drinking.
  • Dr. Jack Newman, the author of ‘Ultimate Breastfeeding Book of Answers’, holds the following opinion. He says that “Reasonable intake should not be discouraged at all… Prohibiting alcohol is another way to make life unnecessarily restrictive for nursing mothers.”

Effects on the Mother’s Body

Breast milk is the natural supply of nutrients for newly born babies (for at least the first six months of their lives), so it has a big role to play in the physiological and psychological development of the baby. When alcohol is consumed by the mother, it first makes way into her bloodstream. It then also enters the mother’s breast milk, by the process of diffusion. Though less than 2 percent of the total alcohol consumed ends up in the breast milk, it can still be very harmful for the baby.

If alcohol is consumed by a mother who’s nursing her baby, she needs to take care that she doesn’t breastfeed for at least 2 to 3 hours after the alcohol consumption. This is so because the alcohol levels in the breast milk reach a peak at about 1.5 hours of the consumption, and then drop steadily. Once out of the blood stream, the alcohol also dissipates from the breast milk.

Last but not the least, drinking leads to different effects in different women. La Leche League’s research on a 120 pound woman shows that it takes her 2 to 3 hours for one serving of beer or wine to leave her system completely. For a hard drink cocktail, this may go up to 13 hours. For most women though, this effect stays for a variable amount of time, depending on various factors, like the mother’s height and weight, the mother’s body fat concentration, her last meal consumption, and the baby’s age.

Effects on Mother and Child

The following are the known medical reasons given by experts for discouraging mothers from undertaking both the things together.

  • Drinking alcohol reduces the volume of the mother’s breast milk by a noticeably considerable amount.
  • Nursing after alcohol intake when done on a regular basis, one can see a change in the baby’s sleeping patterns.
  • Younger babies have a slower metabolism rate to digest alcohol, than older babies. For very small babies, alcohol can cause serious liver problems, as their livers are not capable of handling that kind of workload.
  • It can increase the chances of SIDS (Sudden Infant Death Syndrome)
  • It can lead to slow weight gain in the babies.
  • Alcohol in the mother’s breast milk can retard the baby’s mental growth, and are known to inhibit the baby’s motor skills development and can also lead to hyperglycemia.

Some other pointers for this problem are as follows:

  • If you have just delivered a baby, all experts are unanimous in their discouragement of alcohol consumption. This is so, because a new mother’s body is yet to adjust to life and eating post delivery, and should not be given the added burden of coping with the alcohol content as well.
  • If you have had a cesarean delivery and are on some painkillers (stronger than Tylenol), alcohol intake is much more risky for you. The combination of alcohol with these painkillers can make mothers unresponsive towards their baby’s needs.

Though a safe limit for drinking while breastfeeding hasn’t been defined yet, many agree that an occasional, small, single drink, in infrequent bouts, is safe if the nursing is done 2 to 3 hours later. It is valuable for you to note that a drink once a day, or several times a week does not constitute as occasional, but one or two (preferably just stick to one) drinks per week is perfectly healthy for both mother and baby. Pumping and dumping milk is not the right way to get rid of the alcohol-tainted breast milk, as the new milk production is also tainted with alcohol if it hasn’t still left the blood stream. Be aware of what you are doing, and be very careful of your baby’s health. As it is your first priority, you must just remember two things (i) Do not follow myths without scientific backing. (ii) Try not to play with fire, and refrain from consuming alcohol, at least for the six months when you are breastfeeding your baby. Though breastfeeding and alcohol can go together, it is in the best interests of your child that you do not let them go together.

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Diet While You’re Breastfeeding

Just holding your bundle of joy is a bliss like no other. Having a baby, is the defining moment in a woman’s life. A mother always wants to provide the best care and nutrition for her child. It begins, right from the time she conceives the baby. Expecting mothers, add extra vegetables, milk, and all the food items that contain essential nutrients in their diet. Breastfeeding is one of the magical moments of motherhood. Calories required for production of breast milk are gained from fat reserves made during pregnancy. However, those are not enough and need to be replenished, which is why a balanced diet helps in producing ample milk for the baby.

