Breastfeeding: Frequently Asked Questions (FAQs)

Breastfeeding

Frequently Asked Questions (FAQs)

How many infants born in the United States are breastfed?
According to findings from the 2003 CDC National Immunization Survey, a nationally representative sample of the U.S. population,

70.9 percent of all U.S. infants were ever breastfed
36.2 % of infants were still breastfeeding at 6 months of age
17.2 % of infants were breastfeeding at 1 year of age

Are growth charts available to assess growth in breastfed infants?
In May of 2000, CDC released revised Growth Charts for children of all ages. The population studied to determine the desirable rate of growth included many breastfed infants. Although there are no growth charts specific to breastfed children alone, these revised CDC Growth Charts are recommended for all infants in the United States. The World Health Organization is developing growth charts based on breastfed infants. CDC is currently working with WHO on these new growth charts.

When should a baby start eating solid foods such as cereals, vegetables, and fruits?
Breast milk alone is sufficient to support optimal growth and development for approximately the first 6 months after birth. For these very young infants, the American Academy of Pediatrics (AAP) states that water, juice, and other foods are generally unnecessary. Even when babies enjoy discovering new tastes and textures, solid foods should not replace breastfeeding, but merely complement breast milk as the infant’s main source of nutrients throughout the first year. Beyond one year, as the variety and volume of solid foods gradually increase, breast milk remains an ideal addition to the child’s diet.

How long should a mother breastfeed?
The American Academy of Pediatrics (AAP) recommends that breastfeeding continue for at least 12 months, and thereafter for as long as mother and baby desire. The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond.

What can happen if someone else's breast milk is given to another child?
HIV and other serious infectious diseases can be transmitted through breast milk. However, the risk of infection from a single bottle of breast milk, even if the mother is HIV positive, is extremely small. For women who do not have HIV or other serious infectious diseases, there is little risk to the child who receives her breast milk.

Are special precautions needed for handling breast milk?
CDC does not list human breast milk as a body fluid for which most healthcare personnel should use special handling precautions. Occupational exposure to human breast milk has not been shown to lead to transmission of HIV or HBV infection. However, because human breast milk has been implicated in transmitting HIV from mother to infant, gloves may be worn as a precaution by health care workers who are frequently exposed to breast milk (e.g., persons working in human milk banks).

Should mothers who smoke breastfeed?
Mothers who smoke are encouraged to quit, however, breast milk remains the ideal food for a baby even if the mother smokes. Although nicotine may be present in breast milk, adverse effects on the infant during breastfeeding have not been reported. AAP recognizes pregnancy and lactation as two ideal times to promote smoking cessation, but does not indicate that mothers who smoke should not breastfeed.

How do I take care of my breasts during breastfeeding?

By the third or fourth day of breastfeeding, your milk will change from colostrum to what looks more like skim milk. Your breasts will also go from feeling soft to firm. If your nipples leak, use a nursing pad or clean folded handkerchief squares inside your bra to catch the leaking milk. Be sure to change these often. Do not use plastic-lined pads because they will prevent air from circulating around your nipples.

Between feedings, gently pat your nipples dry. This helps prevent them from getting irritated. You may also want to apply a little expressed colostrum, human milk or medical grade modified lanolin on your nipples to prevent dryness.

How often should I nurse?

Breastfed babies tend to feed more often than formula-fed babies, usually eight to 12 times a day. The main reason for this is that their stomachs empty much more quickly because human milk is so easy to digest.

Initially, your newborn will probably nurse every couple of hours, regardless of whether it's day or night. By the end of the first month, your baby may start sleeping longer at night. Let your baby feed on demand — that is, whenever he is hungry. Watch for different signals from your baby, rather than the clock to decide when to nurse. When your baby is hungry, he may do any of the following:

Nuzzle against your breast
Show the rooting reflex
Make sucking motions or put hand to mouth
Cry

It is best not to wait until your baby is overly hungry before you breastfeed.

Some newborns can be sleepy and hard to wake. Do not let your baby sleep through feedings until your milk supply has been developed, usually about two to three weeks. If your baby is not demanding to be fed, wake her if three to four hours have passed since the last feeding. If this persists, call your pediatrician.

How long does breastfeeding take?

While some infants nurse for only 10 minutes on one breast, it is quite common for others to stay on one side for much longer. Some feedings may be longer than others depending on your baby's schedule and the time of day. Some babies may be nursing even though they appear to be sleeping. If your baby has fallen asleep at your breast, or if you need to stop a feeding before your baby is finished, gently break the suction with your finger. Do this by slipping a finger into your baby's mouth while he or she is still latched-on. Never pull the baby off the breast without releasing the suction.

When you breastfeed, alternate between which breast you offer first. (You may want to keep a safety pin or short ribbon on your bra strap to help you remember on which breast your baby last nursed.) While you should try to breastfeed evenly on both sides, your baby may prefer one side over the other and nurse much longer on that side. When this happens, the breast adapts its milk production to your baby's feedings. Remember, your baby's feedings control how much milk your breasts produce. It is important to let your baby nurse on both sides so that each breast gets stimulation over the course of a day.

You will soon get to know your baby's feeding patterns. Each baby has a particular style of eating, some slower, some faster. Learning your own baby's eating patterns makes it easier to determine when she is hungry, when she has had enough, how often she needs to eat, and how much time she needs for feedings.

For some mothers and babies, breastfeeding goes smoothly from the start. For others, it takes a little time and several attempts to get the process going effectively. Like anything new, breastfeeding takes some practice. This is perfectly normal. If you need help, ask the nurses while you are still in the hospital, your child's pediatrician, a lactation consultant or a breastfeeding support group. Remember, the most important keys to successful breastfeeding are proper positioning and correct latch-on.

Until you and your baby develop a feeding routine, stay positive and try not to get discouraged. Remember, your milk gives your baby more than just food. It also provides important antibodies to fight off infection and has medical and psychological benefits for both of you. Breastfeeding is the most natural gift that you can give your baby.

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