While breast feeding

What to Expect While Breastfeeding | Nutrition

Every mother’s experience with breastfeeding is different. Whether this is your first baby or you have many, each baby is unique. Breastfeeding will be a learning process.

Your baby is learning how to:

• Latch.
• Suck.
• Swallow.

You are learning how to:

• Position your baby to feed.
• Observe and follow his or her hunger cues.
• Manage your breast milk supply and breast health.

Breastfeeding support is available. Visit our resources page to find the right kind of help for you.

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First Days and Weeks

Milk Coming In

At birth, your breasts will make a thick, yellowish substance called colostrum. Colostrum is packed with nutrients and other important substances that help your baby start building up his or her immune system. There will not be a lot of this liquid at first, but the amount will gradually increase over the first couple of days. Most babies will get all the nutrition they need through colostrum during the first few days of life. As you begin breastfeeding, your baby’s sucking will tell your body to start making milk. For most mothers, this thinner, whiter form of milk comes in by about 3 days after birth, but may take longer for first-time moms. You may notice your breasts feeling full, hard, and warm as this happens. Your baby may begin to want to breastfeed more frequently around this time. If you are concerned about your milk coming in, talk to a lactation consultant or your doctor or nurse.

Pacifiers and your baby.

If you are breastfeeding your baby, you may want to wait to use a pacifier until breastfeeding is well-established. At that time, using a pacifier for naps and at bedtime can help reduce the risk of Sudden Infant Death Syndrome (SIDS).

Leaking

Your breasts may feel full and leak. Over time, the leaking may slow down as your body gets used to breastfeeding. If your breasts leak, you may find it helpful to put disposable or cloth pads in your bra.

Engorgement

Over the first few weeks after birth, your breasts may become larger, firm, warm, and uncomfortable as your body adjusts to making milk. This is called engorgement. As your breasts get used to filling and emptying as you feed your baby, this should improve. Feeding your baby frequently should help to prevent severe engorgement and relieve discomfort.

Sore Nipples

During the first few weeks of breastfeeding, your nipples may be sore or sensitive as they adjust to your baby’s sucking. If you have cracked or damaged nipple skin, or pain that is not improving over the first 1–2 weeks, talk to a lactation consultant or your doctor or nurse.

Pain While Breastfeeding

Although your breasts and nipples may be tender or uncomfortable, once your baby is well-latched, breastfeeding should not be painful. Sometimes pain can happen if you have an improper latch, a milk duct that is clogged with milk (plugged milk duct), a breast infection (mastitis), or other issues. If you have pain while breastfeeding, especially with a fever, talk with your doctor or nurse to figure out why.

Postpartum Depression

Postpartum depression is depression that some women feel after having a baby. Feelings of postpartum depression are more intense and last longer than those of “baby blues,” a term used to describe the worry, sadness, and tiredness many women experience after having a baby. “Baby blues” symptoms typically resolve on their own within a few days. Postpartum depression is common and doesn’t feel the same for everyone. How often symptoms occur, how long they last, and how intense they may feel can be different for each person. Mothers with postpartum depression can usually continue to breastfeed. If you think you may be experiencing postpartum depression, or have other mental health concerns, contact your healthcare provider for help right away.  Many medications do pass into breastmilk, but you can work with your healthcare provider to identify treatment options that are safe to use while breastfeeding.

Breastfeeding Considerations

Human milk provides the best nutrition for most babies, including premature and sick newborns. However, there are rare exceptions when human milk or breastfeeding is not recommended. Learn more about when breastfeeding is not recommended.

Only a few medications are not recommended while breastfeeding. Learn more about safe prescription medication use while breastfeeding.

Learn more about breastfeeding and certain illnesses and conditions.

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As Your Baby Gets Older

Teething/Biting

You can continue to breastfeed once your baby starts to get teeth. Babies use their tongues, not their teeth, to breastfeed. If your baby is latched well and sucking, you should not feel the teeth while your baby is feeding. Once in a while babies might bite the nipple or breast, especially when they are teething. Talk to a lactation consultant for tips on how to teach your baby not to bite.

Refusing to Breastfeed

Sometimes babies will suddenly stop wanting to breastfeed. Many times it is hard to know why this happens. Refusing to breastfeed is usually temporary and your baby will start breastfeeding again within a few days. Some reasons your baby may refuse breastfeeding include teething, illness, stress, a change in environment such as a new childcare situation, or a major change in routine. This usually does not mean your baby is ready to wean.alert icon

To help your baby return to breastfeeding:

• Keep offering your baby the breast or breast milk from a bottle if bottle feeding.
• Spend extra time cuddling and holding your baby.
• Offer the breast in quiet spaces and when your baby is sleepy or relaxed.
• Pump or express milk frequently to keep your breast milk supply up until your baby starts breastfeeding again.

