By Metropolitan Pediatrics Certified Lactation Consultants.
Many parents choose to provide their own milk to their babies, either through breastfeeding, chestfeeding, pumping and bottle feeding, or a mixture. Human milk is designed for human babies, and it can offer a wide variety of benefits to both the nursing parent and to baby, such as potentially reduced risk for allergies, fewer ear infections, lower risk of certain breast cancers, and several other physical and mental health benefits.
What works best for each person is as unique as their family. One thing that remains true for each family is the importance that their feeding goals are sustainable and supported. Sustainable means that it’s not causing an undue amount of stress (either physical or mental, or both) to feed baby day in and day out. Another key factor for long-term success is the availability and accessibility of high-quality support for family feeding goals from the start.
It’s perfectly typical to have questions and concerns, especially for new parents. Even experienced parents can struggle with feeding from time to time, as every baby is different.
We’re Here to Help You
Remember, you are not alone in this. At Metro Pediatrics, we have a team of Internationally Board-Certified Lactation Consultants (also known as IBCLCs) ready to help you feel confident in feeding your child, even if the plan changes unexpectedly. Reach out to our team with any questions or concerns.
We will support you in your goal of nourishing your child through breastfeeding, chestfeeding, exclusive pumping, or combination feeding, and more. Our lactation consultants are feeding experts, meaning we can support families who are feeding their babies bottles and formula, too. Every family deserves excellent feeding support.
Concern #1: The Perfect Latch – Myth or Reality?
In the beginning, one of the first things you’ll hear about is the “latch” or “latching on.” This describes how a baby gets milk from the breast or chest. Babies have innate reflexes that help them open their mouth wide and use their tongue to make a seal to the nipples and areola, allowing them to suck and swallow in a rhythm.
It’s true that a good latch is critical to breastfeeding, but it’s not always as easy as it sounds, and no one is striving for perfection. The goal is stress-free nourishment and a good experience for you and your baby.
There are many factors in determining whether your baby has a good latch. Over time, you’ll become familiar with what looks and feels right. You cannot determine if your baby’s latch is good by looks alone – it’s also important how it feels when baby is latched on and nursing.
Here are some ways to think about a good latch:
A Good Latch Feels Good
Baby’s mouth should not be pinching or compressing your nipple or areola, and it should feel both comfortable and strong. Many parents identify with the description of “someone pulling a string deep within your breast or chest” to describe the feeling of baby nursing. There shouldn’t be any compression or flattening anywhere on your nipple when baby unlatches or comes off the nipple.
A Good Latch Looks Good
Baby should approach the breast or chest chin-first, with their body held close so that there are no large gaps between their body and yours. When baby’s chin makes contact and rests on the breast, their innate feeding reflexes should kick in and baby’s mouth should open wide with their tongue down and slightly out.
They should latch on with their mouth in a large open gape (imagine your baby saying “hooray!”; that mouth shape is likely the right one). This should look like a large mouthful of breast in baby’s mouth, with no pursing of baby’s upper and lower lips at the corners of their mouth, and their lips relaxed and not curled into their mouth.
A Good Latch Sounds Good
Babies use their wide-open mouth and tongue to draw your nipple deep into their mouth – all the way back to the soft part of the palate on the roof of their mouth. When baby gets a deep latch, with their tongue making a cupped seal around the nipple and areola and their upper lip forming a relaxed seal, it allows baby to create a strong vacuum to get milk from the breast.
This means no air should be getting sucked in while baby is latched on. A good latch is quiet; there should be no clicking, gulping, squeaking, or slurping. Those sounds are air leaking in and breaking that important vacuum, and it can cause problems if it’s not corrected. Baby’s swallowing is much more visual than audible, and a lactation consultant can show you what to look for if you’re not sure.
A Good Latch is Efficient
Babies who are latching well usually drink well. This looks like active sucks and swallows in a rhythm, with some softer, fluttery non-nutritive sucking and some breathing breaks. Active drinking should be the bulk of baby’s activity during the feeding, and should outweigh the breaks, pauses, or non-nutritive “flutter” sucking. You’ll feel your breasts or chest soften during and after baby’s feeding, which should last less than 30 minutes at first, and less than 15-20 minutes after the first month of life.
Some Other Conditions to Ensure a Good Latch
- Skin-to-Skin Contact: This promotes relaxation and natural rooting reflexes in your baby. Hold your baby close, tummy to tummy, right after birth to encourage them to latch on their own
- Proper Positioning: Different positions can work for different babies. Experiment with different positions to find one that feels comfortable and allows for a deep latch.
