Navigating Breastfeeding: Benefits, Best Practices, and Support
August 6, 2024
Q: What are the benefits of breastfeeding?
Casey Wunderink: Breastfeeding provides many benefits to mother and baby. We know that women who breastfeed have decreased incidences of cardiovascular disease, Type 2 diabetes, and breast/ovarian cancer over their lifetime, well after they have stopped breastfeeding. There’s also a strong correlation between breastfeeding and overall health benefits for babies.
Providing colostrum (the nutrient, antibody-rich milk present at birth) as a baby’s first food begins to establish a healthy microbiome, which is vital for human health across a life span as it helps process infections and health outcomes. Breast fed babies have lower instances of Type 1 diabetes and obesity later in life. They also have decreased rates of ear infections, upper respiratory infections, eczema, and certain allergies.
Breast milk is always changing to meet a baby’s needs. When a breastfed baby is in a different environment from their mom and returns to breastfeed, the baby is giving input, communicating to the mother’s body what antigens (bacteria/viruses) they were exposed to. The mother’s body then generates antibodies (a protein that neutralizes bacteria/viruses) specific to their baby’s needs. Think of it as custom designed medicine, constantly evolving to protect your baby.
Q: How often should I breastfeed my newborn?
Wunderink: Breastfeeding is an organic process. We often talk about “feeding on demand” and watching your baby, rather than the clock. This means offering your baby the breast whenever feeding cues are present. Feeding cues can include hands moving to mouth, sucking on hands, licking lips, etc. The good news is you can’t overfeed a breastfed baby. They won’t latch and actively feed unless they want to. When in doubt, offer the breast.
Every feeding is different. The important thing is to allow your baby to remain at the breast as long as they are actively engaged in feeding (regular sucking with swallows you can hear). Once the baby slows down or becomes sleepy, it is important to offer the second breast as well.
Typical newborn feedings last 15 to 20 minutes between both breasts and may be as long as 45 minutes. Most babies will eat eight to 12 times in 24 hours, typically cueing to feed every two to three hours on their own. Cluster feeding (frequent, shorter feeds over a few hours, particularly in the evening) is a normal newborn behavior.
Q: How can I tell if my baby is getting enough milk?
Wunderink: The gold standard for knowing your baby is getting enough milk is weight gain. All babies lose some weight after birth, but they should start gaining by day five of life and return to birth weight by two weeks of age. A half ounce to one ounce daily is adequate weight gain for the first few months of life.
A good breastfeeding session will have the baby active and engaged, with regular sucking bursts and frequent audible swallows. Another tell-tale sign is a baby’s body language: when first latching, babies are often tense, balling up their fists by their faces. Think of their arms as a gauge – As the feeding progresses, that tension relaxes, and by the end of the feeding, their arms should be fully relaxed at their side, sleepy and content.
Adequate wet and dirty diapers are also an indication that your baby is getting enough milk.
Q: Can I supplement with formula?
You can certainly supplement with formula, but it is important to know that early formula supplementation is correlated with lower milk supply over time.
There are instances where formula supplementation is medically indicated (jaundice, late pre-term infants, babies that are large or small for gestational age), but mothers are generally able to produce adequate milk for their babies’ needs without supplementation.
If you are concerned about supply and are considering supplementing, we encourage you to connect with a lactation consultant to have feeding evaluated. If you do choose to offer supplemental formula, be sure to pump at the time your baby is supplemented to protect your milk supply and stay on track with your baby’s needs.
Q: What should I do if breastfeeding is painful?
Wunderink: People often expect pain and discomfort during breastfeeding, but truly, breastfeeding should not be painful. The best way to avoid pain while breastfeeding is to get lots of practice latching in the hospital with professional help. Nipple soreness usually comes from a shallow latch, and we are happy to help you learn.
A proper latch should have a baby’s mouth open widely, lips turned out, with more than just the nipple in the mouth. It should feel like rhythmic tugging as baby sucks. If it feels like biting or pinching, break the latch and try again.
After discharge from the hospital, Trinity Health Birth Center – Grand Rapids offers one on one outpatient lactation consults. You can call and schedule directly with lactation at 616-685-5602. We also host a free public support group every Thursday from 4:00 p.m. to 5:30 p.m. More information can be found here.
Trinity Health Birth Center – Oakland Hospital also hosts a weekly support group every Tuesday from 10:00 a.m. to noon.
Q: What should I eat while breastfeeding?
Wunderink: Interestingly, women produce great quality breastmilk even if their diet isn’t the healthiest. However, we recommend a healthy balanced diet, similar to what is recommended during pregnancy, to allow your body to recover and heal quickly.
