Breastfeeding Questions and Answers

While most parents and pediatricians understand that breastfeeding is beneficial for both babies and their mothers, there are still a lot of things that get in the way of effective breastfeeding. Get educated about breastfeeding and get help if you have trouble.


Isn't Breastfeeding Supposed to Be Easy?

mother breastfeeding her baby
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While breastfeeding is natural, it is not always easy, especially in the first weeks after a baby is born. If breastfeeding were easy, we wouldn't have so many books and websites dedicated to helping breastfeeding mothers. We wouldn't need lactation consultants, and more mothers who start breastfeeding would likely continue and reach their breastfeeding goals​.

Breastfeeding is a learned skill. It requires patience and practice. For some women, the learning stages can be frustrating and uncomfortable. And some situations make breastfeeding even harder, such as babies born early or health problems in mother or baby. Breastfeeding usually gets easier with time.


How Can I Avoid Colic While Breastfeeding?

Unfortunately, colic is not easily avoided, whether you are breastfeeding or not. Sometimes, though, a breastfeeding baby is intolerant or sensitive to something in the mother's diet, often cow's milk. (It's a myth that broccoli, cabbage, cauliflower, chocolate, onions, or spicy foods cause colic or other problems in breastfeeding babies.)

While eliminating foods from your diet is typically not necessary, if you and your pediatrician think that food allergy is a problem, you may decide to try an elimination diet.

  • Target specific foods and food groups, including cow’s milk (and other products made with milk and milk proteins, including butter, cheese, and ice cream, etc.), soy, citrus fruits, eggs, tree nuts, peanuts, wheat, corn, strawberries, and chocolate.
  • Eliminate foods one at a time, and wait to see if your baby's colicky symptoms (or other symptoms, such as diarrhea or eczema) improve.
  • Add that food back into your diet and eliminate another if there is no change in your baby's symptoms after two or three days. It is sometimes necessary to wait two to four weeks to see if your baby's symptoms will resolve, though.
  • Re-test if you find a food your baby is sensitive to. If it continues to cause symptoms, remove it from your diet until your baby for at least 6 months old.

In addition to your regular prenatal vitamins, be sure to take extra calcium if you have eliminated dairy products from your diet. In addition to your pediatrician and lactation consultant, a pediatric gastroenterologist can help if your baby is having severe GI symptoms while you are breastfeeding.


Is My Baby Getting Enough Breast Milk?

The first week is a challenge for many breastfeeding mothers, as they wonder if their baby is getting enough breast milk, especially as they know their baby is losing weight (which is normal). Signs that your baby is getting enough breast milk include:

  • On day 2, at least 2 wet diapers and 2 bowel movements that are likely still thick, tarry, and black
  • On day 3, at least 3 wet diapers and 3 bowel movements, with the BMs becoming looser and greenish to yellow in color
  • On day 4, at least 4 wet diapers and 4 yellow, soft and watery bowel movements
  • On day 5, at least 5 wet diapers and 5 yellow, loose and seedy bowel movements.

After losing weight their first three to five days of life, your newborn should start to gain at least two-thirds of an ounce to one ounce each day. Feed your baby at least 8 to 12 times a day. Get help if your baby isn't latching on or if you don't feel like your milk is coming in by the time your baby is three to five days old.

Your pediatrician will help monitor your baby's weight loss/gain at the first visit, which normally occurs by the time your baby is three to five days old. Keep in mind that an early checkup for your baby is especially important if your baby went home from the hospital less than 48 hours after birth. According to the American Academy of Pediatrics, these babies should be examined by a health professional within 48 hours of going home.


What Can I Do About Sore Nipples?

In addition to making sure that your baby is latching well, you can:

  • Change breastfeeding positions.
  • Manually express some breast milk and rub it on your sore nipples.
  • Let your nipples air-dry after nursing.
  • Wear a soft cotton shirt and avoid tight-fitting shirts and bras.
  • Frequently change your nursing pads.
  • Apply a nipple balm or cream.

See a lactation consultant if sore nipples are getting in the way of nursing your baby.


How Can I Treat Blocked Ducts and Mastitis?

Blocked or plugged ducts are a common source of pain when breastfeeding. When a milk duct becomes blocked, it can become tender and inflamed. Unlike mastitis, plugged ducts are not associated with fever and often get better if you breastfeed more often. Other treatments might include massaging your breast and applying warm compresses to the area.

