I’ve Had My Baby - Now What?: Breastfeeding During the First Week

Originally published on Jan 24, 2014; Revised Feb 22, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

Welcome to our new series, I’ve Had My Baby - Now What?  This is a guide with basic information to help you navigate the first days, weeks, and months of chest/breastfeeding your new baby.  

Today we would like to talk about that first week after your baby has arrived.  Chest/breastfeeding can often seem overwhelming and  unfamiliar.  New parents often receive a *huge* amount of differing advice from many well-intentioned people, which can be incredibly confusing and discouraging.  Below is a quick guideline to what “normal” chest/breastfeeding looks like, as well as some examples of when things aren’t going as they should and when you might want to seek help.

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

How often should my new baby be eating and how long should each feeding take?

A newborn needs to feed 8 or more times in 24 hours.  It’s especially important in the early days to feed your baby “on demand”, or whenever the baby shows signs of hunger, regardless of when baby ate last.  If your baby is not asking to eat every 2-3 hours, or 8 or more times in 24 hours, it is important to wake the baby to feed him/her, until they have regained their birth weight.  A feeding session typically takes approximately 30-45 minutes, and both breasts should be offered during this time.  It’s important to keep the baby actively feeding during those 30-45 minutes.

How do I know my baby is getting enough milk?

A great way to be sure baby is getting enough breastmilk is to keep a physical log of all feedings (start time and length), as well as all pees and poops. A baby who is taking enough milk will be feeding 8 or more times in 24 hours, for 30-45 minutes, and having 1 pee diaper and 1 poop diaper per day of life, until day 5.  For example, on day 1, baby should be having 1 pee and 1 poop diaper, day 2, 2 of each, etc.  After day 5, baby should be having 5 or so of each per day.  A baby who is getting enough should be satisfied for approximately an hour or two after feeding.  However, most babies will cluster feed for a 4-5 hour period during the day, when they may want to eat more frequently.  This is normal baby behavior!

How much milk does my baby actually need?

A baby needs very little milk per feeding during their first few days of life.  This is because they’re born full of meconium, which are those first few poops.  This is a perfect fit for you, as your first milk, colostrum, is low in volume.  The small amount you make is just the right amount for your baby.  The amount your baby needs slowly increases, and as your milk makes the transition from the low volume colostrum, to the higher volume mature milk between day 3 and day 5, your baby’s needs go up as well.  Nature works beautifully!

I need to supplement my baby, what are my options?

Sometimes, a baby may need to be supplemented with additional milk.  There are many reasons for this - a baby has jaundice,  is not latching well, there is a delay in the parent’s milk “coming in”, etc.  When supplementation is necessary, it’s important to remember that you can use your own pumped milk.  If you aren’t able to pump the amount you need, you can use donor milk instead.  Formula is the last resort option.  There are various methods to supplement your baby as well.  You can supplement your baby at your chest/breast using a supplemental nursing system, you can finger feed your baby, or cup/spoon feed your baby.  A slow flow bottle is always an option as well and a lactation consultant can show you how to feed your baby a bottle in a chest/breastfeeding-friendly manner.

Holy moly,  my boobs are like rocks!  They hurt and I can’t get baby latched on, what can I do?

As  your milk transitions from the low volume first milk, to the higher volume mature milk, it is common for your chest/breasts to feel full and sometimes experience engorgement.  Engorgement occurs when the chest/breasts fill up with so much milk that they become hard and  uncomfortable.  It can sometimes be difficult to get the milk flowing and baby sometimes has a hard time latching on.  

Some tricks to latch your baby on during this time are:

• Pump or hand express for a few moments before latching your baby to soften your chest/breasts and get milk moving

• Use warm compresses or take a shower just before feeding

• Use cold compresses in between feedings to reduce inflammation.  

  If you still  feel incredibly uncomfortable after your baby feeds, you can pump or hand express some additional milk - but it is important to only pump to comfort as you don’t want to send the message to your body to make even more milk.  

  Please be aware that if you begin to run a high fever, have flu-like symptoms, and hot or red spots on your chest/breast, you may be developing a breast infection (mastitis) and it’s important to seek medical attention immediately.  

Why do my nipples hurt and what can I do to heal them?

It’s normal for all parents to feel some initial nipple tenderness and discomfort in the first days and weeks of chest/breastfeeding.  Anything beyond tenderness is a sign that something may not be going right, especially if there is any tissue breakdown, damage, cracks or bleeding.  If you experience any of these, please seek the help of a lactation consultant.  Great healing items are organic coconut oil and hydrogels, or soothing gels, sold by many different companies and available at big box stores.  The best prevention for sore nipples is a good latch. If you are having trouble finding a correct latch, give us a call!

When should I seek help?

There may be times when things aren’t going the way they should.  Our IBCLCs can absolutely help you with all of this!  Some signs that you might need some additional help:

• Damaged/cracked/bleeding nipples.

• Baby isn’t gaining weight/parent’s milk hasn’t “come in” by day 5.

• You suspect your baby is tongue-tied.

• Baby isn’t peeing or stooling the amount that they should.

• Breast infection/Breast abscess

• Oversupply

• Extremely fussy/gassy baby

If you’re unsure about your baby’s latch, milk intake, or feeding patterns, know that you’re not alone—we’re here to help!

The first week of breastfeeding comes with many changes, and it’s completely normal to have questions or concerns along the way. Whether you need guidance on positioning, reassurance about your baby’s feeding cues, or support with any challenges that arise, our team is here to provide the care and expertise you deserve. Schedule a one-on-one appointment (consider a virtual appointment, if you don’t live in San Diego!) with one of our lactation consultants for personalized care and expert advice tailored to your baby’s unique needs.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

On-Demand vs. Scheduled Feeding: Which is Best for Baby?

