Breastfeeding your baby

Brochure

Breastmilk is best for babies

  • The guidelines on this page are for healthy, fullterm babies.

Breastmilk is the only food and drink baby requires during the first six months for healthy growth and development. It is recommended that you continue to breastfeed baby for two years or more.

All breastfed babies need to have a 400 IU vitamin D supplement every day. Some babies may need more vitamin D. Call Health Link Alberta if you have questions.

Learning to breastfeed

image of woman breastfeeding babyYour baby is unique. It will take time for mom and baby to learn to breastfeed. It can take up to six weeks to establish breastfeeding. Continuing to breastfeed is important for your baby.

  • Create a quiet and pleasant environment during breastfeeding. This will help you to relax and to bond with your baby.

Once you and baby have learned to breastfeed, let baby guide the number and length of feedings. Breastfeed whenever baby shows signs of hunger. In the first three months baby is feeding eight to twelve times in 24 hours. A baby who is breastfeeding well knows best how often and how long to feed. Baby will stop feeding when full. Try to offer the breast before baby cries by watching for earlier signs of hunger.

  • Baby may feed slow or fast, in a steady manner or in a start and stop manner. Watch for cues that baby is finished feeding on one breast before offering the second breast. Baby may or may not eat from the second breast. If baby doesn’t take the second breast, start the next feeding with that breast.
Signs of hunger Signs of fullness
  • Sucking motions
  • Looking around
  • Putting fist or fingers into the mouth
  • Searching with an open mouth (rooting)
  • Crying (late sign)
  • Baby lets go of your breast in a relaxed manner
  • Sucking and swallowing become few and far between or stop completely
  • Baby is content and relaxed when coming off the breast

Most babies feed 8–12 times in 24 hours during the first three months. Some babies may eat several times in a short period of time, especially during growth spurts. As your baby gets older, the number of times per day that baby eats may decrease or increase.

  • During the first few weeks, your breasts may feel full before you feed and soften after feeding. You may not notice the full feeling after a few weeks; this does not mean that your milk supply has decreased.

There may be times when your baby seems to eat more or less than usual. Watching your baby for feeding cues and allowing baby to guide the length and number of feedings will ensure baby is getting enough breastmilk to grow. Your milk supply will increase if baby starts to feed more often.

  • There are several ways to hold your baby while feeding. Speak to your health care provider.

Things to remember –

  • Spend lots of time holding and cuddling baby. Skin to skin contact is best for you and your baby.
  • Your baby’s stomach is small. It fills and empties quickly. This is why you need to pay attention to baby’s signs of hunger.
  • All babies grow differently. Growth spurts usually occur at about two to three weeks, six weeks, three months and six months.
  • It is normal for newborn babies to lose a small amount of weight after birth. A healthy baby will regain this weight by two weeks of age.

Helping baby to latch well

  • Support your baby behind the neck and shoulders.
  • Wait for baby to open their mouth wide like a yawn with tongue down.
  • Bring baby to the breast, chin first, with head slightly tipped back. Nose will be slightly away from the breast.
  • Baby will have a large portion of breast in their mouth if they are latched correctly.

Signs that baby is taking enough breastmilk

  • Breastfeeding is comfortable and you do not feel pain.
  • You can hear or see baby swallowing. You will see jaw movements.
  • Baby’s mouth will fill up with every suck.
  • You will hear your baby’s “ca” sound.
  • Baby is content and satisfied after most feedings.
  • Baby is gaining weight. If you are concerned about your baby’s weight, speak to your health care provider.
  • The number of wet diapers and bowel movements may also indicate that baby is getting enough breastmilk.
  • Baby’s urine should be pale and have no odor.
  • Constipation in breastfed babies is rare. If the bowel movement is hard, dark coloured or baby cries when passing a bowel movement, contact your health care provider.
Age Number of wet diapers each day Number and type of bowel movements
Birth to 1 day At least 1 At least 1. Dark green, almost black and sticky.
1–2 days 1–2 At least 2 per day. Changing to brown-green colour.
2–3 days 3 or more At least 1 to 3 or more per day. Lighter in colour, changes from green-brown to yellow, and is runny.
4–6 days 4–5 heavy wet diapers At least 3 to 4 per day. Runny and yellow, will look like little seeds or curds.
2–3 weeks 6 or more heavy wet diapers Frequent bowel movements, at least 4 per day.
1–6 months Individual pattern will develop May not have a bowel movement for several days and may then have a large, soft bowel movement.
6–12 months Individual pattern will develop When solid foods are introduced, bowel movements will become firmer, darker brown in colour, and may be less frequent.

When to get help

A small amount of breast or nipple discomfort is normal when you first start to learn to breastfeed. Learning and practicing good technique helps to ensure this passes quickly.

