Breastfeeding Information

When is the Best Time to Start My Baby on Foods Other Than Breastmilk?

NOTE: This article is the first of a series about introducing solids and weaning. The next articles in the series are:
Good Foods for Babies
Thinking About Weaning?

The World Health Organization and the American Academy of Pediatrics (AAP) recommend that babies be exclusively breastfed for six months before other foods are introduced. Some babies are ready to start new foods around this time, while others show no interest until they are a bit older. The Recommendations on Breastfeeding by the AAP also state:

“Unique needs or feeding behaviors of individual infants may indicate a need for introduction of complementary foods as early as four months of age, whereas other infants may not be ready to accept other foods until approximately eight months of age.

Introduction of complementary feedings before six months of age generally does not increase total caloric intake or rate of growth and only substitutes foods that lack the protective components of human milk.”1

As you can see, there is no clear cut age when it is best to start solids. The best time to start offering your baby other foods is when he shows signs of being ready.

Of course this time will be different for each baby. We do not expect all babies to crawl or walk or potty train on a certain day of their lives, and we should not expect them all to need solid foods at the same time either. You are the expert on your baby!

Here are some of the signs that your baby may be ready for solids.

He will be able to:

  • sit up on the floor for about ten minutes without support 2
  • use his finger and thumb to pick up toys and put them in his mouth
  • swallow a tiny bit of soft food, like ripe banana, without pushing it out of his mouth with his tongue

At this stage, he will probably also seem to be more hungry than usual. If you have already tried nursing him more frequently, and he still does not seem to be satisfied, he may be ready to start adding other foods to his diet. Babies sometimes also want to nurse more because they are teething or not feeling well or going through a growth spurt, so be sure to rule those things out first.

Mothers sometimes wonder if their babies are ready for solids at about four months because of the way their babies are behaving.

Four months is about the time that many babies start to become more interested in the world around them. They are taking everything in. For example, they may pull away from the breast in response to a sudden noise. They may even try to take the breast with them! They may not seem to be as interested in nursing so often or may learn to gulp down their milk quickly to get back to more fun activities.

These are all normal and common ways for four-month-olds to behave. You may find it helpful to nurse your baby in a quiet, dark room a couple of times during the day in order to avoid distractions. Some mothers like wearing a nursing necklace (beads strung and knotted on extra-strong cord that the baby can hold while nursing) because it can help him stay focused on breastfeeding.

Have you noticed your baby watching you very carefully while YOU eat? Does he pretend to chew? This behavior shows how babies learn and practice, and it is one of the signs that they will soon be ready to start eating table foods.

Just follow your baby's cues and your own instincts.

There is no rush. Nothing magical happens on the very minute/hour/day of the sixth month birthday. A switch does not suddenly turn off and make mother's milk suddenly inadequate! In fact, some babies have no interest in other foods until much later, sometimes not until they are about a year old.

As long as your baby is happy and healthy, gaining weight, and meeting all his milestones, he is doing fine!

Some parents are told that they must introduce solids by a certain age to provide extra iron and prevent anemia. If there is a concern about your baby's being anemic, your doctor can do a simple blood test. It only takes a few minutes to see if your baby has enough iron. It is almost unheard of for a completely breastfed baby to have low iron stores or low hemoglobin values before six to nine months. One study, by Piscane, 1995 3, found infants who were exclusively breastfed for seven months (not given iron fortified cereals or iron supplements) had significantly higher hemoglobin values at one year old than breastfed babies who had received solid foods before seven months. None of the babies who were breastfed exclusively for 7 months were anemic at one year, while some of the babies who did receive solids before seven months were found to be anemic. Research like this suggests that delaying solids can reduce the risks of anemia.

Enjoy this special time with your completely breastfed baby. You may be interested in reading the next article in this series, Good Foods for Babies, where I share some suggested first foods and ways to introduce your baby to the delights of a wide variety of healthy foods.

You may also like to read:

Starting Solids-The Facts Behind Today's Media Hype
http://www.lactivist.net/?p=2426

References:
1. American Academy of Pediatrics. Policy Statement on Breastfeeding and the Use of Human Milk, PEDIATRICS Vol. 115 No. 2 February 2005, pp. 496-506 (doi:10.1542/peds.2004-2491)

2. Hassink, Sandra G. MD, FAAPA Parent's Guide to Childhood Obesity: A Road Map to Health, American Academy of Pediatrics, 2006 http://www.healthychildren.org/English/ages-stages/baby/feeding-nutritio...

3. Pisacane A, et al. Iron status in breast-fed infants. J Pediatrics 1995 Sep;127(3):429-31

© Copyright Breastfeeding USA, Inc. 2012. All rights are reserved. No part of this article may be reproduced, copied, modified or adapted, without the prior written consent of Breastfeeding USA and the author.

Disaster Preparedness: Breastfeeding Matters During an Emergency

One of the things that we can depend on, unfortunately, is that disasters and emergencies will continue to happen around the world. From tornadoes and hurricanes to earthquakes and floods to the effects of war, few people are immune to the possibility of dealing with at least one or more of these situations sometime in their lifetime. During a disaster or emergency, breastfeeding becomes even more important and has been proven to save lives.

The American Academy of Pediatrics states:

In an emergency
• There may be no clean drinking water.
• There may be no sterile environment.
• It may be impossible to ensure cleaning and sterilization of feeding utensils.

The cleanest, safest food for an infant is human milk.

Below is a list of resources for those looking for detailed information about breastfeeding during emergencies:

Emergency Nutrition Network: http://www.ennonline.net/resources/6

IBFAN (International Baby Food Action Network): http://www.ibfan.org/fact-feeding_emergency.html

American Academy of Pediatrics: http://www.aap.org/breastfeeding/files/pdf/InfantNutritionDisaster.pdf

WellStart: http://www.wellstart.org/Infant_feeding_emergency.pdf

Transcript from WHO podcast from 2009: The importance of breastfeeding during emergencies
http://www.who.int/mediacentre/multimedia/podcasts/2009/breastfeeding_20...

Australian Breastfeeding Association: https://www.breastfeeding.asn.au/bfinfo/infant-feeding-emergencies

My power went out and I have breastmilk in the freezer – Help!
http://kellymom.com/bf/pumpingmoms/milkstorage/frozen-milk-power-outage/

Emergency Baby carriers (broken glass is a real concern!)
http://www.parentdish.com/2005/08/30/hurricane-katrina-inspires-videos-o...

Breastfeeding USA. All Rights Reserved.

Find a Breastfeeding Counselor

Accredited Breastfeeding Counselors are listed by state and location. They are volunteers working from their homes, so please be considerate of the time of day when calling. Please note the type of service offered in italics. These services may include telephone helping (phone), support gatherings (meeting), and electronic helping (email).

Arizona

Metro Phoenix Chapter
meeting, phone, email
Charlene (480) 543-9162 charlene.shenk@breastfeedingusa.org
Michelle michelle.hottya@breastfeedingusa.org
New meeting time and location coming soon!
Connect with other mothers in the Metro Phoenix area on Facebook.