Importance of Breast Milk
Just as the diet plays an important role during pregnancy, the post-pregnancy diet is equally important. After delivery, a mother has to be conscious of what she eats, because the same becomes the source of food for the baby. Breast milk is the first form of nutrient and baby food. Ayurveda studies show, that breast milk is the safest and the easiest way of providing the child with nutrition. It helps the baby to build its immune system by reducing the risk to infections. Breast milk contains vitamins, minerals, and enzymes, which help the baby to develop its digestive system. Rich in lymphocytes and macrophages, breast milk prevents the newborn from intestinal inflammation. Breast milk is also a rich source of iron, which helps cell growth and division.

Foods to Eat During Breastfeeding

Pots of Fluid Intake
Drinking oodles of water, is extremely crucial during this phase. During delivery, the body sheds a lot of water, which makes the mother thirsty in the first few days. However, the thirst will quench with adequate water consumption. As many mothers feel thirsty while breastfeeding, it is advised to drink lots of water. Keep a glass of water with you while feeding. Juices, pulses, and milk are the recommended fluids. However, avoid caffeine as it may be harmful for your baby.

Eat in Variety
Try pushing yourself beyond the comfort zone of your taste buds. The first 7 months of breastfeeding may make you feel hungry. Thinking from the baby’s nutrition point of view, experiment with your food to get adequate diet. Have lots of fresh fruits, vegetables, calcium rich foods, and iron rich foods. Going hungry will hamper your ability to produce milk. Treat yourself to the culinary delight of your choice, but only occasionally.

Calories are Good
Calories are good for lactating mothers, and thus are an integral part of the diet for breastfeeding mothers. A lactating mother spends 500 calories per day, to produce milk for her child. Obviously, the calories have to be refilled into the body. Don’t avoid calories in a hope that you’ll reduce weight. In fact studies show, that mothers who breastfeed their baby loose 0.5 kg a month. Maintain a calorie intake of 2500, spread over 5 meals in a day. The body is continuously producing milk, which is why it needs a regular caloric intake.

No Coffee-No Soda
In the diet during breastfeeding, a mother has to avoid caffeine contained in coffee, and carbon dioxide contained in soda. These can be very harmful for the child. The baby may not be able to sleep well, if caffeine is passed on through breast milk.

Alcohol and Tobacco: A Strict No
Alcohol passes in the breast milk in about less than an hour. Alcohol can retard baby’s growth, and is best when avoided. If the craving for alcohol is too much to handle, have after the feeding session. Even if you have a glass of hard drink and have to breast feed, pump the milk and feed only when sober. Every dietitian will tell you that tobacco is harmful not only for the baby, but you as well. Tobacco reduces appetite and increases nicotine levels in the body. Nicotine passage through milk is likely to cause respiratory ailments, fast heartbeat, restlessness, and vomiting.

Iron and Folic Acid
Consuming foods high in iron and vitamin B9 is an essential part of the diet, during breastfeeding. Folic acid is vital nutrient for development of baby’s nervous system. Eating a lot of spinach, corn, cabbage, fenugreek, asparagus, chickpeas, and beet root will give you the daily dose of iron and folic acids.

Breastfeeding diets are not any different from healthy diets. If a would-be mother adheres to a health diet throughout her pregnancy, there really won’t be any need to take extra efforts to garner all the nutrients post delivery. A follow-up of the healthy diets will ensure good health for you and your baby.

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Breastfeeding FAQs: Supply and Demand

Whether you’re a new mom or a seasoned parenting pro, breastfeeding often comes with its fair share of questions. Here are answers to some common queries that mothers — new and veteran — may have.

How can I increase my milk supply?

Your milk supply is determined by the stimulation that your baby provides while nursing. In other words, the more you breastfeed, the more milk your body produces. So, if you seem to be producing less milk than usual, try to feed your baby more often. You also can pump after nursing to help stimulate more milk production.

Stress, illness, and some medicines can temporarily decrease your supply. Drinking plenty of water and eating good, nutritious food can help. But also try to take some time for yourself each day, even if it’s only for 15-30 minutes.

