2. My milk looks thin and watery. Is it all right?

A. The breast milk at the beginning of a feed is called “Foremilk”.
It contains more water to quench the baby’s thirst and has less fat. As the baby feeds the milk begins to change and becomes thicker and more full of fat. This change in the milk we call the “Hind milk” because it occurs toward the end of a feed. A baby needs both for a complete feed. So it is important for the infant to empty one side before he is switched to the other side. Only breast milk has this incredible ability to change as the needs of the baby change.

A mother will know when her baby has finished the first breast when he lets go by himself or falls asleep. Then she can burp him if necessary and offer the other breast, which he may or may not take.

3. My baby is one month old and breastfeeding. I am worried because he is not gaining weight very well and is very fussy. I was told to only nurse for 20 minutes per feed and so I am very careful to only nurse for 10 minutes on each side. What should I do?

A. If the baby is fussy, suffers gassiness, green stools and has poor weight gain even though the mother seems to have a plentiful supply of milk it could be a sign that the problem is “foremilk - hind milk imbalance”. This happens sometimes when a baby receives too much of the watery lactose rich foremilk and not enough of the fatty high calorie hind milk. Too much lactose stimulates the baby’s digestive tract to move the milk along too fast causing watery green stool.
Breastfeeding should never be timed. The baby should be allowed to empty the first breast before trying to switch to the second. Most often a baby will be satisfied with only one side for a full feed.

4. My baby is passing frequent loose stools. Do I need to worry?
A. An exclusively breastfed baby sometimes passes frequent loose stools. It is normal. But if the baby is bottle fed with artificial baby milk you should consult your doctor.

5: I need to have some dental work done, and I can’t bear to think of doing it without some kind of pain relief. Is there a safe numbing agent for a breastfeeding mom?

A: Most dentists use only local anesthetic for minor dental work. This leaves your body very quickly and only a very tiny amount gets into the milk.

6: I know it is not safe to have a x-ray taken while you are pregnant, but is it all right to have a dental x-ray while you are breastfeeding? My dentist said it was ok, but I am still worried.

A: Your milk will not be affected by a dental x-ray. You can breast feed as usual as soon as your dental appointment is over.

7: I have heard that breast milk does not cause cavities like formula does. My 6 month old breastfeeding baby is starting to get her teeth. Is there anything I should do to take care of my baby’s teeth as they come in?

A: The chance for healthy smiles depends on their parents starting mouth care early. I have three concerns to discuss.

First is mouth cleaning. Some parents may want to start right at birth by using a water-dampened cloth to wipe their infants’ gum pads, tongue, and other soft tissues. Once teeth appear, you should continue mouth cleaning with a soft toothbrush or a clean cloth especially before bed. If you are providing daily mouth cleansing and not overusing bottles, I suggest avoiding fluoride toothpaste until your baby’s molars appear.

Second, some parents know that tooth decay can happen with on demand bottle-feeding, but most parents do not realize that baby teeth can suffer decay with breastfeeding. Research suggests that human breast milk is not as cariogenic (decay producing) as cow’s milk ; however, breast milk can support tooth decay as other foods rich in sugars and starches are common parts of an infant or toddler diet. It is the frequency of nursing (or any feeding of sugars and starches) that is the key risk to tooth decay. Therefore, if you nurse your baby on demand, and especially if your baby sleeps with you and can nurse on demand, the risk for decay increases. I would suggest that you do mouth wiping more frequently and especially before bed if you nurse your baby on demand once teeth first appear.

Third, parents, especially the primary caregiver (usually mom), must know that if they have tooth decay and bleeding gums, the germs that cause these problems will be passed in their saliva to their infants or toddlers. This happens through normal activities of child-care (i.e. sharing spoons, their hands to your mouth, kissing their hands, etc).

So it is very important that not only mom clean here children’s mouth and teach a healthy routine, but it is just as important that mother see the dentist for herself and make sure her own teeth and gums are healthy.
Mouth care for your infant is about love and bonding and is an investment in your baby's health and future.

8. When should I start giving my baby solid foods?

A. Solid foods are not recommended for infants until sometime around the middle of the first year. Prior to that time, an infant's digestive system is not mature enough to digest foods other than human milk adequately.
The American Academy of Pediatrics says, "Babies don't need other foods in their diet until somewhere in the middle of the first year of life." This statement is very useful, because it doesn't say your baby needs other food at some specific age. You can let your baby be your guide. And babies will tell you when they are ready for solids, somewhere between 6 and 12 months.
Watch for these signs of readiness for solids:
• increased nursing that continues for more than a few days and is unrelated to illness or teething;
• increased interest in table food while others are eating;
• the ability to sit up; absence of the tongue-thrusting reflex so that baby does not push solids out of his mouth;
• And an ability to pick up food and put it in his mouth.
Sometimes when you take a bite of food, the baby's eyes follow your fork from the time it leaves your plate until it's in your mouth. Or if the baby is on someone's lap, he reaches for food on your plate, puts it in his mouth, and quickly does it again. There is a time around three or four months when a baby gets really good at grabbing things, but after it goes into the baby's mouth, he really isn't interested in eating it.
Also keep in mind that four months is the bare minimum age at which your baby might be ready for a taste of solid food.