Mastitis causes symptoms similar to a blocked duct, but you will likely also have a fever and other flu-like symptoms. While a plugged duct is caused by milk stasis (milk sitting in the breast too long), mastitis is actually an infection. Treatments are similar, though, including breastfeeding more on the side that is affected. You may need to take an antibiotic if you aren't quickly feeling better.


When Would I Use a Nipple Shield?

Nipple shields are worn over your nipple and areola while you are nursing. Some situations when they might be helpful include:

  • Flat nipples
  • Inverted nipples
  • Breastfeeding a premature baby

Just remember that they are not for long-term use and should be used under the supervision of a lactation consultant. The consultant can help you use the nipple shield properly and fix the underlying breastfeeding problem.


What Can I Do About Engorgement?

Symptoms of engorgement can include hard, painful, swollen breasts, flattened nipples, and even a low-grade fever. Engorgement typically occurs as your milk comes in when your baby is two to five days old.

Common treatments for engorgement include continuing to feed on demand at least eight to 12 times a day, warm compresses, gentle breast massage, cool compresses or ice packs. Cabbage leaf compresses may also help, but these should not be used in the early days of breastfeeding since they may decrease milk supply.


What Are the Benefits of Using a Lactation Aid?

A lactation aid can help prevent nipple confusion and stimulate your breasts to produce milk. It is a good alternative to giving your baby a bottle to supplement with expressed breast milk or formula.

The lactation aid is basically a feeding tube that you attach to a bottle and to your nipple so that when your baby latches on and attempts to nurse, they get a supplement from the bottle along with some breast milk. A lactation aid is also included in supplemental nursing systems (SNS), along with a disposable feeding tube device.


Is Gentian Violet a Good Treatment for Thrush?

Thrush is an oral infection that is caused by Candida albicans yeast. Common treatments for infants with thrush include the prescription medications Nystatin oral suspension and Fluconazole oral suspension.

Some breastfeeding mothers prefer gentian violet as it is available without a prescription, often works as a one-time treatment, and can also be used to treat their own infection. But it does have some downsides. Gentian violet is very messy. It will stain clothing and skin (not permanently).


What Is Breastfeeding Jaundice?

Most parents are aware that newborn babies can become jaundiced—getting a yellow discoloration to their skin and eyes from high levels of bilirubin (hyperbilirubinemia). They are often surprised to learn that there are different types of jaundice, including:

  • Breastfeeding jaundice: Jaundice that worsens because of poor breastmilk supply or inadequate nursing in a baby's first week, which can lead to dehydration and excessive weight loss. This is a type of physiologic jaundice that also occurs in formula-fed infants, but may be exaggerated if a baby is also not nursing well and has lost a lot of weight.
  • Breast milk jaundice: Unlike breastfeeding jaundice, these babies are nursing well and have mild levels of jaundice that may linger for two or three months.

Whatever the cause, jaundice is not a reason to stop breastfeeding. Instead, work with your pediatrician and/or a lactation consultant to get your baby breastfeeding more effectively and improve your breast milk supply. If it becomes necessary to supplement, talk to your pediatrician about using a lactation aid instead of a bottle.


What Is Finger Feeding?

Finger feeding is a technique that can help to avoid nipple confusion when your baby doesn't want to latch on and nurse. It is an alternative to using a bottle.

Similar to using a supplemental nursing system, with finger feeding, you simply insert a lactation aid and your finger into your baby's mouth so that your baby sucks on your finger and gets a supplement through the lactation aid. A syringe attached to the other end of the lactation aid can help to push the supplement into your baby's mouth. A lactation consultant can help you with this technique.


Should I Stop Breastfeeding If I Am Sick?

Breastfeeding mothers rarely need to stop breastfeeding when they are sick or taking some drugs and medications. Exceptions include:

  • Certain infections, like HIV; untreated, active tuberculosis (okay to pump); untreated brucellosis; active herpes lesions on the breast (okay to pump); and mothers who are positive for the human T-cell lymphotropic virus type I or II
  • Drugs of abuse
  • Chemotherapy
  • Medications that are dangerous for a breastfeeding baby (find out if there are alternative drugs that you could take instead)

Simply having a cold, fever, stomach bug, or most other illnesses is not a reason to stop breastfeeding your baby. It is much more common to have to stop breastfeeding temporarily because a mother is sick and has to take a medication that is not safe for a breastfeeding baby. In these cases, mothers may want to pump and dump to keep their breast milk supply up.


