Many new moms expect breastfeeding to come naturally. For most, it takes time, practice, and support. Despite strong evidence in favor of breastfeeding, many parents supplement or switch to formula within the first year. Preparing yourself with foundational knowledge can make a big difference in reaching your breastfeeding goals. This episode covers the essential information you need to get started, along with practical tools and tips to make breastfeeding more manageable and rewarding.

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Article and Resources

I support the decisions you make for you and your baby when it comes to feeding. My goal is to provide accurate, evidence-based information and support to help you succeed. You can find all of the breastfeeding resources, episodes, and articles here.

The Importance of Breastfeeding 

Breastfeeding is arguably the best thing you can do for a new baby. Your milk contains every vitamin, mineral, and nutritional element your baby needs. While infant formulas have improved over the years, none come close to mimicking all of breastmilk’s beneficial properties.

The evidence in support of breastfeeding is overwhelming. There is extensive evidence on the positive effects of breastfeeding on immunity, health, and the connection between mother and baby. Your baby is born without natural immunity, and breastmilk helps build their immune system. Breast milk contains living cells to inhibit the growth of bacteria and viruses. It has antimicrobial proteins and peptides, anti-inflammatory and antioxidative factors. Your milk will produce antibodies in response to germs your baby transfers to your breasts.

Breastfeeding benefits your baby’s health in both the short and long term. The microbiome in your milk shapes your baby’s intestinal microbiome. Breastfed babies are at a lower risk for ear infections, intestinal upsets, respiratory problems, and dental problems. There is also evidence that breastfed infants are less likely to be overweight and have a lower risk of type II diabetes. If that isn’t enough, breastfeeding is also associated with increased intelligence and a higher IQ.

There are even benefits to you breastfeeding. If you exclusively breastfeed (including at least once at night), you most likely will not get your period for at least six months after your baby is born. However, that can and will vary from one woman to the next. Exclusively breastfeeding can act as birth control, but please talk to your care provider about this and the specifics before relying on it. Breastfeeding even reduces your risk of breast and ovarian cancer. Breastfeeding produces prolactin and oxytocin, hormones that foster a connection to your baby and help you recover from birth better. Studies show that breastfeeding is associated with maternal responsiveness. 

Breastfeeding Rates and Trends

Despite the recommendations, data shows that most mothers do not exclusively breastfeed. In the United States, 83.2% of babies are ever breastfed. That number decreases to 55.8% at six months, and only 35.9% still receive breastmilk by twelve months. These numbers include mothers who may also supplement with formula, and the rates for exclusive breastfeeding are even lower. Only 45.3% of babies are exclusively breastfed by three months of age. At six months, that drops to 24.9%. Unfortunately, there is no data on exclusive breastfeeding beyond six months. Based on the declining rate overall, we can expect the rate of exclusive breastfeeding beyond six months to decrease.

With all of the evidence supporting breastfeeding, why are the majority of parents not doing it? Many factors contribute to a lack of support for exclusive breastfeeding. This is partly due to a need for more community resources and social support. For an interesting interview on breastfeeding issues in the real world, see this episode. While breastfeeding may come naturally to some mothers, for many, it is challenging. Hopefully, the information in this article will add some tools to your toolbox to make breastfeeding easier. 

How Breastfeeding Changes Your Breasts 

Your breasts go through many changes during pregnancy and postpartum. Everyone is different, and you may not gain several cup sizes, but that seems most common across the whole population. One study showed that the average breast size increase didn’t change based on the initial size. Your areolas will get larger and darker. Your nipples will also change by getting bigger, sticking out more, and may even change shape slightly. Like the changes to your areolas, your nipples will get smaller and go closer back to what they were pre-pregnancy after pregnancy and cessation of breastfeeding. For more in-depth information on breast changes during pregnancy and postpartum, see this article.

If you are concerned about how your breasts will look after breastfeeding, this study on breastfeeding and breast aesthetics showed that breastfeeding did not have a negative effect on aesthetics. Your breasts are designed to produce milk for your baby. While physical changes to your breasts may be unwelcome, have some compassion for the hard work your body is doing to support your baby. 

How Long to Breastfeed? 

There are common misconceptions about the length of time babies should be breastfed. These surround some milestones your baby will hit, like getting teeth at six months or talking and walking after about age one. Any length of time your baby receives breast milk is beneficial. If you stop breastfeeding before the first year, you must supplement with formula. Some mothers only breastfeed for a short time, and others continue it well into the toddler years. 

Official Breastfeeding Recommendations

The American Academy of Pediatrics recommendation is consistent with the World Health Organization and many pediatric associations worldwide. You should exclusively breastfeed your baby for the first six months. At around six months, you should introduce your baby to solid foods while continuing to breastfeed for up to two years and beyond. Two years may sound like a very long time. Any amount of time your baby is getting breastmilk will benefit them greatly. If you stop breastfeeding before your baby’s first birthday, you must supplement with infant formula.

Two Keys to Success 

You can do two key things to ensure you are successful with breastfeeding. First, educate yourself. Learn about the benefits of breastfeeding, how it works, and how to troubleshoot common issues. One of the most comprehensive resources is Womanly Art of Breastfeeding. This is a complete guide on everything you need to know from the moment your baby is born until the end of your breastfeeding relationship. I have personally read this book numerous times and referenced it many times throughout my own breastfeeding experiences. As a disclaimer, it is very thorough and leans heavily toward exclusive breastfeeding without formula supplementation.

The second key is to find support. Do not wait until you run into a problem. Consider connecting with a breastfeeding support group early on. La Leche League is a fantastic, and free, resource with local and online groups. While it is ideal to have support from your partner, family, and friends, not everyone will understand what you are going through. Surrounding yourself with knowledgeable and encouraging people can make all the difference, even if that support comes from outside your immediate circle.

How Your Partner Can Help with Breastfeeding 

If you are supplementing with formula, your partner can help feed your baby. But even if you are exclusively breastfeeding, there are still many meaningful ways your partner can be involved and supportive. Breastfeeding may be something only you can physically do, but your partner can play a big role in making the experience easier for both you and your baby.

Encouragement goes a long way. Your partner can regularly check in with you about how breastfeeding is going and encourage you to seek support if needed. That could be attending a group, reaching out to your doctor or midwife, or contacting a lactation consultant. Just hearing your partner acknowledge how hard you are working can be incredibly validating and uplifting, especially on tough days.

When you are stuck in one spot feeding your baby, your partner can bring you a drink or a snack you can manage with one hand. Breastfeeding can feel isolating in the early weeks, especially when your baby wants to nurse constantly. Having your partner sit with you, keep you company, or watch a show with you can make a big difference. If you are out in public, your partner should support you in nursing your baby wherever you feel comfortable, whether that means sitting with you on a park bench or helping find a secluded spot. 

While you handle the feeding, your partner can pitch in by doing diaper changes, washing dishes, cooking, cleaning, or running errands. Keeping a household going is a team effort. If your partner is not usually the one to take on these responsibilities, now is the time for them to step up and help.

Breastfeeding and Skin-to-Skin Contact 

One of the best ways to get breastfeeding off to a strong start is through skin-to-skin contact with your baby. This means your baby is wearing only a diaper, and you are bare-chested without a bra or shirt. You can place a blanket over both of you if the room is cool, or wear a button-up shirt you can open easily.

Skin-to-skin contact offers many benefits. It helps regulate your baby’s heart rate, breathing, and body temperature, and it reduces stress for both of you. This close contact also stimulates your baby’s natural instincts to breastfeed and encourages a deeper bond. The more time you spend skin-to-skin, the more likely you are to establish a successful breastfeeding relationship and continue it longer.

Colostrum 

Your body begins producing colostrum during pregnancy. This early milk is packed with immunological benefits and is perfectly designed to nourish and protect your newborn. Colostrum contains high levels of secretory immunoglobulin A, an anti-infective agent that coats your baby’s intestines to block germs and foreign proteins that could trigger allergies. It also includes pancreatic secretory trypsin inhibitor, which helps protect, repair, and seal your baby’s intestinal lining. Although the amount produced may seem small, it is exactly what your baby needs, especially since their stomach is about the size of a marble at birth. Colostrum is nature’s perfect first food, providing powerful protection until your milk comes in.

Transitional and Mature Milk 

Around day 3 or 4 after birth, your milk will come in. You will likely notice this when your breasts feel much fuller and potentially uncomfortable. If your baby is not ready to nurse and your breasts are overly full, you can hand-express a small amount of milk to relieve the pressure. In the first two weeks postpartum, your body produces transitional milk. During this time, the composition of your milk shifts. Protein and antibody levels gradually decrease, while lactose, fat, and water-soluble vitamins increase to support your growing baby. By around 4 to 6 weeks, your milk matures and its composition stabilizes. Mature milk continues to meet your baby’s nutritional needs and remains consistent over time, even as your baby grows and their feeding patterns change.

Afterpains

In the first few days after birth, it is common to feel cramping or discomfort when you breastfeed. This happens because your baby’s sucking triggers the release of oxytocin, a hormone that causes your uterus to contract. You might also notice a small gush of blood during these contractions. While uncomfortable, these afterpains are a normal and healthy sign that your uterus is shrinking back to its pre-pregnancy size. This cramping typically fades within the first week. Although afterpains can be unpleasant, they are a positive indication that your body is recovering as it should.

How Milk Production Works

Breast milk production is based on demand and supply. The more milk you remove from your breasts, the more your body will produce. This is the foundation of breastfeeding. The first two to three weeks after birth are especially important for establishing your milk supply. During this time, frequent nursing helps signal your body to keep producing milk. Each breast functions independently, so it is important to use both throughout the day. You do not need to track or split feeding time equally, but try not to favor one side over the other consistently.

Pro tip: If milk is not being removed, your body will stop making it. The good news is that you can use this to your advantage to increase supply. However, be mindful not to overstimulate production, which can lead to oversupply issues.

In general, you will breastfeed your baby on demand, whenever they show signs of hunger. However, in the early days, if your newborn is especially sleepy, you may need to wake them every 3 hours to nurse, at least until they regain their birth weight. Ask your pediatrician or a lactation consultant for personalized guidance on feeding frequency. As you and your baby settle into a rhythm and you become more familiar with their hunger cues, you can relax a bit about tracking exact timing. Breastfeeding becomes more intuitive with time.

Pro tip: Feeding tracker apps can be helpful in the beginning to log when and how long you nurse on each side. But once you are comfortable and breastfeeding is going well, tracking every detail can become tedious and unnecessary.

Measuring Your Baby’s Weight Gain

It is normal for babies to lose some weight after birth before they begin gaining. In most cases, care providers do not want to see more than a 10% drop from birth weight, and babies are typically expected to return to their birth weight within two weeks. There is evidence to support using your baby’s weight 24 hours after birth as a more accurate baseline. This accounts for extra fluids your baby may retain due to IV fluids during labor. This is especially common if you had an epidural or Pitocin. As your baby sheds that excess fluid in the first day, it can appear as weight loss, even though it may not reflect actual nutritional concerns.

Pro tip: While your pediatrician will monitor weight, it is just one piece of the puzzle. Pay attention to other signs that your baby is feeding well.

Measuring Your Baby’s Consumption 

One of the best ways to tell if your baby is getting enough milk is by tracking diaper output. In the first 24 hours, you will likely see meconium, which is thick, tar-like, and black poop. In the next 24 hours, expect at least two brown, sticky stools. By days 3, 4, and 5, you should see at least three poopy diapers each day. The color will shift from green to yellow, with yellowish poop becoming the norm around day five.

Pro tip: Your pediatrician will ask about diaper output at each checkup. To make this easy, keep a pen and paper by your changing area to keep track for the first week or so.

Breastfeeding Pain and the Proper Latch 

You will hear it often that breastfeeding is not supposed to hurt. But if you are like most moms, it may feel uncomfortable at first. In the early days, your nipples will likely be sensitive, but they should not be cracked or bleeding. The key to avoiding pain is making sure your baby has a proper latch.

A good latch makes all the difference. Your baby’s mouth should be wide open, with a good portion of your breast, not just the nipple, in their mouth. If your baby latches only on the nipple, it can be painful for you and less effective for removing milk. Once latched, your baby will usually begin with quick, short sucks to trigger your milk to release (called letdown), then shift to slower, deeper sucking once the milk is flowing.

If you need to reposition, do not just pull your nipple out because it will be painful. Instead, break the suction by gently placing a finger in the corner of your baby’s mouth and turning it slightly. That motion will break the suction so you can easily pull your nipple out of their mouth.

Pro tip: If it hurts, break the suction and get a better latch. Your nipples will thank you. 

Taking Care of Yourself 

Your body is working hard to produce milk for your baby, and it is essential that you take care of yourself, too. That means making sure you are getting the vitamins and nutrients you need. Keep taking a high-quality prenatal vitamin while breastfeeding, and prioritize staying hydrated. You need extra fluids when you are nursing, and adding electrolytes to your water can be a helpful boost.

Breastfeeding burns an estimated 300–500 calories per day, so be sure to eat enough nourishing foods. You may often find yourself eating with one hand while holding or nursing your baby with the other, so keep easy-to-prepare meals and snacks on hand.

Pro tip: Keep a stash of water bottles and snacks in the spots where you usually breastfeed. It is a simple way to make sure you are staying fueled and hydrated throughout the day.

Alcohol and Breastfeeding

If you enjoyed the occasional glass of wine or cocktail before pregnancy, you might be eager to enjoy one again. While alcohol can pass into breast milk, that does not mean it is completely off-limits. The key is understanding how timing and moderation play a role. Alcohol enters your breast milk in the same way it enters your bloodstream, and it also leaves your milk as your blood alcohol level drops. You do not need to “pump and dump” after having a drink unless your breasts become uncomfortably full and you need relief. It is safe to enjoy a drink while breastfeeding as long as you plan around it. Be mindful of when you nurse or pump in relation to when you drink. For more details on alcohol, see this Pregnancy Podcast article. Kelly Mom also has an informative article on alcohol and breastfeeding.

Pro tip: If you choose to enjoy an alcoholic beverage while breastfeeding, pay close attention to both the alcohol content and the portion size. A standard drink contains about 14 grams (0.6 ounces) of pure alcohol. This is roughly equal to:

• 12 ounces of beer (at 5% ABV) 
• 8 ounces of malt liquor (at 7% ABV) 
• 5 ounces of wine (at 12% ABV) 
• 1.5 ounces of hard liquor or one shot (at 40% ABV)

Caffeine and Breastfeeding

If you look forward to enjoying caffeinated beverages again after having your baby, it is important to know that caffeine can also pass into your breast milk. While this does not mean you have to avoid it entirely, it is something to be mindful of. Most recommendations suggest that breastfeeding mothers limit caffeine intake to 200 mg or less per day. For reference, an 8-ounce cup of coffee can contain anywhere from 95 to 200 mg of caffeine, depending on the bean, strength, and brewing method.

Unlike alcohol, which enters and leaves breast milk with your blood alcohol level, caffeine stays in your system much longer. In adults, the half-life of caffeine (the time it takes to reduce its concentration by half) ranges from 3 to 7 hours. For someone with a slower metabolism, a significant amount of caffeine may still be present in their system many hours later.

Newborns process caffeine even more slowly. The half-life of caffeine in a newborn is estimated to be as long as 80 hours. As your baby gets older, their ability to metabolize caffeine improves. Infants who drink breastmilk with caffeine can show signs of jitteriness, fussiness, and poor sleep patterns.

To learn more, see this episode, the LactMed database, or this Kelly Mom article.

Burping and Spitting Up 

It is completely normal for babies to spit up during or after feedings. While it can be messy, especially when it ends up all over you, it usually does not bother your baby. Even if it looks like a lot, it is often much less than it seems.

There are a few simple ways to help minimize spitting up. One of the most effective is burping your baby during and after feedings to release any air they may have swallowed. You can burp your baby by holding them against your shoulder and gently rubbing or patting their back, or by sitting them upright on your lap, leaning them slightly forward while patting their back. Keeping your baby upright for a little while after feeding instead of laying them down right away may also help reduce spit-up.

Pro tip: Keep an extra T-shirt for yourself, and maybe your partner, in your diaper bag. If your baby spits up on you while you are out, you will be glad to have a clean shirt to change into.

Breastfeeding Supplies

There are many products marketed for breastfeeding, but you do not need everything. However, a few key items can make the experience more comfortable and convenient. If you are unsure what you will use, you can always wait to buy or register for items later. Most products are easy to find at major stores or online with quick delivery.

Nursing Bras and Clothes 

While not essential, nursing bras and tanks can make breastfeeding easier, especially when you are out and about. Today’s options are much more comfortable than they used to be. Bodily makes my favorite nursing bras. They can also help you nurse more discreetly in public, if that is something you value. Whatever you choose, make sure it fits well and does not compress your breasts.

Pro tip: Before buying anything new, check what you already have. Front-clasp bras, bralettes, or soft sports bras can work just as well. Button-down shirts or layering a tank under a T-shirt can give you easy access while keeping you covered.

Breast Pads

Leaking is common in the early weeks, as you and your baby calibrate your supply, and breast pads can help. You can choose between disposable or washable options. Disposable pads are easy to use and toss, and many have adhesive to stay in place. Washable pads are eco-friendly and reusable, though they may feel wet against your skin if you leak. Bamboobies were my go-to when I was breastfeeding.

Pro tip: Keep a few extra pads in your diaper bag. If using reusable ones, stash a small Ziploc bag to carry wet pads home.

Breast Pump

A breast pump is good to have on hand, even if you are not sure you will need it. In the U.S., most health insurance plans cover the cost. Aeroflow is a company that makes it easy to get one through your insurance—I have personally had a great experience with them.

Pro tip: If the pump you want is not covered by insurance, consider adding it to your baby registry, and hopefully, a generous friend or family member will help cover it.  

Storage Bags 

Milk storage bags are a convenient way to store and freeze pumped breast milk. Lansinoh bags are my favorite. I have used hundreds and rarely had one leak.

Pro tip: Lay bags flat when freezing. This makes them easier to stack and saves space in your freezer.

Nipple Creams 

Many moms-to-be stock up on nipple cream in preparation for breastfeeding. This may be helpful, but you may not need it. The best way to prevent sore nipples is to ensure your baby latches properly. If you choose to use a nipple cream, most use lanolin, which comes from sheep’s wool. There are also lanolin-free alternatives. You could even use olive oil or your breastmilk to soothe nipples.

Pro tip: Breast milk contains antimicrobial and anti-inflammatory properties. Many parents use it to soothe sore nipples, heal minor cuts, or even treat cradle cap.

Don’t Wait to Get Help

If breastfeeding is not going smoothly, do not wait to reach out for help. Trying to push through challenges on your own can make things more stressful than they need to be. Take advantage of the support available to you while you are still in the hospital or birth center and ask staff to assist you with breastfeeding before you go home. You can also meet with a lactation consultant or attend a breastfeeding support group. Many of these resources are free. Even if things are going well, connecting with other parents who are in the same stage can be reassuring and helpful.

Thinking Long Term

As amazing as breastfeeding is, the early days and weeks of breastfeeding can be tough. It is a learning curve for both you and your baby, and it may take time to find your rhythm. The good news is that it gets easier. With each passing day, you and your baby will get more comfortable and confident. At first, it might feel like your baby wants to nurse all the time and that is completely normal. As your baby grows, feedings will gradually become more spaced out, and nursing will feel less constant. Breastfeeding is a commitment, but the benefits for your baby’s health and development and the bond you share are well worth the effort.

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