Breastfeeding Your Baby:

Getting Started
Getting ready for the birth of your baby is an exciting and busy time. One of How Breastfeeding Works
the most important decisions you will make is how to feed your baby. When you become pregnant, your body begins to prepare for breastfeeding.
Deciding to breastfeed can give your baby the best possible start in life. Your breasts become larger and after your fourth or fifth month of pregnancy,
Breastfeeding benefits you and your baby in many ways. It also is a proud your body is able to produce milk.
tradition of many cultures.
The following are excerpts from the American Academy of Pediatrics’ What is colostrum?
(AAP) booklet Breastfeeding Your Baby: Answers to Common Questions. Colostrum is the first milk your body makes. It’s thick with a yellow or
orange tint. Colostrum is filled with all the nutrients your newborn needs. It
Benefits of Breastfeeding also contains many substances to protect your baby against diseases and
In general, the longer you breastfeed, the greater the benefits will be to you infections.
and your baby, and the longer these benefits will last. It’s very important for your baby’s health to get this early milk, though it
may seem like a small amount. Your baby only needs less than 1 tablespoon
Why is breastfeeding so good for my baby? per feeding on the first day and about 2 tablespoons per feeding on the
Breastfeeding is good for your baby because second day.
1. Breastfeeding provides warmth and closeness. The physical contact
helps create a special bond between you and your baby. What’s the difference between milk coming in and let-down?
2. Human milk has many benefits. Milk coming in and let-down mean different things, but both are important.
• It’s easier for your baby to digest. • Milk comes in 2 to 5 days after your baby is born. This is when colostrum
• It doesn’t need to be prepared. increases quickly in volume and becomes milky-white transitional milk.
• It’s always available. Signs that your milk is coming in include
• It has all the nutrients, calories, and fluids your baby needs to be healthy. — Full and tender breasts
• It has growth factors that ensure the best development of your baby’s — Leaking of milk
organs. — Seeing milk around your baby’s mouth
• It has many substances that formulas don’t have that help protect your — Hearing your baby swallow when fed
baby from many diseases and infections. In fact, breastfed babies are Breast milk changes daily and will adjust to your baby’s needs for the rest
less likely to have of the time you breastfeed. Because the color or creaminess of the milk
— Ear infections can change daily, don’t worry about how your milk looks.
— Diarrhea • Let-down is the reflex that creates the flow of milk from the back of the
— Pneumonia, wheezing, and bronchiolitis breast to the nipple. Let-down occurs each time the baby suckles. It is
— Other bacterial and viral infections, such as meningitis triggered when you are relaxed and your baby is latched on to your breast
properly. Let-down may also happen between feedings, such as when
Research also suggests that breastfeeding may help protect against
the breasts are somewhat full or when you hear a baby’s cry. The first
obesity, diabetes, sudden infant death syndrome (SIDS), and some cancers.
few times you breastfeed, the let-down reflex may take a few minutes.
Why is breastfeeding good for me? Afterward, let-down occurs faster, usually within a few seconds. Let-down
occurs in both breasts at the same time. It may occur several times during
Breastfeeding is good for your health because it helps
each feeding.
• Release hormones in your body that promote mothering behavior.
The signs of let-down are different for each woman. Some women
• Return your uterus to the size it was before pregnancy more quickly.
feel nothing, even though breastfeeding is going fine. Other women feel
• Burn more calories, which may help you lose the weight you gained during
— Cramping in the uterus. This can be strong for the first few days after
pregnancy.
delivery but often goes away after breastfeeding is well-established.
• Delay the return of your menstrual period to help keep iron in your body.
— A brief prickle, tingle, or even slight pain in the breast.
• Provide contraception, but only if these 3 conditions are met: (1) you are
— A sudden feeling that breasts are heavier.
exclusively breastfeeding and not giving your baby any other supplements,
— Milk dripping from the breast that’s not being used.
(2) it is within the first 6 months after birth, (3) your period has not returned.
— Their baby swallowing or gulping when fed.
• Reduce the risk of ovarian cancer and breast cancer.
• Keep bones strong, which helps protect against bone fractures in older age.
What is demand and supply?