Originally published on Dec 9, 2014; Revised Nov 10, 2024 

Author: Robin Kaplan, M.Ed, IBCLC, FNC

When it comes to chest/breastfeeding, parents often wonder whether on-demand feeding (also known as on-cue feeding) or scheduled feeding is best for their baby’s growth and well-being.

We get asked this question in our clinic all of the time!  Parents hear a lot of differing information about when to feed their babies in the early weeks - every 2-3 hours, 8-12 times in a 24 hour period, etc.  It can be confusing to know what this means exactly - is it every 2 hours or every 3 hours?  What if the baby goes longer than 3 hours?  What if the baby seems hungry before 2 hours?  In this post, we’ll break down the differences between on-demand and scheduled feeding to help you decide what works best for you and your baby.

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges. 

SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

On-Demand vs Scheduled Feedings

What’s the difference between demand feeding and scheduled feeding?

Demand feeding, or on-cue feeding, involves feeding a baby whenever they show signs of hunger, like rooting, sucking on their hands, or fussing. 

Scheduled feeding means feeding a baby at set intervals, like every 3 hours, regardless of hunger cues.

What Does On-Demand Breastfeeding Look Like?

• Babies regulate their own intake: Babies feed as often and as much as they need to support their growth and development.  Some feedings can last 10 minutes.  Others can last 45+ minutes.

• Babies are fed when they show common hunger cues: For the first few months, your infant will show you they are hungry by licking their lips, sticking out their tongue, rooting around, and sucking on their hands, etc.  Crying can also be a hunger cue.  

• Babies show signs when they’ve had enough: When a baby is done with a feeding, they may unlatch themselves and not try to relatch or fall asleep while nursing and seem content when the parent unlatches them.  

Benefits of On-Demand Breastfeeding

• Optimizes milk supply: In the immediate days following birth, putting a baby to chest/breast at any and all hunger cues is excellent for bringing in a robust milk supply.  Mammary glands make milk in response to the frequency of suckling. The more a baby nurses, the more milk a parent produces. If a baby suckles less frequently, milk production slows. Frequent feedings during growth spurts also boosts milk production.

• Ensures proper infant growth: Parents have different storage capacities in their chest/breasts and all babies take in different amounts - even the same baby will take differing amounts throughout a day.  On-demand feeding optimizes the baby’s ability to take in the amount of milk they need within a 24 hour period, rather than the same amount every feeding session.

• Bonding opportunities galore: Feeding on demand allows for more skin-to-skin contact and closeness between parent and baby, as infants tend to settle more easily when held.  Plus, infants smell delicious, which helps parents release oxytocin (aka the love hormone!)

What Does Scheduled Breastfeeding Look Like?

• Fixed feeding intervals: In scheduled breastfeeding, parents feed their baby at set intervals, such as every 3 hours, regardless of whether the baby shows hunger cues. 

• Limited feeding duration: Some parents may set specific feeding times, like feeding for 15 minutes on each side.

• Structured daily routines: Scheduled feeding often fits into a structured daily routine, like feeding before naps or bedtime to establish predictable eating and sleeping patterns. 

Benefits of Scheduled Breastfeeding

• Sleepy newborns don’t always wake for feeding sessions: Some infants are very tired for the first few weeks and may not wake up on their own to feed 8+ times in 24 hours.  To help babies get back to birth weight by 2 weeks old, we recommend that parents wake their infants to feed at least every 3 hours during the day and at least every 4 hours at night for the first few weeks.  If your baby wants to feed more frequently, go for it!

• Helps manage triple feeding: Triple feedings is when a parent is chest/breastfeeding, supplementing, and pumping. This is most common for babies born prematurely, babies with jaundice, babies with tongue ties, and babies who are having a difficult time gaining weight.  Ineffective and infrequent feedings can cause slow weight gain and can possibly cause a low milk supply.  Temporarily putting a baby on a feeding schedule can ensure that they are getting enough in a 24 hour period.

What If I’m Feeling Exhausted From On-Demand Breastfeeding?

• Help your baby feed as effectively as possible: If your baby is feeding frequently, due to ‘snacking’, try to help your baby take in more milk at each feeding.  Keep your baby alert while breastfeeding by stripping them down to just a diaper, using breast compressions to help your baby get a let down more easily, or switching back and forth between breasts (switch nursing) when your baby’s swallows start to slow down.  Also, if using a nipple shield, see if removing it helps your baby take in more milk per feeding.

• Prioritize rest when possible: Try to nap or rest whenever your baby sleeps, even if it’s just for short periods. Sleep is essential, especially during the early weeks when feedings are frequent.  

• Share the load: Ask for help from your partner, family, or friends. They can assist with diaper changes, burping, or soothing your baby after a feed, allowing you more time to rest and recover.  

• Remember that this feeding frequency is temporary: In the early months, babies feed frequently to build up milk supply and ensure proper growth. As your baby gets older, feedings will naturally space out, and you’ll have more flexibility and rest as a result.

So, how do I choose between on-demand feeding and scheduled feedings?

Honestly, it all comes down to what feels best for you and your family.  Remember you can always do a combination of on-demand and scheduled feedings.  It doesn’t have to be all or nothing.  

What should I do if my baby wants to breastfeed constantly? This is a great time to meet with a lactation consultant and we are just a consult away!

If your baby wants to breastfeed constantly(i.e. snacking at feeding sessions), and it is not a temporary growth spurt, this is a great reason to meet with a lactation consultant! Let us help you figure out the root cause and an effective solution.  Book a one-on-one appointment with one of our lactation consultants today for personalized support tailored to you and your baby’s needs.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

Ease Up on Yourself

Written by Ashley Treadwell, IBCLC

Picture it: You’re having coffee with a good friend and she’s confiding in you about her guilt over not knowing her son had a double ear infection when he was running a fever recently.  He wasn’t pulling at his ears or crying when she laid him down.  He ran a fever for a few days, but had no other symptoms, and when she took him into his pediatrician, they diagnosed a double ear infection and prescribed antibiotics.  Your friend is feeling awful that she waited a few days to take her baby in.  She’s calling herself a bad mom.  