If your baby is younger than 6 months old and you’re away from your little one for long stretches during the day (for instance, at work), pump or hand express every 3 hours to maintain your supply. Your freshly pumped breast milk can stay at room temperature for 6-8 hours, or in the refrigerator for up to 5 days. When keeping it in the refrigerator, never store it on the shelves in the door.

If the milk is not going to be used within 5 days, store it in the freezer. Pumped breast milk can be safely stored in the freezer compartment of a refrigerator that has a separate suction-sealed door for 3-6 months or in a deep freezer for 6-12 months.

If your milk supply still seems low and you’re concerned, you may want to talk to your doctor, your pediatrician, or a lactation consultant.

If I wait to nurse, will my milk supply increase?

Actually, no — it’s the opposite. Waiting too long to nurse or pump can slowly reduce your milk supply. The more you delay nursing or pumping, the less milk your body will produce because the overfilled breast sends the signal that you must need less milk.

Once babies are back to their birth weight, they can sleep for longer stretches at night and will gradually lengthen the time between nighttime feedings. Letting your baby sleep for longer periods during the night won’t hurt your breastfeeding efforts. Your baby is able to take more during feedings, and that, in turn, will have him or her sleeping longer between nighttime feedings. Your body will adjust to the longer spacing.

Some moms wake during the night with full breasts and a sleeping baby. If that happens, pump for comfort and to help your body adjust to your little one’s new schedule at night.

The interval for daytime feedings usually stays between 1-3 hours for the first few months and then may lengthen to 4 hours or so. Cutting back on feedings during the day can lead to a decreased milk supply over time.

If you follow your baby’s cues and spread out the feedings as he or she wishes, your milk supply should remain at what your baby needs.

I’m producing too much milk. What can I do?

Whereas some women may feel like they don’t have enough milk, others may feel like they’re making too much. Some mothers’ bodies just produce more milk than their babies need. Others overstimulate their breasts by pumping or expressing milk between feedings. If expressing or pumping to relieve discomfort, remove just enough to feel comfortable but don’t empty the breast.

Alternate the breast that you start each feeding with. Let the baby stay at the first breast until either the breast is very soft or the baby is full. If the baby is not satisfied with the first breast, then offer the second breast.

A mom may try nursing on only one breast during a feeding to help to lessen her milk supply. Over time, she should notice her milk supply and “let-down reflex” (the milk ejection reflex) become easier to handle.

Sometimes a woman’s let-down is really strong and causes the baby to gag and pull off of the breast. If your baby is staying on the breast and handling the flow of milk, you don’t need to do anything. If the baby is pulling off and coughing, sit your baby up in a seated burp position. Pat your baby’s back to help him or her regain composure. You can use a burp cloth pressed into the breast to help slow the flow, then latch your baby back onto your breast when ready to resume feeding.

Nursing your baby in a more upright position (head above the breast) also may decrease the force of the let-down. A side lying position also might help slow the flow of milk.

My baby favors just one breast. Is this OK?

Some babies might prefer one breast over the other. If this happens, to keep up your milk supply in both breasts (and prevent painful engorgement), alternate breasts and keep your baby on the first breast until it’s soft, then move your baby to the second breast. This ensures that your little one gets the hindmilk, which is creamier and contains more calories than the foremilk, which comes at the beginning of a feeding.

Some babies will always take the second breast and some will be satisfied with just the first breast. At the end of the feeding, if both breasts are comfortable, you don’t need to pump. But if either breast is still full and uncomfortable, pump or hand express to comfort.

Of course, if your baby won’t latch onto one of your breasts, pump or hand express that breast to maintain its milk supply until your little one is latching onto both breasts easily.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: February 2015
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Breastfeeding FAQs: Your Eating and Drinking Habits

Whether you’re a new mom or a seasoned parenting pro, breastfeeding often comes with its fair share of questions. Here are answers to some common queries that mothers — new and veteran — may have.

What should I eat?

Just as when you were pregnant, it’s important to eat well while you’re breastfeeding, with plenty of wholesome fruits, vegetables, whole grains, protein, and calcium-rich foods. Follow the recommendations in the MyPlate food guide and you’ll be well on your way to giving both you and your baby a nutritious diet.