The more milk your baby takes from your breast, the more milk you make. Early Signs of Hunger
This is called demand and supply because the more milk your baby demands Your baby starts to let you know when she’s hungry by the following
the more you will supply. Many women with small breasts worry that they early signs or cues:
won’t be able to make enough milk. However, because of demand and supply, • Small movements as she starts to awaken
there’s no relationship between breast size and how much milk is produced. • Whimpering or lip-smacking
• Pulling up arms or legs toward her middle
Getting Started • Stretching or yawning
Babies are very alert after they are born and ready to find the breast! The more • Waking and looking alert
relaxed and confident you feel, the faster your milk will flow to your baby. Getting • Putting hands toward her mouth
comfortable will help you and your baby get started toward a better latch-on. • Making sucking motions
• Moving fists to her mouth
How soon can I breastfeed? • Becoming more active
You can and should breastfeed within the first hour after birth if you and your • Nuzzling against your breast
baby are physically able to do so. After delivery, your baby should be placed
on your chest or stomach, skin to skin. The early smell and taste of your milk
helps your baby learn to nurse. Your breast milk is all your baby needs if your Why is latch-on so important, and how is it done?
baby is healthy. Other liquids, including sugar water and formula, will only A good latch-on means that your baby has opened his mouth wide and is well
lessen the benefits your baby receives from the early breast milk. Try to stay back on the breast, taking both the areola and nipple far back into his mouth.
with your baby as much as you can. Rooming in with your baby day and night Correct latch-on is very important because it
during your hospital stay has been shown to help start breastfeeding and keep • Makes milk flow better
it going longer. • Prevents sore nipples
• Keeps your baby satisfied
What are different breastfeeding positions? • Stimulates a good milk supply for baby’s weight gain
Always take time to get comfortable. Don’t be shy about asking for help during • Helps to prevent engorged (overly full) breasts
the first feedings. It may take a few tries but with a little patience, you and
You can help your baby latch on by holding your breast with your free
your baby will succeed. The following are 3 breastfeeding positions:
hand. Place your fingers under your breast and with your thumb on top. Move
Cradle hold—the traditional breastfeeding position. your fingers well back from the areola so they don’t get in the way. Position
Firmly support your baby’s back and bottom. When your baby with his entire body facing you.
feeding this way, make sure your baby’s entire body Touch your nipple to the center of your baby’s lower lip. This will cause
is facing your body, not the ceiling. your baby to open his mouth widely. This is called the rooting reflex. As this
occurs, pull your baby onto the nipple and areola. Keep in mind that when
Clutch hold—may be more
your baby is correctly positioned, or latched on, your nipple and much of the
comfortable if you’ve had a
areola are pulled well into his mouth. Your baby’s lips and gums should be
cesarean delivery because it keeps the baby’s weight
around the areola and not just on the nipple. Your baby’s chin and nose should
off of the stitches.
be touching your breast.
Reclining—feeding your Support your breast and tickle your baby’s
baby while lying down lower lip with your nipple to stimulate his rooting
lets you relax and can be helpful if you’ve had a reflex
cesarean delivery or are tired. When your baby’s mouth is wide open, bring
him quickly, but gently, toward your breast.
How can I get comfortable while
At first you will feel a tugging sensation.
breastfeeding?
You also may feel a brief period of pain. If
A few simple things can help you feel comfortable and relaxed. breastfeeding continues to hurt, pinch, or burn,
• Sit on a comfortable chair with good back and arm support. your baby may not be latched on properly. Break
• Lie on your side in bed with your baby facing you. Place pillows to support the latch by slipping your finger into the corner of
your back and neck. your baby’s mouth, reposition, and try again. It can
• Take deep breaths and picture yourself in a peaceful place. take several tries.
• Listen to soothing music while sipping a healthy drink. Hospital staff should watch a feeding and
• Apply moist heat (such as warm, wet washcloths) to your breast several make suggestions. If breastfeeding continues
minutes before each feeding. to hurt, you may need the help of a lactation
• If your home is very busy, find a quiet place where you won’t be disturbed specialist. Let your pediatrician know if there’s a
during feedings. problem.
• If you had a cesarean delivery, use extra pillows to help position your baby.
• Try different breastfeeding positions.
• Make sure the baby is latched on correctly. (See next question.)
Beyond the First Feedings How can I tell if my baby is getting enough milk?
How often should I nurse? There are several ways you can tell whether your baby is getting enough milk.
Some newborns need to nurse every 1½ hours, while others feed about They include the following:
every 3 hours. Newborns are hungry at different times, with a long cluster of • Your baby has frequent wet and dirty diapers.
feeding in the late afternoon or night. Most breastfed newborns feed 8 to 12 • Your baby appears satisfied after feeding.
or more times per 24 hours (once the milk has come in). If your baby isn’t • Your baby is gaining weight.
waking on her own during the first few weeks, wake her if 3 to 4 hours have Your baby should have several wet or dirty diapers each day for the first
passed since the last feeding. If you are having a hard time waking up your few days after delivery. Beginning around the time that your milk comes in,
baby for feedings, let your pediatrician know. the wet diapers should increase to 6 or more per day. At the same time, stools
should start turn¬ing green, then yellow. There should be 3 or more stools per
What’s the best feeding schedule for a breastfed baby? 24 hours. Typically, once breastfeeding is going well, breastfed babies have a
Feeding schedules are different for every baby, but it’s best to start nursing yellow stool during or after each feeding. As your baby gets older, stools may
your baby before crying starts. Crying is a late sign of hunger. Whenever occur less often, and after a month, may even skip a number of days. If stools
possible, use your baby’s cues instead of the clock to decide when to nurse. are soft, and your baby is feeding and acting well, this is quite normal.
