Frequently Asked Questions

Thank you for choosing La Leche League Canada as your source for breastfeeding information and support. The following FAQs are introductory answers to questions mothers ask about breastfeeding. For more information, please see the LLLC Information Sheets listed (on the left sidebar of the Breastfeeding Info page) or contact a local Leader. If this is not practical for you, you can submit a question on-line. These FAQs are not intended to replace medical care. If you have an urgent concern regarding your own or your baby’s health, please contact a healthcare professional. Because babies come in both male and female varieties we have alternated pronouns.

About La Leche League (1)

General questions about La Leche League

We apologize for any inconvenience as we add more FAQs to this page.  You may indeed see changes as they are added and the order of questions altered to improve readability.  This is a slow process and may take several days.  Thank you for your patience.

Getting Started (0)

Questions about prenatal preparation and establishing breastfeeding

Babies breastfeed frequently; often every one-and-a-half to three hours. Time feeds from the start of one feed to the start of the next. Expect an average of eight to twelve feeds in 24 hours.

Watch your baby. Look for smacking lips, sucking movements, bringing her hand to her mouth and bobbing around with her face. Crying is a late hunger cue. Your baby will latch and feed better if you get ready to feed her when she begins to give you the first hunger cues. A poster with a series of photographs showing baby cues can be found HERE

FAQ categories: 

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. The timing of these sessions is very individual and the spacing between feeds is variable - babies do not feed by the clock.

In the early days, when the baby is getting colostrum, many mothers don't hear swallows. This doens'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. It is important for the baby to be latched on to the breast deeply and effectively so he can get all the colostrum he needs.

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. These smaller feedings encourage your baby to go back to the breast often in the first few days. This frequent stimulation is what increases your milk production - a lovely and effective feedback loop!

There are three main ways to tell: look at your baby's weight, output (wet and soiled diapers) and behaviour. If your baby is gaining weight properly, that is the most certain sign. Information Sheet #457 How to Know Your Baby is Getting Enough Milk provides more details.

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.

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.

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). These will typically be very loose and bright yellow in colour, often with a "seedy" appearance. This is summarized in a table at the end of the information sheet How to Know Your Breastfed Baby is Getting Enough or contact a local Leader.

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.

In the early days, when the baby is getting colostrum, many mothers don't hear swallows. This doens'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. It is important for the baby to be latched on to the breast deeply and effectively so he can get all the colostrum he needs.

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.

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.

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.

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.

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.

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.

It helps regulate the baby's temperature, breathing, heart rate and sugar levels. It also calms the baby so he doesn't get stressed out or cry a lot. It is easier for many babies to latch on to the breast when held skin-to-skin. It is good for both full term and premature babies.

The mother's body is the baby's habitat. During the first few weeks skin-to-skin can be done often or even continuously. There is no age at which skin-to-skin is no longer recommended.

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.

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.

There are natural laxatives in colostrum which help babies expel the meconium. The more breastfeeding your baby does in the early days the more colostrum he takes in and the faster the meconium clears. As the milk volume increases, he will start to have transitional stools.

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 How to Know Your Breastfed Baby is Getting Enough. Contact a local Leader to get a copy.

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. (Remember: the longer it has been between stools, the bigger it will be.) Expected bowel movements are summarized in Information Sheet #457 How to Know your Baby is Getting Enough Milk.

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.

You do not need to eat any special foods or be concerned if you don't eat a balanced diet every day. Nature ensures that the baby gets the right amount of nutrients automatically by using vitamins stored in your body as needed. It's important for all women to eat healthy food for themselves and for their babies.

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!

If you find that you need to use a soother, it is best to wait for at least a month before introducing it. Giving babies soothers or bottles before they have learned how to breastfeed can be confusing for them. Give your baby a chance to learn one thing at a time.

No, a breastfed baby does not require anything other than your milk. Exclusive breastfeeding is recommended for the first six months. Your milk will adjust to ensure that your baby gets all the fluids she needs to stay hydrated. You will likely want to drink more fluids to meet your extra fluid needs.

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.

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.

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. These smaller feedings encourage your baby to go back to the breast often in the first few days. This frequent stimulation is what increases your milk production - a lovely and effective feedback loop!

Common Concerns and Challenges (16)

Issues that can often be overcome with appropriate information and support

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. Nursing strikes can last from 2-4 days.