Distracted Breastfeeding

Your baby is starting to notice all the things going on around him or her. This can mean that your baby might get distracted while breastfeeding. Help your baby focus by turning off the TV, dimming the lights, or feeding in a quiet place.

Weaning

Although breastfeeding is recommended until your baby is at least 12 months old, weaning may happen before then. Learn about when and how to wean your baby from breastfeeding.

Visit the Office on Women’s Health websiteexternal icon for more information on learning to breastfeedexternal icon and breastfeeding challengesexternal icon.

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Alcohol | Breastfeeding | CDC

What is “moderate consumption”?

The Dietary Guidelines for Americans defines moderate consumption for women of legal drinking age as up to 1 standard drink per day.

What is a “drink”?

The Dietary Guidelines for Americans defines a standard “drink” as 12 ounces of 5% beer; 8 ounces of 7% malt liquor; 5 ounces of 12% wine; or 1.5 ounces of 40% (80 proof) liquor. All of these drinks contain the same amount (i.e., 14 grams, or 0.6 ounces) of pure alcohol. However, many common drinks contain much more alcohol than this. For example, 12 ounces of 9% beer contains nearly the same amount of alcohol as two (1. 8) standard drinks. Consuming one of these drinks would be the equivalent of two standard drinks.

Is it safe for mothers to breastfeed their infant if they have consumed alcohol?

Not drinking alcohol is the safest option for breastfeeding mothers. Generally, moderate alcohol consumption by a breastfeeding mother (up to 1 standard drink per day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours after a single drink before nursing. However, exposure to alcohol above moderate levels through breast milk could be damaging to an infant’s development, growth, and sleep patterns. Alcohol consumption above moderate levels may also impair a mother’s judgment and ability to safely care for her child.

Drinking alcoholic beverages is not an indication to stop breastfeeding; however, consuming more than one drink per day is not recommended.

Can alcohol be found in breast milk?

Yes. Alcohol levels are usually highest in breast milk 30-60 minutes after an alcoholic beverage is consumed, and can be generally detected in breast milk for about 2-3 hours per drink after it is consumed. However, the length of time alcohol can be detected in breast milk will increase the more alcohol a mother consumes. For example, alcohol from 1 drink can be detected in breast milk for about 2-3 hours, alcohol from 2 drinks can be detected for about 4-5 hours, and alcohol from 3 drinks can be detected for about 6-8 hours, and so on. However, blood alcohol levels and the length of time alcohol can be detected in breast milk after drinking will depend on a number of factors, including the amount of alcohol consumed, how fast the alcohol is consumed, whether it is consumed with food, how much a mother weighs, and how fast alcohol is broken down in a mother’s body.

What effect does alcohol have on a breastfeeding infant?

Moderate alcohol consumption by a breastfeeding mother (up to 1 standard drink per day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours before nursing. However, higher levels of alcohol consumption can interfere with the milk ejection reflex (letdown) while maternal alcohol levels are high. Over time, excessive alcohol consumption could lead to shortened breastfeeding duration due to decreased milk production. Excessive alcohol consumption while breastfeeding could also affect the infant’s sleep patterns and early development.

Alcohol and Caregivers

Caring for an infant while intoxicated is not safe. Drinking alcohol could impair a caregiver’s judgement and his or her ability to safely care for an infant. If a caregiver drinks excessively, he or she should arrange for a sober adult to care for the infant during this time.

Can expressing/pumping breast milk after consuming alcohol reduce the alcohol in the mother’s milk?

No. The alcohol level in breast milk is essentially the same as the alcohol level in a mother’s bloodstream. Expressing or pumping milk after drinking alcohol, and then discarding it (“pumping and dumping”), does NOT reduce the amount of alcohol present in the mother’s milk more quickly. As the mother’s alcohol blood level falls over time, the level of alcohol in her breast milk will also decrease. A mother may choose to express or pump milk after consuming alcohol to ease her physical discomfort or adhere to her milk expression schedule. If a mother decides to express or pump milk within two hours (per drink) of consuming alcohol, the mother may choose to discard the expressed milk. If a mother has consumed more than a moderate amount of alcohol, she may choose to wait 2 hours (per drink) to breastfeed her child, or feed her infant with milk that had been previously expressed when she had not been drinking, to reduce her infant’s exposure to alcohol. Breast milk continues to contain alcohol as long as alcohol is still in the mother’s bloodstream.