West Valley Chapter
phone, text, e-mail, in-person
Jessica (602) 551-6455 jessica.c@breastfeedingusa.org

California

Alameda Chapter
phone, email, home visits
Patty (510) 410-7752 Patty.Jacobs@BreastfeedingUSA.org
Facebook: San Francisco Bay Area Chapter

Amador, Calaveras, Tuolumne Counties Chapter
Motherlode Moms

meeting, phone, email
Teglene (209) 795-4393 teglene.ryan@breastfeedingusa.org
Jen (209) 985-9284 jen.kimber@breastfeedingusa.org
Facebook: Motherlode Moms

Breastfeeding USA/Antelope Valley
phone, email, meetings, in-person, text
Angela Hayes (323) 450-7969 angela.hayes@breastfeedingusa.org
Meeting info coming soon.

Inland Empire Chapter
email, face to face, home visits, meetings
Tamika Simpson Tamika.simpson@breastfeedingusa.org

Greater Sacramento Area Chapter
meetings, phone, email
Jewel (530) 318-1097 julie.mohr@breastfeedingusa.org
Facebook: Greater Sacramento Area

Redlands Chapter
phone, email, in-person
Cristy (909) 521-0746 cristy.h@breastfeedingusa.org
Meetings held 2nd Thursday of every month at 10AM.

San Francisco Bay Area Chapter
phone, email, home visits
Patty (510) 410-7752 Patty.Jacobs@BreastfeedingUSA.org
Facebook: San Francisco Bay Area Chapter

SF South Bay Breastfeeders
email, facebook
Rachel rachel.f@breastfeedingusa.org
Meeting info: Meetings coming soon
Facebook: BfUSASouthBay

Santa Clarita Chapter
in-person, email, text, phone
Nina Withers (661) 977.6872 nina.withers@breastfeedingusa.org
Meeting Information: Coming Soon

Silicon Valley Chapter
in-person, email, text, phone
Kristy Johnson (734) 377-4417 kristy.johnson@breastfeedingusa.org
Meetings coming soon!

Torrance Chapter
phone, email, online
Karen (626) 318-8218 karen.c@breastfeedingusa.org
Genevieve (818) 980-5090 genevieve.colvin@breastfeedingusa.org

Colorado

Castle Rock Chapter
phone, email, meetings
Kari Wheeler (303) 880-4534 kari.wheeler@breastfeedingusa.org
Meetings: First Friday of every month, from 11am to 12pm, at the Family Enrichment Center, 107 5th Street, Castle Rock

Front Range Chapter
phone, email
Sharon (315) 331-2140

Grand County Breastfeeding Network
phone, email, in-person visits, monthly meetings
Rosalie (303) 478-2054 Rosalie.rust@breastfeedingUSA.org
Meeting information: 4th Thursday of the month, from 2-3 pm, at the Pregnancy Resource Connections building in Granby Colorado.

Morgan County Nurslings
phone, email, home visits
Cassie Potts (970) 370-4948 cassie.potts@breastfeedingusa.org

Connecticut

Colchester
meeting, phone, email
Nicky Prince (860) 729-2970 nicky.prince@breastfeedingusa.org
1st Monday of each month, 6:30pm: Colchester Library, 8 Linwood Ave Norton Room B
Facebook: Connecticut Chapter of Breastfeeding USA

East Hartford
meeting, phone, email
Jennie Bernstein (860) 372-5276 jennie.bernstein@breastfeedingusa.org
Mia Gonzalez mia.gonzalez@breastfeedingusa.org
Sherri Witherell (860) 595-2358 sherri.witherell@breastfeedingusa.org
2nd Monday of each month, 6pm: With Women Wellness, 87 Church Street Suite 204, East Hartford
Facebook: Connecticut Chapter of Breastfeeding USA

Ellington
meeting, phone, email
Carol Delaney (860) 644-4109 carol.delaney@breastfeedingusa.org
Joy Delaney (860) 375-0569 joy.delaney@breastfeedingusa.org
Kora Gilbert (860) 468-5790 kora.gilbert@breastfeedingusa.org
3rd Monday of each month, 7:30pm: Indian Valley YMCA (childcare room), 11 Pinney Street
Facebook: Connecticut Chapter of Breastfeeding USA

Enfield
meeting, phone, email
Becca Dean (860) 916-5543 rebecca.dean@breastfeedingusa.org
Spencer Joslin-Montlick (860)580-9630 spencer.jm@breastfeedingusa.org
2nd Saturday of each month, 10:15am: 7 Elm Street (St. Francis Access Center), room 301
Facebook: Connecticut Chapter of Breastfeeding USA

New Britain
meeting, phone, email
Alexis Hennessey (860) 281-1121 alexis.hennessey@breastfeedingusa.org
Shiyrah S (860) 880-0817 shiyrah.s@breastfeedingusa.org
Last Thursday of each month, 6:00pm: YWCA New Britain, 19 Franklin Square
Facebook: Connecticut Chapter of Breastfeeding USA

New Haven
phone, email
Meredith Sinclair (860) 468-5270 meredith.sinclair@breastfeedingusa.org
Facebook: Connecticut Chapter of Breastfeeding USA

South Windsor
phone, email
Jaime Lyn Procaccini (860) 644-2117 jaime.procaccini@breastfeedingusa.org
Facebook: Connecticut Chapter of Breastfeeding USA

Tolland
phone, email
Jennifer Veit (860) 690-9853 jennifer.veit@breastfeedingusa.org
Facebook: Connecticut Chapter of Breastfeeding USA

West Hartford
meeting, phone, email
Erica Grossman erica.grossman@breastfeedingusa.org
Shiyrah S (860) 880-0817 shiyrah.s@breastfeedingusa.org
1st Wednesday of each month, 7pm: Outer Peace Wellness, 12 North Main Street
Facebook: Connecticut Chapter of Breastfeeding USA

Florida

East Central Chapter of Florida
email, meetings
Rachel rachel.n@breastfeedingusa.org
Meetings: Monthly, Third Saturday from 10:00 to noon. Email for address.
Facebook: East Central Chapter of Florida

North Central Florida Chapter
meetings, phone and email
Stormy (352) 247-2333 stormy.miller@breastfeedingusa.org
Cynthia (352) 247-2333 cynthia.sears@breastfeedingusa.org
Facebook: North Central Florida Chapter

Northeast Florida Chapter
phone, email, text, in-person
Cara Piper (904) 891-4941 Cara.Piper@breastfeedingusa.org

Southwest Florida Chapter
phone, email, in-person
Lauren (850) 491-3001 lauren.fruehan@breastfeedingusa.org
Facebook: Southwest Florida Chapter
Meetings: Coming soon!

Georgia

Middle Georgia Chapter
phone, email, in-person
Evelina (919) 619-0965 evelina.borjesson@breastfeedingusa.org
phone, email, text, in-person
Denise (478) 952-9151 denise.stroud@breastfeedingusa.org
Monthly breastfeeding support meetings hosted in collaboration with the Middle Georgia Breastfeeding Alliance.

