FAQs

Women who are pregnant or may become pregnant should avoid travel to areas where the Zika virus is found. What about someone who is breastfeeding? Should they keep breastfeeding if they may be infected?

As of this writing, the Center for Disease Control (CDC) has indicated that breastfeeding should continue. Please find the most up to date information here: www.cdc.gov/zika/index.html  or www.cdc.gov/mmwr/volumes/65/wr/mm6502e1.htm 

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With Ebola in the news on a daily basis, mothers may be searching for information about the safety of breastfeeding.

The likelihood of anyone in Canada being infected with Ebola is extremely small and, therefore, the chance it would be a breastfeeding woman who becomes infected is very remote. The recommendations around breastfeeding in Ebola affected areas are continuously changing as more information about the virus and transmission is gathered. Please see the Centers for Disease Control (CDC) website for the most current information.

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A baby cannot be allergic to his mother’s milk. Your milk is made specifically for your baby. If your baby is showing signs of food sensitivities it is most likely a reaction to something you have eaten. If you suspect your baby is reacting to something you are eating, you can try stopping that food for a short period of time to see if it helps. If you do not notice any improvement, contact your local La Leche League Leader for more information.

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Most medications are safe to take while breastfeeding, but it is wise to check on specific medications to be sure. If you are told that you cannot breastfeed while taking a medication, ensure this advice is supported by evidence. A decision to interrupt breastfeeding should be based on accurate information.  You can contact your local La Leche League Leader for more information specific to your situation; she has access to current resources on medications and breastfeeding.

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Most likely not.  There are very few medical conditions which would require a mother to wean her child.  Many mothers worry that they will need to wean if they get a cold or the flu. This is not true.  It is important to continue nursing so your baby gets the antibodies you are making in response to the cold or flu. To help protect your baby: wash your hands frequently and avoid coughing near your baby.

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Many toddlers and preschoolers nurse primarily for comfort and to “touch base” rather than for food. However, breastmilk can still contribute significant nutrition and calories to the toddler’s diet. Also, many mothers find that a short nursing session will defuse a tantrum, cure a “boo-boo” or soothe hurt feelings. Breastfeeding is an important mothering tool that can work magic in stressful situations.

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Your breastmilk continues to be a highly-nutritious, easily-digested food even as toddlers or young children add other foods to their diets. There is no age at which breastmilk loses its nutritional or disease-fighting value. The antibodies in breastmilk actually increase after the baby is 12 months old. This provides added protection for toddlers who have more opportunities to pick up germs. In addition, glands in the breast can produce antibodies against illnesses the toddler is exposed to.

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While many mothers can completely avoid mastitis without extra thought, a few mothers have to be more careful. First, make sure your baby is latched on well so that you avoid cracked nipples and there is no way for germs to get in. Mastitis is much less prevalent when mothers feed their babies as frequently and for a long as the baby wants, i.e. on cue. If your baby suddenly changes his sleeping and eating pattern, your breasts will need to adjust to longer stretches without being emptied. Listen to your body: express a little milk, or wake the baby, if needed.

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A common cause of a breast infection is normal bacteria from your skin entering the milk ducts through a crack on, or other damage to, your nipple.  Most likely this crack is from a shallow latch. Sometimes a breast infection follows a plugged duct and can be caused by the same things: irregular feeding patterns or missed feedings, tight clothing (bras, bathing suits, etc.), pressure on the breast from a baby carrier, heavy purse or diaper bag, sleeping on one’s stomach and unusual stress or fatigue.

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There are many kinds of heat sources you can use. Many mothers find that moist heat (wet washcloth) is more effective than dry heat (heating pad). It is most important that the heat source to be not too hot or it might cause minor burns to the skin. Heat is required for 10-15 minutes at a time to be effective. Some commonly used safe heat sources are:

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Nurse frequently on the affected side, get extra rest and drink plenty of fluids.  Many mothers also find heat on the sore breast helpful. Drop any activities except for breastfeeding to lie down and rest. If you are doing all of this and are the same or worse after 24 hours, contact a health care provider. If your fever or pain is worsening rapidly then see your doctor the same day. You may also wish to discuss pain relief options with your health care provider.  Many mothers find that pain relievers which have anti-inflammatory effects are the most useful.