What to eat while breastfeeding | Breastfeeding Diet

You know that breast milk is the best food for your baby. What about your own nutrition while breastfeeding? We asked the nutritionist a few questions about the nutrition of a nursing mother.

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Priya Tew, UK-based registered dietitian :
Priya is a nutritionist, M. D., multi-award winning member of the British Dietetic Association and the Health Professions Council. She has three children, and she breastfed each of them for up to 18 months. nine0003

During breastfeeding, there is no need to follow a special diet, the main thing is that your diet is balanced. It should include plenty of fruits and vegetables, whole grains such as oats, brown rice, various cereals, and breads labeled "whole grain", "wholemeal" or "wholemeal". These foods, along with potatoes, pasta, and couscous, are high in starch, an important source of energy.

In addition, you need lean proteins found in chicken, eggs, legumes, lentils, fish, and lean beef, as well as healthy fats found in olive oil, nuts, seeds, avocados, and fatty fish such as salmon and mackerel. Oily fish is very good for your health and development of your baby, but you should not eat more than two servings per week (about 140 g), as it may contain harmful impurities. nine0014 1

Should I take vitamins while breastfeeding?

The most important is vitamin D. It is essential for healthy bones, you and your baby. We get most of this vitamin from the sun. If you live in a region with insufficient solar activity, especially in winter, your body may lack it. In this case, the doctor may advise taking vitamin D supplements. ²

You also need to get enough calcium, as it is excreted from the body during breastfeeding. nine0014 3 Try to eat four servings of foods rich in this mineral a day. These can be dairy products such as milk, yogurt, and cheese, or non-dairy products such as nuts, tofu, sesame seeds, and leafy vegetables. One serving may consist of, for example, half a cup of green vegetables or a small piece of cheese (50 g).

What foods should I avoid while breastfeeding?

The good news is that you can eat almost anything while breastfeeding. Only the consumption of oily fish should be limited. In small quantities, even caffeine is acceptable - more on this below. nine0003

If you are not allergic to peanuts, there is no reason to deny yourself products that contain peanuts. Recent studies show that if you eat peanuts while breastfeeding and gradually introduce them into your baby's diet during the first year, your baby will be less likely to become allergic to them in the future. ⁴

Are extra calories needed while breastfeeding?

Breastfeeding mothers need about 500 more calories a day. nine0014 5 But every mother is unique and your energy needs will change throughout your breastfeeding period. The number of calories you need depends on your baby's age, appetite, height, and weight, as well as your body mass index (BMI), your activity, and factors such as whether you are exclusively breastfeeding or not, and whether you are breastfeeding twins or multiple babies.

Can I go on a diet while breastfeeding?

Trying to lose weight while breastfeeding is not a good idea because you need to get enough nutrients for you and your baby. The fat accumulated during pregnancy is used to produce milk, so breastfeeding in itself will help you shed those extra pounds. nine0003

If your weight changes by more than 1 kg per week, check if you are eating a healthy and balanced diet and adjust if necessary. You can also ask your doctor for advice.

How can I find time to prepare healthy meals?

Having devoted yourself to feeding a child, you can forget about your own nutrition. However, it is important to ensure that your diet does not consist only of sweets and cookies. Of course, sweet snacks are easy and quick, but they do not bring any benefit to your body. nine0003

Opt for quick yet nutritious meals like scrambled eggs with spinach or fried chicken with brown rice. Oatmeal is great for breakfast, as it provides a slow release of energy from grains and soluble dietary fiber, which is what you need to restore strength in the morning after a night of breastfeeding.

Store pre-cut fruits and vegetables in the refrigerator for light snacks, or carry unsalted nuts in your bag. It's much easier than peeling tangerines with one hand while holding a baby with the other. nine0003

Should I drink more water while breastfeeding?

Breastfeeding can make you thirsty, so it's important to drink enough water. A person needs six to eight glasses of fluid a day, and even more if breastfeeding. ⁶ Make it a habit to drink a glass of water, milk or fruit juice without sugar every time you feed your baby.

I love coffee. Do I need to quit caffeine?

