Prenatal Education & Resources
How to Build & Protect Milk Supply
How does milk supply work?
Remove milk early & frequently.
The more you nurse, the more milk you make!
Skin to Skin & the First Hour
Do an hour of skin to skin immediately after delivery (or as soon as you can) and as often as possible for the first few weeks. This encourages frequent breastfeeds. We also encourage your partner or support person to have skin-to-skin time with the baby.
Rooming In
Rooming in is the best policy for getting your baby to your breast frequently.
Second Night Syndrome
Until the second night of life, babies are often sleepy and recovering from birth. Around the second night, many babies begin to “wake up” and become more alert to this new world around them. Breastfeeding makes them feel safe as they adapt and babies will often begin to “cluster feed,” or act like they are hungry shortly after you just fed them. This may go on for several hours and is a very normal behavior of newborns. It won’t last forever and does not mean that you don’t have enough milk! Allow them to latch when they want to, and trust that it will pass.
When and How Often to Feed Baby
Offer the baby the breast on demand, offering both breasts as needed, for a minimum of 8-12 feeds per 24 hours.
Read more about how to tell when baby is hungry or full.
When to Switch/End a Feeding
Whenever baby shows hunger cues, allow them to remain at the breast as long as they are actively sucking and swallowing. They may take short breaks, but when actively feeding they’ll return to a pattern of strong pulls and regular swallows after a few seconds of pausing.
When you see the sucks and swallows decrease (often marked by much longer breaks or light, fluttery sucks), you can offer breast compressions to perk his/her activity level at the breast. If the compressions are not waking baby – unlatch and offer the other breast.
If both breasts have been offered and baby is no longer actively nursing, some babies will unlatch on their own. Others may stay latched and enjoy comfort sucking. Once active nursing is done, you may end the feeding at any time by breaking their seal with your finger and unlatching them from your breast.
Newborn Stomach Size & Appropriate Quantities
Babies have tiny stomachs in the early days, therefore their intake needs are low. If, for some reason, your baby needs to be supplemented in the early days, they only need small amounts of expressed milk or formula. The fast flow of bottles makes it easy to overfeed babies, so try to follow appropriate intake guidelines in mind when supplementing.
Pacifiers
Pacifiers are not always necessary, but can be a helpful tool for many babies. The most important guidelines are:
- Make sure to balance pacifier use with feeding, ensuring that pacifiers don’t delay feedings by masking your baby’s feeding cues.
- Try to use pacifiers that support oral development.
Signs Baby Is Getting Enough Milk
What Are the Signs?
Common signs that can provide reassurance your baby is getting enough:
- Appropriate diaper output (pees & poops)
- No pain during feedings
- Baby loses a bit of weight then returns to birth weight by 2 weeks
- Infant is tight before feeds and relaxed after
- Uterine cramping during feedings (in the beginning)
- Audible swallows (after milk transitions)
- Breasts soft after feeding (after milk transitions)
I Know the Signs & Am Still Worried
If you find yourself worrying about whether or not your baby is getting enough milk, you are not alone. Many parents feel anxious about this. It’s a natural part of caring so deeply for your new little one.
Any amount of concern is a legitimate reason to schedule an appointment with an IBCLC – regardless of whether you’ve got concrete concerns or you think things are probably fine and just want some reassurance. We are here for all of it!
Latch & Positioning
Positions
In the early days, laid back breastfeeding, cross cradle & football hold will probably be most comfortable for you.
Click here for more positioning techniques, types & visuals.
Getting a Good Latch
Remember the basics of latch and positioning:
Belly to belly
Baby’s ears, shoulders and hips aligned
Nose directly in front of parent’s nipple (Let your breasts fall naturally rather than moving your breasts to baby)
Use one hand to support baby’s neck right behind ears
Use other hand to shape your breast to match the direction of baby’s mouth (like a sandwich)
Chin to breast, then wait for a WIDE gape
When you see this wide gape, bringing baby into breast, neck extended, nipple pointing up into roof of mouth.
Check for wide open mouth with lips flanged outward, creating a good seal
Wait a minute and notice how it feels. It should feel like tugging, but not painful or pinching.
See more latch tips & videos here.
Pain: What is Normal?
During the first few weeks, if you experience a short amount of pain after latch that gets better within 30 seconds, this may be normal. Pain that lasts throughout a feeding is not normal and is a great sign to seek help.
Nipple & Breast Care
The Transition from Colostrum to Mature Milk
The milk you have for the first few days of your baby’s life is different than you may expect. The white, flowing milk everyone imagines doesn’t usually arrive until 3-5 days after your baby is born. Your early milk is called colostrum, and it is the perfect first food for your baby.
Engorgement
Feeling engorged, or uncomfortably full, often occurs and is normal when your milk transitions from colostrum to mature milk. Normal engorgement should resolve within 48 hours. If it persists, it would be good to make an appointment with lactation support.
Reverse Pressure Softening & Lymphatic massage can be useful tools for temporarily navigating engorgement.