What’s your response?  

You tell her that she IS a bad mom, that she should have known that more was going on with her baby, even though he wasn’t showing any signs that he was in pain.  She obviously doesn’t have the instincts it takes to be a good mom.  You’d probably even tell her that her child would be better off if he was parented by someone else.

Right?

OF COURSE NOT.  

We would NEVER say these words to a friend.  Why?  Because they’re aggressive, mean, and meant to tear someone down.  And most of all…. because they aren’t true.  We would never say these words to a friend for fear of hurting her.  So why are we so quick to treat ourselves this way?  Don’t we deserve the same gentleness and support our friends do?

From the moment my first was born, a heavy layer of guilt settled over me - and breastfeeding was the first manifestation of this new guilt.  Breastfeeding hurt.  I mean, *really* hurt.  By the time I left the hospital two days after my daughter was born, my nipples were cracked and bleeding, and I was having anxiety attacks every time she began to show hunger signs.  Because of this, I made the decision to pump my milk and feed it to her in a bottle.  I had failed.  I had failed to do the one thing I was meant to do as a new mother.  I didn’t want to take her out of the house, in fear that she’d get hungry and people would see me feed her a bottle, and know that I had failed.   

Looking back, I realize the amount of dedication and perseverance it took for me to strap myself to that pump, every 3 hours, around the clock, so that I could feed my baby my breast milk, but at the time, I could only see my shortcomings, my weakness.  Looking back, I remember the sheer and overwhelming devotion I felt for my baby - she filled up my every day.  I was an amazing mother.  Her every need was met.  I look back at myself, almost 7 years ago, and wish I had half the patience and gentleness I did then.  I hadn’t failed at all.

The thing is, almost 7 years later, I still feel like I’m failing. Every time the television goes on so that I can cook dinner (which is sometimes (often) frozen fish sticks), or I find myself screeching at my girls to ‘hurrrrry up!’ as our hectic morning rages on.  Every time I cut a chapter in half at bedtime because I’m too worn out to read the entire thing, and especially every time I hear my oldest daughter’s loud, disgusted sigh - that she learned from me.  I feed my kids non organic fruit.  I spend too much time on my iPhone.  I let them eat Otter Pops.  In my mind, I’m a complete and utter failure at the one job I was built to do.

But you know who I need to hear from?  Myself, 7 years from now, looking back.  She will remind me that every day, before my kids went to sleep, I laid in bed with each of them and snuggled them.  That my girls went to bed every night with the comfort that comes with being loved completely.  That I was totally devoted to both of them, and their every need was met.  And I have something to say to this woman - myself in 7 years.  I want to thank her for her reassurance, and then I want to tell her “Ease up on yourself.”

I’ve Had My Baby - Now What? Breastfeeding During Weeks 3-6

Welcome back to our new series, I’ve Had My Baby - Now What?  This is a guide with basic information to help you navigate the first days, weeks, and months of breastfeeding your new baby.  

Today we’d like to talk about weeks 3 through 6 of your baby’s life, and what breastfeeding looks like.  What can you expect for normal behavior from your new baby, and when do you know there’s a problem that you should seek professional help for?

What does normal breastfeeding look like in weeks 3-6?  How often should my baby be eating, and how long should feedings take?

It’s extremely common for babies at this age to still want to feed frequently, every 2-3 hours.  Some *may* become more efficient and take in more at feedings and start to space them out a bit more, but don’t fear if your baby hasn’t done this yet!  Feedings may start to speed up as mom’s milk volume is higher and baby has had good practice breastfeeding, but again, don’t worry if your baby still feeds at the breast for as long as he/she did in the early weeks.  It can take some time for mom and baby to really get their groove and you may still be working out some kinks during weeks 3 through 6.

How much weight should my baby be gaining at this age?  How will I know if he/she is getting enough when I’m not seeing my pediatrician as frequently for weight checks?

Up to 4 months of age, we expect babies to gain .5-1 oz/day, or 4-7 ounces a week.  There are many ways other than weight to be sure that your baby is getting enough milk.  If your baby is having plenty of wet and soiled diapers each day, and generally seems content after feedings for two hours or more (outside of growth spurts and cluster feeding periods), you can feel good that he/she is probably getting enough.  If you want a little more concrete evidence, a great way to track your baby’s weight is by attending a free weekly breastfeeding support group.  There will often be a scale there to weigh your baby, you can do test weights to see how much baby is taking during that feeding, get help from a lactation consultant or educator, and, the BEST part, meet and connect with other moms.

Can I give my baby a bottle now?  If so, who should give it and how often should they do so?

 Once breastfeeding has been established, weeks 3-5 are the perfect time to introduce a bottle to your baby if you’d like them to take one.  It’s normally best that someone other than mom gives the baby the bottle, as babies often associate mom with breastfeeding and may refuse a bottle from her.  Plus, often times, partners and grandparents have been waiting for their moment to participate in the feeding of the baby.  We recommend that mom start pumping after week 3, once a day or so, to start to save up milk for that first bottle.  2-3oz is an appropriate amount to start with.  Be sure that the bottle is fed to the baby in a breastfeeding friendly manner.  If mom is going back to work, we recommend that baby receives a bottle on a somewhat regular basis, a few times a week, so that he/she remains familiar with it.  Plus, mom should pump every time baby receives a bottle to maintain her milk supply.

My baby is inconsolable for a few hours in the evenings.  Why is this happening and what can I do?