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:

  • taking a warm bath together
  • making the breast available while baby is sleepy, especially when he is just waking up
  • singing to or rocking your baby while holding him skin-to-skin
  • nursing in a different position or location

Do not try to make your baby breastfeed; rather just hold him (skin-to-skin when possible) and let him take the lead when he is ready to try again.

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”.

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.

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:

  • teething or other changes in your baby’s mouth that affect how he latches on
  • changing nursing patterns (if your baby spaces out his feedings, flow may be faster and he may adjust his latch to cope)
  • pregnancy
  • use of an ineffective breast pump
  • skin reactions such as eczema and psoriasis
  • skin infections such as herpes and chicken pox (You would also see sores on your breast.)

Thrush is an infection of the breast by yeast (Candida albicans). This same yeast can cause vaginal yeast infections, infect a baby’s mouth and cause a diaper rash. C. albicans is found on and in everyone’s body. Sometimes the balance between the different normal flora of the body gets out of whack and yeast can take over, resulting in symptoms of a yeast infection. Information Sheet #461 Thrush & the Breastfeeding Family contains detailed information. 

The first step in treating thrush is to get an accurate diagnosis from your healthcare provider. There is no reliable lab test for thrush. If your doctor diagnoses thrush, it is essential for both you and your baby to be treated for thrush at the same time, even if only one of you has symptoms. Yeast is easily spread and thrives in warm moist environments such as your baby's mouth and your nipples.

Thrush on the nipples can be very difficult to treat and should be done with the guidance of a healthcare provider. There are many treatment options from topical anti-fungal creams to anti-fungal oral medication; your doctor can help you decide the correct treatment to choose. An alternative health care practitioner, such as a naturopathic doctor, can provide guidance with the use of nutraceuticals and homeopathy. The most important part of treatment for thrush is to complete the treatment, even after your nipples begin to feel better. Tell your doctor if you are not feeling better within the first week of treatment. You can find more information in Information Sheet #461 Thrush & the Breastfeeding Family (revised 2016), or contact a La Leche League Leader.

Your baby may have white patches on the inside of his cheeks, roof of his mouth, inside of his gums or on his tongue that cannot be wiped off. He may also have a persistent, painful diaper rash.  Occasionally, babies are fussy at breast when they have a yeast infection.

Persistent nipple pain in the early weeks of breastfeeding that isn’t improved with a deep latch, or nipple pain that appears after several weeks or months of pain-free nursing, may be caused by thrush. Additional symptoms can include:

  • Itchy or burning nipples that appear bright pink or red, shiny, flaky, and/or have a rash with tiny blisters
  • Cracked nipples becoming deep without bleeding, often in a fold at the base of the nipple. Occasionally cracks are seen on the front surface of the nipple in a crevice
  • Shooting pains in the breast during or after feedings
  • Deep breast pain
  • Nipples sting more after the feeding rather than during the feeding

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.  If the pain doesn’t resolve or you’re having difficulty getting a deeper latch, consider having a lactation expert (A LLL Leader, International Board Certified Lactation Consultant, or knowledgeable health nurse) observe your baby at breast.

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)

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.

Thawed milk should be kept refrigerated and used within 24 hours.  If it hasn’t been used by that time, it should be discarded or refrozen. However, repeated freezing and thawing will affect milk quality.

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. If the breastmilk has been frozen and thawed some of these properties are lost. The final choice is yours; let common sense be your guide. If the baby's next feeding of pumped breastmilk ends up being 7 or more hours later (because he slept through the night, for example) or the breastmilk was stored in the fridge for several days before being fed to the baby, you may choose to err on the side of caution. To avoid wasting precious breastmilk, mothers usually prepare bottles with a small amount, 1 to 2 oz (30 to 60 ml), to start a feeding.  More breastmilk can be added to the bottle if needed.

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.

This information is covered in the LLLC Information Sheet Storing Human Milk, which can be requested from your local Leader, and The Womanly Art of Breastfeeding tear-sheet toolkit: “Storing Milk for Your Healthy Full Term Baby”

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.

In the early days, when the baby is getting colostrum, many mothers don't hear swallows. This doens'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. It is important for the baby to be latched on to the breast deeply and effectively so he can get all the colostrum he needs.

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!

If you find that you need to use a soother, it is best to wait for at least a month before introducing it. Giving babies soothers or bottles before they have learned how to breastfeed can be confusing for them. Give your baby a chance to learn one thing at a time.

