Answers to the Most Common Questions About Breastfeeding Posted on August 5, 2019 There are lots of myths and misconceptions about breastfeeding, so we sat down with Silvana Michael, a lactation nurse at Connecticut Children’s, to get answers to the most common questions. Our Lactation Team is based out of the neonatal intensive care unit (NICU), but they provide care to all breastfeeding families as well as employees throughout the medical center. Can breastfeeding moms drink caffeine? Yes! It can be safe up to 25 ounces per day because a baby only gets about one percent of what a mom ingests. Should you stop breastfeeding if you’re sick? No. When you get exposed to a virus, your body creates antibodies against that virus to fight it off. Your child is exposed to you and that virus whether or not you are breastfeeding. If you are breastfeeding, your child ingests the antibodies through the breast milk to help fight that cold or illness. How do you know your baby is getting enough breast milk? We find this is the question new moms and dads worry about the most. It’s all about paying attention to the quality of the feedings and the baby’s output. Breastfed babies should feed anywhere between 8 and 12 times per day. If they are feeding much more often than that, they may not be getting enough per feeding. Additionally, you need to pay attention to their diapers. When a baby is 1 day old, they should have at least one wet diaper, when they’re 2 days old, two wet diapers. It goes up each day until they hit 6 days and at that point, it’s at least six to eight wet diapers and at least two stools in a 24-hour period. Weight checks at the pediatrician’s office will also assure moms and dads that things are going well. Do moms with babies who are born prematurely make different breast milk than moms with babies born full term? Yes, if a baby is born prematurely, the mother’s breast milk is higher in immune protective factors as well as protein, magnesium, and iron. It is specific to how many weeks into the pregnancy the baby was born—the more premature the delivery, the higher the levels of these important protective factors in the milk. As time goes on and the baby gets older, the milk will transition to look more like the milk of mothers who deliver at term. Can moms who deliver a preterm or sick infant still breastfeed? Yes. Most babies born preterm or sick will not be able to breastfeed in the delivery room or during the first days following delivery. They may take longer to achieve an effective latch and productive feeding, but with time, patience and support, they can become very successful breastfeeders. Is it safe to buy breast milk on the internet? In most cases, no. Studies have shown that breast milk purchased off the internet can be contaminated with bacteria and viruses. Donor milk is a wonderful option for mothers who cannot produce milk for their own infant, but it should always be purchased through a reputable donor milk bank, such as the Human Milk Banking Association of North America or Prolacta. Do moms with smaller breasts produce less breast milk? No, breast size is based on fatty tissue, while breast milk production is based on the amount of milk ducts in the breast. Women with small breasts can produce just as much milk for their baby as moms with larger breasts. Can you have an alcoholic drink while breastfeeding? Yes. It’s best to consume the alcohol immediately following a breastfeeding or pumping session, so that your body has the most time possible to metabolize the alcohol before the next feeding or pumping. By the time the baby is ready to breastfeed or you’re ready to pump again, it’s at least two hours later and the amount of alcohol in the breast milk is very low. If you have more than one drink, you should pump and dump for at least one pumping session. Is breastfeeding supposed to hurt? No. There is often some tenderness felt early on because it is something new and different, but the pain should not be sharp or severe. The most common cause of pain with breastfeeding is an ineffective latch. Moms should strive for a deep latch, meaning the baby’s wide-open mouth takes in a large portion of the areola. If we can get the newborn to achieve a deep latch, there is less chance of pain because the baby is bringing the nipple all the way to the soft palate of their mouth. If the latch is more shallow, they’re pinching the nipple against their hard palate, which can be very painful for mom. Moms should be able to achieve a deep latch using any breastfeeding position, but we recommend the football or cross cradle hold for a preterm or small baby. These positions allow the mother to have more control over the baby’s head and shoulders, which often makes a deep, effective latch easier. What resources do you recommend for people who are interested in learning about breastfeeding? We typically recommend: La Leche League Kelly Mom Dr. Jack Newman’s Breastfeeding Inc. The CDC How long should moms breastfeed? When we hear this question from moms, we ask them: What is your goal? Our job is really to help moms achieve their goals when it comes to breastfeeding. The American Academy of Pediatrics recommends six months of exclusive breastfeeding and continued breast milk with food for up to a year. After 1 year, breastfeeding can and should be continued if mutually desired by the mother and her infant. There is no specific age when a mother should stop breastfeeding her child. This is a personal decision for each family, and like many aspects of parenting and child development, there is no one right or wrong answer. When moms are ready to start weaning off of breastfeeding or pumping, we recommend cutting out a pumping or breastfeeding session, waiting a couple of days, and then cutting out another session. It’s important to do it gradually, so the mother doesn’t end up with engorgement. This also provides the infant with time to adjust to the change as well.