- Observe Your Baby’s Cues: Look for rooting reflexes, such as turning their head towards your breast, opening their mouth wide, and sticking out their tongue.
- Seek Professional Help: A lactation consultant (IBCLC) can observe your baby’s feeding and offer personalized guidance on positioning and attachment techniques.
Concern #2: Ouch! Nipple Pain and Discomfort
Sore nipples are a common complaint, especially in the first week or two as you get used to a new sensation and figure out what works well for you and your baby. But persistent pain, changes in color or the shape of the nipple after a feeding, or broken skin can be a sign of an improper latch which should be evaluated right away by an IBCLC to prevent further damage.
Solutions to Reduce Discomfort:
- The Latch: Ensure your baby has a deep latch, with a large mouthful of breast tissue.
- Sore Nipples: Moist wound healing is the top treatment for sore or damaged nipples. This looks like keeping the nipples covered when baby’s not feeding. You can use any food-grade oil, such as coconut oil, or specialized nipple creams like nipple butter or lanolin to help the skin heal and prevent infection. If you have an allergy to wool, you may consider avoiding lanolin cream, as it’s made from sheep’s wool. There are many high-quality plant-based alternatives, which are also generally preferred by vegan and vegetarian parents.
- Breast Shells or Nipple Protectors: There are lots of products on the market that are designed to protect the breasts and nipples from rubbing against clothing or absorbent nipple pads while they’re healing. They can be made from plastic, silicone, silver, even seashells. If you’re unsure which is right for you, you can meet with a lactation consultant to make a nipple care plan that is tailored to you.
- Be Gentle with Yourself: Nipple tissue is delicate and won’t “toughen up” over time. Addressing the cause of nipple pain is the best way to start the healing process.
Remember: Painful breastfeeding is not normal. If you experience persistent discomfort, consult an IBCLC Lactation Consultant for personalized advice and latch assessment. Damage to nipples can pose a risk for a type of infection called mastitis, which can be quite serious if untreated. Seeking care right away for nipple damage is important.
Concern #3: Am I Making Enough Milk?
Milk supply anxieties are a major concern for parents. Here are some signs your baby is getting enough milk:
- Frequent Wet Diapers: Expect at least 6-8 wet diapers per day by the end of the first week.
- Dirty Diapers: Stool frequency varies, but 3-5 poops per day is the general recommendation after the first week of life. Before that, parents should look for “diapers per day of life” or as many diapers as baby is days old. New parents have LOTS of questions about poop, and we are happy to help. Generally, as a rule of thumb, you can “count” any amount of poop that is larger than a quarter. The color will change from dark green, brown or black shortly after birth to lighter green, brown, and then mustard yellow by baby’s 7th day of life.
- Weight Gain: Your baby should be gaining weight steadily. Consult your pediatric health provider to track growth. All babies, breastfed or formula fed, should regain their birth weight by their 2-week pediatrician visit. If they’re not gaining enough weight, talk with your pediatrician and schedule a visit to check in about baby’s feeding with our lactation team.
- Active Feeding: Observe your baby actively sucking and swallowing during breastfeeding sessions. Baby may start with sucking and swallowing at a faster pace at the beginning of a feeding. Then you may notice baby starts to relax and take longer sucks. Babies will unlatch themselves when they are done.
- Content Baby: A baby who is feeding well and gaining weight will have a few periods during the day when they are awake and content. Babies who are gaining weight too slowly, born early, or that have a condition called jaundice (which creates a yellowing of the skin) may be very sleepy and need to be woken up to feed. If this is happening regularly, schedule a visit with a Metro Pediatrics Lactation Consultant to check on baby’s growth and feeding.
Solutions for Low Milk Supply
Often, people worry about having a low milk supply when it’s actually something else. Social media is full of tips to increase milk supply, but many are ineffective, pricey, or even harmful
It’s important to see an IBCLC if you’re worried about your milk supply. A full evaluation is necessary in determining what next steps will be helpful, so that parents don’t waste precious time (and sleep) on finding the right solution for baby.
