While breastfeeding has many benefits for newborns, many moms struggle with it. The amount of information involved with the process can be overwhelming – from knowing how to properly store breast milk to whether baby is getting enough milk from breastfeeding. We hope that you, and the rest of our mom community, find clarity in UCHealth lactation consultant Kezia’s response to your questions. Breastfeeding can be hard. But, that doesn’t mean you have to do it alone.
Q: “I am going back to work and have started pumping my breast milk. How long can I keep it at room temperature? In the refrigerator? In the freezer? And can I reuse leftover breast milk? Thanks!”
A: My easy answer is that breast milk is good at room temperature for four hours, in the refrigerator for four days, the freezer for four months. Once you defrost breast milk in the refrigerator overnight then it is good for 24 hours. After you have warmed the bottle/the bottle has touched baby’s lips it’s good for one hour.
The technical answer is:
Freshly pumped milk – room temperature (up to 77 degrees) 6-8 hours.
Refrigerator – (39 degrees) up to five days
Freezer – attached to a refrigerator (0 degrees) 3-6 months
Deep Freeze (free standing freezer) (-4 degrees) 6-12 months
Q: “Any thoughts on the circumstances surrounding the death of an infant from dehydration that was highlighted in this highly circulated article?”
A: I can’t think of a greater tragedy than the death of a child, you can feel the pain of this mother in her words. Supporting new mothers and families to breastfeed their babies and promoting breastfeeding is not wrong. Women need compassion and education to ensure that they are making fully informed decisions when feeding their babies. Ignoring the evidence that breastfeeding is biologically more beneficial to mothers and their babies are not helpful. I prefer to respond to new mother’s fears with compassion and love not judgment.
Q: “I feel like cold and flu bugs are everywhere! Is it true that breastfeeding could help keep baby and me healthy? I’d love to stop worrying about everyone around me hacking up a lung.”
A: Breast milk is a truly remarkable substance that offers babies much more than food. There are many protective properties within breast milk that shield babies from infections. The protective properties work in many different ways. The immunities that it offers is dose dependent – the more milk baby gets the better the immunity. So if you are exclusively breastfeeding your baby, they are getting the most benefits. The best protection from infection and illness for you is handwashing.
Q: “Can you explain how long alcohol stays in your system? Mama’s gone a long time without some wine, but with in-laws coming with their disapproving glances, I want to know all the facts! (I’m not a big drinker and never have been, so I would be practicing moderation too.)”
A: Breastfeeding is not a reason to completely abstain from alcohol. Good for you for wanting to do it responsibly. Always nurse your baby before you have a drink. Your breast milk alcohol level rises at about the same rate as your blood alcohol level. So if you feel tipsy or drunk you should not breast feed your baby. A good rule of thumb is that it takes two hours for one drink (12-ounce beer, four ounces of wine and one 30 ml shot) to be out of your breastmilk. More than 2 drinks in 4 hours and you should pump and dump.
Q: “Can I breastfeed if I’m not large breasted?”
A: Yes! Large breasts are not an indication that you will make a lot of milk and small breasts do not mean that you won’t make enough milk. The old adage that size doesn’t matter pertains here. There are rare times that your anatomy puts you at risk for a low milk supply. It’s estimated that only 1 percent of mothers experience this. If you have concerns, make an appointment with an International Board Certified Lactation Consultant before you deliver your baby to have an assessment of your risk factors and breasts.
Q: “How often should I breastfeed? How will I know whether my baby is getting enough milk?”
A: Typical newborns will nurse every 1.5-2.5 hours for 20 minutes, for a total of 8-10 times a day. There are many ways to tell that your baby is getting enough milk. First ask your baby – does your baby show signs when they are hungry, do they seem satisfied after they are fed and burped? Do your breasts feel firm before feedings and softer after? Are you hearing the baby swallow when at the breast? Or, as I call it, drinking/gulping at the breast? Babies less than 6 months of age should have at least six wet diapers a day and three stools every day. Your baby should also be gaining weight about one ounce a day. Your baby’s pediatrician will be the person to alert you to any weight concerns. Any time you are concerned about your baby’s breast milk intake schedule an appointment with a lactation consultant and they can help you assess if baby is getting enough.
Q: “Is it okay to buy a used pump? My doctor said yes, but then a nurse told me no, because some pumps allow the milk to get into the pump which can’t be sterilized. So, is it okay to buy a used pump?”
A: Maybe, some breast pumps are designed to be single-user pumps (for use by only one person). Some breast pumps are designed to be used by multiple people. I would research the brand and the manufacturer’s recommendations before purchasing a used breast pump.
Q: “My preemie is having a tough time latching and getting enough to eat. What can I do to help him?”
A: There are many ways to help and support a preemie baby with latching. I always recommend first establishing a good milk supply. Begin with pumping your breasts frequently to bring your milk in and to maintain your supply. Preemies require time and patience before they are developmentally ready to be fed from the breast exclusively. I would recommend scheduling a one-on-one consultation with a lactation specialist for tips tailored to your situation and baby.
Q: “With my first two children, my milk dried up. With my first one I’m certain it was because I was pregnant with my second child, but with my second baby my milk dried up around eight months. What are your comment tips for helping your milk to not dry up?”
A: There is so much pressure on moms to: lose the baby weight, go back to work at six, eight, 12 weeks after delivery, have our babies sleep through the night by a month of age, etc. When a Mom calls me and says that she’s losing her milk supply my first question is; are you eating enough? 1,800 calories a day? Drinking enough water? Two liters or more a day? Sleeping enough? It is not unreasonable to nap once a day. I frequently find that Moms take care of themselves last and their milk supply can suffer. My other suggestion is to nurse your baby frequently. Babies go to the breast for nourishment and comfort. If you are gone all day and your baby wakes up frequently at night to nurse, you may take it as a sign that your milk supply has gone down when really baby is saying that they miss you and want to be close to you. Finally, call a lactation consultant — someone from the La Leche League or a friend who has breastfed, and ask is this behavior normal or is it a supply issue?