Your diet doesn’t have to be perfect. You need an estimated 300-500 extra calories per day as a breastfeeding mother. Breastfeeding might make you thirsty, so consider keeping a water bottle nearby so it’s there when you need it.

Also ask your doctor if you should still take your prenatal vitamins — many doctors have women continue them during breastfeeding. To prevent problems associated with iodine deficiency, the American Academy of Pediatrics (AAP) recommends that all lactating women take a supplement that contains 150 micrograms of iodine per day, use iodized salt in their cooking, and eat foods high in iodine, like seafood and dairy products. If you are vegan or don’t eat dairy or fish, talk to your doctor about getting checked for iodine deficiency.

Does my breastfed baby have an allergy?

A breastfed baby may have an allergy or sensitivity reaction after the mother consumes certain foods or drinks (such as common food allergens like cow’s milk, soy foods, wheat, corn, oats, eggs, nuts and peanuts, and fish or shellfish).

Signs of a baby having such a reaction to food can include:

  • frequent spitting up or vomiting
  • apparent belly pain (lots of gas and/or pulling up the knees in pain)
  • bloody, mucousy stools (poop)
  • hard stools
  • rash and swelling

If you think your baby has had a reaction to food, call your doctor and avoid eating or drinking anything your little one can’t seem to tolerate. If your baby has difficulty with feeding, try to keep a journal of exactly what you eat and drink, along with any reactions your baby had, which could help both you and your doctor pinpoint what the problem food, or foods, might be.

Although such a reaction is extremely rare, if your child has trouble breathing or has swelling of the face, call 911.

Should I avoid certain foods?

Every baby is different. Some moms may find that if they eat beans, cauliflower, or broccoli, their little ones get gassy or fussy while other babies can tolerate these foods just fine. And some mothers can confirm that after they eat spicy foods, their babies don’t seem to like the taste of their breast milk. Again, other babies may not mind if mom just enjoyed a bunch of hot chili peppers.

Just like during pregnancy, nursing moms should avoid or limit their intake of fish high in mercury, since high mercury levels can damage the developing nervous system.

Also, if you notice a pattern (of fussiness, gassiness, colicky behavior, etc.), try to keep track of exactly what you eat and how your baby reacts to it each time, then talk to your doctor. He or she may suggest not eating the food (such as dairy products, a common allergen) for a few days to see if there’s any change.

Is alcohol still a “no-no”?

Drinking in moderation — one or two drinks within a 24-hour period — is fine, as long as you wait before feeding your baby.

When you drink alcohol, a small amount of it gets into your breast milk. The amount of alcohol in breast milk depends on the amount of alcohol in the blood. It takes about 2 hours after having one drink for the alcohol to be metabolized and no longer be a concern for nursing. So do not give your baby fresh breast milk, from your breast or pumped for a bottle, for at least 2 hours if you’ve had one drink, 4 hours if you’ve had two drinks, and so on.

If you plan to drink more than a few (preferably after breastfeeding’s been established for about a month), you can “pump and dump” — pump your milk and then throw it away.

But drinking to excess when you’re nursing is not recommended. Even if you “pump and dump,” there are other risks to your baby. Drinking too much affects how you care for your baby and may prevent you from responding to your baby’s needs appropriately, since it alters your ability to be alert and think clearly. It’s also a risk factor for SIDS (sudden infant death syndrome).

Can I have caffeine?

As with alcohol, it’s best to limit the amount of caffeine you consume while breastfeeding. One or two cups of coffee a day are fine, but more than one or two servings of caffeine per day may affect your baby’s mood and/or sleep.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: February 2015
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Breastfeeding vs. Formula Feeding

Choosing whether to breastfeed or formula feed their baby is one of the biggest decisions expectant and new parents will make.

A number of health organizations — including the American Academy of Pediatrics (AAP), the American Medical Association (AMA), and the World Health Organization (WHO) — recommend breastfeeding as the best choice for babies. Breastfeeding helps defend against infections, prevent allergies, and protect against a number of chronic conditions.