Southeast Georgia Chapter
phone, email, in-person
Megan (337) 277-1885 megan.hebert@breastfeedingusa.org

Hawaii

West Oahu Chapter
phone, email
Naomi S. (808) 221-3179 naomi.shimamoto@breastfeedingusa.org

Illinois

BFUSA West Dundee
phone, email, meetings
Beth & Aimee (630) 220-0765 aimee.t@breastfeedingusa.org
Babies and children always welcome. Meetings always free of charge.
Weekday Chapter meetings: Second Monday of each month from 10am-12noon at Radiant Heart Yoga, 647 S 8th St, West Dundee, IL 60118.
Nursing Beyond Infancy meetings (for those seeking support for nursing older babies (over 5 months) and toddlers, 2015: January 26, March 16, April 27, June 15, July 20, August 31, October 19, November 30, January 11, 2016 at Radiant Heart Yoga, 647 S 8th St, West Dundee, IL 60118.
Facebook: BFUSAWestDundee

Breastfeed DeKalb
Phone, email, in-person, meetings
Deanna Soper-Pinkelman (219) 928-0620 deanna.soperpinkelman@breastfeedingusa.org

Champaign-Urbana, IL
phone, email
Ashley Price (217) 391-3946 ashley.price@breastfeedingusa.org

Chicago - Northside
email
Aimee Barker aimee.barker@breastfeedingusa.org

Chicago - North Suburbs
email, meetings
Susan Urbanski susan.urbanski@breastfeedingusa.org
Contact Susan for meeting information.

Chicago - West
(Serving the areas in Chicago's near-western suburbs)
phone, email, meetings, in person, text
Maura Frauenhofer (716) 799-3290 maura.frauenhofer@breastfeedingusa.org
Elle Morton (314) 560-6672 elle.morton@breastfeedingusa.org
Meeting Info:
-Second Monday of the month, 9:30-11:30 am, Mission House Cafe located at 6818 W 34th St, Berwyn IL 60402
-Last Saturday of the month, 2-4pm, PCC Birth Center located at 6201 Roosevelt Rd, Berwyn, IL 60402 (ring bell for security guard)
Facebook Page: Please check our page the day of meetings in case of changes or cancelations.

Chicago Area
phone, email
Danika Amusin (773) 510-3416 danika.amusin@breastfeedingusa.org

Chicago Area
phone, email
Shevy Lowinger (773) 240-1762 shevy.lowinger@breastfeedingusa.org

DuPage County Chapter, Mother-to-Mother
email, phone
Lisa (630) 474-4815 lisa.wilkins@breastfeedingusa.org
Facebook: DuPage Mother to Mother

Elmhurst Area Chapter
email, meetings
Elise Fulara: elise.fulara@breastfeedingusa.org
Heather Dvorak: heather.dvorak@breastfeedingusa.org
Group website & meeting calendar: elmhurstbreastfeedingusa.wordpress.com
Facebook page: Elmhurst Area Chapter

Joliet Chapter
meeting, email, phone
Colleen and Karyn
(815) 317-6065 jolietbfusa@gmail.com
Facebook: Breastfeeding USA- Joliet Chapter
Meetings are held the 4th Monday of the month, 7:00 PM. No RSVP required. Meetings held at ANEW Medical and Rehabilitation 115 Republic Ave. Joliet, IL 60435

Mt. Vernon Chapter
meeting, phone, email
Rose (618) 204-9081 bfusa.mtvernon@gmail.com
Meeting time and location: 2nd Tuesday evening of each month 6:30 pm
Hosted at: First United Methodist Church 1133 Main St. Mt. Vernon, IL (enter through back door)

Schaumburg Area Chapter
phone
Tracy Torgerson (224) 200-7031

Spring Grove, IL Chapter
phone, email
Kristy Hinz (847) 533-5361 kristy.hinz@breastfeedingusa.org
Facebook: Spring Grove, IL Chapter

Tri-Cities Chapter
Serving Batavia, Geneva, St Charles, and surrounding areas
phone, email, text, meetings
Krista (630) 934-6214 krista.schroeder@breastfeedingusa.org
Meeting details: second Tuesday of every month from 10-12am. Located in the basement youth room of the Geneva United Methodist Church at 211 Hamilton St. Geneva, IL 60134. Babies and children always welcome.

Indiana

Breastfeeding USA of Bloomington
meetings, phone, email
Brianna Horne (571) 921-2559 brianna.horne@breastfeedingusa.org
Next Meeting: Wednesday, September 23rd from 6pm-8 pm in meeting room 2A at the Main Library in Bloomington, IN.
Facebook: Breastfeeding USA Bloomington

Hamilton County Moms Breastfeed
meeting, email, phone
Amie (317) 674-3237 Amie.Hood@breastfeedingusa.org
Elissa (317) 674-3237 elissa.m@breastfeedingusa.org
Chapter Meetings:
Morning meetings second Wednesdays of each month, 10 a.m.-12 p.m. Please see our Facebook page for additional meeting times and locations.
Facebook Page: Hamilton County Moms Breastfeed
Facebook Chat Group

Indy Breastfeeding Moms
meeting, phone, email
Ali, Amie, Megan, Jillian, Jasmine, Ann, & Sara
(317) 782-5819
indybreastfeedingmoms@breastfeedingusa.org
Facebook Page: Indy Breastfeeding Moms Chapter
Facebook Chat Group: Indy Breastfeeding Moms Chat Group
Website: IndyBreastfeedingMoms.org
Morning Chapter Meetings: Second Friday of each month,10:15 AM
College Avenue Branch Library, 4180 N. College Ave.
Evening Chapter Meetings: First Wednesday of each month, 6:00 PM
Nora Library, 8625 Guilford Avenue.

Lawrence (East Indy) Chapter
meeting, email, in person
Erin erin.smallwood@breastfeedingusa.org
Chapter Meetings:
Indianapolis-Marion County Public Library LAWRENCE Branch Meeting Room:
August 6, September 17, October 1, November 19, December 17
ALL meetings will start at 6:00 pm
Panera, located at 9145 East 56th Street, Indianapolis, IN 46216:
September 3, November 12, December 3
ALL meetings will start at 6:00 pm

Southeastern Indiana Breastfeeding Moms
meeting, phone, social media, email
Cara (812) 212-9512 cara.mehlon@breastfeedingusa.org

Iowa

Breastfeeding USA Eastern Iowa Chapter
meeting, email, text, home visits
Natalie Goyette (319) 329-6875 natalie.goyette@breastfeedingusa.org
Sarah Bengtson sarah.bengtson@breastfeedingusa.org
www.breastfeedingincedarrapids.wordpress.com
Meetings are held at Birth, Baby & Beyond, 4330 Czech Square, Cedar Rapids, IA 52402. We meet the second Thursday of the month at 7 pm and the 4th Monday at 10 am.