Q: “I successfully nursed three babies, approximately 18 months each. My son – now nine months old – suckled as an infant, but had a “low suck” problem. He would nurse 30 minutes-plus and still only transfer about one ounce. I visited several lactation consultants, rented a hospital-grade pump to make sure my supply was adequate, and explored tongue and lip tie possibilities with a pediatric dentist. From birth to two months, I triple fed (nursed, pumped, bottle fed), and finally decided (for time sake and sanity with three other kids), to exclusively pump and have continued to do so. Have you run into the low suck problem before? What is your protocol for addressing such a problem?”
A: Oh, sweet mama, it sounds like you have been through the ringer working to nurse this baby of yours. You are so dedicated! I would have suggested the same things that you’ve done to solve this problem and the only other suggestion I have is a referral to a feeding clinic for a physical therapist or occupational therapist to further assess the baby.
Q: “How can a mama best prepare to breastfeed for the first time?”
A: Education! Classes, videos, books. Read and watch anything about breastfeeding you can get your hands on. I have a friend who says women go to classes to learn about labor and delivery, which is only one day out of your whole life and skip the breastfeeding classes which you will do for a minimum of 365 days.
Q: “I had my baby via C-section and seem to have a low supply of breast milk. While I am more than willing to supplement if needed, I would like to find ways to try to increase my production. Any suggestions? Does regular pumping really help? Thank you!”
A: When a mom calls me and says that she has a low milk supply my first question is; are you eating enough? 1,800 calories a day? Drinking enough water? Two liters or more a day? Sleeping enough? It is not unreasonable to nap once a day. I frequently find that moms take care of themselves last (or not at all) and their milk supply can suffer. Yes, regular pumping should help increase your milk supply. Before you start supplementing or pumping, schedule an appointment with a lactation specialist to determine if you truly have a low supply.
Q: “What are the best grab-and-go snacks for a new breastfeeding mother? I am thinking of gifting a friend with a breastfeeding goody basket.)”
A: You are such a sweet friend! Nuts and dried fruits are great healthy options for breastfeeding mothers. A few low sugar/high protein granola/energy bars are a good option and fresh fruit that she can grab and eat while nursing will help her keep her energy up.
Q: “I was able to nurse my son for a year, which was awesome! But, I was always afraid he wasn’t getting enough. I had tons of milk at first, but he got on a schedule super quickly and then it never felt like I had enough of a supply, which I think was exacerbated by the fact that he’s always been small (about 1 percent for weight). He was always very happy after feedings and is healthy as can be, so as I prepare to begin this process again with baby #2, I just want to see if there’s a way to tell if I’m producing enough.”
A: If you nursed a baby for a full year then you did make enough milk. The second time that you breastfeed a baby your milk should come in sooner and more plentiful than it did the first time. To feel reassured, ask yourself these questions:
Does your baby show signs when they are hungry? Does he or she seem satisfied after being fed and burped?
Do your breasts feel firm before feedings and softer after? Are you hearing the baby swallow when at the breast? Or, as I call it, drinking/gulping at the breast?
Babies less than six months of age should have at least six wet diapers a day and three stools every day. Your baby should also be gaining weight about one ounce a day. Your baby’s pediatrician will be the person to alert you to any weight concerns. Any time you are concerned about your baby’s breast milk intake schedule an appointment with a lactation consultant and they can help you assess if baby is getting enough.
Q: “My daughter is one year old, and hasn’t really let up on breastfeeding, but I’d like to start weaning her… What’s the best way to go about doing this? She’s kind of all over the place when it comes to her schedule.”
A: There is no one-size-fits-all approach to weaning. The best method is the one that works for you and your daughter.
Don’t offer, don’t refuse: This method involves not offering to nurse but also not refusing your child’s expressed desire to nurse. Many moms move into this naturally as their child gets older.
To actively wean your baby: Drop one feeding every 3-7 days. Some moms drop one feeding a week. This allows your milk supply to decrease slowly, without fullness and discomfort.
Choose the feeding that is the least important one for your baby, then you can approach it in a couple of different ways. You can either offer a sippy cup (or snack/distraction) instead of nursing, or begin shortening that particular nursing session.
Some additional weaning tips…
Try to anticipate when your child may want to nurse and plan to distract him or offer a substitution in place of nursing. A snack, a game, a playdate with a friend, an outing, a walk outside, playtime outside, a favorite book, etc. can all be effective with this method. You are more likely to be successful with this plan if you can employ it before your child indicates a need to nurse.
Change in routine or schedule
If your child typically wants to nurse more when you are at home, try to be out and about more during the weaning process. If he seems to need to nurse more when you are out and he is away from all that’s familiar, try to stay close to home as much as you can while you wean. If sitting down in a certain chair cues him to nurse, try to avoid doing that, or anything else that may remind him of nursing.
When your child asks to nurse, say: “Not now, later.” Sometimes later never comes as he gets too busy with everything else. He also learns that he can wait a while.
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About Kezia Hagiwara, RN, LCCE, IBCLC
Kezia is a lactation consultant and labor and delivery nurse at UCHealth – Memorial Hospital. She has been a nurse since 2004, working exclusively in OB/GYN starting out with postpartum patients and then transitioning to labor and delivery. Kezia is a Lamaze Certified Childbirth Educator and has her international board certification as a lactation consultant. She is also working on her master’s degree to become a family nurse practitioner.