Suggestions to Ensure Good Milk Supply
- Frequent Feedings: Frequent feeding and pumping, on cue, stimulates milk production. This might mean nursing every 1-2 hours in the beginning, or about 8-12 feedings every 24 hours. After the first 2 weeks, babies should be eating roughly 8 times every 24 hours, with one longer stretch for sleep that’s no more than 5 hours. Unfortunately, that longer stretch of sleep isn’t usually at night. Babies do get their days and nights sorted out with time, so don’t worry.
- Skip the Timer: There is no specific number of minutes that all babies need to feed on each breast. Before switching sides, check in to see if your breast feels softer and that baby seems more relaxed and content than at the start of the feeding. You can then burp baby, which helps to wake them up and stimulate them, and offer the other side. Babies should generally take both sides at each feeding, and the breast softening signals milk has been removed. This tells your body to “dial up” milk production. You can even try “switch nursing” by putting baby to each side more than once during a feeding. This looks like switching baby between sides after about 5-7 minutes. This “switch nursing” helps stimulate more “let-downs” and helps to empty the breasts more completely, which can help increase milk supply over time.
- Stay Hydrated: Drink plenty of fluids throughout the day to support milk production but know that drinking more water will not increase your milk supply. Many parents end up over-hydrating thinking they’re helping to improve their milk supply. Drink to thirst, and not to a magic number.
- Healthy Diet: Eat a balanced diet rich in fruits, vegetables, and whole grains. During lactation, nursing parents need an average of 400-700 more calories than their non-pregnancy baseline. During pregnancy, that number is 300-500 more calories. That’s right, in most cases lactation needs even more calories than pregnancy. This is because making milk takes as much energy as running 3 miles every single day.
- Keep up the Calories: Don’t restrict your calories after your baby is born, or it could affect your milk supply. Instead, follow a balanced and healthy diet with plenty of fats, carbs, protein, and fiber. It can be hard to get a whole meal in with a newborn, so many parents choose many smaller snacks throughout the day, instead of 3 larger meals. The old advice is to “sleep when baby sleeps” but better advice is to “eat when baby eats!”
Remember: Every baby has a different feeding pattern. Cluster feeding, where your baby nurses often for short periods, is common during growth spurts, during the evening, or when baby is overwhelmed and needs to be snuggled in their parents’ arms. Cluster feeding “around the clock” is not usual and your IBCLC can help you figure out what’s happening and come up with a plan.
Trust your body’s natural ability to produce enough milk for your baby. If you have concerns, consult your pediatric health provider or an IBCLC lactation consultant for personalized advice.
Concern #4: Feeling Overwhelmed and Exhausted
Being the parent of a newborn is a demanding process, especially in the beginning. It’s typical to feel overwhelmed and exhausted. Here are some tips to cope:
- Ask for Help: Don’t be afraid to delegate tasks and ask for support from your partner, family, or friends. Most people want to help. Be willing to accept offers for help and even ask them to delegate tasks to others. This allows you to rest and focus on breastfeeding.
- Join a Support Group: Connecting with other parents who are breastfeeding/chestfeeding can be incredibly helpful. Sharing experiences and offering encouragement can ease anxieties and boost confidence.
- Take Care of Yourself: Prioritize getting enough sleep whenever possible. Eat healthy meals and snacks to support your energy levels. Don’t forget to take time for yourself, even if it’s just a short shower or a walk. Your IBCLC can help you make a feeding plan which takes care of baby’s needs and your needs, too.
Remember: Feeding your infant is a demanding process and each parent and baby is different but seeking help and prioritizing self-care are key to navigating this journey successfully.
Concern #5: Breastfeeding in Public: Can I Do This?
Your decisions about the best way to feed your baby are valid and wonderful. Whether breastfeeding, chestfeeding, pumping, bottle feeding, you are protected by Oregon law to feed your baby anywhere you have the legal right to be. You should never be made to feel ashamed for feeding your baby in public whenever they are hungry. No one has the right to ask you to leave a place or go somewhere unsanitary and uncomfortable, like a bathroom, to breastfeed, chestfeed, or bottle feed your baby.
Luckily, most of our community understands and respects your choice to feed your infant and are likely to be supportive. Even with all that said, it’s okay if you are feeling a little hesitant about nursing in public at first. It’s completely typical to feel awkward— you and your baby are both brand new at this. You’ll get the hang of it quickly.
Here some helpful tips for a smooth public feeding experience
- Be Prepared: Pack a nursing cover or light blanket, and wear clothing that allows for easy access for breastfeeding. Avoid covering baby with a blanket on warm days as this can cause overheating.