Many babies have a “witching hour”, or as I like to call it, “an unhappy hour”.  The term is a bit misleading as the behavior normally lasts for more than an hour!  It occurs most frequently in the late afternoon/evening hours.  Babies are often fussier than normal during this time, and want to eat often.  And while they want to feed often, they may pull off more frequently as well.  There are a number of theories as to what causes this fussiness at this time.  They may be feeding often to “tank up” on calories before taking a long sleep (sounds wonderful!).  They may be overstimulated from their day and having a hard time winding themselves down.  This is often a busy time for the entire household, as partners are home from work and older siblings may be home from school.  Best thing that you can do during this time is to offer the breast often.  Learning to nurse in a baby carrier can be a lifesaver as it will allow you to be hands-free while the baby is snuggled, fed, and comforted.

How will I know if my baby is colicky?  Is this the same as the ‘witching hour?’

Many parents confuse normal fussy behavior for colic.  Colic is defined as 3 hours or more of crying, 3 or more times a week, for 3 or more weeks in a row.  It normally resolves itself around month 4.  If your baby’s crying looks like this, he/she may have colic.  There are no definitive cause for colic, but it could be related to gut issues due to food sensitivities.  The “witching hour” is the period of time of day when your baby may seem unusually fussy, normally lasting for a couple of hours. This behavior peaks around 6 weeks and then often starts to fade.

If I am still having a challenging time building up my milk supply at this time, have I missed the window for increasing my milk supply?

Not at all!  Depending on the reason for mom’s low supply, there are plenty of things that can help boost  supply at this stage.  The most important thing is to learn why mom is struggling with her milk supply.  As always, lots of good breast stimulation is best - either from a baby or a hospital grade pump. There are also herbs and medications that are available that can help boost supply as well.

There may be times when things aren’t going the way they should.  If you find this, please contact an International Board Certified Lactation Consultant to help you.  Some signs that you might need some additional help:

• Sore, cracked, bruised, or bleeding nipples.

• Baby is gaining less than 4oz per week.

• You suspect your baby may be tongue-tied.

• Painful, recurrent engorgement.

• Oversupply.

• Baby is having problems stooling.

• Overly gassy, fussy, or colicky baby.

• Breast infection - mastitis, abscess, or thrush.

For  more information about what normal breastfeeding looks like in the first few weeks, check out our article,What Every Mom Should Know About Breastfeeding During the Early Weeks, which highlights our brand new brochure!  Also, check out Ashley as she discusses more tips and tricks for breastfeeding during weeks 3-6 on the Boob Group episode, New Mom Breastfeeding Manual: Weeks 3-6.

I’ve Had My Baby - Now What? Breastfeeding During the Second Week

Welcome to our new series, I’ve Had My Baby - Now What?  This is a guide with basic information to help you navigate the first days, weeks, and months of breastfeeding your new baby.  

Today we’d like to talk about the second week of your baby’s life, and what breastfeeding looks like.  What can you expect for normal behavior from your new baby, and when do you know there’s a problem that you should seek professional help for?

Now that my milk has increased in volume, what should feedings look like?  How much does a baby need at each feeding and how long should it take?

Most moms will see their milk change from the first low-volume colostrum to the fuller-volume mature milk somewhere between day 3 and day 5.  So by week 2, there is often more milk for baby to take per each feeding.  However, in the early days of the second week, a baby only needs about 1.5 ounces per feeding.  By the end of the second week, the baby will need 2-2.5 ounces per feeding.  Feeding length should still be determined by baby and when baby seems satisfied, but most little ones at this age should be able to get a full feeding in 30 - 60 minutes.

How much weight should my baby gain in week 2 of life? When should they regain their birth weight?

It’s normal for all babies to lose some of their birth weight in the first few days of life.  Once mom’s milk transitions to the fuller volume milk between day 3 and day 5, baby should gain ½ - 1 oz per day.  Most babies who are breastfeeding well will reach their birth weight by 10-14 days.  If your baby doesn’t regain their birth weight by 14 days, it might be a good idea to seek the help of a lactation consultant.

My baby seems to prefer one of my breasts over the other, and even has a difficult time latching onto the other one - is this normal and what can I do?

It is common for babies to prefer one side over the other.  They have often been lying in one position in utero, which can cause tightness in their necks and jaws.  Sometimes a long and difficult labor can affect the baby’s ability to latch onto one side - if the pushing section was long and baby was in birth canal for many hours - the compressions to his head may affect him in this way.  Often babies will work it out in the first few weeks, but if your baby continues to struggle, we often recommend body work for the baby, in the form of Craniosacral Therapy or Chiropractic care.

My baby starts choking shortly after starting to breastfeed.  What is causing this and what can I do?

Some moms find that their milk “lets down” very quickly.  When a baby begins to feed, the stimulation of the nipple releases hormones for mom to signal her body to “eject” the milk from the milk ducts.  When this happens quickly and forcefully, sometimes the sudden flow can take the baby by surprise and they may come off the breast coughing and sputtering.  If all is going well, the baby should learn to manage this within the first couple of weeks.  Feeding in a laid-back position can also be very helpful to slow down your let down. If your baby continues to struggle with a forceful letdown, it could indicate that there is something happening anatomically that is preventing him from being able to adapt.  This would be a good time to visit with a lactation consultant.

My 2 week-old baby is suddenly famished!  He went from eating every 2-3 hours to wanting to eat *constantly*!  He never seems satisifed and is fussy at the breast. Does this mean my milk supply is decreasing?

All babies go through a growth spurt around 2 weeks of age. The behavior above describes what a baby will act like during these growth spurts. It’s a natural occurrence to help build your milk supply to help keep up with the baby’s increasing needs.  Growth spurts usually last 48-72 hours.  As long as your baby is continuing to have plenty of wet and dirty diapers, there is no reason to think that your milk supply is faltering.

