Breastfeeding

Start to learn about breastfeeding while you are still pregnant. During your prenatal appointments, ask your health care provider about breastfeeding, why it is important and what to expect during the first few days with your baby.

More questions you can ask your health care provider or lactation consultant include:

• What is immediate skin-to-skin contact, and how can it help me and my baby after birth?
• What are the benefits of keeping a newborn with me the whole time I am in the hospital (also called "rooming-in")?
• What steps should I take to ensure my baby has a good breastfeeding latch?
• Is there anything else I should know about breastfeeding?

Asking these questions can help you understand your baby's behavior and make feeding your baby easier.

Health experts recommend that you feed your baby only breast milk for the first six months of their life. During this time, they do not need water or any other foods.

At six months, experts advise to start giving your baby solid foods and continue to breastfeed for two years or longer, as long as you are comfortable.

Any amount of breastfeeding can be beneficial for your baby, though the longer you breastfeed, the better.

Healthy newborn babies need to eat at least eight times every 24 hours. You should feed them whenever they start showing signs of hunger. These "feeding cues" include:

• Sucking on their hands
• Smacking their lips/opening their mouth
• Moving their mouth or head side to side (called "rooting").

Babies do not eat at regular intervals. It is important to make sure they get food early on when they tell you they are hungry. If you do not feed a baby quickly after they show signs of hunger, they will get fussy and cry. This makes it harder to feed them.

When your baby is full, their hands and body relax, they let go of your breast or they fall asleep.

If your baby still seems hungry after finishing on one side, burp them and then offer them the other breast. They do not need to eat from both sides every feed, but it is always good to offer in case they are still hungry. If your baby fell asleep after the first breast, burp them or change their diaper to wake them up for the second breast. Alternate which side you start with at each feed.

When a baby is born, their stomach is the size of a cherry and they do not need a lot of milk. By day three, it is the size of a ping pong ball, and by day 10, it is as big as a chicken egg.

As your baby grows, they will need to eat more at each feeding and nurse more frequently. This is called "cluster-feeding," and it will occur around day three and again when they go through growth spurts. It is an important step to establishing your milk supply by feeding early and often. It does not necessarily mean you do not have enough milk. Breastfeeding often during the first few weeks of life will help you build a good milk supply for your baby.

Breastfeeding is based on "supply and demand." The more you breastfeed your baby, the more breast milk your body will produce. Talk with your health care provider or lactation consultant if you have concerns about your milk supply.

You can tell if your baby is eating enough by counting their wet and dirty diapers and keeping an eye on how much weight they are gaining. Ask your health care team to help you track this when you are in the hospital. When you go home, you can keep track of their diapers and have a health care provider weigh them during regular appointments.

The following may be signs your baby is sick or not getting enough food:

• Yellow skin
• Hard to wake up for feeds
• Fussy
• A high-pitched cry
• Is not feeding at least eight times every 24 hours
• Is not making enough wet or dirty diapers

Parents who smoke tobacco can still breastfeed, but it is better that you do not smoke at all. If you smoke, it is still better to breastfeed than formula feed. To reduce nicotine exposure to your baby, smoke after you nurse rather than before.

Whether you breastfeed or formula feed, you should not smoke in the same place as your baby. Smoke far away from your baby and change your clothes afterwards to help reduce their exposure. Secondhand smoke is harmful to babies and can increase the risk of sudden infant death syndrome (SIDS) and asthma.

Learn about local resources that can help you quit smoking.

You should avoid alcohol while you are nursing. An occasional, single drink a day is fine, but be sure to drink after you nurse rather than before.

When you are sick, your breast milk contains antibodies that can help protect your baby against infection. In most cases, you should continue to breastfeed your baby, even if you are sick.

There are some illnesses and medical treatments that may require you to stop breastfeeding for a period of time. Many medicines are safe to take when breastfeeding, but some are not. Certain medicines can also lower your breast milk supply. Ask your health care provider or lactation consultant if your illness or medicines could affect your baby or your breast milk production.

You have the right to pump or express your milk without discrimination in your workplace or school. New York State law also allows people to breastfeed in any public place at any time.

In New York City, all employers must allow parents reasonable time and space to pump or express breast milk for at least three years after they give birth. A lactation space must be a sanitary, private place, other than a restroom, that you can use to express breast milk. It should include an electrical outlet, a chair, a surface on which to place a breast pump and other personal items, and nearby access to running water.

Employers with at least four employees are required to have a workplace lactation policy that describes accommodations and how employees can request them. Employers must also provide a refrigerator for employees to store breast milk.

Before giving birth, discuss your rights and resources with your employer or school. Make sure you have a plan for continuing to provide breast milk to your baby when you return, and that your employer or school is aware of what you will need. Before you return, talk with your health care provider or lactation consultant about how to begin pumping, when to pump and how to store and handle your breast milk safely.

If you are an employer, learn how you can make your workplace more welcoming for breastfeeding.