Coffee, like everything you eat or drink, passes into your breast milk, so it is advisable to limit your intake while breastfeeding. Legal coffee limits vary by country, but the average recommendation is not to exceed 200-300 mg of caffeine per day (300 mg is equivalent to two cups of filtered coffee or four cups of tea). Talk to your doctor about the acceptable amount of coffee consumption for you. Also, don't forget that caffeine is found in cola and energy drinks, and a small bar of dark chocolate can contain up to 50 mg. nine0014 7

If I eat a varied diet, will my baby be less picky?

Breast milk has the flavor of everything you eat. ⁸ Therefore, if you eat a variety of foods during breastfeeding, giving your baby different tastes to try, he may like them in the future.

If you like spicy and spicy foods, there is no reason to refuse them while breastfeeding. When my first child was born, I ate a lot of spicy food. When my daughter was two years old, we went to Sri Lanka, coincidence or not, but she ate absolutely everything. nine0003

Can something in my diet not be suitable for a child?

At an early age, babies often suffer from colic or are picky eaters, so mothers naturally wonder if their diet is causing this. Most likely no. Studies show that the proportion of children who are allergic to any component of breast milk is only slightly more than 1%. ⁹ Cow's milk, eggs, corn, and soy proteins in moms' diets are much more likely to cause allergic reactions than spicy foods, hot sauces, or cruciferous vegetables, which moms usually worry about. nine0003

If your baby is allergic to substances in your milk, it can cause profuse vomiting, rash, bloody stools, or prolonged constipation. If your baby has an intolerance to any food, you will notice symptoms such as moodiness and crying after feeding, burping, diarrhea, or the baby will press his knees to his chest. Contact your doctor if something is bothering you. He may suggest eliminating certain foods for a couple of weeks, and then see if the child's behavior changes after eating them again. nine0003

You can also keep a food diary: write down everything you eat and drink, as well as your child's symptoms, and you may notice some patterns. However, before cutting out any foods, such as dairy, always check with your doctor, as it's important to know that you're getting the nutrients you need from other sources. Depending on where you live, you will be referred to a nutritionist or other specialist.

Does a vegetarian diet affect breast milk? nine0018

If you are getting enough calories and all the nutrients your body needs (carbohydrates, proteins, fats, vitamins and minerals), then you have nothing to worry about. A vegetarian or vegan diet requires plenty of vitamin B12, vitamin D, calcium, and omega-3 fatty acids while breastfeeding, so opt for foods and supplements that provide you with these essential nutrients.

If you are on a vegetarian, vegan, macrobiotic, or other special diet, you may need additional medical advice to make sure you are getting all the nutrients your baby needs. nine0003

Literature

1 National Health Service (NHS) [Internet]. Burnley, UK: Department of Health; 2018. Should pregnant and breastfeeding women avoid some types of fish?; 2015 Jul 06 [cited 2018 Apr 12]; Available from: https://www.nhs.uk/chq/Pages/should-pregnant-and-breastfeeding-women-avoid-some-types-of-fish.aspx - National Health Service (NHS) [Internet]. Burnley, UK: Department of Health; 2018. "Should a pregnant and lactating woman refrain from eating certain types of fish?"; July 6, 2015 [cited April 12, 2018]; See article on site https://www.nhs. uk/chq/Pages/should-pregnant-and-breastfeeding-women-avoid-some-types-of-fish.aspx

2 Oberhelman SS et al. Maternal vitamin D supplementation to improve the vitamin D status of breast-fed infants: a randomized controlled trial. Mayo Clin Proc. 2013;88(12):1378–1387. - Oberhelman S.S. et al., Introduction of Vitamin D to the Diet of Nursing Mothers to Increase Vitamin D in children: a randomized controlled trial. Mayo Klin Prok. 2013;88(12):1378–1387. : effects on the mother and the fetus. Am J Obstet Gynecol. 2006;194(4):937-945. - Thomas M., Weisman S. M., "Calcium supplementation during pregnancy and lactation: effects on the mother and on the fetus". Am J Obstet Ginekol (American Journal of Obstetrics and Gynecology). 2006;194(4):937-945.

4 Pitt et al Reduced risk of peanut sensitization following exposure through breast-feeding and early peanut introduction. J Allergy Clinic Immunol. 2018;141(2):620-625. e 1 - Pitt et al., "Reducing the Risk of Peanut Allergy by Introducing Peanuts into the Breastfeeding Mother's Diet and as a Baby's First Food." nine0095 G Allergy Clean Immunol. 2018;141(2):620-625.e1