There may be times when things aren’t going the way they should.  If you find this, please contact an International Board Certified Lactation Consultant to help you.  Some signs that you might need some additional help:

• Sore, cracked, bruised, or bleeding nipples.

• Baby is still well under birth weight near 14 days of life.

• You suspect your baby may be tongue-tied.

• Painful, recurrent engorgement.

• Oversupply.

• Baby is having problems stooling.

• Overly gassy, fussy, or colicky baby.

• Breast infection - mastitis, abscess, or thrush.

For  more information about what normal breastfeeding looks like in the first few weeks, check out our article, What Every Mom Should Know About Breastfeeding During the Early Weeks, which highlights our brand new brochure!

What Every Mom Should Know About Breastfeeding During the Early Weeks

How much breast milk does my baby need per feeding?
What is common nursing behavior for a newborn?
How will I know that my baby is getting enough?

As a new mom, these are common questions that you may ask your pediatrician, midwife, postpartum nurse, family, and friends and GUESS WHAT..... they may all have a different answer!

How complicated is that?  

Sometimes you may feel like there are ‘too many cooks in the kitchen’ and that all of the advice you receive contradicts what you just heard from someone else 5 minutes ago. 

Talk about frustrating! 

Well, one of our goals at the San Diego Breastfeeding Center is to make breastfeeding as seamless and uncomplicated as possible.  We want to empower moms with knowledge and confidence to get breastfeeding off to a great start!

After listening to local moms express discontent about hearing contradictory breastfeeding information, we decided to do something about it.   First, we canvased our local breastfeeding mamas and asked, “What information do you wish you would have known about breastfeeding during those early weeks?”  Then we hired one of those awesome mamas, Elisa Suter, of Paper Doll Design Studios, to design a brochure that shares our top tips that every mom (and pediatrician) should know about breastfeeding during the early weeks.

Here is the final product!  Isn’t it beautiful?  We hope that this brochure provides the clear, consistent, evidence-based breastfeeding information our mamas are looking for.  

If you live in San Diego and would like us to deliver these brochures to your pediatrician's office, please email us at robinkaplan@sdbfc.com. 

If you live outside of San Diego and would like to order the Adobe file to personalize this brochure for YOUR local pediatricians and clients, please email us at robinkaplan@sdbfc.com

Nurturing your Child's Potential with Voila Montessori

This week, we’re highlighting a local practitioner who is helping parents establish and integrate their parenting beliefs and styles into a peaceful, nurturing environment for their children.  She also offers Skype consultations for those not located in San Diego.  I’m thrilled to introduce Jeanne-Marie of Voila Montessori!

_____

1. What does it mean to have a Montessori home?  

A Montessori home is one that is adapted to meet the child’s ever changing needs, as well as it being nurturing, peaceful and respectful to all family members. It is a home where obstacles to children’s natural development are minimized, enabling children to become life long independent and confident learners.

2. What modifications do you help parents make in their homes?  Why are these modifications important?

When helping parents make simple adjustment, I first look at the four main areas depending on the child’s age and the size of the home. These areas are the sleeping, feeding, personal care and movement areas. For example the feeding area at first will be for the sole purpose of bonding with the child while breastfeeding. I usually recommend a quiet, comfortable place where the caregiver can give a 100% of their attention to the infant. This area will then change once the child is introduced to other foods. 

To name only a few simple ideas I share with parents: make sure children have access to real child-size utensils to do ‘real work’, such as cooking, cleaning, personal care, caring for animals or plants as well as creating a quiet reading area just for them etc. I also recommend many different activities to set-up depending on the age and interest of the child.

(photo credit: Laura Christin Photography) 

These modifications evolve and change as the child grows and their needs are different; they are not going to be the same for an infant as they are for a walking toddler or a preschooler. These changes are also about being mindful parents, aware of the child’s needs by learning to observe and never interrupting when they are concentrating on their own self-construction. 

I believe that these changes are important in that they help the entire family to live in peaceful harmony.  These are small modifications that will make a world of difference for everyone involved. They are wonderful tools for the development of the child’s will as well as their self-esteem “I can do it!”

3. How does clutter in the home affect a child's ability to reach his/her full potential?

Clutter is actually an obstacle to their development. A home that is cluttered with too many toys and activities can be very overwhelming for a young child. Children have a real need for order and routines in their early years. External order brings internal order. Young children are absorbing so much information in these early years that it is helpful for the home to be clutter free and orderly to help them make sense of it all. I am always overjoyed to hear parents tell me how much their child’s behavior improved by simplifying their play area. 

4. How does having a Montessori home go hand in hand with Positive Discipline? 

Beautifully! There are a lot of misconceptions about Montessori that it is a place “where children are left to do whatever and it is a free for all”. Montessori is actually a very simple and intuitive way of life and educational method, where all freedoms are within limits. Positive Discipline is a great compliment to Montessori since it is a very respectful way of guiding children. It is firm and kind at the same time believing that connection before correction is crucial for the child’s healthy development.

5.  What type of consultations and classes do you offer to local parents?  Do you conduct Skype visits?

I have many different types of consultations. I work with expectant parents helping set-up a baby-focused nursery as well as parents, grandparents and any caregivers of young children from birth to six years. My consultations are for families wanting guidance on how to adapt their home to meet their child’s needs as well as for families who need help with having children be more cooperative and respectful. 

I offer workshops throughout the San Diego County. Small workshops can be created for specific parent groups.

I am also available to help set-up larger learning environments such as home daycares or family home school co-ops.

Yes, I do offer long-distance consultations either by phone or via Skype.  Parents from different parts of the country and world have asked for advice, so I needed to make myself available.  I’m also working on developing some online webinars.

_____

Jeanne-Marie's multicultural upbringing and travels planted the seeds of a lifelong curiosity regarding the fundamental needs of children and families.