North Iowa Chapter
calls, text, email, meetings, in-home help by appointment
Alissa Gomez-Dean (641) 512-6614 alissa.gd@breastfeedingusa.org

Kansas

Wichita Kansas Chapter
phone, email, text
Chris Clark (316) 747-9652 chris.clark@breastfeedingusa.org

Kentucky

Breastfeeding Moms of Ashland
meeting, phone, email
Alissa Parker (925) 297-KIDS bmoashland@breastfeedingusa.org
Meeting Info: First Saturday of the month, 10:00am
Visit us on Facebook

Louisiana

Northeast Louisiana Chapter
phone, email, in-person
Nina (318) 348-7999 nina.simpson@breastfeedingusa.org

Massachusetts

Greater Western MA Chapter
meeting, phone, email
westernmass@breastfeedingusa.org
Kate N. (413) 213-0843
Rachael (413) 221-1582
Meeting Information: 2nd Friday of each month at 6:30pm at the Belchertown Family Center
Visit us on Facebook

Maryland

Carroll/Baltimore County Chapter
meeting, phone, email, in-person, text
Brittany (410) 800-7048 brittany.davidson@breastfeedingusa.org
Julie KL (703) 395-8957 julie.klingerluht@breastfeedingusa.org
Meeting information: First Saturday of each month at Amazing Spiral, 5851 York Road, Baltimore, MD 21212, 10:30-11:30 am
Visit us on Facebook

Montgomery County Chapter
meeting, phone, email
Beth (301) 326-4715 beth.lichy@breastfeedingusa.org
Leah (301) 593-2082 leah.kocsis@breastfeedingusa.org
Dorothy dorothy.kane@breastfeedingusa.org
Chapter meetings are the third Tuesday of each month at Holy Cross Resource Center, 9805 Dameron Dr., Silver Spring, MD 20902. 6:00 pm
Visit us on Facebook

Michigan

Genesee County Chapter
email
Toi L. toi.l@breastfeedingusa.org

Kalamazoo Chapter
phone, email, meetings
Jennifer (269) 317-8581 Jennifer.nardi@breastfeedingusa.org

Michigan Chapter
phone, email
Shannon (616) 295-1128 shannon.p@breastfeedingusa.org

Minnesota

Greater Twin Cities Chapter
phone, email, home visits
Becca Morgan (320) 333-4496 rebecca.morgan@breastfeedingusa.org

Maple Grove/Plymouth Chapter
phone, email, meetings, in-person, text
Andrea Meyer (612) 413-5611 andrea.meyer@breastfeedingusa.org

Twin Cities Chapter
phone, email
Alison (612) 314-5504 alison.cromie@breastfeedingusa.org
Visit us on Facebook

Missouri

St. Louis Metro Breastfeeding USA
phone, email, home visits
Dorothy (314) 635-8692 dorothy.r@breastfeedingusa.org
Visit us on Facebook

Montana

Mineral County
email, phone, in-person, meetings
Amy L. (406) 207-4020 amy.lommen@breastfeedingusa.org

Nebraska

Breastfeeding USA of Kearney
phone, email, meetings
Victoria Narcisse (402) 413-8811 victoria.narcisse@breastfeedingusa.org

New Hampshire

Monadnock-Brattleboro Chapter
email, text, phone, in-person, meetings, online support group
Clarissa Murch (929) 322-3872 clarissa.murch@breastfeedingusa.org
Meeting information: Please check our Facebook page for current meeting times and locations
Facebook Page: Monadnock-BrattleboroBFUSA
Online Support Group: Monadnock Breastfeeding Group
Babies and children and partners always welcome. Meetings always free of charge.

New Jersey

North Jersey Chapter
phone, email, in-person
Steph Stohrer (973) 534-9368 Stephanie.Stohrer@breastfeedingusa.org
Gina (516) 713-6576 gina.gk@breastfeedingusa.org
Allyson Murphy (908) 331-0243 allyson.murphy@breastfeedingusa.org
Please visit our Facebook page for meeting details.

New Mexico

Curry County
email, phone
Tiffany (850) 496-6163 tiffany.campion@breastfeedingusa.org

Greater Albuquerque Area Chapter
email
Robin robin.hayter@breastfeedingusa.org

New York

Capital Region
meetings, email
Anne O. anne.o@breastfeedingusa.org
Norma NormaBfUSA@gmail.com
Facebook: Capital Region Chapter
Chapter meetings:
-Clifton Park: Second Saturday each month, 10:15am to 11:30am. For meeting location, email Anne anne.o@breastfeedingusa.org
-Glenville: Second and Fourth Tuesdays of the month, 10:15am to noon. East Glenville Fire Department, 433 Saratoga Road (Rt 50), Glenville, NY 12302 NormaBfUSA@gmail.com

Mechanicville Chapter
meetings
Erica Svatek erica.svatek@breastfeedingusa.org
Meetings: First and third Thursday mornings of the month, 9-10:30 am at the Mechanicville Community Services Center, Mechanicville NY, starting Thursday, December 4th

Tompkins/Cortland Chapter
phone, email, in-person, meetings
Brenda (315) 510-5760 brenda.f@breastfeedingusa.org
Facebook: tompkins.cortland.mothers
Meeting Schedule Still Evolving, Please check our facebook page or email Brenda for up to the date information!

North Carolina

Cary Chapter
phone, email, text
Anna (919) 593-4681 anna.w@breastfeedingusa.org
Lindsay (860) 389-6262 lindsay.giroux@breastfeedingusa.org
Meetings are held on 2nd and 4th Tuesdays at 10am in downtown Cary. Contact Anna for directions.

Lake Norman Chapter
email, phone, text, meeting
Volunteer Breastfeeding USA Counselors: Rebecca, Kate, Brittany

Central Mooresville meeting, 3rd Thursdays 7pm-9pm
Email: lakenormannc@breastfeedingusa.org
Warmline: (704) 761-8238 -- call or text
Facebook: Lake Norman Chapter

East Mooresville meeting, 1st Tuesdays 10am-noon
Email: eastmooresvillenc@breastfeedingusa.org
Warmline: (704) 980-8238 -- call or text

South Charlotte/Fort Mill
email, phone, meetings
Amie (704) 619-9469 amie.kw@breastfeedingusa.org
Meeting info: 3rd Saturday of each month at 10am

Ohio

Cincinnati Breastfeeding Moms
meeting, email, phone, text
Suzanne Please send text to (513) 226-9272 suzanne.crable@breastfeedingusa.org
Krista (513) 377-6328
Chapter meetings are the third Thursday of each month.
Cincinnati Breastfeeding Mothers Yahoo! Group

Greater Cleveland West Chapter
phone, email, meetings
Spanish speaking - contact Samantha
Facebook - BFUSA.CuyahogaWest
(216) 618-5265
Angela angela.d@breastfeedingusa.org
Samantha samantha.w@breastfeedingusa.org
Lisa lisa.w@breastfeedingusa.org
Chapter meetings are 4th Tuesday of every month at 7pm.
Toddler meetings on the First Friday of each month.
Meetings are held at 15800 Detroit Avenue, Lakewood, OH 44107, Suite D

Clintonville Breastfeeding Support Group (Columbus Area)
phone, text, meetings, email
Rachelle Lesteshen (614) 500-3862 rachelle.lesteshen@breastfeedingusa.org
Meeting Information: Second Wednesday of every month at 10:00am at CHOICE - Center for Humane Options in Childbirth Experiences 5721 North High Street Worthington, Ohio 43085
Visit our Facebook Group

Dayton Area: Wright-Patt Nature & Nurture Nursing Support Group
phone, email, text, meetings, in-person
Mary (937) 405-6103 mary.ft@breastfeedingusa.org
Meetings: 1st Wednesday of month at 5:30pm; 3rd Tuesday of month at 7pm (contact Mary for locations)
Facebook: Wright-Patt Nature & Nurture Nursing Support Group

Oklahoma

Oklahoma County Chapter
in-person, phone, email, text
Nikki (405) 651-2880 nikki.c@breastfeedingusa.org
Visit us on Facebook for meeting details.

