Won't breastfeeding "tie me down"?
	I want to breastfeed, but what if I find it embarrassing?
	How can I tell if my baby is getting enough to eat?
	I tried to breastfeed my first baby, but I was unable to produce enough milk. How can I keep this from happening again?
	What are growth spurts?What are nursing strikes?
	When should I call my baby's doctor?

Won't breastfeeding "tie me down"?.

Yes and no.  In the beginning, when babies are breastfeeding often, breastfeeding can be time-consuming.  Once your milk supply is stable (about 6-12 weeks after birth), and your baby is breastfeeding less often, you will find it easier to come and go.  If necessary, a substitute feeding can be given using expressed breastmilk or infant formula.  You can use a cup, hollow-handled medicine spoon, medicine dropper, teaspoon, or bottle, whichever you prefer.

I want to breastfeed, but what if I find it embarrassing?.

Some mothers feel embarrassed when they first start to breastfeed, while others do not.  How you feel will depend on your breastfeeding experience as well as the experience of those around you. Unfortunately, many people see the breast as a sexual object. As a result, many women are uncomfortable handling or exposing their breasts, even for something as natural and wonderful as breastfeeding. Be aware of your own feelings.  If necessary, find a private place to breastfeed.  Unplug the telephone.  Put a small sign on your front door, "Hungry baby, do not disturb."  With patience and practice your confidence in your choice to breastfeed will grow.  Remember experienced mothers can breastfeed discreetly and modestly anywhere.

How can I tell if my baby is getting enough to eat?.

The amount of milk taken from the breasts at each feeding cannot be measured.  As a result, many mothers worry about whether their babies are getting enough to eat.  Remember one important fact about your baby, "Nothing comes out the bottom unless something goes in the top." The following signs will help to reassure you:

• Expect 3 stools a day for the first 3 days and at least 4 stools a day for the next 4 weeks.  Your baby's stool will be black and sticky (meconium) for several days.  Once your baby is taking larger amounts of breastmilk, his stool will become watery and yellow, usually by the fourth day.
• Breastfed babies' stools look like a mixture of water, yellow mustard, cottage cheese, and sesame seeds.  Expect small, frequent, watery stools with very little solid material. Sometimes, a yellow stain in the back of the diaper is all that you see.
• After the first 4-6 weeks, expect larger, softer, formed stools every 1-5 days.
• Expect at least 3 wet diapers a day during the first 3 days and at least 6 wet diapers a day after that.  Disposable diapers absorb liquid so well that it is often hard to tell if a diaper is wet. To check for wetness, place several sheets of toilet paper inside the diaper when a new diaper is used.
• While wet diapers are important, a decrease in the number of stools is the first sign that your baby may not be getting enough to eat.

I tried to breastfeed my first baby, but I was unable to. produce enough milk.  How can I keep this from happening again?

Almost every mother can produce enough milk to nourish her baby. Some women have a limited number of milk-producing cells (alveoli); however, this is rare.  When a mother's milk supply or a baby's weight gain is low, it is often the result of too little information, incorrect information, or too little support.  The following suggestions will help you build and keep a good milk supply:

• Breastfeed whenever your baby seems fussy or hungry.  During the early weeks, expect to breastfeed at least 8-12 times in 24 hours or every 1-3 hours during the day and every 2-3 hours at night.  Sometimes a sleepy baby will not ask or demand to eat often enough.  Therefore, during the first 4 weeks, keep your baby with you day and night.  Watch for early signs of hunger or light sleep such as wiggling, lip smacking, finger sucking, yawning, or coughing, and offer the breast at those times.

• Breastfeed as long as the baby wishes on the first breast before offering the second breast.  If the baby falls asleep while breastfeeding and the first breast is still firm and full, break the suction, burp him, wake him, and put him back on the first breast.

• Offer both breasts at every feeding.  However, do not be concerned if your baby seems satisfied with one breast. Remember each breast can provide a full meal. It is more important that he breastfeed well on one breast than that he breastfeed on both breasts.  Begin each feeding on the breast offered last.

• Avoid the use of water or formula supplements/substitutes during the first 4 weeks.  Supplements/substitutes can confuse your baby's suckling pattern and limit breastmilk production.

• Drink to satisfy your thirst.  Water and unsweetened fruit juices are suggested.  It is not necessary to drink milk to make milk. Mothers who drink lots of milk or eat lots of milk products can have fussy babies.

• Eat a balanced diet.

• Get plenty of rest.  Nap when the baby naps.

• Should problems occur, get help from people you trust.
  
   

What are growth spurts?.

Growth spurts or frequency days often occur around 3 weeks, 6 weeks, 3 months, and 6 months.  However, growth spurts can occur at any time.  Your baby may be fussy and restless and want to breastfeed all the time.  Well-meaning but inexperienced friends and relatives may suggest that "your milk isn't rich enough," that "you're not making enough milk," that "solid foods or formula supplements are necessary," or that "it is time to stop breastfeeding."  After 2-3 days of frequent breastfeedings, your milk supply will catch up with the increased demand, and the length and frequency of breastfeedings will decrease.  Feeling confident in your ability to breastfeed your baby is very important.  Seek advice from experienced friends or relatives or a certified lactation consultant (IBCLC) in your community.

What are nursing strikes?.

A nursing strike occurs when a baby suddenly refuses to breastfeed.  It can last for several feedings or several days.  Sometimes the cause is easily identified, such as teething, fever, ear infection, stuffy nose (cold), constipation, or diarrhea.  Occasionally, menstruation (monthly bleeding) or something in your diet will change the taste of your milk. Deodorant, perfume, or powder placed on the mother's skin can be the cause of the strike.  Frequently no cause is found.  Until the strike ends, you will need to hand express or pump to relieve fullness and maintain your milk supply.  Continue to offer the breast.  However, do not insist if the baby refuses.  Give expressed breastmilk by teaspoon, eye dropper, hollow-handled medicine spoon, or cup until breastfeeding resumes.  Be patient and relax.  Watch for early signs of hunger and offer the breast at those times.  Limit noise and distractions during feedings.  Give your baby undivided attention.  Nursing strikes seldom lead to weaning.  With time, the baby will return to the breast.

When should I call my baby's doctor?.

Problems can occur during the early weeks when a mother and baby are learning to breastfeed.  You can prevent serious problems if you know the early warning signs that your baby may not be getting enough to eat.  If your baby is less than 6 weeks of age and any of the following occur, call your baby's doctor:

• fewer than 3 bowel movements a day during the first 3 days or fewer than 4 bowel movements a day during the next 4 weeks
• fewer than 3 wet diapers a day during the first 3 days or fewer than 6 wet diapers a day during the next 4 weeks
• fewer than 8 breastfeedings a day
• no sign of suckling and swallowing (milk transfer) when breastfeeding
• no sign of milk release (let-down)
• your baby is either restless and fussy or listless and sleepy for long periods of time
• your baby has lost more than 7% of his birth weight
• your baby is below birth weight at 2 weeks of age
• your baby is gaining less than 4-8 oz. a week

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