Breastfeeding and Breast Milk Storage: Resources and FAQ

Breastfeeding can start as soon as your baby is born. To begin breastfeeding, you need only latch your baby on the breast and let them suckle. We encourage new mothers to latch their baby just after birth when both of you are alert and awake.

To latch your baby, first clean your hands and get into a comfortable position. Align your baby's chest with your stomach and their nose with your nipple. Hold your breast, with four fingers underneath and your thumb on top, to slightly compress it. 

Rub your nipple lightly above your baby's upper lip to promote the rooting response. Wait until your baby's mouth is wide open. Then, aim your nipple toward the roof of your baby's mouth while pulling the baby toward your breast.

While putting them on your breast, support their head. Make sure you can see their nose to ensure they can breathe well. A well-latched baby will have the entire nipple in their mouth, and their lips will curl back, not under.

Most babies nurse at least eight to 12 times in 24 hours, often every two to three hours from the beginning of one nursing session to the start of the next.

Because their tiny stomachs and digestive systems digest breast milk quickly, babies get hungry often, especially during their first few days. They may stay latched and feed for half an hour per side.

Your baby may also cluster feed, meaning they will want to nurse more frequently than usual. Feeding your baby when they are hungry helps establish a healthy milk supply and supports their growth and development. Whenever possible, follow their hunger cues and feed on demand.

Signs that your baby is hungry include:

• Opening their mouth.
• Putting a hand in their mouth.
• Smacking their lips.
• Rooting — moving their head and face against your chest.
• Turning their head from side to side.

Crying is usually a late sign of hunger. Since newborns are sleepy and may not cry much, it is vital to watch for their hunger cues during the first weeks. 

Your baby may not seem hungry during the first few days of life. Pay attention to hunger cues and increase skin-to-skin contact, especially before feeding. Latch your baby to the breast at least every three hours, even if they're not showing hunger signs.

It is also helpful to keep your baby interested and awake during feedings. Massaging and compressing your breast during the feeding may help to increase milk flow and remind the baby to continue sucking. Take off their clothes if they're having trouble staying awake – too many layers may make them warm and sleepy.

Your baby has a good latch when your entire nipple and as much of the areola as possible are in their mouth. Your baby's lips should flange or turn out, and you may hear or see the baby swallowing (once your milk has come in). 

A good latch is not painful; your baby should easily stay on your breast. If it is painful, gently place your finger in your baby's mouth, between their gums, to detach them and try again.

Signs your baby is full include self-detaching from your breast, sucking less vigorously, or becoming sleepy. Once your milk has come in, your breast will also feel less full after feeding. You can offer the other breast to see if your baby is still hungry. 

Burp your baby between breasts and after a feeding to get rid of any air swallowed during feeding. To burp the baby, hold them upright and gently rub and pat their back with your fingertips. Not all babies will burp within the first few days after birth.

You can breastfeed while sick with a cold or mild illness, but it's best to check with your doctor to get an accurate diagnosis.

If your doctor says it's okay to feed your baby and you feel well enough to nurse, go ahead and feed your baby. Wash your hands well and wear a mask to reduce the transmission of a cold or mild virus. Ensure you're well enough not to fall asleep while feeding the baby.

Your doctor may advise you not to breastfeed with certain illnesses or if you take certain medications. You will continue to produce milk even if you don't breastfeed for a few days. To maintain milk production, pump or express your milk every few hours, but discard it if your doctor says baby shouldn't drink it.

You can and should breastfeed your baby if they are sick. Breast milk contains antibodies that can help the baby fight off germs. 

A plugged or clogged milk duct happens when the duct doesn't drain properly. It causes a hard, tender, or sore lump in your breast. To loosen the plug, use warm compresses on your breast and massage the area starting behind the painful spot and moving toward the nipple. Try to breastfeed on the affected side every two hours. 

If it is very painful or red or you develop a fever, call your doctor to rule out mastitis, an infection that may require antibiotics.

If you wish to continue breastfeeding but are away from your baby for work, you can pump and store your breast milk. Emptying your breasts regularly is important to maintaining your milk supply.