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.

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.

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). These will typically be very loose and bright yellow in colour, often with a "seedy" appearance. This is summarized in a table at the end of the information sheet How to Know Your Breastfed Baby is Getting Enough or contact a local Leader.

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.

There are three main ways to tell: look at your baby's weight, output (wet and soiled diapers) and behaviour. If your baby is gaining weight properly, that is the most certain sign. Information Sheet #457 How to Know Your Baby is Getting Enough Milk provides more details.

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. These smaller feedings encourage your baby to go back to the breast often in the first few days. This frequent stimulation is what increases your milk production - a lovely and effective feedback loop!

Illness (5)

The media is reporting that women who are pregnant or may become pregnant should avoid travel to areas where the Zika virus is found. What about a breastfeeding mother? Should she keep breastfeeding if she may be infected?

As of this writing, the Center for Disease Control (CDC) has indicated that breastfeeding should continue. However, as research is on-going, please check www.cdc.gov/zika/transmission/ for the most current information. 

Pregnant women, or those considering becoming pregnant, can find more information about Zika here: www.cdc.gov/zika/index.html  or www.cdc.gov/mmwr/volumes/65/wr/mm6502e1.htm 

General information is available at http://healthycanadians.gc.ca/ and The Public Health Agency of Canada  

If you have any health concerns about yourself or your nursling, please contact your health care provider for personal advice.

FAQ categories: 

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.

If you have specific concerns about your own health, please contact a health professional.

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.

FAQ categories: 

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. As your own baby’s advocate, double-check that your healthcare provider is using up-to-date information and resources to confirm any recommendation for breastfeeding interruption or weaning.

FAQ categories: 

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.

FAQ categories: 

The first step in treating thrush is to get an accurate diagnosis from your healthcare provider. There is no reliable lab test for thrush. If your doctor diagnoses thrush, it is essential for both you and your baby to be treated for thrush at the same time, even if only one of you has symptoms. Yeast is easily spread and thrives in warm moist environments such as your baby's mouth and your nipples.

Thrush on the nipples can be very difficult to treat and should be done with the guidance of a healthcare provider. There are many treatment options from topical anti-fungal creams to anti-fungal oral medication; your doctor can help you decide the correct treatment to choose. An alternative health care practitioner, such as a naturopathic doctor, can provide guidance with the use of nutraceuticals and homeopathy. The most important part of treatment for thrush is to complete the treatment, even after your nipples begin to feel better. Tell your doctor if you are not feeling better within the first week of treatment. You can find more information in Information Sheet #461 Thrush & the Breastfeeding Family (revised 2016), or contact a La Leche League Leader.

A plugged duct is when one of the ducts (tubes) that carries milk from the “milk factory” in your breast to the nipple is blocked in some way—usually by a thick clump of milk. It might be tender or feel bruised, and you may be able to feel a lump.

FAQ categories: 

Plugged ducts either result from milk not being taken out (baby sleeps through the night, misses a feeding or changes how he nurses) or pressure on a milk duct (tight bra/clothing, straps from a baby carrier or bag, how you sleep). Very often two causes happening at the same time creates the problem.

FAQ categories: 

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. Gently massage or apply pressure to the hard area after applying heat or while nursing to help dislodge the plug.

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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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No. In fact, you will want to nurse more often on the affected side. A breast infection may require treatment with antibiotics (see next FAQ).  Most antibiotics are compatible with continued breastfeeding. Your baby will not get sick from drinking milk from your affected breast.

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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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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. Antibiotics may be required to treat the infection. Most antibiotics are compatible with breastfeeding.

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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:

  • A washcloth soaked in hot tap water (Wring out excess liquid, re-soak as required.)
  • A (clean) disposable diaper soaked in hot tap water (stays warmer longer than a washcloth)
  • Soaking affected breast in a bowl of hot water
  • Soaking in a hot bath with the affected breast under water
  • Allowing water from a hot shower to flow over your breast. You may be most comfortable with your back to the shower, so that the water is not directly hitting the breast.
  • Magic Bag™ or similar bag which can be heated
  • Hot water bottle (Be sure to place cloth between bottle and skin.)
  • Re-heatable gel packs (There are some made specifically for use by breastfeeding mothers.)
  • Heating pad, set on low
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Yes. Because the breast is hot and inflamed, some mothers find that cold or cool compresses applied between feedings makes them feel more comfortable.