Oregon

Silverton Breastfeeding USA Chapter
phone, email, and in-home support
Bethany (503) 419-4151 bethany.griffinshetler@breastfeedingusa.org
Facebook: SilvertonOregonBFUSA

Pennsylvania

Central Pennsylvania Chapter
phone, email, monthly meetings and classes
Ruth (570) 884-4398 email
Please contact Ruth for more information on monthly meetings and classes.
Central PA Facebook Page

Southeastern PA Chapter
phone, e-mail
Gena (813) 495-1428 gena.ortega@breastfeedingusa.org

Southwestern Pennsylvania Chapter
email, phone, text, home visits, classes and meetings
Mallary Powell, (724) 557- 0857 mallary.powell@breastfeedingusa.org
Phone messages will be returned after 6pm (generally) Monday- Friday. Times will vary on Saturday and Sunday.
Facebook group: Breastfeeding USA Southwestern Pennsylvania Chapter
Meeting information: Please contact Mallary or refer to Facebook for meeting information

Upcountry South Carolina Chapter
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Carol (864) 558-5020 carol.kelley@breastfeedingusa.org

South Dakota

Breastfeeding USA General Support
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Jacklyn Rymer (816) 457-3069 Jacklyn.Rymer@breastfeedingusa.org

Tennessee

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Lisa Paul lisa.paul@breastfeedingusa.org
Facebook facebook.com/bloomlisapaul (friend me, and I will add you to the private group)

Murfreesboro Mom-to-Mom Breastfeeding Support
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Melissa (615) 567-3890 melissa.c@breastfeedingusa.org

Texas

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Aly Colman (817) 925.5206 aly.colman@breastfeedingusa.org

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El Paso Chapter
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Bonnie Rutkowski (915) 490-3407 bonnie.rutkowski@breastfeedingusa.org
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Meeting information will be posted soon.

Orange County Chapter-Breastfeeding USA
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Erin Sanderson (409) 466-8303 erin.sanderson@breastfeedingusa.org
Facebook Page: orangecountybfusa
Facebook Group: orangecountybfusa group

Waco Chapter
phone, email, meetings
Ashley Jones (254) 744-6984 ashley.jones@breastfeedingusa.org
Meeting Info: Free weekly breastfeeding support meeting at My Little Play Place (7524 Bosque Blvd Waco, Tx 76712) on Fridays at 10:30 am.
Facebook Group: TXBfUSA

Vermont

Monadnock-Brattleboro Chapter
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Clarissa Murch (929) 322-3872 clarissa.murch@breastfeedingusa.org
Meeting information: Please check our Facebook page for current meeting times and locations
Facebook Page: Monadnock-BrattleboroBFUSA
Online Support Group: Monadnock Breastfeeding Group
Babies and children and partners always welcome. Meetings always free of charge.

Virginia

Central Virginia Chapter
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Maggie (434) 547-0454 maggie.williams@breastfeedingusa.org
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Fredericksburg Chapter
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Mishka mishka.brownley@breastfeedingusa.org

Shenandoah Valley Chapter
phone, email, monthly meetings, free courses
Megan Hartless (540) 860-0567 megan.hartless@breastfeedingusa.org
Facebook Page: Breastfeeding USA: Shenandoah Valley Chapter
Facebook Group: Breastfeeding USA Shenandoah Valley Circle
Website: Shenandoah Valley Chapter

Washington

Tacoma Area Chapter
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Sarah Harding: (515) 201-6418 sarah.harding@breastfeedingusa.org
Meetings: Email for dates and location
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Whatcom Breastfeeding Moms
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Elizabeth (360) 474-7286 elizabeth.p@breastfeedingusa.org
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Facebook Page: whatcombreastfeedingmoms

Wisconsin

Burlington Chapter
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Kristy Hinz (847) 533-5361 kristy.hinz@breastfeedingusa.org
Facebook Page
Chapter Meetings: Second Friday of the month 10am
Drop In Support: Monday and Wednesday 9-5
Located at 101 S. Pine St. Burlington WI

Madison-area Chapter
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Marinette Chapter
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Phenix Mieko Patrick (715) 732-1658 phenix.patrick@breastfeedingusa.org

Watch us grow! More chapters opening soon.

Nipple Shield: Friend or Foe?

I recently spoke to a mother whose 1-month-old baby was born 4 weeks preterm. She was breastfeeding with a nipple shield, which she was given in the hospital, and she was confused by conflicting advice. Should she pump after feedings? Was her baby getting enough milk? How should she wean from the shield? This was her sixth breastfeeding baby but her first preterm baby and first time using a shield. She was emotional and unsure of herself. My answers below were based on the research described in my book, Breastfeeding Answers Made Simple.

Express milk after breastfeeding? As long as her baby was gaining weight normally (which she was), there was no reason to pump after feedings. A study of 54 mothers and babies compared babies breastfeeding with a nipple shield to those breastfeeding without it and found no difference in weight gain during the first 2 months of life. 1 Although one 1980 study found babies took 22% less milk at the breast with a shield,2 these mothers used thicker, rubber shields. As long as the baby is suckling effective, today’s thin, silicone shields do not appear to decrease milk intake during breastfeeding.

How to gauge baby’s milk intake. Weight gain is the best way to know a breastfeeding baby is getting enough milk. This baby was gaining well, so adequate milk intake was guaranteed. After feedings, other signs of milk intake include reduced feelings of breast fullness and milk seen in the tip of the shield.

Weaning off the shield. A hospital nurse told this mother to wean her baby from the shield by gradually cutting it away. This strategy made sense with rubber shields, but cutting silicone shields produces sharp edges that could irritate the baby’s mouth. A better strategy is to start the baby feeding with the shield and when the mother hears swallowing to quickly slip off the shield and slip in the breast. But I told this mother to be patient. Her preterm baby may not be ready to wean from the shield. One study found nipple shields increased milk intake in preterm babies having trouble suckling actively and staying on the breast.3 While not all preterm babies need to use a shield, I told this mother that for now her preterm baby may breastfeed better with it. The baby’s readiness to wean from the shield is as important as the mother’s readiness.

In general, should nipple shields be considered “friend” or “foe”? It depends. As 88% of the mothers in one study reported,4 when used appropriately, nipple shields can help preserve breastfeeding. Or—like any breastfeeding tool—they can be misused and undermine it. In some cases, weaning off the shield may be the right thing to do. In others, a mother should be patient and wean from the shield later rather than decrease her baby’s breastfeeding effectiveness or turn the breast into a battleground.

References

1. Chertok, I. Reexamination of ultra-thin nipple shield use, infant growth and maternal satisfaction. J Clin Nurs 2009;18(21):2949-2955.

2. Woolridge, M. et al. Effect of a traditional and of a new nipple shield on sucking patterns and milk flow. Early Hum Dev 1980; 4(4):357-364.

3. Powers, D., & Tapia, V. B. Women's experiences using a nipple shield. J Hum Lact 2004; 20(3):327-334.

4. Meier, P. et al. Nipple shields for preterm infants: effect on milk transfer and duration of breastfeeding. J Hum Lact 2000; 16(2):106-114.