Her goal is to help parents appreciate the true importance of their role – not as servants or teachers, but as supporters and guides of their children’s natural development. Families who work with Jeanne-Marie reap the benefit of her Masters in Montessori education, her two AMI Montessori certifications covering childhood development from birth through age 6, her Positive Discipline certification for both parents and the classroom as well as her extensive classroom experience, and first-hand parenting knowledge. 

She launched Voila Montessori in response to the overwhelming demand from parents for advice and guidance for raising children in a gentle, peaceful, and supportive environment that’s conducive to their full development – psychological, academic, artistic, spiritual, physical, cultural, etc.

Jeanne-Marie describes herself as “genuine, passionate, and straightforward”. She’s honest and direct, because she realizes that clear and precise information is what will help parents cut through the overwhelming amount of advice that engulfs them.

To learn more about Jeanne-Marie and how she can support you and your children, please visit www.VoilaMontessori.com and like her page, Voila Montessori, on Facebook.

Jeanne-Marie will be offering a monthly workshop at Nature’s Whisper Yoga starting Thursday, November 21, 2013.

Comebacks for ‘Why Are You Still Breastfeeding?’

Any woman who has ever had a breastfeeding challenge or has breastfed longer than than someone else deems ‘normal’ has been asked this question at one time or another.

“Why are you still breastfeeding?”  

Sometimes this question is passive aggressive with undertones of “I can’t believe you have breastfed your baby for THIS long.”  Other times it comes from a place of love meaning “You seem like you are in pain... are you sure you still want to try this?”

Regardless, if you are anything like me, the snappy comeback or educated response that I SO desired to say only comes after the situation is long gone and I am kicking myself for not defending myself and my choice to breastfeed the way I wanted to.

Well, ladies... look no further!

Here are some handy, snappy (evidence-based) comebacks that you can tuck away in your back pocket, only to whip out at the most appropriate times, pun intended! (P.S. These comebacks also work if someone asks why you are STILL exclusively pumping!)

Top 10 Comebacks to Answer the Question: Why Are You Still Breastfeeding?

 

1. “It’s the perfect food for my child. 24 hours a day, 7 days a week!”

• Babies can digest human milk more easily than the milk of other animals, probably because human milk contains an enzyme that aids in this process. 
• Breast milk forms softer curds in the infant's stomach than cow's milk (the basis for most formulas) and is more quickly assimilated into the body system. 
• While it contains less protein than does cow's milk, virtually all the protein in breast milk is available to the baby. By contrast, about half the protein in cow's milk passes through the baby's body as a waste product. 
• Similarly, iron and zinc are absorbed better by breastfed babies.

2. “Breastmilk doesn’t lose it’s nutritional value.  Can you say that about the food YOU eat?”

• Even at a year, breastmilk continues to pack a powerful punch for nutritional value.
• In the second year (12-23 months), 448 mL of breastmilk provides:29% of energy requirements

• • 43% of protein requirements
  • 36% of calcium requirements
  • 75% of vitamin A requirements
  • 76% of folate requirements
  • 94% of vitamin B12 requirements
  • 60% of vitamin C requirements

Dewey KG. Nutrition, Growth, and Complementary Feeding of the Breastfed Infant. Pediatric Clinics of North American. February 2001;48(1), from Kellymom.com Breastfeeding Past Infancy Fact Sheet

3. “Breastmilk protects against disease for my baby.  Don’t you want my (our) baby to be healthy?”

• Because the mother makes antibodies only to pathogens in her environment, the baby receives the protection it most needs-against the infectious agents it is most likely to encounter in the first weeks of life. 
• Here are a few ways that breastmilk helps make a healthy baby:
  • Breastfed babies also have less diarrhea and fewer gastrointestinal infections than babies who are artificially fed.
  • Six months or more of exclusive breastfeeding reduces risk of food allergies. 
  • Breastmilk decreases a child’s risk of Crohn's disease and ulcerative colitis in adulthood.
  • Breastfed babies have lower risk for developing recurrent wheezing when they are older (age 6 or more) – asthma
  • They have less reflux
  • They have less eczema 
  • Breastfeeding protects baby against respiratory infections
  • Women who were formula-fed as infants have higher rates of breast cancer as adults. For both premenopausal and postmenopausal breast cancer, women who were breastfed as children, even if only for a short time, had a 25% lower risk of developing breast cancer than women who were exclusively formula-fed as infants.

4. “There are incredible health benefits for my breastfed baby.  Do you really think it’s wise to limit my baby’s intellectual and physical potential?”

• Breastfed children have higher IQ
• Breastfeeding reduces a baby’s risk of SIDS by 50%
• Breastfeeding protects baby against vision defects.  Breast milk is generally the main, if not the only source, of vitamin A during a child's first 24 months of life (or for the duration of breastfeeding).
• Suckling at the breast is good for a baby's tooth and jaw development, as the constant pulling at the jaw muscles promotes a well-formed jaw and healthy teeth.

5. “Breastfeeding improves my overall health.  Who’s going to cook all of the meals and take care of the home if I’m not healthy? (I know...super snarky!)”

• Breastfeeding decreases mom’s risk of postpartum hemorrhaging as it stimulates contractions to shrink he uterus back to pre-pregnancy size.
• Breastfeeding reduces mom’s risk of osteoporosis
• Breastfeeding reduces mom’s risk of anemia, as breastfeeding postpones the return of menstruation for many women. 
• Breastfeeding reduces mom’s risk of breast cancer. Women who breastfeed reduce their risk of developing breast cancer by as much as 25 percent. The reduction in cancer risk comes in proportion to the cumulative lifetime duration of breastfeeding. That is, the more months or years a mother breastfeeds, the lower her risk of breast cancer.
• Breastfeeding reduces the risk of uterine and ovarian cancer.

