Simple

Simple Breastfeeding Solutions

Note: This page is for educational purposes only. Receiving a link to this page should not be considered marketing of my services.

(For more help with breastfeeding, please go back to Common Problems and follow the links there.)

First Week of Baby's Life

Sleepy or Unsatisfied Baby, Weight Loss, or Poor Weight Gain

Note: the following is a 3-5 day plan. If you do not see any increase in your milk supply in 3-5 days, see a lactation consultant (IBCLC).

Step 1:

Feed your baby their full calorie needs at every feeding

Temporarily limit breastfeeding to no more than 15 minutes per session until the situation stabilizes.

How Much Milk Does My Baby Need?

Important note: these numbers are average feeding amounts. Always follow your baby’s hunger and fullness cues.

Average Amount of Milk

Per Feeding

(more is fine)

Day One: 0.5 oz (15 ml)

Day Two: 0.5–1 oz (15–30 ml)

Day Three: 1–1.5 oz (30–45 ml)

Day Four: 1.5–2 oz (45–60 ml)

Day Five to Six Months: see milk calculator

Step 2:

Keep your breasts emptied by frequent & thorough pumping

in addition to (or in place of) breastfeeding. Milk production increases with more milk removal, by baby and/or pump; not removing milk tells your body to lower your production.

Sample pumping schedule (customize as needed):

15 min pumping at 8 am, 10 am, 1 pm, 4 pm, 7 pm, 10 pm, 12 am (sleep for 5 hours* while partner does a feeding). When you wake up, breastfeed/pump again.

*If you wake up with very hard breasts (engorgement), you may need to cut the 5-hour sleep to 4 or even 3 hours if your goal is a full milk supply. Here's why.

Sleep deprivation is bad for milk production! Your needs matter!

Step 3:

Breastfeed whenever you and your baby are both up to it

(if you’re pressed for time or exhausted, just keep baby at breast when they’re actively swallowing.) Swallowing sounds like little puffs of air: "kuh...kuh...kuh":

Breast compressions while baby is nursing should increase your baby's swallowing, empty your breasts better, and reduce the need to pump:

Source: International Breastfeeding Center. Used with permission.

Note: when the speaker says "there," look at baby's chin; that is a swallow.

After the First Week

Sleepy or Unsatisfied Baby, Weight Loss, or Poor Weight Gain

Note: the following is a 3-5 day plan. If you do not see any increase in your milk supply in 3-5 days, see a lactation consultant (IBCLC).

Follow the same recommendations as outlined above (Steps 1-3), with these changes:

First, start with a mentally and physically healthy mom and baby. If you need sleep, get it! Many mothers (and fathers) of new babies develop depression or anxiety, which are treatable with help. Take some time to clarify what your goals are for feeding your baby, and what support you have available.

Second, use the milk calculator to determine the average amount your baby needs to eat. If your baby has to catch up, expect them to eat more. If your baby fights at the breast, temporarily stop breastfeeding and just cuddle skin to skin until your baby remembers your breast is a nice place to be. No pressure, just cuddling.

Third, add power pumping to the above pumping routine. Power pumping is 20 min pumping, 10 min rest, 10 min pumping, 10 minute rest, 10 min pumping. Do this after your longest sleep. Make sure one of your pumping sessions is between the hours of 12-6 a.m., as your prolactin levels are highest then.

Look at these pumping hacks for more ideas on increasing your milk output. The more milk you get out, the more you will make (within the limit of what is possible for your body at this time).

Sore or Injured Nipples, Shallow Latch, Tongue/Lip Tie

The three principles of comfortable latching:

1. Smush baby’s body firmly against yours (baby wiggling? not close enough). If your baby feels like they're falling, latching will be harder.

2. Baby’s nose lines up with your nipple, their chest snuggles into your breast, their hips are firmly against your rib cage. Baby must be positioned so that they can tilt their head back in order to open their mouth as wide as possible. (Try opening your mouth and swallowing with your head tipped forward; it doesn’t work well.) Do not put pressure on the back of their head; put your finger and thumb behind their ears for head support. See these videos for demonstrations:

Positioning and Latching (note that there is no sound):

3. The nipple goes far back in the baby’s mouth. Run your tongue along the roof of your mouth (from your teeth towards your throat)—your palate is hard, smooth, and there is plenty of room up there; as you move your tongue back, there is a softer area. Right between the hard and soft area is where your nipple needs to be, both for its protection and for your baby to get more milk more easily.

Source

There are other causes of nipple pain besides shallow latching, but this is the most common.

Baby Won’t or Can’t Latch

Until you can get the help you need, there are three things you should do:

Make sure your baby is well-fed (milk drunk after every feeding; see milk calculator if you're not sure how much your baby should eat)
Keep your breasts emptied frequently and thoroughly (sample pumping schedule in this section)
Ensure that your baby’s only time near the breast is comfortable and enjoyable—no trying to force or pressure baby to latch.

If you have not already tried it, a nipple shield can help.

Good, deep latch on nipple shield

*be sure to follow up with a lactation consultant to make sure it fits well, you're putting it on correctly, and to plan how and when to stop using it. More about nipple shields.

Applying a nipple shield

Photo credit: La Leche League UK

Engorgement, Plugged Ducts, & Mastitis

Note: If you have a fever over 100.5, severe pain in your breasts, or your skin looks reddened or darkened, call your OB or go to the nearest emergency room.

These conditions are largely the result of swelling and pain (inflammation), or a bacterial infection. They have different causes, but similar treatments. The swelling must be reduced to allow the breasts to provide optimal milk flow. Do the following:

(1) Lie on your back with cold compresses around your breasts for about 10 minutes
(2) Perform gentle massage called lymphatic drainage on your breasts (shown below)
(3) Breastfeed your baby or pump (only as much milk as you expect baby to eat)

If your milk isn't flowing, do this:

Reverse pressure softening (shown below)
Short (5 min) frequent (every 10-15 min for no more than an hour) pumping sessions (make sure the suction strength is comfortable, not too high).
Repeat the 3 steps above (cold, lymphatic drainage, breastfeed/pump)

Source: Maya Bolman, IBCLC; see also "breast gymnastics" video for more tips on relieving full breasts

Reverse Pressure Softening:

Video by Newman Breastfeeding Clinic

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