Use heat or cold, whichever works best for you.

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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. Your body will figure out a balance with time. Avoid unnecessary activities and listen to your body’s signals that you may be doing too much. Rest when your baby naps.  Eating nutritious whole foods can help you stay healthy.  Make sure that your bra and other clothing are not too tight, especially when your breasts are full of milk.

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Beyond the First Six Weeks (7)

Questions cover 6 weeks to one year

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.

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”.

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.

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. Nursing strikes can last from 2-4 days.

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:

  • taking a warm bath together
  • making the breast available while baby is sleepy, especially when he is just waking up
  • singing to or rocking your baby while holding him skin-to-skin
  • nursing in a different position or location

Do not try to make your baby breastfeed; rather just hold him (skin-to-skin when possible) and let him take the lead when he is ready to try again.

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.

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.

Pumping (6)

Information about expressing and storing milk

This information is covered in the LLLC Information Sheet Storing Human Milk, which can be requested from your local Leader, and The Womanly Art of Breastfeeding tear-sheet toolkit: “Storing Milk for Your Healthy Full Term Baby”

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. If the breastmilk has been frozen and thawed some of these properties are lost. The final choice is yours; let common sense be your guide. If the baby's next feeding of pumped breastmilk ends up being 7 or more hours later (because he slept through the night, for example) or the breastmilk was stored in the fridge for several days before being fed to the baby, you may choose to err on the side of caution. To avoid wasting precious breastmilk, mothers usually prepare bottles with a small amount, 1 to 2 oz (30 to 60 ml), to start a feeding.  More breastmilk can be added to the bottle if needed.

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.

Thawed milk should be kept refrigerated and used within 24 hours.  If it hasn’t been used by that time, it should be discarded or refrozen. However, repeated freezing and thawing will affect milk quality.

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.

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. These smaller feedings encourage your baby to go back to the breast often in the first few days. This frequent stimulation is what increases your milk production - a lovely and effective feedback loop!

Nursing During Toddlerhood and Beyond (4)

Questions about benefits and challenges of nursing a toddler

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:

  • taking a warm bath together
  • making the breast available while baby is sleepy, especially when he is just waking up
  • singing to or rocking your baby while holding him skin-to-skin
  • nursing in a different position or location

Do not try to make your baby breastfeed; rather just hold him (skin-to-skin when possible) and let him take the lead when he is ready to try again.

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. Nursing strikes can last from 2-4 days.

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.

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.

Weaning (6)

Questions cover if, when, and how, to wean

Ideally, breastfeeding continues until the baby outgrows the need.  Your baby is an individual and will outgrow breastfeeding at his own pace, which may be different from other babies you know.

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There is no age at which a baby has to wean.  Research by anthropologist Kathy Dettwyler suggests that the natural age range for weaning is between 2.5 and 7 years. This is consistent with LLLC experience that most babies will choose to wean somewhere between those ages.

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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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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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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. Nursing strikes can last from 2-4 days.

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:

  • taking a warm bath together
  • making the breast available while baby is sleepy, especially when he is just waking up
  • singing to or rocking your baby while holding him skin-to-skin
  • nursing in a different position or location

Do not try to make your baby breastfeed; rather just hold him (skin-to-skin when possible) and let him take the lead when he is ready to try again.

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.

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. As your own baby’s advocate, double-check that your healthcare provider is using up-to-date information and resources to confirm any recommendation for breastfeeding interruption or weaning.

The media is reporting that women who are pregnant or may become pregnant should avoid travel to areas where the Zika virus is found. What about a breastfeeding mother? Should she keep breastfeeding if she may be infected?

As of this writing, the Center for Disease Control (CDC) has indicated that breastfeeding should continue. However, as research is on-going, please check www.cdc.gov/zika/transmission/ for the most current information. 

Pregnant women, or those considering becoming pregnant, can find more information about Zika here: www.cdc.gov/zika/index.html  or www.cdc.gov/mmwr/volumes/65/wr/mm6502e1.htm 

General information is available at http://healthycanadians.gc.ca/ and The Public Health Agency of Canada  

If you have any health concerns about yourself or your nursling, please contact your health care provider for personal advice.

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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.

If you have specific concerns about your own health, please contact a health professional.

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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