The AAP recommends that babies be breastfed exclusively for the first 6 months. Beyond that, breastfeeding is encouraged until at least 12 months, and longer if both the mother and baby are willing.

Although experts believe breast milk is the best nutritional choice for infants, breastfeeding may not be possible for all women. For many, the decision to breastfeed or formula feed is based on their comfort level, lifestyle, and specific medical situations.

For mothers who are unable to breastfeed or who decide not to, infant formula is a healthy alternative. Formula provides babies with the nutrients they need to grow and thrive.

Some mothers worry that if they don’t breastfeed, they won’t bond with their baby. But the truth is, loving mothers will always create a special bond with their children. And feeding — no matter how — is a great time to strengthen that bond.

The decision to breastfeed or formula feed your baby is a personal one. Weighing the pros and cons of each method can help you decide what is best for you and your baby.

All About Breastfeeding

Nursing can be a wonderful experience for both mother and baby. It provides ideal nourishment and a special bonding experience that many mothers cherish.

Here are some of the many benefits of breastfeeding:

Fighting infections and other conditions. Breastfed babies have fewer infections and hospitalizations than formula-fed infants. During breastfeeding, antibodies and other germ-fighting factors pass from a mother to her baby and strengthen the immune system. This helps lower a baby’s chances of getting many infections, including:

  • ear infections
  • diarrhea
  • respiratory infections
  • meningitis

Breastfeeding also may protect babies against:

  • allergies
  • asthma
  • diabetes
  • obesity
  • sudden infant death syndrome (SIDS)

Breastfeeding is particularly beneficial for premature babies.

Nutrition and ease of digestion. Often called the “perfect food” for a human baby’s digestive system, breast milk’s components — lactose, protein (whey and casein), and fat — are easily digested by a newborn.

As a group, breastfed infants have less difficulty with digestion than do formula-fed infants. Breast milk tends to be more easily digested so that breastfed babies have fewer bouts of diarrhea or constipation.

Breast milk also naturally contains many of the vitamins and minerals that a newborn requires. One exception is vitamin D — the AAP recommends that all breastfed babies begin receiving vitamin D supplements during the first 2 months and continuing until a baby consumes enough vitamin D-fortified formula or milk (after 1 year of age).

The U.S. Food and Drug Administration (FDA) regulates formula companies to ensure they provide all the necessary nutrients (including vitamin D) in their formulas. Still, commercial formulas can’t completely match breast milk’s exact composition. Why? Because milk is a living substance made by each mother for her individual infant, a process that can’t be duplicated in a factory.

Free. Breast milk doesn’t cost a cent, while the cost of formula quickly adds up. And unless you’re pumping breast milk and giving it to your baby, there’s no need for bottles, nipples, and other supplies that can be costly. Since breastfed babies are less likely to be sick, that may mean they make fewer trips to the doctor’s office, so fewer co-pays and less money are paid for prescriptions and over-the-counter medicines.

Different tastes. Nursing mothers usually need 500 extra calories per day, which means they should eat a wide variety of well-balanced foods. This introduces breastfed babies to different tastes through their mothers’ breast milk, which has different flavors depending on what their mothers have eaten. By tasting the foods of their “culture,” breastfed infants more easily accept solid foods.

Convenience. With no last-minute runs to the store for more formula, breast milk is always fresh and available whether you’re home or out and about. And when women breastfeed, there’s no need to wash bottles and nipples or warm up bottles in the middle of the night.

Smarter babies. Some studies suggest that children who were exclusively breastfed have slightly higher IQs than children who were formula fed.

“Skin-to-skin” contact. Many nursing mothers really enjoy the experience of bonding so closely with their babies. And the skin-to-skin contact can enhance the emotional connection between mother and infant.

Beneficial for mom, too. The ability to totally nourish a baby can help a new mother feel confident in her ability to care for her baby. Breastfeeding also burns calories and helps shrink the uterus, so nursing moms may be able to return to their pre-pregnancy shape and weight quicker. Also, studies show that breastfeeding helps lower the risk of breast cancer, high blood pressure, diabetes, and cardiovascular disease, and also may help decrease the risk of uterine and ovarian cancer.