It's much more common for a baby to be ready for solids later in his first year. If you are a first time mother, you may be eager to try it. Your own mother and friends may also be excited to help, or discuss it with you. You may be looking forward to this new stage in your baby's life, but there's a chance your baby won't be ready for solids until eight or ten months, or even later. Rest assured that your milk is still meeting all your baby's nutritional needs at this time.

When your baby does start other foods, remember to breastfeed first and then offer solids. Also, a baby doesn't need large quantities, just a teaspoon or so to start. Other foods still aren't as good for your baby as human milk during the first year, so you're just trying to get baby used to other tastes and textures. Mashed banana is an easy food to start. When you start feeding your baby solids, introduce only one new food at a time, and wait a week before trying each new food. This way you can watch for any signs of allergic reaction (such as rashes, hives, wheezing, or diarrhea). Foods that commonly can be allergenic include cow's milk, eggs (especially the whites), citrus fruits, peanuts, wheat, and corn.

9. My doctor told me that I must give my newborn baby formula until my milk comes in. But I have a friend who said this is not true. Who should I believe?

A. Most often the most highly skilled doctor may not have had Lactation Management training. Formula producers have managed to remove this training from even the very best medical and nursing schools. So lets look at the facts. Even though you might not notice the colostrums, your body is making it. Think of it as pure gold. Colostrum is highly concentrated so even the tiniest drop packs enough nutrients for your babies needs. Colostrum lasts about 3 or4 days until your mature milk comes in.
Most babies normally lose a little bit of weight right after birth. As long as the baby is not dehydrated and her weight goes back up by the second week, you can be assured that she is gaining properly. To insure a good supply of colostrum and mature milk when it comes in, let the baby suckle whenever she is awake and willing.

10. I was told that I must stop breastfeeding at nine months or I would never be able to get the baby to stop. The doctor says I have to switch to a bottle for the baby’s sake.

A. You and your baby are the only ones who should work out the right time for you both to cut down and stop breastfeeding. This should be done gradually. There are no hard and fast rules about the timing and it will not hurt your baby to continue breastfeeding even after you have introduced other foods, if you both want to do so. Weaning should be a gradual process of less and less feeds and as more foods and drinks are given. The only measure is the health and well being of your infant and yourself. It would also be much better to go from breastfeeding to a cup and spoon than to ever introduce the bottle.

11. My friends tell me that if I breastfeed my baby I will never get any sleep at night.
I don’t want to be tired all the time, so what should I do?

A. Breast milk is the perfect nutrition for your baby and unlike formula the baby’s body easily and quickly digests it. This is why a breastfed baby may wake up more often at night or throughout the day than a baby who is formula fed with a bottle. It can take up to eight hours for a baby to digest formula. This does not mean that the baby is doing well or is happier, he sleeps long periods so that his body can spend all its energy trying to deal with the formula. It is true that lack of sleep is the hardest thing any new parent has to deal with when you have a child. Unlike bottle-feeding, once you and your baby are breastfeeding well, you do not have to be fully awake during a feed. Have your baby sleep near you and take him into bed when he cries, feed lying in your side and fall back to sleep. Both of you will rest better together.

12. I want to breastfeed, but I don’t want to wait to start dieting. What will happen if I just start dieting right away after the baby is born?

A. It is very important for mothers to try to eat a balanced diet for both the baby and for the mother. In women who are terribly malnourished the production of milk drops and there is less milk available to the baby. This fact that there is a relationship between a healthy diet and the amount of milk that a mothers body makes should serve as a warning to women who don’t take the time to eat right or who go on crash diets while breastfeeding. It is important to go slowly. Breastfeeding mothers should not do anything about weight loss the first two months after they have given birth. Their bodies need time to recover and to establish a good milk supply. Most breastfeeding mothers will lose weight naturally just by following a normal diet. If after two months, a mother has not lost weight she should simply increase her activity and cut back on the calories.

13. I never remember to drink water. I am expecting a baby next month. My friend says that I can’t breastfeed if I don’t drink water all the time. Is that true?

A. Water is the most abundant and the most important nutrient in the body. It is responsible for and involved in almost every body process. A pregnant or nursing mother needs to consume more water than usual to supply her infant with adequate fluids for the babies’ body to function well. A woman should respond to her natural increase in thirst by drinking enough to satisfy that thirst. During both pregnancy and while breastfeeding; a mother needs at least six to eight glasses of fluid a day. Some women find it easier to remember if they have a drink every time they feed the baby.Learn to listen to your body and have drink whenever you are thirsty. Try to drink water so that you don’t take in unnecessary calories from sweet drinks.


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