August 01, 2022
Breastfeeding is one of the most natural things in the world. It’s also shrouded in some mystery and typically accompanied by lots of conflicting chatter about how to do it, when to do it and whether you should do it at all. If you’re planning to breastfeed, it’s important to have realistic expectations to reduce stress and sustain your plan.
“A lot of people normalize what they see on TV and social media or have heard or seen in their family,” says MU Health Care’s Jennifer Bock Apperson, a certified lactation consultant. “They’re comparing their own experience to others instead of really understanding the normal process.”
To help us set the record straight on breastfeeding expectations, Bock Apperson explains seven commonly misunderstood facts about breastfeeding:
1. Every Baby (and Breast) Handles Breastfeeding Differently
The most common question new breastfeeding moms have is, “Is this normal?” — worries around how their breasts look, how they feel, how much they’re leaking (or not leaking) and how the first hours of breastfeeding are going. But unless you’re in pain while breastfeeding (see #2 below), whatever is happening is probably normal for you and your baby.
“Many moms are concerned about the size and shape of their breasts and nipples, and whether they are breastfeeding correctly,” Bock Apperson says. “However, most breasts are designed to breastfeed and make milk for baby.”
Keep in mind that how a baby breastfeeds can look different from baby to baby, and even from sibling to sibling. Some babies don’t show as much interest in nursing and fall asleep at the boob. Others are big eaters or never want to come off because the sucking soothes them. Some infants want to be held like a football while eating, and others prefer to be cradled.
If your new baby handles breastfeeding differently from your first child, your sister’s child or every newborn on “Grey’s Anatomy,” that doesn’t mean what’s happening isn’t normal. But if you have questions, a lactation consultant, newborn nurse or pediatrician can certainly address your concerns.
2. Cracked Nipples and Pain are a Sign Something Is Wrong
Although breastfeeding can cause some discomfort or irritation, it’s not normal for it to hurt. “Usually pain means there’s something going on with how the baby latches. The latch should not feel like the baby’s biting, and your nipples shouldn’t have blisters, cracks or bleeding,” Bock Apperson says.
The good news is that a lactation consultant can offer guidance for many of the common causes of latching issues, such as:
- Engorgement, or full breasts that make it more difficult for your baby to latch.
- Feeding position, so your baby’s mouth and body are aligned to latch and don’t put excess pressure on painful areas of your breast.
- Inverted or flat nipples, which may need to be drawn out to support a more successful latch.
- Tongue tie, which occurs when the frenulum (membrane that anchors the tongue to the mouth floor) restricts the tongue’s mobility and interferes with your baby’s ability to attach to your breast.
If your breastfeeding has been relatively painless but you’ve recently started having pain, it could be a more serious issue such as:
- Blocked milk duct, which can cause pain or a lump in an area of the breast.
- Mastitis, an infection in the breast tissue, which can cause fever, soreness, red streaks or an ongoing red, tender, hard spot on the breast and flu-like symptoms.
3. There’s No Such Thing as a Newborn Breastfeeding Schedule
It’s usually best to follow your newborn’s lead when it comes to sleeping and eating. Most parents don’t see a pattern or start establishing a schedule until their baby is at least a month old.
“Feeding is different for everyone and can be dependent on the needs of the mom, baby and family,” Bock Apperson says. “Babies who stay skin-to-skin with mom tend to have shorter, more frequent feedings. Babies swaddled in a crib may need to be woken up to nurse but then may have a much longer feeding.”
Bock Apperson offers some very general guidelines for those early hours, days and weeks:
- First 24 hours: Newborns typically feed well for a few hours immediately following birth and then go into a sleepy phase.
- Second night: Many infants will cluster feed, feeding frequently throughout the night. Cluster feeding is normal and helps to bring in more milk.
- First days at home: Feeding at least eight times a day with a cluster feed at some point, usually in the evenings.
- Early weeks: Most babies will eat at least eight times a day, but usually become much better at nursing once they regain birth weight. During growth spurts, many parents notice their baby will again cluster feed for a few days before settling into a new routine.
4. You May Not See Milk Right Away
There’s no need for new moms to worry that they won’t produce enough milk in their baby’s first hours or days. Babies are born with a belly full of amniotic fluid to hydrate them. The first nursing sessions provide newborns with colostrum — thick, concentrated milk made up of proteins, minerals and antibodies. The smaller amount — only 1 to 4 teaspoons per day — makes it easier for babies to learn to suck and swallow milk.
“That little bit of colostrum has all that baby needs those first few days,” Bock Apperson says. “And every day, mom produces a little bit more.” Most women feel their breasts get heavier when their milk comes in, usually after three to five days. But it can take up to 14 days if the birth was stressful or medically difficult.
Once milk fully comes in, the baby’s latch triggers a let-down reflex — the breast’s release of milk. But don’t worry if you don’t feel the let-down — only half of women feel a sensation associated with it. More important, your breast should feel full at the beginning of each feeding and empty at the at the end.
5. It’s Normal for Newborns to Lose Some Weight
Babies carried to term almost always lose weight after birth, regardless of whether they are breastfeeding or formula feeding. Newborns delivered vaginally typically lose weight for up to three days. Babies born by cesarean section (C-section) may lose weight for four days. In the week or two after birth, both your baby’s appetite and your milk production typically adjust to regain that lost weight.
“Expect the amount of time spent breastfeeding to increase after birth for about seven to 10 days,” Bock Apperson says. “Once the baby reaches birth weight again, the amount of time spent feeding drops significantly.”
If your baby loses more than 10% of their birth weight or continues to lose weight after the first week, your doctor may recommend supplementing your breastfeeding until they identify the cause. Common reasons newborns lose too much weight after birth include latching issues, sleepiness and a delay in milk production.
6. Breastmilk Changes According to the Baby’s Needs and What You Eat
Breastmilk changes throughout each feeding session, from day to day and over time — changes that may be more noticeable if you pump regularly. Breastmilk changes happen:
- Within each feeding: Milk typically begins watery and bluish and transitions to thick, calorie-laden milk that helps your baby grow.
- With your diet: Each day, breastmilk can change in taste and color depending on your diet — these changes expose your baby to various tastes in preparation for eating solid food.
- As your baby grows: The composition of breastmilk changes over time in response to your baby’s changing needs and provides necessary nutrients as they grow.
- When your baby is sick: Your baby’s saliva tells your body to produce breastmilk with higher concentrations of infection-fighting cells.
- When you are sick: Your breastmilk contains antibodies to reduce your baby’s risk of catching the same bug.
Lactation Consultants Are Available the Entire Time You Breastfeed
Most breastfeeding moms see a lactation consultant during their time in the hospital, but the services a lactation consultant provides reach far beyond the first stage of breastfeeding.
“Sometimes, a new mom gets home and starts to have concerns or worries,” Bock Apperson says. “She’s not getting enough solid sleep or her mental health is suffering or she needs to start a new medication. A lactation consultant can help come up with a plan, even if that includes pumping or supplementing so someone else can help.”
Lactation consultants can also help with the transition from home to work. Common issues associated with pumping and oversupply can become painful or even lead to issues like mastitis. “Sometimes it’s helpful to have an outside person provide perspective and help identify a plan of action,” Bock Apperson says. “We are here to support each mom, her breastfeeding and whatever goal she has with feeding her infant.”
Next Steps and Useful Resources
- Want to learn more about lactation services? Read more.