6. “Breastfeeding promotes mother/infant bonding and emotional well-being.”  

• Babies feed for about 45 minutes per time in the first few months.  This is nature’s way of making moms sit down and relax and promote her postpartum healing.
• Breast milk actually contains chemicals that suppress pain (endorphins). This is the perfect remedy for a child who accidentally hurts himself and is in need of some pain relief and comfort.  It's like having a boo-boo-healing superpower!
• Babies can also feel the warmth of mom's skin, take in her scent and hear her heart beating. This helps to neurologically center thebaby after birth and help him/her adjust to the outside world.  
• Breastfeeding also decreases a mother’s risk for postpartum depression.

7. “Breastfeeding can promote a positive relationship between mom and a supportive partner.”

• Partner support is crucial during breastfeeding, especially when there are challenges along the way.
• In the beginning, when baby is pretty much just eating and sleeping, mom and her partner can spend this time together, hanging out while the baby is feeding, getting to know one another as parents, not just partners.
• This is a great time to reconnect with your partner as the both of you get to know your baby, as this is a new time for your family.
• You are also a team during this time.  Partners can make sure that all visitors offer positive breastfeeding comments, especially when breastfeeding is a challenge.  No sabotaging comments allowed!

8. “Breastfeeding is definitely more convenient and less expensive than formula.  I thought we were on a tight budget!”

• Breast milk, in any supply, is free. Ready-made formulas can cost families $800 to $1800 per child, annually.
• Nipples, bottles, bottle brushes and bottle bag inserts are additional costs, as well.
• Breastfed babies are ill less often, meaning that their parents miss fewer days at work and spend less on prescriptions, doctor's visits, and hospital stays.

9. “Breastfeeding, just like parenting, has bumps along the road and I won’t quit on my worst day.”

• As all thing that have to do with parenting, what works some days, doesn’t work on others and most things don’t go smoothly as planned.  
• Your baby is born with a personality and a style that requires becoming familiar with and understanding.  
• What works for some babies and children may not work for yours, so seek support anywhere you can find it: friends, family, lactation consultants, websites, Facebook groups, physicians, etc.  
• Don’t quit on your worst day.  Let 24 hours pass to gain some perspective and reach out  for help during that time.  
• Have an IBCLC evaluate your situation and provide a plan for overcoming your challenge.

10. “I promise you that my child won’t breastfeed until his high school graduation, but if he did, he’d probably be the smartest, healthiest graduate there!”

• Ok, maybe that’s a little too sassy, but you get the point.  It is your choice to breastfeed for as long as mutually beneficial for you and your child.  Every drop of breastmilk your child gets is liquid gold and you are a superstar for producing that for him/her!  So stay strong, mama, and know that your ‘breast friends’ have your back!  Happy nursing!

Top 10 Ways to Stop Caregivers from Overfeeding Your Breastfed Baby

I hear it all the time. 

Mom and partner get home from a much-needed date night to find out that grandma gave their 4-month old two 6oz bottles in 4 hours.

Mom picks up her baby from daycare to find out that her 6-month old took three 5oz bottles, plus the backup 5oz bottle in the freezer, in 8 hours.  She pumped 12oz at work and thought that would be plenty for the next day. (which it is!)

Mom comes home from getting a haircut to find that her partner gave their 3-month old a 5oz bottle.  The baby only ate 3oz, so her partner threw the extra 2oz away.

Who ever said there’s no crying over spilled (or wasted) milk never pumped breastmilk for her baby!

It’s hard work to pump… who has extra time when taking care of a newborn to pop on some plastic milk-extracting contraption and just sit for 15 minutes?  Um… no one!  So when a caregiver over feeds a baby, or throws away breast milk that could have been used at another time, it can be very frustrating and defeating for a mom.  And as that extra freezer stash starts to dwindle because of misuse and over feeding, moms might feel their stress levels spike to an uncomfortable high.

So how can a mom ensure that her baby’s caregiver isn’t overfeeding, or unnecessarily throwing away, that precious liquid gold she spent time to pump out?

Top 10 Ways to Stop Caregivers from Overfeeding Your Breastfed Baby

1. Keep bottles in small increments (2-4oz, depending on the weight and age of your baby) and tell the caregiver to wait in between bottles to assess the baby’s mood (to see if he/she is really hungry) – Haley

2. Use the slowest flow nipple you can find and use the 1oz per hour rule (offer 1oz per hour that you are away from your baby) – Miranda

3. Pre-make bottles in small increments. For example, leave two 3oz bottles so caregivers don’t have to divide a 6oz bag into two separate bottles. – Shelly

4. Go over Kellymom’s article with your baby’s caregiver, How to bottlefeeding the breastfed baby, which talks about paced bottlefeeding – Tova and Megan

5. After baby has taken the bottle, try other soothing techniques (i.e. rocking, singing, swaying, take on a walk) rather than offering more breastmilk in an extra bottle.

6. Keep a few extra 1oz bags of breastmilk in the freezer or fridge. That way, if your baby’s caregiver really needs to offer your baby a little bit more, it is a small amount and won’t go to waste.

7. Talk to your baby’s caregiver about reusing breastmilk. While there are no definitive studies that state the exact amount of time that breastmilk must be used within (once the bottle has been fed from), most lactation consultants believe that if a bottle of breastmilk isn’t completely finished, it is safe to place it back in the fridge and the remainder used within 4 hours. (Kellymom.com article - Reusing Expressed Breastmilk)

8. Use the milk calculator to figure out how much your baby will need per bottle. Keep in mind, this is only accurate until your baby weighs 14lbs. After that, your baby’s breastmilk need plateaus at about 28-35oz per day. It won’t go up beyond that, so those 6-8oz bottles are really unnecessary.