Get help from your health professional if:

  • You experience pain while breastfeeding;
  • You have sore or cracked nipples;
  • You have flu-like symptoms or your breasts are sore;
  • Your breasts have red areas or lumps;
  • Baby has trouble latching or staying latched;
  • You do not hear or see baby swallow milk;
  • Baby has rapid, shallow sucking, or seems to nibble for the whole feeding;
  • Wet and dirty diapers are not similar to the information outlined in the above chart;
  • Baby is very sleepy or fussy; or
  • You are concerned about how often your baby is feeding.

Expressing and storing breastmilk

It is best to wait until breastfeeding is well established, about four to six weeks after birth before you give baby expressed breastmilk.

If you need to express breastmilk, you can express breastmilk manually by hand or by using a breast pump. Breast pumps are available to purchase or rent in your community. If you need help learning to express breastmilk, contact Health Link Alberta or a health professional.

  • Wash your hands for 30 seconds with soap and warm water before expressing breastmilk manually.

Store expressed breastmilk in small portions, such as two to four ounces (60 to 120 ml), to reduce waste.

Storing Breastmilk

Freshly expressed breastmilk can be refrigerated or frozen.

  • Use a sterilized container to store breastmilk. Do not use a disposable bottle liner.
  • Put the day, month and year on the container with a waterproof marker.
  • Leave some room at the top of the container because breastmilk will expand when frozen.
  • Chill newly expressed breastmilk for one hour in a fridge or ice packed container before freezing.
  • If you express breastmilk when you are away from home, it can be stored for no more than 24 hours in a gel-packed cooler.

How long to store freshly expressed breastmilk

Room Temperature Refrigerator Freezer compartment of one door fridge Separate freezer Deep Freeze
Up to 4 hours Up to 2 days Up to 2 weeks 3 to 4 months Up to 12 months

Research varies as to proper storage times for expressed breastmilk. Alberta Health and Wellness has chosen to recommended the shortest storage periods.

To use frozen breastmilk

Thawing

  • Use the breastmilk that has been frozen the longest, first.
  • Place frozen breastmilk in a container of warm water until thawed or thaw frozen milk in the fridge several hours before it is needed. If the thawed breastmilk is not used within 24 hours, or baby does not finish it, it must be thrown out.
  • Frozen milk can separate when thawed so gently swirl the container to mix the milk. Do not refreeze breastmilk that has thawed.

To feed expressed breastmilk

  • Feed expressed breastmilk from a bottle, cup or spoon.
  • To warm breastmilk, place the container into a bowl of warm water. Shake the container and test on your wrist before feeding to baby. The milk on your wrist should not feel hot nor cold.
  • Start by feeding small amounts of expressed breastmilk. If baby is still hungry, continue to offer small amounts of breastmilk until baby is satisfied. Let your baby guide the feeding.

Things to remember –

  1. NEVER MICROWAVE THE BABY’S BOTTLE – Microwaving destroys important nutrients in breastmilk and also causes “hotspots” that may burn baby’s mouth.
  2. Before baby’s teeth appear, wipe baby’s gums with a soft cloth. As soon as baby’s first tooth appears you can begin to brush baby’s teeth twice a day and especially before bed. Use a small soft bristle toothbrush.

Questions

What foods should I avoid when breastfeeding?

  • Most foods can be enjoyed while breastfeeding. Eat a variety of foods from Eating Well with Canada’s Food Guide. If you think you are eating a food that causes problems for your baby call Health Link Alberta.
  • Fish is an excellent source of protein and healthy fats. Health Canada recommends choosing at least two food guide servings of fish per week. To limit your exposure to mercury, avoid fish such as fresh or frozen marlin, tuna, shark, escolar, orange roughy and swordfish. If you eat canned tuna, select “light” tuna. If you have questions about the types of fish you are eating, contact Health Link Alberta.
  • All women of child bearing age should take a multi vitamin containing folic acid.
  • Drink fluids such as milk and water throughout the day.
  • Caffeine passes into breastmilk and may keep baby awake and decrease your milk supply. Limit your intake of caffeine to 300 mg a day or less; no more than two cups (500 ml) of coffee. Caffeine is also found in hot and iced tea, soft drinks, chocolate and some medications.

What about smoking, alcohol and medications?

  • Smoking may reduce breastmilk supply and make baby fussy. If you smoke, smoke after you breastfeed baby. Even if you smoke, breastfeeding is still best for baby.
  • It is best to avoid alcohol while breastfeeding. If you have questions about the safety of alcohol and breastfeeding call Health Link Alberta for guidance.
  • Check with Health Link Alberta about the safety of over-the-counter medications.

When do I offer solid foods to baby?

Call for help

More questions? Health Link Alberta offers nurse advice by telephone 24 hours a day, seven days a week. You can call from anywhere in the province:

  • Calgary region: 403-943-5465,
  • Edmonton region: 780-408-5465,
  • In Alberta toll-free: 1-866-408-5465.