What is the let-down reflex?
The let-down reflex means your milk is ready to flow. It makes breastfeeding easier for you and your baby. You may feel a tingle in your breast(s) as you start to breastfeed. Milk may drip from the breast not being used. These are signs that your milk has “let-down.” The let-down reflex also may occur if a feeding is overdue, if you hear a baby cry, or if you think about your baby.
The reflex can be forceful enough to cause your baby to cough. If this is a problem, try to discharge some of your milk by hand before a feeding.
How often should I feed my baby?
Feed your baby as often as they want to be fed. Learn how to tell when they are hungry. Crying can be a sign of hunger, but it may be too late. Babies who are crying or are upset have a harder time latching on. Watch out for early signs of hunger. Your baby may:
- make sucking motions
- turn toward the breast if they are being held
- put their hands in their mouth
- become excited or alert.
After birth, they may be hungry 8 to 12 times a day or more. This number may decrease over time or increase during a growth spurt. Growth spurts occur at about 2 weeks and 6 weeks of age and again at about 3 months and 6 months of age.
Let your baby eat until they are satisfied. This may be for about 15 to 20 minutes at each breast. Try to have your baby nurse from both breasts at each feeding. Make sure your baby finishes one breast before starting the other. Your baby should let go on their own once they are done.
Do not limit the time you let your baby nurse. It may keep your milk ducts from completely emptying. This can decrease your milk flow and make it harder for your baby to latch it on. It also can cause swelling and pain. Applying a cold compress before nursing can ease discomfort.
How do I know if my baby is getting enough milk?
Your baby is getting enough milk if they:
- act satisfied after each feeding.
- gain weight consistently after the first 3 to 7 days after birth. (Your baby may lose a little weight during the first week after being born.)
- has about 6 to 8 wet diapers a day.
- has about 2 to 5 or more stools a day at first. This number may decrease to about 2 stools or less a day.
Sometimes babies fall asleep while nursing. You can squeeze your breast to make more milk flow. This may wake them up. If you are not sure they got enough milk, offer your other breast to see if they latch on again.
How can I increase my milk supply?
If you think your baby needs more milk, increase the number of feedings a day. It’s important for you to get plenty of rest and eat right. Give your body time to catch up to your baby’s demands.
Do not replace breast milk with baby formula or cereal. This can make them lose interest in breast milk. It also will decrease your milk supply. You should not give your baby solid foods until about 6 months of age.
Things to consider
What food should I eat while breastfeeding?
The best diet is well balanced and has plenty of calcium. A balanced diet includes eating from all 5 food groups. You should get 5 servings of milk or dairy products each day. It is okay to eat foods that were restricted while you were pregnant. These will not make your baby sick.
If you do not eat meat or dairy, you can get calcium from foods such as broccoli, sesame seeds, tofu, and kale. Talk to your doctor about taking a calcium supplement if you don’t get enough from your diet.
You should eat about 500 extra calories per day. Make sure you drink extra fluids as well. Continue to take a prenatal vitamin so your body gets enough nutrients.
What should I avoid while breastfeeding?
Certain foods can bother your baby. They may make them fussy or gassy. Pay attention to what you eat and how your baby acts after feedings. Stop eating foods that affect them. These may include spicy foods, broccoli, or milk.
Some babies react to cow’s milk that is in your diet. Symptoms can include gas, vomiting, diarrhea, rash, or colic. Your baby also can have an allergic reaction to something you eat. Common foods are eggs and peanuts. They may get a rash or have trouble breathing. Contact your doctor right away if your baby has any of these signs.
Limit your intake of caffeine and alcohol. These can get into your milk. Do not have more than a couple cups of coffee, tea, soda, or other caffeine. Do not have more than one alcoholic drink. Avoid drinking either less than 2 hours before a feeding.
Some medicines can get into your milk. This includes over-the-counter drugs and prescriptions, such as antidepressants and birth controls. Do not take anything without talking to your doctor first. Smoking also is bad for breastfeeding. The chemicals and smoke can get it your milk. Smoking can cause you to make less milk. If you smoke, try to quit.
If possible, avoid using bottles or pacifiers after birth. This can confuse your baby and make breastfeeding harder.
What can I do if my nipples get sore?
It’s easier to prevent sore nipples than it is to treat them. The main cause of sore nipples is when your baby doesn’t latch on the right way. You need to start over to correct this. To take your baby off your breast, release the suction by putting your finger in the corner of your baby’s mouth between the gums. Switch breasts and try to breastfeed again.
Other ways to help prevent and heal sore nipples are:
- Make sure your baby is sucking the right way. If the sucking hurts, your baby’s mouth may not be in the right position.
- Offer your baby the less sore of your two nipples first. Your baby’s sucking may be less forceful after the first few minutes.
- If possible, position cracked or tender parts of your breast at the corner of your baby’s mouth. This way the spots get less pressure during feeding.
- Change positions.
- Let your nipples air dry between feedings. Let the milk dry on your nipples instead of wiping it off.
- Wash your nipples daily with warm water. Do not use soap or lotion that may contain alcohol. This can dry out your skin.
- Rub lanolin on your nipples to help soothe them.
- Avoid bra pads lined with plastic. Change bra pads between feedings to keep your nipples dry.
- Discharge milk with your hand until the let-down reflex occurs. This can help make your milk flow easier so your baby sucks less hard.
When to see your doctor
Call your doctor if you have:
- a red, sore, or painful spot on your breast
- painful engorgement (overfull breasts)
- a fever or if you feel achy. These may be signs of an infection.
You also should call your doctor if your baby is losing weight for no apparent reason.
Questions to ask your doctor
- Where can I take a breastfeeding class?
- What type of breastfeeding care and information will the hospital provide after birth?
- What should I do if my baby won’t latch on?
- What can I do if my body is not producing enough milk?
- Is it okay to give my baby bottles or pacifiers?
Resources
American Academy of Family Physicians, Breastfeeding Clinical Recommendation
