Breastfeeding Common Questions

Should I supplement with formula?
Giving your baby formula may cause him or her to not want as much breast milk. This will decrease your milk supply. If you are worried that your baby is not eating enough, talk to your baby's doctor.

Does my baby need cereal or water?
Your baby only needs breast milk for the first six months of life. Breast milk alone will provide all the nutrition your baby needs. Giving the baby cereal may cause your baby to not want as much breast milk. This will decrease your milk supply. Even in hot climates, breastfed infants do not need water or juice. When your baby is ready for other foods, the food should be iron rich.

Is it okay for my baby to use a pacifier?
If you want to try it, it is best to wait until the baby is 3-4 weeks old to introduce a pacifier. This allows the baby to learn how to latch well on the breast and get enough to eat.

When should I wean my baby?
The American Academy of Pediatrics recommends breastfeeding beyond the baby's first birthday, and for as long as both the mother and baby would like. The easiest and most natural time to wean is when your child leads the process. But how the mother feels is very important in deciding when to wean.

Is my baby getting enough vitamin D?
Vitamin D is needed to build strong bones. All infants and children should get at least 400 International Units (IU) of vitamin D each day. To meet this need, all breastfed infants (including those supplemented with formula) should be given a vitamin D supplement of 400 IU each day. This should start in the first few days of life. You can buy vitamin D supplements for infants at a drug store or grocery store. Sunlight is a major source of vitamin D, but it is hard to measure how much sunlight your baby gets, and too much sun can be harmful. Once your baby is weaned from breast milk, talk to your baby's doctor about whether your baby still needs vitamin D supplements. Some children do not get enough vitamin D through diet alone.

Is it safe to smoke, drink, or use drugs?
If you smoke, it is best for you and your baby to quit as soon as possible. If you can't quit, it is still better to breastfeed because it can help protect your baby from respiratory problems and sudden infant death syndrome. Be sure to smoke away from your baby and change your clothes to keep your baby away from the chemicals smoking leaves behind. Ask a health care provider for help quitting smoking! You should avoid alcohol, especially in large amounts. An occasional small drink is okay, but avoid breastfeeding for two hours after the drink. It is not safe for you to use or be dependent on an illicit drug. Drugs such as cocaine, marijuana, heroin, and PCP harm your baby. Some reported side effects in babies include seizures, vomiting, poor feeding, and tremors.

Can I take medications if I am breastfeeding?
Although almost all medicines pass into your milk in small amounts, most have no effect on the baby and can be used while breastfeeding. Very few medicines can't be used while breastfeeding. Discuss any medicines you are using with your doctor and ask before you start using new medicines. This includes prescription and over-the-counter drugs, vitamins, and dietary or herbal supplements. For some women with chronic health problems, stopping a medicine can be more dangerous than the effects it will have on the breastfed baby. You can learn more from Medications and Mothers' Milk, a book by Thomas Hale, found in bookstores and libraries.

The National Library of Medicine also offers an online tool for learning about the effects of medicines on breastfed babies.

Can I breastfeed if I am sick?
Some women think that when they are sick, they should not breastfeed. But, most common illnesses, such as colds, flu, or diarrhea, can't be passed through breast milk. In fact, if you are sick, your breast milk will have antibodies in it. These antibodies will help protect your baby from getting the same sickness.

Breastfeeding is not advised if the mother:

  • Has been infected with HIV or has AIDS.
  • Is taking antiretroviral medications.
  • Has untreated, active tuberculosis.
  • Is infected with human T-cell lymphotropic virus type I or type II.
  • Is taking prescribed cancer chemotherapy agents such as antimetabolites that interfere with DNA replication and cell division.
  • Is undergoing radiation therapies, but such nuclear medicine therapies require only a temporary break from breastfeeding.

What should I do if I have postpartum depression?
First, postpartum depression is different than postpartum "blues." The blues -which can include lots of tears, and feeling down and overwhelmed -are common and go away on their own. Postpartum depression is less common, more serious, and can last more than two weeks. Symptoms can include feeling irritable and sad, having no energy and not being able to sleep, being overly worried about the baby or not having interest in the baby, and feeling worthless and guilty.