Nipple Wounds
Cracking and bleeding nipples, though common, are not just a normal part of breastfeeding. (Not to mention, quite uncomfortable!)
While there are many creams and products on the market meant to help nipple damage to heal, nipple wounds are a sign that there is something going on with your latch, positioning, or baby’s anatomy that need to be addressed in order to prevent the issue from continuing.
Nipple Shields
A nipple shield is a thin, silicone cover with holes at the tip that can be placed over the nipple to assist with certain feeding challenges. It is important to know that nipple shields are not meant to be used long term, can be difficult to wean from, and do not address the root cause of an issue. If someone encourages you to use a nipple shield, be sure that you are also receiving support from a lactation consultant who is also working with you on the underlying issue.
Pumping, Milk Storage & Bottles
When Do I Need to Pump?
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Hand Expression
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How Do I Use My Breast Pump?
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Getting the Correct Pump Flange Size
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Milk Storage
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Paced Bottle Feeding
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What Bottle Should I Use?
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Protecting Supply During Bottle Feeds
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Food, Medications & Drugs
Diet & Nutrition
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Do Some Foods Boost Milk Supply?
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Medications & Herbs
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Alcohol
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Nicotine
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Cannabis
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Substance Use Disorder
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How Support People Can Help
Myth Busting: Bottle Feeding to Give Mom a Break
It is common to see how much time, lost sleep, and work goes into feeding a newborn and it’s natural to want to help by feeding the baby so that the lactating parent doesn’t have to.
The unfortunate truth: if the goal is to have a full milk supply, taking over feedings doesn’t usually reduce the work load for the lactating person because they still have to express milk every time that the baby is fed a bottle (this protects their milk supply).
While there are exceptions, a general rule of thumb to remember is that the most helpful way to support breastfeeding success is to tackle as many of the other logistical and mental tasks as possible, so that the lactating parent can focus on the full time work of feeding the baby.
Ways to Support the Lactating Parent
Since taking over feedings doesn’t usually give the lactating parent a break, here are some examples of really meaningful ways you CAN support them:
- Wash & sanitize pump parts, bottles, pacifiers
- Understand milk storage guidelines and take care of the milk after pumping sessions
- Frequently offer water and nourishing snacks
- Retrieve TV remotes, phone chargers, anything needed
- Go along to lactation appointments (much of the information is good for partners to know, too)
- Be a second set of eyes for positioning adjustments
- Help with initial adjustment/pillows/etc.
- Log the diaper or feeding diary entries (in the early days)
- Prepare meals
- Be the contact person for meal trains and visitors
- Act as Chief Boundary Enforcer and “time to wrap it up” person when visitors come (with a smile, of course!)
- Educate family members on paced bottle feeding
- Change diapers and settle baby to sleep (particularly wonderful after nighttime feedings)
- Initiate and supervise regular tummy time
Types of Lactation Visits Recommended Once Baby Is Born
First Week Visit
Schedule a lactation consultation within the first few days of being home after birth. This is a very detailed consultation. A full feeding is observed. The latch and the baby’s intake will be evaluated. Since each mother and baby pair are different, we’ll determine how to successfully meet your family’s unique breastfeeding goals.
A written care plan is provided, and a full report will be sent to your OB/midwife & pediatrician.
Follow-Up (if needed/desired)
Schedule a Follow-Up appointment in a week, or sooner if you’re struggling. This will reiterate the information previously discussed while tweaking the plan as you and your little one get more comfortable with breastfeeding. A full feeding is observed, and written care plan is provided.
1-2 Months Postpartum
This can be a time when you may see changes happening in response to hormonal shifts and the regulation of milk supply. This is also a good time to discuss incorporating pumps and bottle use if that will be important for your family down the road.
Back to Work Planning Session
A session to strategize your return to work can help you develop a personalized plan based on your work schedule and your baby’s needs. This is often a big transition for many mothers. Planning ahead gives you an opportunity to bring your concerns and questions and get the information you need in order to be successful.
Starting Solids
Starting Solids consultations are a great way to learn how to begin offering solids to your baby. It’s recommended to begin offering solids right around 6 months of age, so schedule this consult when your baby is around 5 months old (or whenever you are beginning to think about it) to discuss how to begin solids and maintain your milk supply.
Weaning Consult
Schedule a weaning consultation when you’ve decided to wean your baby, have a need to, or are just beginning to think about it. People begin to wean for so many different reasons, anywhere from day 1 postpartum to several years into their lactation journey. I am not here to judge when or why you decide to wean, and will support your decision and help you manage the process.
Visits are covered no matter how far postpartum you are.
As Desired: Weight Checks
If you have intake concerns or anxiety about how much milk your baby is taking, I can simply come to do a weighted feed, where I weigh your baby before and after a feeding, and answer any questions you may have.
Information can be faxed to your providers.
As Desired: Flange Fitting
If pumping is not going well and you’d like to try different flange sizes and types for the best fit, you are welcome to schedule a fitting. While not always the case, changes can happen in the middle of your lactation journey (so don’t feel crazy if you’d like a reassessment at any point).