- Find a Comfortable Spot: Look for designated breastfeeding areas in public spaces or choose a quiet corner where you feel comfortable.
- When Traveling with a Baby: Never feed them while they’re in their car seat; they need a break every 2 hours from the seat, so use these breaks to nurse or bottle-feed. If flying, check TSA rules for breastmilk, formula, and bottles, and consider printing the guidelines. Many airports have special rooms or pods for nursing or pumping—ask at the info desk if you need help finding them. For more on TSA rules and support, visit https://www.tsa.gov/travel/security-screening/whatcanibring/items/breast-milk
Focus on Baby: When breastfeeding/chestfeeding in public, focus on you and your baby. Try to minimize distractions so you both stay comfortable and connected.
Bonus Concern: Combining Breastfeeding/Chestfeeding and Bottles
Some babies and families need to combine nursing or pumping with supplementary feeding. There are many reasons a family may need to make this transition, so here are some tips for a smooth transition:
- Establish Nursing and Milk Production First: When possible, focus on establishing a good latch and nursing routine before introducing bottles.
- Pace Infant Feeding: Slow-paced bottle feeding is a technique which allows your baby to comfortably feed from a bottle and reduce their discomfort from a too-fast flowing bottle.
- Lactation Consultant Support: If you need to introduce formula, your IBCLC Lactation Consultant can guide you on safe formula use and strategies to support your milk production while supplementing.
The Power of Support: IBCLC Lactation Consultants
Two things can be true: Nursing your baby is a beautiful and rewarding experience and breastfeeding/chestfeeding can also be challenging at times. Don’t hesitate to seek professional support from an International Board-Certified Lactation Consultant (IBCLC).
Here’s how they can help
- Lactation Assessment: An IBCLC can observe your baby’s latch, assess milk supply, and identify any challenges you might be facing. Your IBCLC can also assess if your baby needs any special help to feed better and make recommendations for gentle movement, stretches, and oral exercises to improve feeding.
- Personalized Guidance: They can provide personalized recommendations on positioning, latching techniques, pumping strategies, lactation nutrition, postpartum stress and mental health as it relates to breast and chestfeeding, sleep, and troubleshooting for all your lactation concerns, from common to complex. The IBCLC credential is the gold-standard for lactation and infant feeding support.
- Help with Common Feeding Concerns: Reflux, gassiness, colic, concerns about tongue tie, or a slow gaining baby? IBCLCs are prepared to support you and your baby beyond basic latch concerns. They are experts in helping you prevent and manage problems from engorgement, mastitis, or nipple pain. Count on your Lactation Consultant to also help you develop a pumping plan and ease your transition back to work, as well as help you with any other baby feeding or milk production concerns.
Metro Pediatrics Offers IBCLC Lactation Consultants for Support
Metropolitan Pediatrics offers IBCLC Certified Lactation Consultants in all our clinic locations; Portland, Beaverton, Tigard, Happy Valley, and Gresham. Parents are welcome to book one-one-one consultations when you need support, and along with your regular pediatric provider visits.
Give us a call today at 833-PDX-KIDS or book your lactation or infant feeding visit on our website. Book a Visit
Remember: Feeding your baby is a journey, not a destination. There will be ups and downs, but with patience, practice, and support, you can achieve a successful and fulfilling breastfeeding, chestfeeding, exclusive pumping, or bottle-feeding experience for you and your baby.
More Resources for Infant Feeding and Postpartum Support
Postpartum Support International: https://www.postpartum.net/
NW Mother’s Milk Bank: https://www.donatemilk.org/
Rachel O’Brien, IBCLC’s excellent blog about breastfeeding and introducing bottles and bottle refusal: https://www.rachelobrienibclc.com/blog/
The Mommy Meds App for information about common medications and lactation safety: https://www.infantrisk.com/infantrisk-center-resources
The Appalachian Breastfeeding Network has a hotline parents can call for free IBCLC support any time, 24/7. You don’t have to live in Appalachia to use the hotline: https://www.appalachianbreastfeedingnetwork.org/24-hour-hotline.html
They also have a lactation support resource database to find lactation support near you: https://www.appalachianbreastfeedingnetwork.org/lactation-resource-database.html
The US Government has funded a 24/7 Maternal Mental Health hotline that staffs licensed perinatal mental health experts who are also trained in basic feeding support. They offer texting and phone support in Spanish, English, and 60 other languages through interpreter support: 1-833-TLC-MAMA Learn more at: https://mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline