Overview

Breastfeeding can feel intimidating, especially if it’s something you’ve never done before. While it’s a natural process, it doesn’t always come easily. With the right education, preparation, and support, you can set yourself up for success. In this episode, we address a listener’s concerns about feeling uneasy about breastfeeding, worries about milk supply, and what she can do to prepare in advance. There are simple yet effective steps you can take before your baby arrives to feel confident and prepared. This episode covers common challenges, practical tips, and essential resources to help you build confidence, establish your supply, and reach your breastfeeding goals.

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Article and Resources

Hi Vanessa,

I’m getting close to my due date, and I’m starting to feel a lot of anxiety about breastfeeding. I really want to exclusively breastfeed, but the more I think about it, the harder it is to imagine actually doing it. I know it’s supposed to be natural, but for some reason, the whole idea just seems so weird.

On top of that, every friend I know who has had a baby ended up having to supplement because they couldn’t make enough milk. It feels like everyone struggles with supply, and I’m worried I’ll run into the same issues. Are there things I can do to give myself the best chance of having a good supply? How do I know if I’ll be able to produce enough?

I’ve already stocked up on basics like nipple cream and a pump, but I’m wondering if there’s anything else I should be doing ahead of time to prepare. I would love any advice you have.

Thank you so much for all of your amazing episodes. I’ve learned so much from your podcast, and I really appreciate the work you do.

Best,
Megan

Megan, thank you for your email and sharing your concerns and your questions. It is fantastic that you are thinking ahead about breastfeeding. Let’s talk about how you can prepare so you can feel more confident going into breastfeeding.

Breastfeeding is Evidence-Based

I am a massive advocate for breastfeeding because it is evidence-based to benefit both you and your baby. Breast 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.

There are decades of documentation on the positive effects of breastfeeding on immunity, health, and the connection between mother and baby. 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 higher IQ.

There are also benefits to you breastfeeding. Studies show that breastfeeding is associated with maternal responsiveness. Breastfeeding produces prolactin and oxytocin, hormones that foster a connection to your baby and help you recover from birth better. Breastfeeding even reduces your risk of breast and ovarian cancer.

Breastfeeding Recommendations and Actual Real-World Data

Many organizations, including the World Health Organization, the American Academy of Pediatrics, and other pediatric associations worldwide, are consistent in their recommendations for breastfeeding. You should exclusively breastfeed your baby for the first six months. At around six months, you should introduce your baby to solid foods with continued breastfeeding for up to two years and beyond.

Despite these recommendations, only 24.9% of babies are exclusively breastfed at six months, which continues to decline as babies age. If breastfeeding came easily and naturally, every mother would do it. The reality is that most mothers lack the two things they need most to be successful. That is education on breastfeeding and support. Let’s start with addressing your concerns and then discuss what you can do to prepare before your baby arrives.

Breastfeeding Seems Weird

Megan, you are not alone in thinking that breastfeeding will be weird if you have never done it before. In our culture, we often associate breasts with sexuality. It can feel like a big shift to think of them as a source of nourishment for your baby. While they are an erogenous zone, the primary biological purpose of your breasts is to feed a baby. Once your baby arrives, some instincts will kick in, and it will feel less strange and more natural. Like anything new, breastfeeding takes some getting used to. Both you and your baby will need practice to get the hang of it. With time, it will start to feel more intuitive.

Not Making Enough Milk

Megan, while I do not want you have anxiety about not making enough milk, the upside is that you can educate yourself about this. The number one reason mothers supplement with formula is that they do not make enough milk. A systematic review and meta-analysis found that approximately 50% of mothers perceived insufficient milk supply as the reason for stopping breastfeeding. There is an important distinction between undersupply and perceiving that you do not make enough milk. Researchers use the term perception of insufficient milk supply. Your baby needs breastmilk or formula as their primary source of nutrition for the first year of their life. If a mother thinks she is not producing enough milk, she will, of course, supplement or switch to formula.

Building Confidence and Setting a Goal

Megan, you asked how you would know if you could produce enough milk. The first step is differentiating between your perception of supply and actual supply. Studies show several factors affect your perception of your milk supply. A significant factor is breastfeeding self-efficacy, which describes your confidence in your ability to feed your baby. You can improve your confidence by educating yourself about breastfeeding and having a long-term breastfeeding plan.

You are seven times more likely to perceive insufficient milk supply if you lack breastfeeding knowledge. Once you have a basic understanding of breastfeeding, I encourage you to set a goal for the duration you would like to feed your baby. Research shows that having a long‐term breastfeeding plan is positively associated with breastfeeding self‐efficacy. This goal is not set in stone; you can always modify your goal or decide to stop breastfeeding or supplement.

Measuring Milk Production

It is essential to have an accurate way to gauge supply. The best way to measure milk production is by your baby’s weight gain and diaper output.