If you have postpartum depression, work with your doctor to find the right treatment for you. Treatment may include medication such as antidepressants and talk therapy.

Research has shown that while antidepressants pass into breast milk, few problems have been reported in infants. Even so, it is important to let your baby's doctor know if you need to take any medications.

Let your doctor know if your blues do not go away so that you can feel better. If you are having any thoughts about harming yourself or your baby, call 911 right away.

Will my partner be jealous if I breastfeed?
If you prepare your partner in advance, there should be no jealousy. Explain that you need support. Discuss the important and lasting health benefits of breastfeeding.

Explain that not making formula means more rest. Be sure to emphasize that breastfeeding can save you money. Your partner can help by changing and burping the baby, sharing chores, and simply sitting with you and the baby to enjoy the special mood that breastfeeding creates. Your partner can also feed the baby pumped breast milk.

Do I have to restrict my sex life while breastfeeding?
No. But, if you are having vaginal dryness, you can try more foreplay and water-based lubricants. You can feed your baby or express some milk before lovemaking so your breasts will be more comfortable and less likely to leak. During sex, you also can put pressure on the nipple when it lets down or have a towel handy to catch the milk.

I heard that breast milk can have toxins in it from my environment. Is it still safe for my baby?
While certain chemicals have appeared in breast milk, breastfeeding remains the best way to feed and nurture young infants and children. The advantages of breastfeeding far outweigh any possible risks from environmental pollutants. To date, the effects of such chemicals have only been seen rarely - in babies whose mothers themselves were ill because of them. Infant formula, the water it is mixed with, and/or the bottles or nipples used to give it to the baby can be contaminated with bacteria or chemicals.

Does my breastfed baby need vaccines? Is it safe for me to get a vaccine when I'm breastfeeding?

Yes. Vaccines are very important to your baby's health. Breastfeeding may also enhance your baby's response to certain immunizations, providing more protection. Follow the schedule your doctor gives you. If you miss any, check with him or her about getting your baby back on track. Breastfeeding while the vaccine is given to your baby - or immediately afterward - can help relieve pain and soothe an upset baby. Most nursing mothers may also receive vaccines. Breastfeeding does not affect the vaccine. Vaccines are not harmful to your breast milk.

What should I do if my baby bites me?
If your baby starts to clamp down, you can put your finger in the baby's mouth and take him or her off of your breast with a firm, "No." Try not to yell because it may scare the baby. If your baby continues to bite you, you can:

  • Stop the feeding right away so the baby is not tempted to get another reaction from you. Don't laugh. This is part of your baby learning limits.
  • Offer a teething toy, or a snack (if older baby), or a drink from a cup instead.
  • Put your baby down for a moment to show that biting brings a negative consequence. You can then pick your baby up again to give comfort.

What do I do if my baby keeps crying?
If your baby does not seem comforted by breastfeeding or other soothing measures, talk to your baby's doctor. Your baby may have colic or may be uncomfortable or in pain. You can also check to see if your baby is teething. The doctor and a lactation consultant can help you find ways to help your baby eat well.

Should my baby always nurse on both breasts?
It is a good idea to encourage your baby to nurse on both breasts at each feeding, but he or she may not always want to. Let your baby nurse on the first breast until finished, then attempt to burp the baby and offer the second breast. If your baby has nursed well on the first breast, and just won't stay awake up for the other, then start on that breast at the next feeding. As your baby becomes more alert for longer periods of time, he or she will probably nurse from both breasts at each feeding.

When should I burp my baby?
Attempt to burp the baby after each breast. Pat the baby on his/her back for about a minute or so, then continue feeding on the second breast. He or she may or may not burp. There is no air in your breast, the breast fills the baby's mouth, and there is not much milk volume in the first few days, so the baby isn't likely to be taking in much air. You may find that the baby burps more readily after you have more milk volume.

How much water should I drink?
Try to drink something each time you nurse the baby, and, of course, drink whenever you are thirsty. You may find that you are thirstier while you are nursing; this is your body's way of reminding you to replace the fluids that your baby is getting through your milk.

Updated June 6, 2016

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