Proper technique is important to make sure the process goes smoothly and the baby consumes enough milk. In addition to techniques, you will have plenty of questions as to how much, when, and how long. Take the time to get the advice, support, education, and encouragement you need from a lactation consultant, pediatrician, family, friends, and support groups.

How Often to Breastfeed

If you have chosen to breastfeed, the process should begin as soon as possible after birth. Babies who are breastfed tend to feed more often than babies who are formula fed. Breastfed babies generally eat eight to twelve times per day. This is basically because breastfed babies' stomachs empty more quickly since breast milk is so easy to digest. The baby should eat until she is full, usually ten to fifteen minutes per breast. At first, most newborns want to eat every few hours, both during the day and at night. Babies generally eat on demand when they are hungry. However, to make sure your baby is eating enough in the beginning weeks, wake her up if she has not eaten in more than four hours. Look for signs from your baby that she is hungry, such as increased alertness or activity, mouthing, or rooting around the breast. Crying seems to be more of a later sign of hunger. As your baby gets older and becomes alert for longer periods of time, you can more easily settle into a routine schedule of feeding every three hours or so with fewer sessions at night. By the end of the first month, babies will generally start sleeping longer throughout the night.

Is My Baby Getting Enough Milk?

A worry for many breastfeeding moms is whether the newborn is getting enough to eat. With formulas, you are able to tell exactly how many ounces the baby has consumed, but with breastfeeding this is harder to identify. It may seem at first that the baby is hungry all the time, which makes some moms wonder if he has had enough. This is completely normal. Babies should be hungry quite often because breast milk is digested within a couple of hours after consumption. After the baby's first few days of life, he will want to nurse about eight to twelve times per day. The baby should be fed on demand, with no worry about schedules, until you have breastfeeding down pat and can begin to recognize your baby's own schedule. The baby's pediatrician will be able to tell if your baby is getting enough to eat by how much weight he gains at each visit.

There are other ways to tell if your baby is getting enough to eat. After the fifth day of birth, she should have at least six to eight wet diapers per day and three to four loose yellow stools per day. She is most likely getting enough if she is nursing at least ten to fifteen minutes on each breast. Your baby should show steady weight gain after the first week of age. Her urine should be pale yellow and not deep yellow or orange. You should find your baby wanting to eat at least every two to three hours or at least eight times per day for at least the first two to three weeks. In addition, she should have good skin color. If you become concerned about whether your baby is getting enough to eat, contact your pediatrician or lactation consultant. Babies who are not getting enough to eat can become easily dehydrated.

Is Breast Milk Enough?

During the first six months of life, most babies who are breastfeeding will not require any additional water, juices, vitamins, iron, or formula. With sound breastfeeding practices, supplements are rarely needed because breast milk provides the infant with just about all the fluids and nutrients he needs for proper growth and development. By six months of age, it is generally recommended that babies be introduced to foods that contain iron in addition to breast milk.

While the water supply in most U.S. cities and towns contains plenty of fluoride, a mineral often found in tap water that is important for strong teeth and prevention of cavities, in certain rural areas the levels can be too low. Breast milk contains very low levels of fluoride. However, babies under six months of age should not be given fluoride supplements, even if levels in your water supply are low.

Vitamin D Controversy

Though breast milk is a complete source of nutrition for your baby, there is some controversy surrounding the need for supplementing with vitamin D. Vitamin D is found in only small amounts in breast milk and is necessary to absorb calcium into the bones and teeth. However, the vitamin D in breast milk is in a very absorbable form and therefore is generally adequate for most infants. Babies who may be at higher risk for vitamin D deficiency include those who have little exposure to sunlight. Moderate sunlight helps to produce vitamin D in the body, and mother and babies with darker skin may have a harder time getting enough sunlight to produce vitamin D.

Mothers deficient in vitamin D also create a risk of low levels in their babies. The amount of vitamin D in breast milk is directly related to the level of vitamin D in the mother's body. If you are taking a prenatal or vitamin/ mineral supplement that contains vitamin D, drinking milk, and getting moderate exposure to sunlight, your breast milk should contain optimal levels of vitamin D. The American Academy of Pediatrics recently began recommending that all infants, including those who are exclusively breastfed, have a minimum intake of 200 international units (IU) of vitamin D per day beginning in the first two months of life.

Other Concerns

Babies sometimes react to certain foods that the mother eats because they may pass through to the breast milk. After eating spicy or gassy foods, the mother may notice the baby crying or fussing as well as nursing more often. However, these symptoms may also show up in babies with colic. You will know it is a reaction to food you have eaten if the symptoms last less than twenty-four hours. Symptoms caused by colic generally occur daily and often last for days or weeks at a time. If your baby seems to react to certain foods that you eat, eliminate those foods from your diet. There is no need to eliminate foods from your diet unless you have a specific reason to suspect a particular food is bothering your baby. If you have a family history of allergies, including asthma, you may want to avoid foods you are allergic or sensitive to while breastfeeding.

Although the reaction is rare, some babies are allergic to cow's milk and foods that contain cow's milk in the mother's diet. Symptoms will usually appear a few minutes to a few hours after a breastfeeding session. They can include diarrhea, rash, fussiness, gas, runny nose, cough, or congestion. Talk to your pediatrician if your baby experiences any of these symptoms. Other foods you consume that may cause reactions in your newborn include chocolate, citrus fruits and juices, and common food allergens such as eggs, wheat, corn, fish, nuts, and soy.