Breastfeeding FAQs: How Much and How Often

Whether you're a new mom or a seasoned parenting pro, breastfeeding often comes with its fair share of questions. Here are answers to some common queries that mothers — new and veteran — may have.

How often should I breastfeed?

Your newborn should be nursing 8-12 times per day for about the first month. If you feel like you're feeding your little one more often than a friend whose baby is formula fed, you might be. Why? Because breast milk digests easier than formula, which means it moves through your baby's digestive system faster and, therefore, your baby is hungry more often.

Frequent feedings also will help stimulate your milk production during the first few weeks. By 1 to 2 months of age, a breastfed baby will probably nurse 7-9 times a day.

Before your milk supply is established, breastfeeding should be "on demand" (when your baby is hungry), which is generally every 1½ to 3 hours. As newborns get older, they'll nurse less often, and may develop a more reliable schedule. Some might feed every 90 minutes, whereas others might go 2 or 3 hours between feedings. Newborns should not go more than about 4 hours without feeding, even overnight.

Are feeding intervals counted from the time my baby starts or stops nursing?

You count the length between feedings from the time when your baby begins to nurse — rather than when he or she ends — to when your little one starts nursing again. In other words, when your doctor asks how often your baby is feeding, you can say "about every 2 hours" if your first feeding started at 6 a.m. and the next feeding was at around 8 a.m., then 10 a.m., and so on.

This means that, especially at first, you may feel like you're nursing around the clock, which is completely normal. Soon enough, you'll both be on a more routine, predictable schedule.

How can I tell when my baby's ready to eat?

It's usually recommended that moms feed a newborn whenever the baby seems hungry. But crying is a late sign of hunger. So try to feed before your baby gets so hungry that he or she gets really upset and becomes difficult to calm down.

It's also important, however, to realize that every time your baby cries it is not necessarily because of hunger. Sometimes babies just need to be cuddled or changed. Or they could be overstimulated, bored, or too hot or too cold.

Signs that babies are hungry include:

• moving their heads from side to side
• opening their mouths
• sticking out their tongues
• placing their hands and fists to their mouths
• puckering their lips as if to suck
• nuzzling again their mothers' breasts
• showing the rooting reflex (when a baby moves its mouth in the direction of something that's stroking or touching its cheek)

Watch for signs that your baby is full (slow, uninterested sucking; turning away from the breast or bottle) and stop the feeding when you see them.

How long does it take to nurse?

That depends on both you and your baby and many other factors, such as whether:

• your milk supply has come in completely
• your let-down reflex (which causes milk to flow from the nipple) is immediate or takes a few minutes into the feeding to start
• your milk flow is slow or fast
• you're positioning your baby correctly on your breast
• your baby tends to get right down to business or dawdles a bit
• your baby is sleepy or easily distracted (which can be the case in older babies, especially)

How long babies nurse also depends on their age. As babies get older, they become more efficient, so they may take about 5-10 minutes on each side, whereas newborns may feed for up to 20 minutes on each breast.

Make sure your baby is latched on correctly from the beginning to ensure the most productive feeding possible. It's important that your baby nurses with a wide-open mouth and takes as much as possible of your areola in his or her mouth (not just the tip of the nipple).

But be sure to call your doctor if you're concerned about the length of your baby's feedings — whether they seem too short or too long.

How often should I alternate breasts?

To keep up your milk supply in both breasts — and prevent painful engorgement in one — it's important to alternate breasts and try to give each one the same amount of nursing time throughout the day. Again, that amount of time differs for every baby and every woman — some babies may be satisfied after 5 minutes on each breast, others may need 10 or 15 minutes on each side.

Some experts recommend switching breasts in the middle of each feeding and alternating which breast you offer first for each feeding. Can't remember on which breast your baby last nursed? Some women find it helpful to attach a subtle reminder — a safety pin or small ribbon — to their bra straps indicating which breast they last nursed on so they'll know to start with that breast at the next feeding. Or, keep a notebook handy to keep track of how your baby feeds.

Your baby may seem to prefer both breasts with each feeding and may be doing well. Or, your little one may like to nurse on just one breast with each feeding. Whichever way you choose, it's important for you to do whatever works and is the most comfortable for you and your baby.

How often should I burp my baby during feedings?

Let your baby breastfeed at one breast then switch to the other side. Try burping your baby when switching breasts and at the end of the feed. Often, the movement alone can be enough to cause a baby to burp.