When Should a Baby Not Breastfeed?

There are very few contraindications to breastfeeding. The main one that exists is having a baby that is diagnosed with classic galactosemia (a rare condition in which the baby cannot digest one of the sugars in breast milk).

While breastfeeding is usually encouraged when kids have a stomach virus, even if they are vomiting, there may be times when your child is hospitalized and so ill that they won't be able to breastfeed. Pump during these times to keep up your milk supply. Once your child is no longer getting intravenous fluids, you should be able to start breastfeeding again.


What Is Breast Compression?

Breast compression is a technique that can help your baby get more milk if they are latched on but not getting enough breast milk. If your baby is not gaining weight well or is falling asleep while eating, breast compression might be a good technique to try.

Make sure that your baby is latched on well. Once it seems that your baby isn't sucking or nursing as well, gently but firmly squeeze your breast and see if the baby starts drinking again. Stop squeezing when they start sucking, wait a little bit, and then do it again. A lactation consultant can help you with this technique and with getting a better latch.


Can Working Mothers Breastfeed?

Yes. You will need a good breast pump, preferably a good quality double electric pump, along with a private area to pump while at work. You will likely need to pump two or three times during your workday. You will also need a place to store pumped breast milk while at work (such as a refrigerator or a small cooler bag).

If you plan to pump at work, talk to your human resources department and review the supports provided by the Affordable Care Act for mothers who breastfeed before going back to work.

In late December 2022, President Biden signed two new bills into law that protect the rights of pregnant workers and nursing parents. The PUMP for Nursing Mothers Act expands on the rights protected in the Affordable Care Act. It requires these rights to be extended to salaried employees, not just hourly employees. The Pregnant Workers Fairness Act (PWFA) requires employers to provide reasonable accommodations to pregnant people. It takes the Pregnancy Discrimination Act one step further, by mandating those reasonable accommodations, like allowing food and drink on the job, and providing seating when necessary.


What Can I Do About People Who Are Unsupportive of Breastfeeding?

It can be challenging to educate those around you who are unsupportive of breastfeeding. Instead, you might need to find other sources of support, such as:

  • A breastfeeding support group
  • A lactation consultant if you need breastfeeding help
  • A pediatrician
  • Peer counselor support and other resources at WIC (if you are eligible)
  • The National Breastfeeding Helpline (800-994-9662)

Should I Try Domperidone to Increase My Milk Supply?

Domperidone is most often prescribed to women who have true, chronic low milk supply. This can be due to hormonal issues, insufficient glandular tissue, or wide breast spacing, among other reasons.

The World Health Organization (WHO) and the U.S. Food and Drug Administration (FDA) warn against the use of domperidone, citing safety concerns about an intravenous form of domperidone that was reportedly linked to cardiac arrhythmias and cardiac arrests. This form of domperidone has been withdrawn from the market.

The FDA also warns that "domperidone is excreted in breast milk, exposing a breastfeeding infant to unknown risks." While many drugs are used off-label for other indications, it is important to note that domperidone is not approved for any use in the United States. Try safer ways to increase your milk supply.


Can I Breastfeed a Toddler?

Why would someone breastfeed a toddler? Another way to look at the question is, Why not? The current guidelines from the American Academy of Pediatrics state that "breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired."


Can I Breastfeed an Adopted Baby?

There are a few ways to breastfeed an adopted baby, including:

  • Getting some or all of your baby's breast milk from a donor milk bank
  • Working with a lactation consultant to induce lactation by pumping regularly, even before you adopt your baby

What Is a Nursing Strike?

A nursing strike happens when your infant temporarily stops nursing and refusing to breastfeed. It might occur when your baby is teething, has a cold, or simply has had a change in routine. Nursing strikes usually only last a few days and are not a sign that a baby is ready to wean or stop breastfeeding.


Can My Baby Be Allergic to My Breast Milk?

Almost certainly not. If a baby has an allergic reaction while drinking breast milk, it could be a reaction to something you have eaten that has passed into your milk.