Breastfeeding Challenges

Breastfeeding can be easy from the get-go for some mothers, but take a while to get used to for others. Moms and babies need plenty of patience to get used to the routine of breastfeeding.

Common concerns of new moms, especially during the first few weeks and months, may include:

Personal comfort. Initially, many moms feel uncomfortable with breastfeeding. But with proper education, support, and practice, most moms overcome this.

Latch-on pain is normal for the first week to 10 days, and should last less than a minute with each feeding. But if breastfeeding hurts throughout feedings, or if their nipples and/or breasts are sore, it’s a good idea for breastfeeding mothers to get help from a lactation consultant or their doctor. Many times, it’s just a matter of using the proper technique, but sometimes pain can mean that something else is going on, like an infection.

Time and frequency of feedings. Breastfeeding requires a big time commitment from mothers, especially in the beginning, when babies feed often. A breastfeeding schedule or the need to pump breast milk during the day can make it harder for some moms to work, run errands, or travel.

And breastfed babies do need to eat more often than babies who take formula, because breast milk digests faster than formula. This means mom may find herself in demand every 2 or 3 hours (maybe more, maybe less) in the first few weeks.

Diet. Women who are breastfeeding need to be aware of what they eat and drink, since these can be passed to the baby through the breast milk. Just like during pregnancy, breastfeeding women should not eat fish that are high in mercury and limit consumption of lower mercury fish.

If a mom drinks alcohol, a small amount can pass to the baby through breast milk. She should wait at least 2 hours after a single alcoholic drink to breastfeed to avoid passing any alcohol to the baby. Caffeine intake should be kept to no more than 300 milligrams (about one to three cups of regular coffee) or less per day because it can cause problems like restlessness and irritability in some babies.

Maternal medical conditions, medicines, and breast surgery. Medical conditions such as HIV or AIDS or those that involve chemotherapy or treatment with certain medicines can make breastfeeding unsafe. A woman should check with her doctor or a lactation consultant if she’s unsure if she should breastfeed with a specific condition. Women should always check with the doctor about the safety of taking medicines while breastfeeding, including over-the-counter and herbal medicines.

Mothers who’ve had breast surgery, such as a reduction, may have difficulty with their milk supply if their milk ducts have been severed. In this situation, a woman should to talk to her doctor about her concerns and work with a lactation specialist.

All About Formula Feeding

Commercially prepared infant formulas are a nutritious alternative to breast milk, and even contain some vitamins and nutrients that breastfed babies need to get from supplements.

Manufactured under sterile conditions, commercial formulas attempt to duplicate mother’s milk using a complex combination of proteins, sugars, fats, and vitamins that aren’t possible to create at home. So if you don’t breastfeed your baby, it’s important to use only commercially prepared formula and not try to make your own.

Besides medical concerns that may prevent breastfeeding, for some women, breastfeeding may be too difficult or stressful. Here are other reasons women may choose to formula feed:

Convenience. Either parent (or another caregiver) can feed the baby a bottle at any time (although this is also true for women who pump their breast milk). This allows mom to share the feeding duties and helps her partner to feel more involved in the crucial feeding process and the bonding that often comes with it.

Flexibility. Once the bottles are made, a formula-feeding mother can leave her baby with a partner or caregiver and know that her little one’s feedings are taken care of. There’s no need to pump or to schedule work or other obligations and activities around the baby’s feeding schedule. And formula-feeding moms don’t need to find a private place to nurse in public.

Time and frequency of feedings. Because formula is less digestible than breast milk, formula-fed babies usually need to eat less often than breastfed babies.

Diet. Women who opt to formula feed don’t have to worry about the things they eat or drink that could affect their babies.

Formula Feeding Challenges

As with breastfeeding, there are some challenges to consider when deciding whether to formula feed.

Lack of antibodies. None of the antibodies found in breast milk are in manufactured formula. So formula can’t provide a baby with the added protection against infection and illness that breast milk does.

Can’t match the complexity of breast milk. Manufactured formulas have yet to duplicate the complexity of breast milk, which changes as the baby’s needs change.