Your pediatrician will track your baby’s weight to ensure they eat enough. Your baby will naturally lose weight after birth before they start gaining. In general, your pediatrician doesn’t want to see your baby lose more than 10% of its birth weight and wants to see your baby back at its birth weight within two weeks. IV fluids during labor can cause your baby to maintain higher fluid levels, leading to more excess fluid loss after birth. Your doctor may see this as weight loss due to not eating enough. Please keep this in mind if you have IV fluids during your labor. This is very common in hospitals, especially if you have Pitocin or an epidural. There is an entire episode on the evidence of IV fluids if you want to learn more.

The output in their diapers is the easiest measurement of whether your baby is getting enough milk. For the first 24 hours, you will probably only see meconium, which is thick, tar-like, black poop. In the second 24 hours, you should see two or more brown sticky poops. On days 3, 4, and 5, you should see three poopy diapers a day, starting green on day three and getting to yellow by day five, which will be the norm moving forward. In addition to stools, you are also looking for wet diapers. According to La Leche League, by day two after your baby is born, look for two wet diapers over 24 hours. Look for three or more wet diapers every 24 hours on days three and four. You should see six or more wet diapers by five days old over 24 hours.

Initiating Breastfeeding and Establishing Supply

There are additional steps you can take to give yourself the best chance of having a good supply. One of the best things you can do to initiate breastfeeding is to get skin-to-skin with your baby immediately after birth. Plus, you are four times more likely to have a perception of insufficient milk supply if you delay the initiation. Once you begin breastfeeding, the amount of milk your body produces depends on how much you remove. This principle is the cornerstone of breastfeeding. There are some tips to help establish your supply in the first few weeks.

The number one thing you can do to establish your supply is to feed your baby frequently. You can expect to breastfeed your baby between 8 and 12 or more times in 24 hours. Frequent feedings are critical to establishing supply; you cannot nurse too often. You may consider pumping, although pumping is not as efficient at removing milk as your baby. Your baby will go through growth spurts and increase feedings as it grows. This instructs your body to make more milk to meet your baby’s demands. This demand and supply system is the first line of defense and the key to establishing and maintaining your milk supply.

Stocking Up on Breastfeeding Supplies

Megan, it is excellent that you already have some supplies for breastfeeding. Some products can make breastfeeding more convenient, but you don’t need to buy everything marketed for nursing moms. If you’re unsure about specific items, you can hold off on purchasing them or adding them to your registry. Many of these products are available at local stores like Target or Walmart, and you can always order them quickly online if needed. Some moms find that stocking up on supplies helps them feel more prepared, while others prefer to wait and see what they actually need. The truth is, you can get by without most breastfeeding products, though a few can make the experience easier and more comfortable.

Educate Yourself

Breastfeeding doesn’t always come naturally or go perfectly right from the start. Many issues can come up during breastfeeding in the first few days and even months down the road. Problems can include symptoms in your breasts like leaking, sore nipples, pain, vasospasms, blebs, plugged ducts, mastitis, and engorgement. Some issues can affect your baby, like jaundice, tongue-tie, thrush, food allergies or sensitivities, nursing strikes, and cluster feeding. Any of the issues can make it difficult to continue breastfeeding. The good news is that there are solutions and remedies for any problem that can come up. If there is a name for it, you can fix it.

The key is educating yourself ahead of time and having resources available. It is worth investing some time to educate yourself about breastfeeding before your baby arrives. It is so easy for a small issue to snowball into a big problem that makes continuing breastfeeding very difficult. If you have a basic understanding of breastfeeding and potential obstacles, you can identify and treat issues as soon as they come up.

Don’t Wait to Get Help

Support for breastfeeding from your partner, friends, and family is also helpful. If you run into any problems, I encourage you to seek professional support as soon as possible. Do not wait and try to struggle through issues on your own. Take advantage of the birth center and hospital staff to assist you with breastfeeding before you go home. You can use a lactation consultant or attend a breastfeeding support group. Often, you can find these resources at no cost. Even if breastfeeding is going well, going to a support group to meet other moms going through the same thing can be encouraging.

Additional Resources

The Pregnancy Podcast has many resources on breastfeeding. See this page for all the breastfeeding resources, episodes, and articles in one place. Here are the top 5 breastfeeding episodes:

The Womanly Art of Breastfeeding 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 read this book numerous times and a referenced it time and time again. As a disclaimer, this book is intense and thick, and it is highly biased toward exclusive breastfeeding and not supplementing with formula.

The Kelly Mom blog is an excellent online resource with detailed articles on every issue and question that can come up with nursing.

The thought of hiring a consultant may sound expensive, but many times you can find these resources for free. La Leche League is an excellent resource for free help and support.

The Nursing Your Baby Course covers everything you need to know about breastfeeding from a registered nurse, Certified Lactation Educator and mom.

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