For example, if your baby has bloody stools, which is often a sign of allergic colitis, a milk protein allergy, it is to the cow's milk proteins you are eating and drinking. These proteins enter your breast milk, causing the reaction. The solution is usually to stop consuming milk and milk products and to continue breastfeeding.

Infants can also have allergic reactions to peanuts and other foods a breastfeeding mother eats, but you would expect the reaction to occur fairly quickly after nursing, typically within minutes to a few hours.


Can I Make Too Much Breast Milk?

Having an oversupply of breast milk isn't a good thing if your breasts become too full and painful. An oversupply of milk can also lead to an overactive let-down reflex.

With an overactive let-down, your baby might have a hard time latching, pull off the breast, or choke or gag while nursing. Sometimes this can lead parents to believe that a baby has reflux. If your overactive let-down is causing any symptoms, work with a lactation consultant to help adjust your milk supply.


What Are Some Common Breastfeeding Myths?

Common breastfeeding myths include:

  • You can't breastfeed if you have inverted nipples. You usually can.
  • You should nurse your baby for 10 minutes on each side. Instead of timing your feedings, nurse until your baby is done and then switch sides. Timed feedings can lead to a foremilk/hindmilk imbalance and a gassy baby.
  • You can't breastfeed if you have had breast surgery. You often can, although you might want to talk to a lactation consultant before your baby is born.
  • You can't breastfeed twins or triplets. You can breastfeed multiples.
  • You shouldn't breastfeed in public. You can and should if it is time to nurse your baby.
  • You can't breastfeed if you are pregnant again. You can.
  • You can't get pregnant if you are breastfeeding. You can.
  • Dads can't help feed if you are breastfeeding. They can and that doesn't have to just mean giving a supplemental bottle of pumped milk or formula. There are other ways for non-breastfeeding partners to help and support their partners who are breastfeeding.
  • You have to eliminate a lot of foods from your diet while you are breastfeeding. You don't.
  • You can't drink coffee or other caffeinated drinks while nursing. You can, but do it in moderation, limiting yourself to two or three cups a day.
  • You can't drink alcohol while nursing. You certainly can't and shouldn't drink any alcohol while you are pregnant, but an occasional drink (not every day) at least two hours before you are going to nurse is probably okay.
  • Breastfeeding at night will lead to cavities once your baby's teeth come in. There is no established link between breastfeeding and cavities.
  • Getting a baby's tongue tie clipped will fix all breastfeeding problems. This procedure can help fix a lot of feeding issues, but not every one.
  • You will have to stop breastfeeding once your baby gets teeth or bites you. You don't.
  • You can't get a flu shot while breastfeeding. You can and you should.

A new myth is that breastfeeding is expensive. It's not and is certainly not more expensive than buying baby formula for a year. The idea comes from a writer who stated that while exclusively breastfeeding her baby for six months, she "spent approximately $2,000 on products and services to make nursing and pumping breast milk easier and less uncomfortable."

However, her expenses included getting her baby's tongue tie clipped. She also rented a hospital grade breast pump and had numerous visits to a doctor who specializes in lactation problems. These are not expenses that the average breastfeeding mother will have.

Nor are all of the "medications and supplements; plus creams, nipple shields and special cooling packs to ease and treat said pain and infections." Many of her other expenses seem a little more reasonable, including "nursing bras and tops that flip down or pull aside for easier access; a nursing smock for modesty in public; reusable and disposable pads to keep milk from leaking at inopportune times; hands-free bras so I could work while pumping milk."

If you are going to compare the expenses of breastfeeding with complications, it should be to formula-feeding with complications. For example, occasionally, a formula-fed baby will need to see a pediatric gastroenterologist and be prescribed a formula that costs $50 a can.

5 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. United States Congress. H.R.3110 - PUMP for Nursing Mothers Act.

  2. United States Congress. H.R.1065 - Pregnant Workers Fairness Act.

  3. U.S. Food and Drug Administration. FDA warns against women using unapproved drug, domperidone, to increase milk production.

  4. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-e841. doi:10.1542/peds.2011-3552

  5. Lavigne V. Breastfeeding and dental caries looking at the evidence. Clin Lactation. 2013;4(1):12-16. doi:10.1891/215805313806998435

By Vincent Iannelli, MD
Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.