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With a plugged duct, there is a hard, tender area (about the size of a pea, sometimes larger) in one breast that may hurt when you press on it; you do not feel sick, just uncomfortable in that specific area. With mastitis on the other hand, a larger part of the breast is painful and tender to touch, will feel warm or even hot, and may look red and swollen. Most mothers will have a fever and feel achy and sick, like when they have the flu. Many mothers will feel sick enough that they will want to be in bed.

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Nurse frequently on the affected side.  Nurse in different positions. One position that mothers find especially helpful is the all-fours position. (To use this position lay your baby on his back.  Get on your hands and knees or elbows and knees. Gravity will help get the milk out as baby sucks on the breast hanging down.) Whatever position you use, it is especially helpful to have your baby’s nose and chin in line with the hard area. A few minutes of heat applied to the tender area before nursing can also be helpful.

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There could be a few reasons but a common cause of sudden nipple pain is thrush, or a yeast infection. This pain often feels intense or “burning” with shooting pains deep into the breast. It occurs both while nursing and between feedings. It is not improved with correcting baby’s latch. (For more information see FAQs Thrush.) Other causes for sudden nipple pain can be:

The most common cause of nipple pain is a shallow latch. This means that your baby does not have enough breast tissue in his mouth.  Babies need a deep latch to get enough milk. If your baby is not latched correctly, you may notice a crease across the tip of your nipple when it comes out of your baby’s mouth.  Or it may be shaped like a new lipstick, or white at the tip.  You may decide to take baby off the breast to try to reposition and fix baby's latch, but you should break the suction first to avoid causing further pain to yourself.

A baby cannot be allergic to his mother’s milk. Your milk is made specifically for your baby. If your baby is showing signs of food sensitivities it is most likely a reaction to something you have eaten. If you suspect your baby is reacting to something you are eating, you can try stopping that food for a short period of time to see if it helps. If you do not notice any improvement, contact your local La Leche League Leader for more information.

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Most medications are safe to take while breastfeeding, but it is wise to check on specific medications to be sure. If you are told that you cannot breastfeed while taking a medication, ensure this advice is supported by evidence. A decision to interrupt breastfeeding should be based on accurate information.  You can contact your local La Leche League Leader for more information specific to your situation; she has access to current resources on medications and breastfeeding.

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Most likely not.  There are very few medical conditions which would require a mother to wean her child.  Many mothers worry that they will need to wean if they get a cold or the flu. This is not true.  It is important to continue nursing so your baby gets the antibodies you are making in response to the cold or flu. To help protect your baby: wash your hands frequently and avoid coughing near your baby.

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Unfortunately, there is no clear answer to this question as there is no research about whether it is safe or not. Until recently, the standard answer was to discard any breastmilk left in the bottle after a feed. However, recently it has been suggested that it might be okay to store breastmilk in the fridge for a short time. The current thinking is that bacteria growth is possible, but not likely, because fresh breastmilk has anti-bacterial properties, and a breastfed baby has a strong immune system to deal with any bacteria that do grow.

You can thaw your frozen breastmilk by holding it under cool running water. Gradually increase the water temperature to heat it to a comfortable feeding temperature. This is a temperature that feels warm, not hot, on your wrist. Periodically mix the milk in the bag or bottle by swirling gently, as it defrosts.  Milk can also be thawed in a refrigerator overnight.  Do not thaw or heat your milk in a microwave or directly on the stove.

During the time that your baby is refusing to nurse, you will need to express your milk either by hand or by pumping, in order to maintain your milk production. Do this as frequently as your baby would normally nurse. If your baby has refused several feedings, you can offer your expressed milk in a cup. Avoiding bottles and pacifiers is recommended during this period in the hope that your baby's sucking urges will encourage him to start nursing again.
 
Spending lots of time skin-to-skin with your baby can be very helpful. You can also try:

Very unlikely. Occasionally, a baby who has been nursing well will suddenly refuse the breast for no apparent reason.  This is called a nursing strike.  It is very rare that a baby will wean on his own during his first year, and weaning usually happens gradually. On reviewing the situation, a cause for the nursing strike can sometimes be identified. Common causes include: an earache or stuffy nose, a scary sound that happened while breastfeeding, a different lotion or deodorant, too many bottles or pacifiers or a recent change in routine.

The term “growth spurt” (also called frequency days) describes times when babies seem to nurse non-stop for a couple of days. It is believed that this is how the baby tells the mother’s body to increase milk production. Babies usually have several “growth spurts” in the first 6 months.  They often occur at 10 days, 3 weeks, 6 weeks, 3 months and 6 months. But they can occur any time.  After about 48-72 hours of frequent nursing, a baby will return to a more regular routine of nursing, rest and playtime.