Your baby can drink your pumped milk from bottles while you're away. You can feed your baby from your breast whenever you're with them or exclusively pump and feed them bottles.

By law, employers with 50 or more employees must provide moms with babies younger than one year adequate break time and a private place to pump at work. Your health insurance should cover the cost of a breast pump.

Colostrum is the first milk you produce right after birth. It is thick, yellowish, and rich in nutrients your baby needs in the first few hours and days. During the first week of breastfeeding, your body replaces colostrum with breast milk.

Mature breast milk is whiter and thinner and may look like skim milk. It is rich in the nutrients your baby needs to grow and develop.

When you give birth, and the first few days after, your body makes thick, yellow colostrum. The baby only needs a tiny amount of this fluid, so it may not feel like you're making much.

Around day three after birth, you'll start making more mature milk. Your breasts may become engorged (swollen with milk) and may feel hard and painful, making it more harder for the baby to latch and suckle. If the baby can't latch, they won't be able to get milk out.

Work out the engorgement by expressing the milk using massage and a warm compress.

If your baby seems satisfied after eating and is growing well, you're making enough milk. Your baby's nursing also tells your body how much milk to make. The more often you empty your breasts, the more milk you'll produce.

Your child's pediatrician will check the baby's weight at each well-baby visit. As long as their growth is on track, you can assume you are producing plenty of milk.

If you're worried about making enough milk, drink more fluids, eat a healthy diet, and get adequate rest. These are all essential to your milk supply. 

Read your pump's manual to understand how best to use the pump. If your pump is in stimulation or massage mode, use that first for a few minutes to prime your breasts for a milk letdown.

When expressing milk, you don't need to use the highest possible setting. Use the suction setting that's strong enough to express milk but doesn't cause discomfort. Try cycling back to massage mode after a letdown to encourage more milk production.

You may find it helpful to look at a picture of your baby or watch a video on your phone. Expressing some milk by hand for one or two minutes stimulates milk flow before you switch to the pump. Bring snacks to eat and drink to stay hydrated and nourished before, during, and after pumping.

Ensure you take apart and clean all the pump parts with hot, soapy water after pumping.

When you're away from your baby, try to pump as often and around the same time as your baby would nurse. Find a quiet, private place where you can pump without interruption. 

If you're nursing your baby and want to build up your milk supply or a breast milk stash, pump after feeding your baby. If they're sleeping long stretches, try fitting a pump in when they're asleep. Your body makes the most breast milk in the early morning.

Proper breast milk storage is vital for your baby's safety. Always use breast milk storage bags or clean, sterile, food-grade glass or plastic containers. Label each individually and date them. Storing breast milk in small amounts can help reduce waste. Placing storage bags into a glass or plastic container can prevent refrigerator or freezer odors from tainting breast milk.

The CDC's breast milk storage guidelines are as follows:

• Store freshly pumped or expressed breast milk for up to four hours at room temperature (77ºF or lower) or up to four days in the refrigerator.
• Freeze breast milk as soon as possible. Store frozen and use it within six months for a regular freezer, or 12 months for a deep freezer.
• If stored at room temperature, feed your baby thawed, previously frozen breast milk within two hours.
• Fully thawed breast milk lasts up to 24 hours in the refrigerator.
• If your baby doesn't finish a bottle of breast milk, use it within two hours or discard it.

Never refreeze previously frozen, thawed breast milk. Store it in the refrigerator for up to 24 hours. If the last ice crystal has been melted for more than 24 hours, discard it.

Never microwave or boil breast milk. Microwaves can heat unevenly, causing hot spots in the milk that could burn your baby's mouth or throat. Overheating the milk can also damage its protein and antibodies. 

To warm or thaw breast milk, run it under warm tap water or place it in a bowl of warm water. Breast milk separates when stored, so roll the bottle or massage the bag gently between your hands before serving to distribute the contents evenly.

• US Department of Health and Human Services. Office on Women's Health. Breastfeeding.
• Centers for Disease Control and Prevention. Common Questions about Infant Feeding During Emergencies.
• USDA WIC Breastfeeding Support. Breastfeeding Basics.
• La Leche League International. Breastfeeding Info A to Z.