Ask the IBCLC: Top Questions about Breastfeeding
Our resident IBCLC shares answers to the most common breastfeeding questions
As natural as breastfeeding is, it’s also natural to have a lot of questions. Bringing home a new baby is joyous and overwhelming at the same time, but it’s not uncommon for mothers to feel a sense of doubt, wondering if they are doing things right. So as moms new and old start their breastfeeding journey, our Resident IBCLC is here to answer all of your most pressing questions.
Do smaller breasts produce less milk?
No. Size does not reflect a woman’s milk production ability. At the end of a 24-hour period, it is possible for a large-breasted and a small-breasted woman to produce around the same amount of milk. Breast size does, however, reflect the capacity to store milk. Therefore, it is not unusual for a woman with small breasts to have to nurse more frequently, because her milk storage capacity is smaller. A mother’s anatomy matters in that she needs an adequate amount of mammary tissue to make milk; however, breast size is not an indicator of whether or not breastfeeding will be successful.
Can I still breastfeed if I have small nipples?
Yes. Newborns have tiny mouths and the baby needs to latch deeply onto the breast. Obtaining a deep latch may be easier for your newborn than for a baby born to a mother with very large nipples. Sometimes, it’s like a puzzle that with a few minor adjustments can easily be solved. An IBCLC can assess the anatomy of both the mother and the baby, and find ways to fit them together to make breastfeeding effective.
How long am I supposed to breastfeed my baby each session?
Watch your baby, not the clock. Very few conclusions can be drawn based on the length of a breastfeeding session alone. One baby might stay latched to the breast for a long session but transfer a minimal amount of milk; another baby may stay latched only for several minutes and transfer several ounces of milk. Learning your baby’s hunger cues (see below) and the cues that say he is satisfied are a more valuable measure than length of feeding sessions.
When your baby is breastfeeding, watch for sucking and swallowing—it will tell you much more about a feeding session than the clock. If you have concerns about milk transfer and intake, a visit with an IBCLC for feedback throughout a nursing session with a scale to measure milk transfer can be helpful.
Attention well-meaning friends, husbands, mothers-in-law and even pediatricians: This is a hard concept to grasp unless you’ve personally experienced it. Babies nurse for lots of reasons, and hunger is only one of them. Remember: you are his whole world. Your baby might nurse because he needed reminding that you are there. He missed you when you walked away for two seconds. He might need the kind of soothing only nursing with you can provide. He might be slightly uncomfortable, or scared, or lonely, or tired, or hey—he might be hungry. Whatever the reason, he needs you. Nursing is often the answer to all of them.
How do I know if my baby is full and/or getting enough milk?
Start breastfeeding when your newborn shows early signs of hunger cues; crying is a late hunger cue. If you are nursing only when your baby cries, you’re most likely missing his earlier hunger cues. Crying babies have a harder time latching, so if you reach point, take extra steps to help kick-start the process—like soothing first with skin to skin—and then try to breastfeed.
| Newborn Hunger Cues | Newborn Satisfied Cues |
| Stirring | Relaxed posture |
| Waking after sleeping | Slowing down at breast |
| Rooting reflex | Releasing breast |
| Stretching | Asleep |
| Tight arms and fists | Relaxed arms and fists |
| Hands to mouth |
I feel kind of weird and sleepy when I’m breastfeeding. Is that normal?
This is hormonal, and totally normal. The relaxed feeling that surges through you when you nurse is a good sign that the hormones that support lactation are working. Whenever possible, rest and recover while your baby sleeps. This feeling of sleep and relaxation is an often underappreciated benefit of breastfeeding.
What’s the best way to hold/position my baby while breastfeeding?
The best way is a way that makes you feel comfortable and facilitates an effective session. Most mothers gravitate toward the “football hold” and cross cradle in the early weeks. These provide a lot of newborn support and control of the baby’s head and of your breast. Once babies gain head control, other positions may become easier, so it is a good idea to switch it up. As your nursing relationship progresses, and your baby becomes more efficient at latching and nursing, you may find yourself nursing in positions that are not in any book.
How will I know if it’s not going well?
While you are still pregnant, learn all you can. Ask for feedback from IBCLCs, especially in the critical early days and weeks. Seek out supportive medical professionals. Meet other nursing mothers. One of the most valuable resources for a first-time mom who is breastfeeding is another mom who is breastfeeding. If you have a friend or family member you can talk to, ask her what she found helped the most. Watch how effortlessly older babies nurse: all the pillows and positioning of the early weeks are replaced with a baby that is latched before the mother even lifts her shirt. The struggles are real, but they are heavily weighted in the earliest weeks. Hang on, because nursing nearly always gets easier.
Seek out a doctor for your baby who is truly supportive and knowledgeable—not just about lactation, but about the mother/baby breastfeeding relationship. This can be tricky, and you may not know if you’ve found the right one until after a couple of visits. There are lots of medical professionals who will truly support you; don’t stay with a doctor that isn’t a good match for your family.
Pregnant and planning to breastfeed? Please attend a La Leche League meeting. La Leche League welcomes all expectant mothers to their meetings. There is no charge and babies are welcome, too. Attend a La Leche League meeting or two while you are pregnant to talk to and meet other nursing mothers. You’ll be so glad you did.