As long as your baby is still having the same number of wet and soiled diapers, there is no reason to panic.  It is normal for a baby at around this age to change his nursing pattern. When a baby starts nursing non-stop for a few days it usually means that he is growing. After a few days of frequent nursing, your baby will fall into a new nursing pattern with your recently increased milk supply.  We call these episodes “growth spurts” or “frequency days”.

Extremely unlikely! It is normal for your milk production to change to meet your baby's needs, and for you to no longer feel "full" between feedings. As long as your baby continues to grow and gain weight appropriately, and is satisfied when he comes off the breast, then there is probably no need to worry. However, if you are still concerned, contact your local Leader for a more personalized discussion.

Preferably, human milk should be refrigerated or chilled right after it is expressed. Acceptable guidelines for storing human milk are as follows:
At room temperature (19-26°C, 66-78°F,) for 4 hours (ideal), up to 8 hours (acceptable)
In refrigerator (4°C, 39°F) for 72 hours (ideal); up to 8 days (acceptable)
In freezer compartment of refrigerator with a separate door (-18°C, 0°F) for 3-6 months.
In deep freezer (-20°C, -4°F) for 6 months (ideal); up to 12 months (acceptable)

Yes. Expressed human milk can be kept in a common refrigerator at the workplace or at a daycare centre. Check that the refrigerator temperature is 4C (39F) or less. Both the US Centers for Disease Control and the US Occupational Safety and Health Administration agree that human milk is not among the body fluids that require special handling or storage in a separate refrigerator.

In the early days, when the baby is getting colostrum, many mothers don't hear swallows. This doesn't mean that your baby is not getting milk. Often you will be able to see swallows as your baby's jaw drops closer down to his chest for an instant. It is this drop in the chin that tells you that colostrum is going into his mouth; it may look like his suck is deeper and longer. Often babies then rest for a couple of seconds before continuing a pattern of little sucks-dropped jaw-pause.

Legally in Canada you can nurse your baby out in public wherever you and your baby are allowed to be. Most mothers find that with a little practice they can comfortably nurse their babies in many different environments. Planning ahead with your wardrobe and stops can make it easier to relax and nurse your baby when he needs it.

Most breastfed babies don't require a soother because they naturally get enough comfort sucking at the breast. Soothers were invented for bottle fed babies because, when full, they may need more time to suckle. During breastfeeding, suckling happens naturally because the milk flows more slowly at the end of a feeding. This gives the baby time to suckle for comfort and not get a lot of milk; her hunger and sucking needs are both met. It's an all-inclusive baby resort!

Holding your baby skin-to-skin is an excellent way to wake a baby and get him interested in feeding. Other ways are to undress him, hold him upright, talk with him, move his arms and legs. While he's sleeping, watch for movement. This is a sign of light sleep. He'll wake more easily from a light sleep than from a deep sleep.

Yes. Many mothers breastfeed in the recovery room after a Cesarean birth. The sooner you can hold your baby skin-to-skin and breastfeed, the better for both of you. If you are separated from your baby for any reason, the baby's father or another family member can hold her skin-to-skin until you are available. Because you have had major surgery, you will likely need to take pain medication. This should not interfere with breastfeeding. Ask for help to find a position that is comfortable for both you and your baby.

A bowel movement with every feeding is common in the early weeks. However around 6 weeks of age some babies change their stooling pattern from very frequently to once a day, or once every few days, to even once every week or so. Your exclusively breastfed baby is not constipated as long as the stool is still loose (pudding like) and a mustardy yellow colour when he does have a bowel movement. The stools should also be substantial.

Between 48 and 72 hours after birth, the meconium changes to dark green and then lightens in colour to yellow. By Day 6 the breastfed baby will have stools which are yellow, loose, and sometimes described as seedy. Normally stools will be at least the size of a Toonie (2.5 cm). This is summarized in a table at the end of the Information sheet #457 How to Know Your Baby is Getting Enough. Contact a local Leader to get a copy.

The first bowel movement will be black, tarry, and sticky; this is called meconium and is often difficult to get off a baby's bottom. This is the stool that was built up in his colon during pregnancy. Over the first few days, the appearance of the stool changes. After the meconium has passed, the normal bowel movement for a breastfed baby is usually bright yellow, seedy, loose and abundant.