It can be less frustrating for you and your baby if you learn your baby’s early Your baby’s feeding patterns are an important sign that he is feeding
hunger cues. Frequent feedings help stimulate the breasts to produce milk enough. A newborn may nurse every 1½ to 3 hours around the clock. If you
more efficiently. add up all the feedings over the course of the day, your baby should feed at
During a growth spurt (rapid growth), babies will want to nurse all the least 8 to 12 times a day.
time. Remember, this is normal and temporary, usually lasting about 4 to 5 When feeding well with good latch-on, the infant will suckle deeply, you
days. Keep on breastfeeding, and don’t give any other liquids or foods. will hear some swallowing, and the feeding won’t be painful. The baby should
appear satisfied and/or sleep until time for the next feeding. If your baby
How long does breastfeeding take? sleeps for stretches of longer than 4 hours in the first 2 weeks, wake him for
Each baby feeds differently: some slower, some faster. Some feedings may be a feeding. If your baby will not waken enough to eat at least 8 times per day,
longer than others depending on your baby’s appetite and the time of day. Some call your pediatrician.
babies may be nursing even though they appear to be sleeping. While some Your child will be weighed at each doctor’s visit. This is one of the best
infants nurse for only 10 minutes on one breast, it’s quite common for others ways to tell how much milk your baby is getting. The AAP recommends that
to stay on one side for much longer. It’s generally good to allow your baby to babies be seen for an office visit (or home visit) between 3 to 5 days of age to
decide when the feeding is over—he will let go and pull back when he is done. check on breastfeeding and baby’s weight. During the first week, most infants
If your baby has fallen asleep at your breast, or if you need to stop a lose several ounces of weight, but they should be back up to their birth weight
feeding before your baby is done, gently break the suction with your finger. by the end of the second week. Once your milk supply is established, your
Do this by slipping a finger into your baby’s mouth while he is still latched on. baby should gain between ½ and 1 ounce per day during the first 3 months.
Never pull the baby off the breast without releasing the suction.
To stimulate both breasts, alternate which breast you offer first. Some Breastfeeding: A Natural Gift
women like to keep a safety pin on their bra strap to help remember. While Breast milk gives your baby more than just good nutrition. It also provides
you should try to breastfeed evenly on both sides, many babies seem to important substances to fight infection. Breastfeeding has medical and
prefer one side over the other and nurse longer on that side. When this psychological benefits for both of you. For many mothers and babies,
happens, the breast adapts its milk production to your baby’s feedings. breastfeeding goes smoothly from the start. For others, it takes a little time
and several attempts to get the process going effectively. Like anything new,
How can I tell if my baby is hungry?
breastfeeding takes some practice. This is perfectly normal. If you need help,
You will soon get to know your baby’s feeding patterns. In addition, babies ask the doctors and nurses while you are still in the hospital, your pediatrician,
may want to breastfeed for reasons other than hunger. It’s OK for you to offer a lactation specialist, or a breastfeeding support group.
these “comfort feedings” as another way of meeting your baby’s needs. Once breastfeeding is going smoothly, it is simple and convenient.
Nearly all newborns are alert for about 2 hours after delivery and show Breastfeeding is the most natural gift that you can give your baby.
interest in feeding right away. Let the hospital staff know that you plan to For more information about breastfeeding, read the AAP book New
take advantage of this opportunity—it’s very important to the breastfeeding Mother’s Guide to Breastfeeding.
process. After 2 hours, many newborns are sleepy and hard to wake for the
T he information contained in this publication should not be used as a substitute for the medical care and advice
next day or so. of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on
Watch for the early signs of hunger. This is the time to pick your baby up, individual facts and circumstances.

gently awaken her, check her diaper, and try to feed her. (See “Early Signs of Illustrations by Anthony Alex LeTourneau.
Hunger” on page 2.)

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical ­sub­specialists,
and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.
American Academy of Pediatrics Copyright © 2005
Web site— www.aap.org American Academy of Pediatrics, Updated 5/09
All rights reserved.