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Breastfeeding Q & A with Onsite’s Dr. Brittany Reid

August is National Breastfeeding Month! As mothers prepare for childbirth, they think about the importance of breastfeeding for the health of their baby. Onsite’s Dr. Brittany Reid answers some questions about breastfeeding that she is often asked as a neonatologist.

Breastfeeding is valuable for both mothers and babies – it facilitates bonding and provides a variety of medical benefits for the pair. However, breastfeeding is a process, and there are challenges that mothers may face. Below are some frequently asked questions that I often discuss with mothers. Understanding more about breastfeeding is the first step towards successfully breastfeeding your baby.  

What is colostrum?

Colostrum is the first milk that a mother produces during pregnancy (12-18 weeks) and continues for the first few days after birth. It usually looks like a thick, sticky, yellow-white liquid. This early milk contains important nutrients and factors to help your baby, so don’t be discouraged if it only seems like a small amount of milk. Every drop you can give makes a difference – why else would colostrum be affectionately called “liquid gold.”

When will my milk come in?

The timing of when milk entirely comes in can vary, but it typically takes between 2-5 days after delivery. Some factors that may delay your milk are the type of delivery (e.g., C-section delivery), lack of ability to start early breastfeeding within the first 1-2 hours after birth, maternal infections, severe stress, or chronic conditions (e.g., diabetes, thyroid problems, and obesity). If any of these apply to you, don’t be disheartened. Continue to breastfeed and pump as able and discuss ways with your doctor to supplement your baby’s nutrition if needed.  

Do I have enough milk?

You can’t exactly measure how much milk your baby is getting when you directly breastfeed. However, there are cues you can monitor and follow to know your baby is getting the right amount: how often your baby feeds per day (goal is 8-12 times a day), adequate pee and poop diapers, listening that your baby is audibly gulping or swallowing during feeding, good weight gain seen at doctor’s visits, and your baby seems content after feeds (e.g., the infant isn’t fussy, has a relaxed posture, and fists are open).

Is all breast milk the same?

Breast milk is very dynamic. It can vary in one person – milk that a mother has in the morning can differ from her evening supply. Breast milk can even vary within the duration of one nursing or pumping session. As time continues, breast milk undergoes more changes to give what a baby needs for proper growth.

What does supplementation mean?

Supplementation means that you give your baby additional milk after breastfeeding. Some mothers may need to supplement if their baby needs extra calories for growth. If you have adequate breast milk, you can supplement using your own breast milk. It’s common that the breast may not be completely emptied after an infant breastfeeds. A mother can do an extra 10-15 minutes of pumping and express more milk after nursing. This additional expressed breast milk can “supplement” whatever the infant ate directly. Expressing milk after breastfeeding can also build a supply of breast milk if you are going back to work.

Are there foods, medications, or medical conditions that prevent me from breastfeeding my baby?

Ask your doctor about how a medication will affect your milk production or your ability to continue breastfeeding. Overall, relatively few medications prohibit breastfeeding; a few exceptions include medicines to treat psychiatric conditions, seizure disorders, or cancer. Certain foods can cause your baby to be fussy or gassy if eaten or drank in excess (e.g., caffeine, spicy foods, etc.), but none completely inhibit a mother’s ability to breastfeed. Lastly, maternal HIV is a medical condition that prohibits breastfeeding due to the increased risk of infection for the baby. Mothers who use illicit drugs (e.g., narcotics, cocaine, PCP, or any medication not prescribed by a doctor) should not breastfeed. Rarely, infants may be diagnosed with a metabolic disorder called galactosemia and cannot receive breast milk because they cannot process specific sugars in the milk.

What foods or supplements can I take to increase my breastmilk supply?

The best methods of increasing your milk production are adequate hydration (e.g., drinking water) and breast stimulation with your baby or a pump. However, some data shows some benefits of eating certain foods or taking supplements. Some examples are oatmeal, fenugreek, and milk. You can always ask your physician about what foods or supplements are safe to try if you are concerned about your breast milk supply.

What is donor breast milk?

Donor breast milk is human milk donated by another lactating mother to a milk bank. The donated milk is screened and pasteurized for other babies who do not have access to breast milk. Donor milk is especially beneficial for premature or sick babies in neonatal intensive care units (NICUs). If you are interested, ask your hospital if this option is available for your baby. Donor milk is sometimes available after hospital discharge as well and should come from a reputable company that adequately tests and pasteurizes the milk.

Medical experts recommend breastfeeding exclusively for at least the first 6-12 months of life. Aim for this goal! But keep in mind that any amount of breast milk you provide is beneficial.

Be strong, be patient, and have faith during your breastfeeding journey!

Additional Breastfeeding Resources:

Kids Health – https://kidshealth.org/en/parents/breastfeed-starting.html

La Leche League International – https://www.llli.org/breastfeeding-info/

US Department of Health and Human Services (Office on Women’s Health) – https://www.womenshealth.gov/breastfeeding

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