9. Have a heart to heart discussion with your baby’s caregiver. Let him/her know how important it is to you that your baby isn’t overfed while away from you. Show empathy and explain that you understand how challenging it is to read your baby’s cues and that things are easier for you because you can always soothe your baby with your breast, which is something the caregiver cannot do. Explain how much milk your baby truly needs in a bottle and during the time you are gone. Anything over that is too much for your baby and makes it difficult for you to keep up. Come up with unique ways for him/her to bond with and soothe your baby, rather than just relying on giving more breastmilk in a bottle.

10. This advice came from a nanny, which was written so well I didn’t want to paraphrase it. ‘I nannies a breastfed baby for about a year and communication with the mom was very important. I also stuck to a schedule. If it was getting close to time for another bottle and I expected her home soon, I would text or call her to see if she wanted me to wait if she was on her way. Also, we would talk in the morning and she would let me know if she planned on coming home for lunch so I knew not to make a bottle. When I noticed that her son’s appetite was increasing, I would let her know that he was acting more hungry increased his bottles 1oz at a time. We also worked on adjusting his schedule so instead of 4oz every 2 hours, we found that 5oz every 3 hours kept him happy. That way he only needed 2 bottles while she was gone (10oz) instead of 3-4 bottles (12-16oz). A big help was her freezer milk in a variety of ounces. I was able to defrost what I needed to give her son without wasting any. As a breastfeeding mom myself, I did my best to respect the hard work she put into building a stash of milk for her son. – Catie.

Advice for a Newly Breastfeeding Mama’s Partner

Let’s face it… becoming a new parent can be extremely overwhelming!  I still remember that first drive home from the hospital.  My husband and I were cracking up as we stared at our son in the car seat behind us.  “Can you believe that they trusted us enough to take this little guy home?  Do they know that we have never changed a diaper or bathed a baby before?  What were they thinking????”

As I spent the first few weeks mastering breastfeeding, it became apparent that two sets of hands were often better than one.  It amazed me that an entire day would pass before I realized that I forgot to eat or take a shower.  It was my hubby, aka breastfeeding cheerleader/parenting partner, that made sure that I was being taken care of as I was all consumed in feeding and caring for our newborn.

I often get asked by the soon-to-be parents in my breastfeeding classes about the roles of the partner.  What role does he/she play while mom is breastfeeding? Many partners often feel like they don’t have a defined role when their partner is breastfeeding because unless his/her breasts start lactating, it is truly a one person feeding show for those first few weeks.   Plus, diaper duty doesn’t sound too glamorous!

So, instead of writing an article for the newly breastfeeding mama this week, this blog post is actually for her partner… the one who makes sure that the ship doesn’t sink!  Let me tell you…. your job is WAY more important than you may think. 

Before we get to the advice, I’d like to let you in on an important secret…. You are the glue that binds your new family together.  You are an integral component in the happiness and sanity of your household!  The bond you form with your partner, who has just stepped into this new parenting role just like you, is just as powerful as the bond you create with your new baby.  Your compassion and support will not only increase your partner’s self-esteem, but will also make or break her breastfeeding experience.

So, now here is some advice for the newly breastfeeding mama’s partner, from a few of my favorite breastfeeding mamas!  Here’s how their partners supported them during those first few weeks:

Marie: Encouragement and the willingness to wake up around the clock with me.  I nursed, he did diapers… it helped me not feel alone and crazy at 2am.

Grace: My partner constantly replenished my snacks and water glass!  And reassured me that what I was doing was the right thing.  I’m so glad he didn’t let me give up and let us see a new lactation consultant, ENT doctor, and chiropractor… otherwise we wouldn’t still be nursing at 13 months!

Jessica: He prepared all of my meals and then did the dishes!  With such frequent breastfeeding in those first few weeks/months, it’s hard to get in good nutrition for mom.  I was so grateful that I didn’t have to think about feeding myself or my husband!

Danielle: My wife did everything…brought me food and water, did the dishes and laundry, fixed our cloth diapers, and made sure I got to bathe.  And when it was super painful, she looked up stuff on google, got ice packs and coconut oil, and helped him latch each time.  It was truly a team effort!

Cassandra:  Helping with household chores – running to the store, encouraging me to drink water… all those things you don’t have time to do in the beginning because you’re busy sustaining your newborn.

Arelis: My baby is now 20 weeks and exclusively breastfed.  My husband calls breastfeeding a ‘special treat.’  Whenever he holds our daughter, he asks her if she is ready for her ‘special treat.” The baby just giggles and knows what’s coming next.

Maren: Dividing duties because breastfeeding in those early weeks is so all-consuming – so, changing diapers, clothes, rocking and comforting – just trying to even out the responsibilities so that I didn’t get overwhelmed.  And not judging me when marathon feeds meant sitting in front of Netflix for 3 hours.  Those were actually wonderful days made more lovely by my awesome husband!

Liana: For me, it was just knowing that he never doubted my ability to nourish our child and never questioned when I said that the baby wanted/needed to nurse again (even if he just finished 15 minutes prior.)  What’s more, with an oversupply, he supported my pumping so that I could donate to others, despite my milk taking over the freezer!

Shannon: I couldn’t have gotten through those 1st 8 weeks without my partner.  He got up with me to help with every night feeding while we still had to finger feed one of the twins.  He helped swaddle them, get them into their crib, and do whatever while I pumped.  He brought me water and snacks, took care of me and the babies each time I got mastitis, and took care of our 4 year old, too.  I think I would have given up if it weren’t for him, but I’m still going strong and the boys are almost 5 months old!

Melissa: Stayed by my side during night time feedings.  He kept me awake when things were going smoothly and kept me calm when feedings were frustrating.

Alicia: Since our daughter was so early, my husband did skin to skin with her for the first few weeks!