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I have small breasts, can I still breastfeed?

Breast size, small or large, makes no difference in the success of breastfeeding or the volume of milk production. Breast size depends on the amount of fat and fibrous tissue, not the amount of glandular tissue.

Will the bonding process with my baby be stronger if I breastfeed?

When done properly, either method, breast or bottle, can provide the adequate nourishment and strong emotional bond that growing babies need. The decision to breastfeed is a personal one. It takes into account the mother's lifestyle, economic situation, and cultural beliefs. If you aren't sure which approach to use, start with breastfeeding. If it isn't right for you, then switch to bottle-feeding. Starting with a bottle, and then trying to breastfeed later is very difficult.

How long will my child be on breast milk or formula?

The American Academy of Pediatrics and most health experts recommend breast milk or iron-fortified infant formula until the first birthday is reached. After that, it is OK to start cow's milk, but use whole cow's milk until age two.

Does my newborn baby need extra bottles of water?

Newborns need little or no extra water. Breast milk or infant formula usually supplies enough fluid. The exceptions are being exposed to hot weather and no air-conditioning. Your baby will lose body fluids by perspiring. Then offer 1-2 ounces of plain water after a feeding. Water should never take the place of breast milk or formula. When your baby begins eating solid food, you can also offer a little plain water, along with the meal.

How often will my baby nurse?

Be prepared to nurse very frequently during the first few months. A newborn will nurse every 2-4 hours, 24 hours a day. That adds up to 8-12 feedings each day. A newborn's stomach is small, and nutrient needs are high during this period of rapid growth and development.

Should I offer both breasts each time I feed?

Yes, the last portion of milk your baby drinks from each breast is called "hind milk". This milk is higher in fat and helps the baby to feel full and satisfied. Then release your baby from the breast by gently putting your finger into the corner of his mouth. This will break the suction without discomfort. Burp the baby and offer your other breast. Burp your baby again at the end of the feeding. Clip a safety pin to your bra as a reminder of which breast to offer first at the next feeding. This ensures that both breasts are emptied regularly.

How will I know when my baby is full?

When babies feel full and satisfied, they may close their lips, turn away, or even fall asleep.

Is it normal for a breast fed baby to have yellow stools?

Yes, a breastfed baby will have loose, yellowish stools, which may resemble watery "mustard seeds".

How will I know if my baby is getting enough milk when I breastfeed?

Following the third or fourth day after birth, your baby will have 6 or more wet, soppy diapers, soiled with light colored urine, every 24 hours. Your baby should be nursing 8-12 times, every 24 hours, during the first month. And your baby's weight will steadily increase.

Can I return to work and still breastfeed?

Many mothers continue to breastfeed after they return to work, but it will require an adjustment for mom and the baby. Some moms express milk during their workday so baby receives bottles of expressed breast milk when mom is away. Others moms decide to continue to breastfeed when they can be with the baby and have caregivers offer bottles of formula when they are away. And some babies may receive both bottles of expressed breast milk and formula. Choose the option that works best for you and your baby. And discuss your plan with your lactation consultant.

• Select a caregiver for your baby who is supportive of breastfeeding.

• Plan to nurse before work, soon after work, and during the evening to keep your milk supply strong.

• Before you return to work, help your baby to learn to take expressed breast milk or formula from a bottle. Begin this at about 3-4 weeks. Experiment with different types of nipples to find a type that your baby prefers. This is the perfect time for dad to get involved in the feedings.

Can I breastfeed if I had a breast reduction?

Many women who have had breast reductions are able to breastfeed, though most do not produce enough milk to nurse exclusively. It will depend in part on how extensive the reduction was, where the incision was made, and how the procedure was preformed. If care was taken to preserve milk ducts and nerve pathways, chances are good that you will be able to produce at least some milk. Check with your surgeon. You should also work with a lactation consultant who has experience in this area. You will also want to monitor closely the baby's growth and development, the number of wet diapers, and the number of dirty diapers each day. Work closely with your pediatrician to make sure your baby's needs are being met. Even if you have to supplement your baby's diet with formula, remember that your baby is still getting some of the extra benefits of breast milk.

Can I breastfeed if I had breast implants?

Breast augmentation is far less likely to interfere with breastfeeding than a breast reduction. Most women are able to produce sufficient milk to feed the baby. However, some women may not produce enough milk and will need to supplement with formula. Monitor closely your baby's growth and development, number of wet diapers, and the number of dirty diapers each day. Work closely with your pediatrician to make sure your baby's needs are being met.

My doctor says that I will have a cesarean birth, can I still breastfeed?

Yes, you can. You may find breastfeeding after a cesarean birth to be uncomfortable at first. There will be less pain if you try to avoid putting pressure on the incision area. One of these positions may help: place a pillow on your lap under the baby, lie on your side, or use the football hold (supported with a pillow). While at the hospital, work with the lactation consultant to find a position that feels best for you.

Can I have an occasionally glass of wine while breastfeeding?

Yes, you can, but alcohol should be limited. Have a single drink only on occasion. Heavy drinking or binge drinking should always be avoided. It can make the baby drowsy and depress the nervous system. It will also slow motor development and reduce your milk supply. If you do have a drink, have it right after nursing and try not to nurse again for at least two hours.

Do I need to avoid any foods if I breastfeed?

Your breastfeeding diet is very important to the health of your baby. Eat a nutritious diet and continue to take your prenatal supplements. Avoid foods in your diet that irritate your baby by causing gas. This is very individualized. Garlic, onions, cabbage, broccoli, cauliflower, chocolate, and certain spices are sometimes common offenders. However, many babies are not bothered by these foods at all. Remember to limit or avoid alcohol. If possible, do not smoke. Do not take any medications without first checking with your doctor and your baby's pediatrician. Cut down on caffeine. Limit yourself to 1 or 2 caffeinated beverages a day. Caffeine is stored in the baby's body and not eliminated quickly. This can cause your baby to be jittery, irritable, or have difficulty sleeping.

Can I get pregnant while breastfeeding?

Yes you can. Although breastfeeding women resume normal menstrual cycles later than those who do not breastfeed, it is not a reliable form of birth control. There is no way to predict when you will ovulate and have your first post-baby period. Therefore, contraceptive caution is highly advisable.

By Becky Hand, Registered and Licensed Dietician