Yes. If you are able to hold your baby, you can do skin-to-skin. Tiny babies on breathing machines, IVs, and heart monitors can often be held skin-to-skin. In fact, they often do better in this position: their heart rate, breathing and temperature are more stable. NICU staff using this type of progressive care will be able to help you hold your baby effectively. Just ask. See Kangaroo Mother Care for more information.

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Take off your bra and have your baby in only a diaper. Place your baby's chest against your bare chest between your breasts. Place a cover over her back. You can also try wearing an oversized shirt and use this to cover her. Let your baby stay on your chest for at least an hour. If she starts to bob around and look for your breast, follow your instincts to help her latch on. Babies benefit from remaining skin-to-skin beyond the first breastfeed, so take every opportunity to hold her this way.

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Skin-to-skin will help you learn your baby's cues. It will also increase the level of prolactin you produce. Prolactin is a hormone responsible for helping your body to make milk. Many mothers find that latching their babies is easier when they are held skin-to-skin. It can also calm a fussy baby. If you are unable to breastfeed because your baby is sick or premature, you will have to express your milk. Holding your baby skin-to-skin helps your body make more milk.

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Skin-to-skin, also called Kangaroo Care or Kangaroo Mother Care (KMC), is holding a baby bare chest to bare chest. It helps newborns adjust to being outside the womb. It is ideally done immediately after the birth and as much as you can during the first few days of life. Skin-to-skin can be done by both mother and father. It is especially useful for dad to hold his baby this way if mother is unavailable because of medical procedures.

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Human milk is designed with all the nutrients in the right proportions for human babies. Mothers all over the world, eating many types of foods, have similar nutrients in their milk. If a mother is very malnourished her milk can have low amounts of some nutrients, but this is extemely rare in Canada.

Healthy full term breastfed babies gain 150-230 grams (5-8 ounces) per week. They gain weight steadily and quickly in the first four months. Then their weight gain slows down. Some babies may gain slightly less or slightly more depending on their family body structure. This is summarized in a table at the end of the information sheet How to Know Your Breastfed Baby is Getting Enough. Click on the title or contact a local Leader to get a copy.

Yes. You can tell that your baby is drinking by watching for swallowing. When your baby swallows, you will see his chin drop almost to his chest and you may hear a soft "kah" sound. You will also notice that your baby has many slow deep sucks before taking a short pause. When your baby is done, your breasts will feel softer, and your baby will appear satisfied.

Even if your baby hasn't been weighed for a few days, his pees and poops will tell you that he is getting enough. During the first day or two after birth expect one or two wet diapers per day. This will increase over the next 2-3 days. After day 4 a baby should have at least five to six really wet diapers per day (more if you use cloth diapers). By the third day, expect the colour of dirty diapers to change to a greenish transitional stool. By the 5th day babies begin having at least three to five bowel movements per day, each at least the size of a Toonie (2.5 cm).

Initially babies lose weight. This is mainly because they are expelling the black tarry stool (meconium) that has built up inside the colon during pregnancy. After the meconium is flushed out, the baby's weight will stabilize and the baby begins to gain weight. This most often happens after the third or fourth day. Many babies lose about 7-8% before they start gaining. A baby is expected to return to his birth weight by 10-14 days of age.

Allowing your baby to suckle often and long enough to remove milk are the best ways to establish a good milk supply. Helping your baby obtain a deep mouthful of breast is also important. For more detailed information: Information Sheet #469: Establishing Your Milk Supply  or contact a local Leader.

Colostrum is the 'first milk' produced by your breasts, starting during pregnancy. It is a concentrated form of "mature milk", which is very high in protein, antibodies and other protective components that are important for your newborn. It is thicker than mature milk and often has a yellowish colour to it. It is produced in small amounts (10-100 mL/24 hours), which is perfect for your newborn's tiny tummy. The smaller volumes also give your baby a chance to learn to nurse without being overwhelmed by a large flow of milk in the first few days.

No. In the first 24 hours, healthy babies can have a wide variety of patterns but a common one is to suckle at the breast eagerly in the first hour or two and then have a sleepy phase with very little suckling. This initial sleepy phase is followed by an active phase where they may want to suckle very frequently for 3-5 hours. This cluster feeding often happens after 20 hours, or on the second night of life. It is normal not to get much sleep that second night! Newborn babies generally have nursing sessions at least 8 times in 24 hours starting on the second day.

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