Breastfeeding mothers need an extra 500 calories a day, so be sure to eat frequent snacks and drink plenty of water. Reminding yourself to eat or drink often goes to the wayside when you are exhausted!
In terms of alcohol, it takes most women two to three hours to metabolize the alcohol in a single beer or glass of wine. If you want to have a drink, the best time is just after a breastfeeding or pumping session. If a breastfeeding mother has several drinks in succession, it’s recommended she use a breast pump to express milk and then dispose of it.
Q: Can I breastfeed if I’m sick?
Wunderink: A baby receives protective antibodies from breastmilk, so breastfeeding while you’re sick can help to keep your baby healthy. Few illnesses preclude mothers from breastfeeding. If you are unsure, reach out to a lactation consultant.
Q: How can I increase my milk supply?
Wunderink: The most basic, helpful way to establish a good milk supply is simply to feed your baby on demand, right from the beginning. Your body is trying to figure out how much milk to make the first few weeks, so frequent, regular feedings are key.
It is a supply and demand-based system. If you offer the breast each time baby shows feeding cues, we expect your body to adjust and make enough milk for your baby’s needs.
There are risk factors for low milk supply or delayed onset of milk production, but the majority of breastfeeding parents are able to produce adequate milk. Early formula supplementation can negatively impact milk supply, so be mindful to pump if offering formula.
Other options to consider include:
- Renting a hospital-grade breast pump
- Power pumping (pumping and resting for specific intervals)
- Triple feeding (breastfeeding, pumping, and supplementing in one session)
- Galactagogues (food or some medications that augment milk supply, be sure to discuss with your provider before starting)
If you are worried about supply, please connect with us! We are happy to create an individualized plan for your needs.
Q: When should I introduce a bottle if I plan to pump and return to work?
Wunderink: We recommend waiting until breastfeeding is well established before introducing bottle feeding, unless it is medically necessary.
If a bottle is introduced too early, your baby may experience nipple confusion or develop a flow preference, making breastfeeding challenging. Breastfeeding is work; the bottle is instant gratification.
That said, introducing the bottle by six to eight weeks is important. If you wait much longer, your baby may have a decided preference for the breast and be unwilling to feed via bottle.
Once you have introduced the bottle, continue to offer it for one feeding daily, to keep your baby in practice. Be sure to pump each time your baby is bottle fed to protect your supply.
Q: What does it mean to be a Baby-Friendly designated hospital?
Wunderink: Trinity Health Grand Rapids was just redesignated as a Baby-Friendly hospital for another five years!
This certification means we have completed the Ten Steps to Successful Breastfeeding, including the provision of extensive lactation education for our staff, as well as the development of protocols and practices designed to support and promote breastfeeding.
One example is protection of the “Golden Hour”: any baby who arrives healthy and stable directly goes skin to skin to promote early bonding and the initial feeding at the breast. We used to whisk babies away to weigh them and clean them up, but now we protect that space, giving babies uninterrupted access until that first feeding is completed.
Additionally, babies now remain directly in the room with their parents, instead of a larger nursery. Rooming together in the early days increases breastfeeding success, as mothers learn their child’s feeding cues and tend to feed more frequently. Frequent milk removal in the first 48 hours is correlated to a larger milk supply in the long term.
Finally, being a Baby-Friendly designated hospital means we offer continued support to our community after discharge. This includes outpatient consults as well as a support group. We are staffed seven days a week and have a phone line for mothers needing assistance at 616-685-5602. If we are unable to answer directly, we strive to return all calls within 24 hours.
Additional breastfeeding medicine care is offered in West Michigan. Family physician Tarajo Hanrahan, MD, is expanding her practice to include breastfeeding medicine with a focus on supporting and managing breastfeeding and lactation for both mother and baby. Dr. Hanrahan offers these services at Trinity Health Medical Group, Primary Care – Norton Shores (3750 Henry St Ste 200, Muskegon, MI 49441).
For those in Southeast Michigan, breastfeeding medicine services are also offered at Trinity Health IHA Medical Group, Breastfeeding Medicine – Ann Arbor Campus (5333 McAuley Dr Ste 2106, Ypsilanti, MI 48197).
Q: What else do you wish new mothers knew about breastfeeding?
Wunderink: Breastfeeding comes with a steep learning curve, but with the right support, you can do it! Our bodies and babies are wired to breastfeed, and I encourage everyone to simply follow your baby’s lead and see where it goes.
Everyone’s journey will be different, and we are here to support you throughout it, whatever turn it takes. The journey will likely look somewhat different than what you expected, but know that whatever your experience is, it’s a gift to both you and your baby.