As your milk comes in and your baby has established good latch-on, you can try burping as often as you think helps your baby. Some infants need more burping, others less, and it can vary from feeding to feeding depending on what the mother has been eating.

If your baby spits up a lot, you may need to try burping more frequently. While it's normal for infants to "spit up" a small amount after eating or during burping, a baby should not vomit after feeding. Vomiting after every feeding may be a problem that needs medical attention. If you have concerns that your baby is spitting up too much, call your doctor.

How can I tell if my baby's eating enough?

New mothers, especially breastfeeding moms, are often concerned that their infants may not be getting enough to eat. You can be assured that your baby is getting enough to eat if he or she:

• seems satisfied and content after eating
• produces about 4-6 wet diapers a day
• has regular bowel movements
• sleeps well
• is alert when awake
• is gaining weight

Your baby may not be getting enough to eat if he or she:

• does not appear to be satisfied after feeding
• seems hungry often
• isn't making several wet and soiled diapers a day
• is fussy or cries a lot
• isn't gaining weight

If you're concerned that your baby isn't getting enough to eat, call your doctor. Breastfed infants should also be seen by their doctor 24 to 48 hours after a mother and newborn leave the hospital. During this visit, the baby will be weighed and examined, and the mother's breastfeeding technique can be evaluated. It's also an opportunity for nursing mothers to ask questions.

Even if a breastfed baby is doing well, the doctor probably will schedule another visit for when the baby is around 2 weeks old. These postnatal checkups can help you be sure that your baby is gaining weight and getting enough nutrients.

For your own peace of mind, it can help to keep a notebook or first-week breastfeeding log to write down each time your baby feeds, how long the baby fed on each breast, and each time the baby stools (poops) or makes a wet diaper.

If you're concerned or notice any signs that your infant isn't getting enough nutrients, call your baby's doctor.

What should my newborn's diapers look like?

Your baby's diapers are excellent indicators of whether your breastfed baby is getting what he or she needs. Because colostrum (the first milk your newborn gets) is concentrated, your baby may have only one or two wet diapers in the first 24 hours.

Your newborn's stools (or poop) will be thick and tarry at first and become more greenish-yellow as your milk comes in, which is usually about 3 or 4 days after birth. The more your baby nurses, the more dirty (or "soiled") diapers he or she will have; but it may be just one a day in the first days after birth.

After 3 to 4 days, here are some signs you should look for:

• six or more wet diapers per day, with clear or very pale urine. Fewer diapers or darker urine may mean your baby's not getting enough to drink. If you see orange crystals in a wet diaper, contact your baby's doctor. They're common in healthy, well-fed babies and usually not a cause for concern, but sometimes can be a sign that a baby isn't getting enough fluids.
• four or more yellow, seedy bowel movements per day, usually one after each feeding. After about a month, though, breastfed babies usually have fewer bowel movements and many may go a few days without pooping.

My baby wants to nurse for comfort. Is this OK?

If your baby seems to be getting enough milk, but continues to suck longer than usual, he or she might be nursing for comfort rather than for nourishment. So, how do you know? Once your baby has fed vigorously, he or she may stay on your breast but show these signs of non-nutritive sucking:

• seems satisfied
• moves the jaws but stops sucking and swallowing
• plays with your nipple

Early on, it's OK to let your baby nurse for comfort, but it can become a problem as your little one gets older because he or she may need to nurse to take a nap or go to bed at night. So, at some point you may want to wean your baby off of sucking for comfort and make breastfeeding sessions only about nourishment.

Instead of nursing, you might offer your baby his or her thumb or hand to suck on. You also could give your little one a pacifier if your child doesn't seem to be hungry. Because pacifiers are associated with a lower risk of sudden infant death syndrome (SIDS), experts now recommend letting babies go to sleep with a pacifier. But only do this after breastfeeding is well established (usually after 1 month).

If possible, also hold off on introducing a bottle until breastfeeding is well established. Some babies have "nipple confusion," though the likelihood of this happening is much less after 4 to 6 weeks.

My baby is hungrier than usual. Is this normal?

As babies gain weight, they should begin to eat more at each feeding and go longer between feedings. Still, there may be times when your little one seems hungrier than usual.

Your baby may be going through a period of rapid growth (called a growth spurt). These can happen at any time, but in the early months growth spurts often occur at around:

• 7 to 14 days old
• 2 months
• 4 months
• 6 months

During these times and whenever your baby seems especially hungry, follow his or her hunger cues. You may need to temporarily increase the frequency of feedings.