Used with Permission. Article originally appeared on the website Breastfeeding Reporter (http://www.nancymohrbacher.com/), where you can find complete article licensing information.

Should All Breastfed Babies Have Above Average Weight Gains?

Just like in the fictional Minnesota town of Lake Wobegon, where “all the children are above average,” many parents believe there is something wrong if their breastfeeding baby’s weight isn’t above the 50th percentile. While it is human to want our children to excel, the assumption that babies at a higher weight percentile are healthier or somehow “better” reflects a basic misunderstanding of growth charts and what they mean.

The purpose of a growth chart is to plot a baby’s growth on a series of percentiles, with the average baby at the 50th percentile. What this really means in terms of weight is that out of 100 children, 49 will weigh less and 50 will weigh more. A weight that falls at a higher percentile is not “good” and a weight that falls at a lower percentile is not “bad.” By definition, there will be healthy children at every percentile. Some will be chunky and some will be petite, but their percentile does not necessarily reflect their overall health or growth.

A child at the 5th percentile is not necessarily growing poorly and the child at the 95th percentile is not necessarily growing well. That’s because growth can only be evaluated over time. For example, a preterm baby born very small will likely fall on a low percentile for weight at first, even when he is gaining weight well. Also, if during pregnancy a mother had high blood sugar levels, gained a lot of weight, or received lots of IV fluids during labor, her baby’s birth weight may be unnaturally high. In these situations, after birth a large baby may fall in percentiles to a weight closer to what his genes naturally dictate.1

But parents are not the only ones confused. A U.K. study2 examined both mothers’ and healthcare providers’ perceptions of growth charts, and found that many mothers worried about their baby’s weight gain between checkups and that both mothers and healthcare providers erroneously considered the 50th percentile a goal to be achieved. When babies fell below the 50th percentile, healthcare providers often recommended the mothers give their babies formula and solid foods to try to boost baby’s weight gain to reach this “desirable” percentile. The researchers concluded that healthcare providers need more training on how to assess the growth of breastfeeding babies and how to support breastfeeding rather than undermine it.

Normal growth means a baby is gaining weight at a healthy pace and growing well in length and head circumference. One point on a baby’s growth chart should never be considered in isolation but rather compared to other points. It’s a baby’s growth pattern over days, weeks, and months that provides an accurate picture of how breastfeeding is going. If a baby is growing consistently and well, his actual percentile is irrelevant.

If over time, however, his weight-for-age percentile drops, first it’s important to determine whether the chart is based on breastfeeding norms, as many are not. (Click here for the World Health Organization’s growth charts based on exclusively breastfed babies.) If the chart is based on breastfed babies and the baby’s weight-for-age percentile has dropped, this is a red flag to take a closer look and see if breastfeeding dynamics can be improved.

References

1. Mohrbacher, N. Breastfeeding Answers Made Simple: A Guide for Helping Mothers. Amarillo, TX: Hale Publishing, 2010.

2. Sachs, M., Dykes, F., & Carter, B. Feeding by numbers: an ethnographic study of how breastfeeding women understand their babies' weight charts. Int Breastfeed J 2006; 1:29.

This article originally appeared on Nancy Mohrbacher Breastfeeding Reporter (http://www.nancymohrbacher.com/) where you can find complete article licensing information. Used with Permission.

Worries About Foremilk and Hindmilk

A little knowledge can be a dangerous thing. This has never been so true as in the ongoing debate about foremilk and hindmilk and their impact on breastfeeding. The misunderstandings around these concepts have caused anxiety, upset, and even led to breastfeeding problems and premature weaning.

The 2003 edition of The Breastfeeding Answer Book defines these terms this way:

“The milk the baby receives when he begins breastfeeding is called the ‘foremilk,’ which is high in volume but low in fat. As the feeding progresses, the fat content of the milk rises steadily as the volume decreases. The milk near the end of the feeding is low in volume but high in fat and is called the ‘hindmilk’” (Mohrbacher and Stock, p. 34).

It goes on to explain that by simply letting the baby “finish the first breast first”—switching breasts when the baby comes off the breast on his own rather than after a set time—the mother can be sure her baby receives the “proper balance of fluid and fat.” Since this book was published, research has expanded our understanding of foremilk and hindmilk and answered many of the common questions mothers have about these concepts.

What worries? Confusion about foremilk and hindmilk has led to all sorts of uncertainty. Are there two distinctly different types of milk? Does the baby need to breastfeed for a specific number of minutes before foremilk suddenly turns to hindmilk? Can a baby miss out on hindmilk altogether if he breastfeeds for too short a time? If this happens often, will his weight gain suffer? Sometimes healthcare providers get into the act, telling breastfeeding mothers they should watch the clock to make sure their baby breastfeeds “long enough to get the hindmilk,” with the number of minutes recommended varying by adviser What do we really need to know about foremilk and hindmilk? And is there any reason to worry?

The truth about foremilk and hindmilk. Research has found this concept is not as simple as it sounds. It is true that fat sticks to the milk ducts in the breast and the percentage of fat in the milk increases during a breastfeeding as the fat is released from the ducts during milk ejections. But the reality of this seemingly simple dynamic is not always as it seems.

There are not “two kinds of milk.” Despite this common belief, there is no “magic moment” when foremilk becomes hindmilk. As the baby breastfeeds, the increase in fat content is gradual, with the milk becoming fattier and fattier over time as the breast drains more fully.

The total milk consumed daily—not the hindmilk—determines baby’s weight gain. Whether babies breastfeed often for shorter periods or go for hours between feedings and feed longer, the total daily fat consumption does not actually vary.

Foremilk is not always low-fat. The reason for this is that at the fat content of the foremilk varies greatly, depending on the daily breastfeeding pattern. If the baby breastfeeds again soon after the last feeding, the foremilk at that feeding may be higher in fat than the hindmilk consumed at other feedings.

How does this work? Interestingly, foremilk and hindmilk are concepts that really only make sense when longer intervals such as two to three hours or more occur between feedings. The longer the time gap between feedings and the fuller a mother’s breasts become, the greater the difference in fat content between her foremilk and hindmilk. These differences in fat content can vary greatly over the course of a day even among individual mothers. For example, when a long breastfeeding gap occurs during the night, at the next feeding a mother’s foremilk will be lower in fat than during the evening when her baby breastfeeds more often.

What really matters. Research indicates that there is no reason to worry about foremilk and hindmilk or to coax a baby to feed longer. As long as a baby is breastfeeding effectively and the mother does not cut feedings short, baby will receive about the same amount of milk fat over the course of a day no matter what the breastfeeding pattern (Kent, 2007). This is because the baby who breastfeeds more often consumes foremilk higher in fat than the baby who breastfeeds less often. So in the end it all evens out.

What’s most important to a baby’s weight gain and growth is the total volume of milk consumed every 24 hours. On average, babies consume about 750 mL of milk per day (Kent et al., 2006). As far as growth is concerned, it doesn’t matter if a baby takes 30 mL every hour or 95 mL every three hours, as long as he receives enough milk overall (Mohrbacher, 2010). In fact, researchers have found that whether babies practice the frequent feedings of traditional cultures or the longer intervals common in the West, they take about the same amount of milk each day (Hartmann, 2007) and get about the same amount of milk fat. Let’s simplify breastfeeding for the mothers we help and once and for all cross foremilk and hindmilk off our “worry lists.”

