Certified lactation counseling
We have a certified Lactation Counselor to help you with your questions and concerns. We can arrange for you to meet with her during your visit. Please note, this additional service may be billed to your insurance company and may be subject to copay or eductible. After your initial counseling visit, our counselor will support you throughout your nursing. She will provide phone follow-up, answer additional questions and provide you with assistance as needed at no additional cost.
When preparing to have a baby, there are many things to consider and many choices to make. How you plan to feed your baby is perhaps one of the more important choices you must make. We understand many women may be apprehensive or unsure at first about breastfeeding vs. bottle-feeding their baby. It’s normal to have many questions related to breastfeeding. Our doctors are here to support you.
Breast milk is nature’s perfect food for infants, specially formulated for your baby. The American Academy of Pediatrics currently recommends that infants be breastfed exclusively for the first six months of life.
Breastfeeding has many advantages for both mom and baby. It has been shown to have a protective effect on children during infancy and beyond. Research shows that children who are breastfed have a lower incidence of various health problems, such as ear infections, pneumonia, bronchiolitis, allergies, meningitis, and SIDS. Breast milk is easy for your baby to digest, does not require any preparation, and costs nothing. Breastfeeding also provides mom and baby with valuable time to bond with one another.
Breastfeeding has several advantages for the mother as well. The hormones excreted during breastfeeding allow the uterus to return to its pre-pregnancy size faster. In addition, the calories burned during lactation help the mother to shed postpartum weight more quickly. Breastfeeding is also correlated with lower rates of breast and ovarian cancer later in life.
The decision to breastfeed is a personal one. Though the benefits are well established, some women are unable to breastfeed for various health reasons, or choose not to breastfeed for individual reasons. If you have any questions or need additional information, please speak with your pediatrician or nurse practitioner. We are committed to promoting breastfeeding while respecting your personal decisions as a parent.
How do I know if my baby is getting enough milk?
This is by far the most common concern of breastfeeding mothers, because you are unable to visualize the amount of milk your baby is getting at each feeding. It is helpful to remember that “what goes in must come out”. Looking at your baby’s urine and stool output is an effective way to determine if your baby is eating enough. Once your milk has come in, your baby should have between 6-8 wet diapers per day and 3-8 yellow seedy stools. Babies should gain about an ounce per day in the first few weeks of life; this will be monitored closely by your pediatrician or nurse practitioner. For further confirmation that your milk supply is adequate, pay attention to your baby’s behavior. You should be able to see and hear swallowing while your baby is feeding. Your baby should seem content after most feedings and fall asleep when his/her belly is full.
You also may see or feel your breasts leaking between or during feedings, and should notice that your breasts feel firm before feedings and softer after a feeding. Please speak with us if you have any concerns.
What can I do about sore nipples?
Nipple soreness is very common in the early days of breastfeeding. Make sure that your baby is latched on to the breast properly. An improper latch is the number one cause of nipple soreness. Your baby’s mouth should be open very wide and should contain as much of the areola (the pigmented area around the nipple) as possible. Your baby’s top lip should be rolled up and the bottom lip should be rolled down, giving the appearance of “fish lips”.
Other measures to help minimize nipple soreness include using different nursing positions. This will prevent your baby from always applying pressure on the same area of the nipple. Keep feedings relatively short (about 10-15 minutes per side) if you experience any soreness or blisters, to allow the skin to heal. Allow nipples to air-dry after feedings and apply 100% lanolin cream to sore areas.
Every time I try to breastfeed my newborn, he falls asleep after a few minutes. What can I do?
This is another common problem in the early days. Newborn babies tend to be very sleepy and can be difficult to feed at first. They act like they are ravenous, and then promptly fall asleep a few minutes into the feeding. This will improve after a few weeks, as your baby gradually has more alert time. In the meantime, there are things you can do to make feedings easier and more productive. First, make sure your baby is fully awake before beginning a feeding. Change your baby’s diaper and stimulate your baby a little before feeding. Stripping your baby down to his diaper is also very helpful in keeping him awake during a feeding. Burp your baby in an upright position before switching breasts and anytime your baby seems to be getting a little too cozy to help wake him and focus on the task at hand. Please speak with us if you are unable to get your baby to feed despite these measures.
When will my baby be on a “schedule”?
To the dismay of many parents, baby’s schedules seem chaotic and hard to predict. This is because your baby grows so quickly in the early months that his nutritional needs and sleep/wake cycles are constantly changing. This is normal! On average, most babies will breastfeed every 2-3 hours. It is very common to have periods of “cluster feeding”, where your baby will demand to be breastfed constantly for 2-4 hours, and then (finally!) have a longer stretch of sleep. Generally, we recommend that you feed your baby on demand; that is, when your baby shows signs of hunger, you feed him, even if it isn’t “time”. Early signs of hunger include rooting, making sucking motions and sucking on hands, and nuzzling when being held. Crying is a later sign of hunger. It is important to make sure your baby eats AT LEAST every 4 hours to ensure adequate nutrition.
How do I store pumped or expressed breast milk?
Breast milk can be stored in the refrigerator for up to 2 days, or in the freezer for up to 2 months. If your baby has eaten breast milk from a bottle, it is important to discard any remaining portion within an hour after feeding, as this milk will “go bad” as a result of the digestive enzymes in your baby’s mouth.
I feel like my milk supply has decreased. What can I do?
First of all, keep in mind that after 2-3 weeks of breastfeeding your baby, your breasts will feel less firm and hard between feedings. This is because your brain is now more efficiently telling your body how much milk to produce for your baby’s needs. Many women interpret this physical change as being a sign that their milk supply is now inadequate, when in fact it is very normal and expected. Again, watch your baby’s output of urine and stool and his hunger cues to determine if your baby is satisfied and getting enough to eat.
Some women do, at some point during breastfeeding, have problems with a true decrease in milk supply. This can occur for many reasons, including: lack of rest, hydration, or nutrition; the side effects of some medications or birth control pills (always check with your pediatrician before taking any medications while nursing); stress; nursing your baby less frequently after returning to work, and others. If this happens to you, there are some simple ways to help increase your supply.
Remember that your milk production works on the principle of “supply and demand”, meaning that the more you stimulate your breasts to produce milk, the more milk your body will produce. It takes several days for your brain to tell your body to make more milk, so it is important to be patient and consistent. If your baby’s feedings are now spaced out to longer intervals, try to either feed your baby more often (a shorter feeding is fine), or stimulate the breasts in between feedings with a breast pump (even if you don’t get any milk out during pumping sessions). Stimulating the breasts at least once in the middle of the night is very important as well, as the hormones responsible for lactation are secreted in larger quantities at night. Though it is a lot of work, stimulating the breasts every 2-3 hours during the day and every 4 hours at night should yield an increased milk supply within a few days. Also make sure that you are eating properly, taking a prenatal vitamin, and drinking 8-10 glasses of water per day. If these measures do not help, please speak with us.
For more information about breastfeeding, try these helpful links: