Your Top Breastfeeding Questions – Answered By Zaya Experts

Breastfeeding is often portrayed as the natural choice, but for many new parents, it can feel like anything but.  There can be a steep learning curve that comes with navigating your nursing journey. 

Parenthood is hard enough, we’re here to help make it simple. We took a look at some of your most commonly asked questions about breastfeeding and compiled the answers… so you can spend less time searching and more time with your baby.

Q: How much breast milk does my baby need?

When your baby is born, your body produces a protein-packed, yellow substance called colostrum to efficiently meet your little one’s nutritional needs (1, 2). 

Aimee Woodhouse, IBCLC, RN, explains, “In the first few days of life, an infant only needs about 1-1.5 teaspoons of colostrum at each feeding, but as mom’s milk comes in this will increase greatly.” Once mature milk comes in, experts recommend that you feed your baby “on-demand,” which basically means whenever your baby gives you hunger cues (3). 

According to Woodhouse, “Breastfed infants need to eat 8-12 times in 24 hours. From ages 1-6 months, 25 ounces of breast milk is the average amount that babies eat in 24 hours. So, the amount of milk needed for each feeding would be approximately 2-3 ounces.” Research shows that total daily intake can vary drastically between babies, ranging between 15.5-43 ounces per day (4, 5). 

It’s important to remember that babies don’t necessarily feed at regular intervals. While some may eat every 2 to 3 hours, many babies have periods of cluster-feeding where they eat more frequently (even more than once per hour) (1, 3). 

Q: When should I supplement with formula or solid food? 

Most lactation consultants agree that if a baby is gaining weight appropriately, having regular diapers, and acting content between feedings, you don’t need to worry about supplementing (2). You should discuss any concerns about your baby’s growth or behavior with your pediatrician.

According to Sandy McCabe, IBCLC, RN, “If supplementation is recommended, mothers’ expressed milk should be used first. If that isn’t possible, donor milk would be the next best thing. If donor milk is not available, you can discuss with your pediatrician which formula would be right for your baby.”

At around 6 months, the American Academy of Pediatrics (AAP) recommends adding solid foods to a baby’s diet (6). By this time, your baby:

• Holds his/her head up and sits with support
• Doubles his/her birth weight
• Shows an interest in solid foods by watching you eat or reaching for food

Even after introducing solids, your baby’s primary source of nutrition will still be breast milk (or formula). The AAP recommends that you continue breastfeeding for at least 12 months, and longer if desired (6).

Q: Are there any foods or drinks I should eat (or avoid) while breastfeeding? 

Breastfeeding parents need an additional 400-500 calories per day to support an adequate milk supply (7, 8). Certain nutrient requirements increase more than others during lactation, including:

• Iodine: Found in dairy products, eggs, seafood, and iodized table salt.
• Choline: Found in animal proteins, beans, lentils, and eggs.
• DHA: Found in salmon, flaxseed, walnuts, pumpkin seeds, and kidney beans.
• Vitamin B12: Found in animal proteins. If you are vegan or vegetarian, consider a daily supplement. 

Some people have heard that consuming oats or dark beer can boost milk supply. Unfortunately, there is no scientific data to support this link (9, 10). Alcohol can actually interfere with the milk ejection reflex and decrease milk supply (11). 

Since alcohol is present in breast milk with peak levels 30 to 60 minutes after drinking, experts recommend limiting consumption to one drink per day and waiting to nurse or pump for at least two hours after drinking (11, 12).

What about your morning cup of coffee? Caffeine does pass through your breast milk, though it is generally considered safe to consume under 300 mg per day (2-3 cups of coffee). Some research has shown that premature babies and babies whose mothers avoided caffeine entirely while pregnant are more likely to be sensitive to caffeine, which may result in fussiness, irritability, or decreased quality of sleep (13-15).

>> Learn more: Breastfeeding meal plan (PDF included) or Drinks that can increase breast milk supply

Q: Can you take any medications safely while breastfeeding?

Yes! So many new parents fear that they will expose their babies to risky substances through their breast milk. Only a small number of medications are completely contraindicated while breastfeeding (16). 

The benefits of many common medications are thought to outweigh the risks (17), including:

• Pain medications like acetaminophen and ibuprofen
• Allergy and cold medications like loratidine and fluticasone 
• Gastrointestinal medications like famotidine, calcium carbonate, and loperamide 
• Antidepressants

It’s always best to check with your healthcare provider prior to taking any medications while pregnant or nursing. For more reassurance, McCabe adds, “There is also an excellent resource called Infant Risk Center. They have a toll-free number you can call Monday to Friday and can answer specific questions about your medication.”

Q: Ouch! Breastfeeding hurts! Is it supposed to feel this way? 

Breastfeeding should not hurt. However, some new parents may find that it takes time to achieve a comfortable latch. It can be helpful to work with a lactation consultant to be sure that your baby is latching properly and transferring milk effectively.

Sometimes, breast pain can be a symptom of a larger issue. Plugged milk ducts, mastitis, and yeast infections of the nipple can all cause pain. 

References

1. Kent JC. How breastfeeding works. J Midwifery Womens Health. 2007 Nov-Dec;52(6):564-70. doi: 10.1016/j.jmwh.2007.04.007. PMID: 17983993.
2. Kellams A, Harrel C, Omage S, Gregory C, Rosen-Carole C. ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeed Med. 2017 May;12:188-198. doi: 10.1089/bfm.2017.29038.ajk. Epub 2017 Mar 15. PMID: 28294631.
3. How much and how often to breastfeed. Centers for Disease Control and Prevention. Published January 13, 2022. Accessed March 14, 2022. Available from: https://www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/how-much-and-how-often.html
4. Kent JC, Mitoulas LR, Cregan MD, Ramsay DT, Doherty DA, Hartmann PE. Volume and frequency of breastfeeds and fat content of breast milk throughout the day. Pediatrics 2006;117:e387–95.
5. Kent JC, Mitoulas LR, Cox DB, Owens RA, Hartmann PE. Breast volume and milk production during extended lactation in women. Exp Physiol 1999;84:435–47.
6. Starting Solid Foods. American Academy of Pediatrics. Last updated March 17, 2021. Accessed March 31, 2022. Accessed from: https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Starting-Solid-Foods.aspx.
7. American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012;129:827–841.
8. Breastfeeding and Special Circumstances: Maternal Diet. Centers for Disease Control. Last reviewed September 2, 2021. Accessed March 18. 2022. Available from: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html.
9. Nice, FJ. Common herbs and foods used as galactogogues. ICAN: Infant, Child, & Adolescent Nutrition 2011;3(3):129-132.
10. Mennella JA, Beauchamp GK. Beer, breast feeding, and folklore. Dev Psychobiol. 1993;26(8):459-466. doi:10.1002/dev.420260804
11. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Alcohol. [Updated 2022 Jan 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501469/
12. Reece-Stremtan S, Marinelli KA. ABM clinical protocol #21: guidelines for breastfeeding and substance use or substance use disorder, revised 2015. Breastfeed Med. 2015;10(3):135-141. doi:10.1089/bfm.2015.9992
13. Berlin CM Jr, Denson HM, Daniel CH, Ward RM. Disposition of dietary caffeine in milk, saliva, and plasma of lactating women. Pediatrics. 1984 Jan;73(1):59-63. PMID: 6691042.
14. Stavchansky S, Combs A, Sagraves R, Delgado M, Joshi A. Pharmacokinetics of caffeine in breast milk and plasma after single oral administration of caffeine to lactating mothers. Biopharm Drug Dispos. 1988 May-Jun;9(3):285-99. doi: 10.1002/bod.2510090307. PMID: 3395670.
15. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Caffeine. [Updated 2021 Apr 19]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501467/
16. Sachs HC, Frattarelli DA, Galinkin JL, Green TP, Johnson T, Neville K, Paul IM, Van den Anker J. The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics. Pediatrics. 2013;132(3):796-809.
17. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/