References

Hartmann, P.E. (2007). Mammary gland: Past, present, and future. in eds. Hale, T.W. & Hartmann, P.E. Hale & Hartmann's Textbook of Human Lactation. Amarillo, TX: Hale Publishing, pp. 3-16.

Kent, J. C. (2007). How breastfeeding works. Journal of Midwifery & Women's Health, 52(6), 564-570.

Kent, J. C., Mitoulas, L. R., Cregan, M. D., Ramsay, D. T., Doherty, D. A., & Hartmann, P. E. (2006). Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics, 117(3), e387-395.

Mohrbacher, N. Breastfeeding Answers Made Simple: A Guide for Helping Mothers. Amarillo, TX: Hale Publishing, 2010.

Mohrbacher, N. and Stock, J. The Breastfeeding Answer Book, 3rd edition. Schaumburg, IL: La Leche League International, 2003.

This article originally appeared on Nancy Mohrbacher Breastfeeding Reporter (http://www.nancymohrbacher.com/) where you can find complete article licensing information. Used with Permission.

Breastfeeding Information Index

Find a Breastfeeding Counselor Near You!

Accredited Breastfeeding Counselors (BCs) are listed by state and location. They are experienced breastfeeding mothers accredited following completion of a comprehensive breastfeeding education program. They provide information and support to pregnant and breastfeeding mothers, in both one-on-one and group situations.

Breastfeeding Articles

These articles may be of interest to mothers and those who support them. This is just the beginning of an extensive online library which will grow over time as the organization grows. Our goal is to provide evidence-based information and support: What Does Evidence-Based Mean? Each article is well researched and contains up-to-date information.

Book Reviews

Book reviews were written by Breastfeeding USA Counselors, interested in sharing their love of discovering evidence-based information and sharing it with the breastfeeding community. This section is under development.

We extend sincere appreciation to all the authors who have donated articles and reviews to Breastfeeding USA.

The 'Magic Number' and Long-Term Milk Production

(Part 1)

In a recent blog post, I told a military mother who had returned to work at six weeks postpartum that she was making as much milk as her thriving baby would ever need. To meet her breastfeeding goal of one year, I told her, “all she had to do was maintain her milk production.” But maintaining milk production is not always easy for employed mothers, especially when they don’t know the basic dynamics affecting how much milk they make. I shared some of these with this mother, and my explanation set her mind at ease.

Breast storage capacity. This is the amount of milk in a woman’s breasts when they are at their fullest each day and this amount can vary greatly among mothers. Breast storage capacity affects how many times every 24 hours a woman’s breasts need to be drained well of milk—either by breastfeeding or expression—to maintain her milk production. When her breasts become full, this sends her body the signal to make milk slower. In other words, “drained breasts make milk faster” and “full breasts make milk slower.” The amount of milk needed to slow milk production will be much greater in a woman with a large breast storage capacity, so she can remove her milk fewer times a day without her milk production decreasing

The “magic number.” This refers to the number of times each day a mother’s breasts need to be well drained of milk to keep her milk production stable. Due to differences in breast storage capacity, some mothers’ “magic number” may be as few as 4-5 or as many as 9-10. But when a mother’s total number of breast drainings (breastfeedings plus milk expressions) dips below her “magic number,” her milk production slows.

Daily totals. Many of the employed breastfeeding mothers I help by phone are diligent about maintaining their number of milk expressions at work, but often, as the months pass, they breastfeed less and less at home. With this change in routine, they may drop below their “magic number,” which causes a dip in milk production.

Recently, as I asked one employed mother with decreasing milk production about her daily routine, she told me that her baby was sleeping in a swing all night. She discovered that in the swing he did not wake at night to feed, so she was sleeping on the couch in her living room next to the swing and waking every hour to check on him. I told her that eliminating those nighttime breastfeedings was the likely cause of her decreased milk production and I asked if she thought returning to breastfeeding at night might mean more sleep for her as well as more milk for her baby.

More Breastfeeding When Together Means Less Expressed Milk Needed. The amount of milk per day babies need between 1 and 6 months stays remarkably stable, on average between 25 and 35 oz. (750-1050 mL) per day. By thinking of the 24-hour-day as a whole, it becomes obvious that the more times each day the baby breastfeeds directly, the less expressed milk will be needed while mother and baby are apart. But many mothers don’t realize that dropping breastfeedings at home and encouraging baby to sleep more at night adds to the amount of expressed milk their baby needs during the day. Understanding these basic dynamics can go a long way in helping mothers meet their long-term breastfeeding goals.

(Part 2)

In response to the previous post, "The 'Magic Number' and Long-Term Milk Production," a reader of this blog wrote: “I have a 6-week-old and just returned to work. I pump once every 3 hours and am pumping more than enough milk for my baby. But I am fearful of pumping less. Given my son’s eating routine is still getting established and will likely change still, how do I determine my ‘magic number?’”

I suggest you begin by thinking back to your maternity leave, assuming you were breastfeeding exclusively and your baby was thriving. On average, how many times every 24 hours did your baby breastfeed? As a starting point, consider this your “magic number.” For example, if the answer is 8 (which seems to be average), assume that to keep your milk production steady long-term you will need to continue to drain your breasts well at least 8 times each day. If you’re pumping 3 times each workday, this means you’ll need to breastfeed 5 times when you and your baby are together. (This will be much easier if 2 of these breastfeedings include one just before leaving your baby for work and another as soon as you and your baby are reunited again.)

Another factor that can affect milk production is the longest stretch between breast drainings (breastfeedings or pumpings). Ideally, to keep milk production stable, do not regularly allow your breasts to become uncomfortably full, as that gives your body the signal to slow milk production. If your baby sleeps for long stretches at night, I usually suggest going no longer than about 8 hours between breast drainings. Despite the social pressure for your baby to sleep through the night as young as possible, for most mothers it is easier to keep long-term milk production stable if they continue to breastfeed at night.

So don’t just focus on your pumpings at work. Also keep your eye on the number of breastfeedings outside your work hours. As I mentioned in a previous post, many of the employed breastfeeding mothers I talk to pump often enough at work, but as the months pass, the number of breastfeedings outside of work gradually decreases. It’s not just how many times you pump at work that determines your milk production. More important is the number of breast drainings every 24 hours and how this total compares to your “magic number.”

This article originally appeared on Nancy Mohrbacher Breastfeeding Reporter (http://www.nancymohrbacher.com/) where you can find complete article licensing information. Used with Permission.

Breast Versus Bottle: How much milk should baby take?

Q: Why does my breastfed baby take at most 4 ounces (120 mL) from the bottle when my neighbor’s formula-fed baby takes 7 or 8 ounces (210-240 mL)? Am I doing something wrong?

A: You are not doing anything wrong. And in this case, more is not necessarily better. Formula-fed babies typically consume much more milk at each feeding than breastfed babies, but they are also more likely to grow into overweight children and adults.1,2 One large study (16,755 babies in Belarus) compared feeding volumes in formula-fed and breastfed babies and found that the formula-fed babies consumed 49% more milk at 1 month, 57% at 3 months, and 71% at 5 months.3 Australian research found that between 1 and 6 months of age breastfed babies consistently take on average around 3 ounces (90mL) at a feeding. (Younger babies with smaller tummies take less milk.)