Planning and organization. Unlike breast milk — which is always available, unlimited, and served at the right temperature — formula feeding your baby requires planning and organization to make sure that you have what you need when you need it. Parents must buy formula and make sure it’s always on hand to avoid late-night runs to the store.

And it’s important to always have the necessary supplies (like bottles and nipples) clean, easily accessible, and ready to go — otherwise, you will have a very hungry, very fussy baby to answer to. With 8-10 feedings in a 24-hour period, parents can quickly get overwhelmed if they’re not prepared and organized.

Expense. Formula can be costly. Powdered formula is the least expensive, followed by concentrated, with ready-to-feed being the most expensive. And specialty formulas (such as soy and hypoallergenic) cost more — sometimes far more — than the basic formulas. During the first year of life, the cost of basic formula can run about $1,500.

Possibility of producing gas and constipation. Formula-fed babies may have more gas and firmer bowel movements than breastfed babies.

Making a Choice

Deciding how you will feed your baby is not an easy decision to make. You’ll really only know the right choice for your family once your baby comes.

Many women decide on one method before the birth and then change their minds once their baby is born, or in the weeks or months after. And many women decide to breastfeed and supplement with formula because they find that is the best choice for their family and their lifestyle.

While you’re weighing the pros and cons, talk to your doctor or lactation consultant. These health care providers can give you more information about the options available and help you make the best decision for your family.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: February 2015
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Burping Your Baby

Feeding a baby is an exciting experience for any new parent. It can also be a little intimidating, especially if you don’t know what to expect. So here’s a quick guide to an important aspect of feeding — burping.

Burping helps to get rid of some of the air that babies tend to swallow during feeding. In some babies, not being burped frequently and too much swallowed air can lead to spitting up, crankiness, and gassiness.

How to Burp Your Baby

When burping your baby, repeated gentle patting on your baby’s back should do the trick — there’s no need to pound hard. To prevent messy cleanups when your baby spits up or has a “wet burp,” you might want to place a towel or bib under your baby’s chin or on your shoulder.

Try experimenting with different positions for burping that are comfortable for you and your baby. Many parents prefer to use one of these three methods:

  1. Sit upright and hold your baby against your chest. Your baby’s chin should rest on your shoulder as you support the baby with one hand. With the other hand, gently pat your baby’s back. Sitting in a rocking chair and gently rocking with your baby while you do this may also help.
  2. Hold your baby sitting up, in your lap or across your knee. Support your baby’s chest and head with one hand by cradling your baby’s chin in the palm of your hand and resting the heel of your hand on your baby’s chest (but be careful to grip your baby’s chin, not throat). Use the other hand to pat your baby’s back gently.
  3. Lay your baby on your lap on his or her belly. Support your baby’s head and make sure it’s higher than his or her chest. Gently pat your baby’s back.

If your baby seems fussy while feeding, stop the session, burp your baby, and then begin feeding again. Try burping your baby every 2 to 3 ounces (60 to 90 milliliters) if you bottle-feed and each time you switch breasts if you breastfeed.

If your baby tends to be gassy, spits a lot, has gastroesophageal reflux disease (GERD), or seems fussy during feeding, try burping your baby every ounce during bottle-feeding or every 5 minutes during breastfeeding. If your baby doesn’t burp after a few minutes, change the baby’s position and try burping for another few minutes before feeding again. Always burp your baby when feeding time is over.

For the first 6 months or so, keep your baby in an upright position for 10 to 15 minutes (or longer if your baby spits up or has GERD) after feeding to help prevent the milk from coming back up. But don’t worry if your baby spits sometimes. It’s probably more unpleasant for you than it is for your baby.

Sometimes your baby may awaken because of gas — simply picking your little one up to burp might put him or her back to sleep. As your baby gets older, you shouldn’t worry if your child doesn’t burp during or after every feeding. Usually, it just means that your baby has learned to eat without swallowing excess air.

Babies with colic (3 or more hours a day of continued crying) might also have gas from swallowing too much air during crying spells, which can make the baby even more uncomfortable. Using anti-gas drops has not proven to be an effective way to treat colic or gas, and some available medications can be dangerous.

Reviewed by: Rupal Christine Gupta, MD
Date reviewed: July 2016

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