As a new mother, feeding your baby, keeping them safe and healthy can feel overwhelming, especially if you’re not getting as much sleep as you used to. If breastfeeding is painful or doesn’t feel like it’s working in the early days, you may think bottle feeding is a better route.

Before you give up on breastfeeding, you should know that with a little help from a lactation specialist, most mothers become successful breastfeeders. I am a certified nurse midwife and lactation consultant–and I’ve coached hundreds of mothers through the breastfeeding process. If you want to breastfeed, with a little help, chances are you can.

This hurts and I’m worried my baby isn’t getting enough nutrition.

When it comes to breastfeeding, a little pain is common, and proper latch technique can put an end to that pain. Once it doesn’t hurt, you can nurse and feel more at ease. Plus, the more you nurse, the more milk you’ll produce.

These days, many families are discharged from the hospital only 24 hours after giving birth. It’s nice to be home in your own bed, but breastfeeding challenges may arise a day or two later when you may not have breastfeeding support.

This is when I encourage new parents to call their birthing provider or the Women, Infant, and Children (WIC) office to ask for a lactation consultation or breastfeeding visit. At Hillside Health Center, our Care for Her Department now offers lactation consultation with an Internationally Board Certified Lactation Consultant (IBCLC) and we have other trained professionals who support lactating moms as well. Through the California Prenatal Screening Program (CPSP), we provide health education for maternal/child health, breastfeeding, lactation, and more.

Why is breast milk so important?

Breast milk not only provides nutrition that evolves to meet your baby’s changing needs, it also boosts your baby’s immune system. The first milk, called colostrum, is like medicine. It coats the infant’s intestinal tract and provides immunity against everything from the common cold to COVID. Research data overwhelmingly shows that people who were breastfed as infants have better health outcomes throughout their lives. So, even if you can only breastfeed for a week, do it!

And here’s a lovely side benefit: breastfeeding reduces the risk of breast cancer for nursing moms. The more mothers breastfeed, the more protection they get.

How long should you breastfeed?

Ideally, it’s great to breastfeed for at least a year. The World Health Organization, the Centers for Disease Prevention and Control, and the American Academy of Pediatrics all recommend breastfeeding. For the first six months of life, breast milk is the only nutrition infants need. Thereafter other foods can be introduced to complement breastfeeding as milk production naturally starts to decline.

In some cases, mothers may need to supplement baby with formula–for example, if there is a delay in the onset of milk production after a cesarean section or if a baby is born prematurely. But generally, breast milk is all babies need. Milk production is based on supply and demand. The more stimulation (emptying of the breast’s milk), the more milk is made. The key is to breastfeed more in the early days. Babies will self-regulate, taking in what they need when they need it, and this determines supply.

How do you know when it’s time to feed?

Newborns need to eat every couple of hours. It’s best to respond to feeding cues early for a happy, healthy baby. When infants first wake up and start looking around, fists in their mouths, sticking their tongues out, and making cooing sounds, they are hungry. Putting them on the breast right away is really important for ease of latch, and keeping them calm and comfortable.

Babies will stop when they’re full. They have very small stomachs, so they’ll need to eat again soon. They may be able to go longer between feedings with formula, but that’s because it’s harder to digest–it’s designed for a cow’s growth and development, not a human’s. Breast milk is designed for a baby’s body and is much easier to digest.

Once the mature milk supply is in (around two weeks), babies are taking in about 24 ounces of breast milk a day (approximately 2 ounces every two hours). As babies develop, breast milk changes. The first milk, colostrum, is high in protein and immunoglobulins. As babies mature, breast milk has higher levels of carbohydrates and fats to help them grow. The milk that your body makes at one month is different from milk you make at four months.

If you need to pump breast milk, try to do so as often as your baby needs to eat to keep up your milk production. If you need a pump, the Mendocino WIC Program offers pumps for people to use. Also, health insurance will cover the cost of a breast pump in most cases.

Final tips

In addition to feeding the baby at the breast during those first two weeks, we recommend at least 60 minutes of skin-to-skin holding each day. This is when you place your diapered baby on your bare chest – dads and other care providers can do this too! Skin-to-skin holding helps to stimulate oxytocin, it encourages bonding, stimulates milk let down, and encourages infant sucking response. It helps to regulate a baby’s body temperature, and heart rate too. Place a blanket over your baby’s back and nuzzle with them. Remember, the first couple of weeks are the hardest, but with the help of a lactation specialist, most mothers can learn to breastfeed comfortably.

Amita Graham is a certified nurse midwife and IBCLC at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental, and behavioral health care to people in Lake and Mendocino Counties.