Breastfed babies’ milk intake doesn’t increase from months 1 to 6 because their growth rate slows.4 As growth slows, breastfed babies continue to get bigger and heavier on about the same daily milk intake, averaging about 25 ounces (750 mL) per 24 hours.

Why do formula-fed babies drink so much more milk? There are several reasons:

The bottle flows more consistently. During the first 3 to 4 months of life, after swallowing, an inborn reflex automatically triggers suckling.5 Milk flows more consistently from the bottle than the breast (which has a natural ebb and flow due to milk ejections, or let-downs), so babies tend to consume more milk from the bottle at a feeding. Before this reflexive suckling is outgrown, babies fed by bottle are at greater risk of overfeeding.

Breastfeeding gives babies more control over milk intake. Not seeing how much milk is in the breast makes a breastfeeding mother less likely to coax her baby to continue after he’s full.3,6 As the breastfed baby grows and thrives, his mother learns to trust her baby to take what he needs from both breast and bottle and also solid foods when they are introduced later. One U.K. study found that between 6 and 12 months of age breastfeeding mothers put less pressure on their babies to eat solid foods and were more sensitive to their babies’ cues.7

More milk in the bottle means more milk consumed. In the Belarus study mentioned before, babies took more formula at feedings when their mothers offered bottles containing more than 6 ounces (180 mL).3

Mother’s milk and formula are metabolized differently. Formula-fed babies use the nutrients in formula less efficiently,8 so they may need more milk to meet their nutritional needs. Formula is also missing hormones, such as leptin and adiponectin, which help babies regulate appetite and energy metabolism.9,10 Even babies’ sleep metabolism is affected, with formula-fed babies burning more calories during sleep than breastfed babies.11

Q: If my baby takes more milk from the bottle than I can express at one sitting, does that mean my milk production is low?

A: See the previous answer. Babies commonly take more milk from the bottle than they do from the breast. The fast, consistent milk flow of the bottle makes overfeeding more likely. So if your baby takes more milk from the bottle than you express, by itself this is not an indicator of low milk production.

To reduce the amount of expressed milk needed and to decrease the risk of overfeeding, take steps to slow milk flow during bottle-feeding:

  • Use the slowest flow nipple/teat the baby will accept.
  • Suggest the feeder try holding the baby in a more upright position with the bottle horizontal to slow flow and help the baby feel full on less milk.
  • Short breaks during bottle-feeding can also help baby “realize” he’s full before he takes more milk than needed.

References:

1 Arenz, S., Ruckerl, R., Koletzko, B., & von Kries, R. (2004). Breast-feeding and childhood obesity--a systematic review. International Journal of Obesity and Related Metabolic Disorders, 28(10), 1247-1256.

2Dewey, K. G. (2009). Infant feeding and growth. In G. Goldberg, A. Prentice, P. A., S. Filteau & K. Simondon (Eds.), Breast-Feeding: Early influences on later health (pp. 57-66). New York, NY: Springer.

3Kramer, M. S., Guo, T., Platt, R. W., Vanilovich, I., Sevkovskaya, Z., Dzikovich, I., et al. (2004). Feeding effects on growth during infancy. Journal of Pediatrics, 145(5), 600-605.

4Kent, J. C., Mitoulas, L. R., Cregan, M. D., Ramsay, D. T., Doherty, D. A., & Hartmann, P. E. (2006). Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics, 117(3), e387-395.

5Wolf, L. S., & Glass, R. P. (1992). Feeding and Swallowing Disorders in Infancy. Tucson, AZ: Therapy Skill Builders.

6Taveras, E. M., et al. (2004). Association of breastfeeding with maternal control of infant feeding at age 1 year. Pediatrics, 114(5), e577-583.

7Farrow, C., & Blissett, J. (2006). Breast-feeding, maternal feeding practices and mealtime negativity at one year. Appetite, 46(1), 49-56.

8Motil, K. J., Sheng, H. P., Montandon, C. M., & Wong, W. W. (1997). Human milk protein does not limit growth of breast-fed infants. Journal of Pediatric Gastroenterology and Nutrition, 24(1), 10-17.

9Li, R., Fein, S. B., & Grummer-Strawn, L. M. (2008). Association of breastfeeding intensity and bottle-emptying behaviors at early infancy with infants' risk for excess weight at late infancy. Pediatrics, 122 Suppl 2, S77-84.

10Doneray, H., Orbak, Z., & Yildiz, L. (2009). The relationship between breast milk leptin and neonatal weight gain. Acta Paediatrica, 98(4), 643-647.

11Butte, N. F., et al. (2000). Energy requirements derived from total energy expenditure and energy deposition during the first 2 y of life. American Journal of Clinical Nutrition, 72(6), 1558-1569.

Used with Permission. Article originally appeared on the website Breastfeeding Reporter (http://www.nancymohrbacher.com/), where you can find complete article licensing information.

Facts Every Employed Breastfeeding Mother Needs to Know

Today I spoke by phone with an employed breastfeeding mother in the military who had recently returned to work. She told me she was worried she would not be able to keep up her milk production over the long term. I shared with her some facts that could smooth the way for any employed breastfeeding mother but are not widely known.

From 1 to 6 months of age the breastfed baby’s daily milk intake stays relatively stable. This mother assumed—like most—that as her baby grew bigger and heavier, he would need more milk. In fact, that’s not what the research shows. Because babies’ rate of growth slows between 1 and 6 months, daily milk intake remains remarkably consistent during this time.1 I told this mother that since her baby had been thriving on exclusive breastfeeding for his first six weeks that she was golden. She was already producing as much milk as her baby would ever need. All she needed to do was maintain it. (Note: This is not the case for the formula-fed baby, as explained in my article Breast Versus Bottle: How Much Milk Should Baby Take? which leads to many mistaken assumptions.)

After solid foods are started, the breastfed baby needs less milk. This mother also expressed concern about meeting her one-year breastfeeding goal because her husband was scheduled to deploy in January, when her baby would be 7 months old. She was worried that as an employed mother alone with a 7-month-old baby and a 2-year-old toddler, she would not be able to keep up with her baby’s need for milk. I told her that once her baby started on solids, which is recommended at six months, the baby would actually need less and less milk, as he ate more and more solids.2,3

She told me that this information was a huge morale booster and that it made meeting her breastfeeding goals seem much more feasible. This is information every employed breastfeeding mother needs to know.

References:

1. Kent, J. C., et al. (2006). Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics, 117(3), e387-395.
2. Islam, M. M., et al. (2006). Effects of varied energy density of complementary foods on breast-milk intakes and total energy consumption by healthy, breastfed Bangladeshi children. American Journal of Clinical Nutrition, 83(4), 851-858.
3. Cohen, R. J., et al. (1994). Effects of age of introduction of complementary foods on infant breast milk intake, total energy intake, and growth: a randomised intervention study in Honduras. Lancet, 344(8918), 288-293.

Used with Permission. Article originally appeared on the website Breastfeeding Reporter (http://www.nancymohrbacher.com/), where you can find complete article licensing information.

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