Feeding your baby is one of the most personal decisions you’ll make — and there’s no one right way to do it. Whether you’re planning to breastfeed, pump, combo feed or formula feed, you deserve support and reliable information. Maya Bunik, MD, leads Children’s Hospital Colorado’s Breastfeeding Management Clinic and has worked with breastfeeding parent and baby pairs for more than 25 years, and she’s publishing her fifth edition book on breastfeeding advice for medical providers. Dr. Bunik addresses some of the most common questions new parents have about breastfeeding.

Getting started with breastfeeding

The benefits of breastfeeding extend beyond just nourishment for your baby, and it’s OK if the breastfeeding relationship does not come naturally right away. In fact, that’s very common.

What are the benefits of breastfeeding?

Breastfeeding can offer many benefits — for both babies and parents. Breastmilk contains nearly all the nutrients your baby needs and provides antibodies that help protect against infections. Breastmilk also adapts to your baby’s needs as they change and grow. It can help prevent respiratory and gastrointestinal infections, as well as chronic diseases such as Type 1 diabetes, obesity, inflammatory bowel diseases, asthma, allergies and certain childhood cancers. Even a small amount of breastmilk can provide these benefits, whether through chestfeeding or pumped milk and bottle feeding.

"The main benefit of breastfeeding lies in the live cells in breastmilk. No formula so far has been able to reproduce this even with adding probiotics," Dr. Bunik says.

For lactating parents, breastfeeding can support postpartum healing and may lower the risk of cancers — such as ovarian and breast cancer — and cardiovascular disease. .

How long do you recommend breastfeeding your child for?

The American Academy of Pediatrics recommends exclusive breastfeeding for about the first six months of your child’s life, then continuing breastfeeding alongside solid foods for up to two years or longer — as long as it works for both you and your child.

Is it normal for breastfeeding to be hard at first?

Absolutely. Breastfeeding is a learned skill for both you and your baby. It can take time, practice and support. Many parents find that the early days are the toughest — but it often gets easier with time and the right help. Dr. Bunik’s main advice is to get help early and often. Breastfeeding is established in the first three weeks of life, and support from a lactation consultant can help get you and your baby on the right track. Whether it’s your first time breastfeeding a child or you have previous experience, every journey will be unique.

What to expect in the first few weeks

The first three weeks of your baby’s life are the most crucial to establishing a successful breastfeeding relationship. Here’s what you can expect right away.

How often should I feed my baby?

Newborns typically feed eight to12 times in a 24-hour period. That can feel like a lot, but remember that they were feeding constantly from the umbilical cord inside, their stomachs are tiny and they digest breastmilk quickly. A full feeding should last no more than 30 minutes, and you’ll want to offer both sides of your chest each time you feed, especially in the early stages. Your baby might not feed as long on the second side, and that’s OK. Start your next feed on that side, so you have a chance to fully empty that side to keep up with milk production. Continue to alternate like this with each feed as the day goes on.

How do I know if my baby is getting enough milk?

Dr. Bunik says one of the most common reasons parents come to see her is concerns that the amount of milk they are making is not enough. She says if your baby is having regular stool patterns and settling easily after a feeding, that’s a good sign. If you still have concerns, lactation specialist or a visit to our clinic here can help you with a weighted feed, where they weigh the baby before and after a feeding and analyze the volume of milk consumed.

You want the baby to be actively suckling while they are latched, not pausing a lot or doing a trickle or fluttery feed. Dr. Bunik compares active suckling to the frequency of popping microwave popcorn. The pulls should be quick, consistent and active.

Is cluster feeding normal?

Cluster feeding is when the baby wants to feed more frequently than expected. It can feel exhausting, but it’s a natural way for your baby to boost your milk supply. Cluster feeding is very normal, especially in the evening hours during the first few weeks of life and with intermittent growth spurts in the early months.

Common breastfeeding challenges and questions

Breastfeeding is a new skill that you and your baby are learning together. It is normal and expected for challenges to arise, especially at first. Here are some of the most common questions and challenges.

What do I do if I feel engorged or have a plugged duct?

Engorgement is the feeling of fullness and pain when milk transitions from the early colostrum (thick, yellow milk your body starts to produce at the end of pregnancy) to the full-volume milk over the first week after birth. This is normal. If engorgement happens later in your breastfeeding journey, it’s typically because the baby hasn’t emptied the breast after a feeding. This could be from a shallow latch or the baby not actively feeding at the breast. You can use cold compresses, cabbage leaves or ice packs to help relieve discomfort, along with over-the-counter pain medicine. Using a pump after feeding to fully empty your chest will help relieve the feeling of being engorged.

Addressing plugged ducts early is important. A back-end of a toothbrush or a heated massager can help break up the milk, especially if you use it while you are pumping or feeding. Plugged ducts tend to come and go and can be a normal part of the breastfeeding experience.

What is mastitis?

Mastitis is swelling and redness of the breast tissue. It can start out as inflammation and  can result in an infection. It can also be accompanied by a fever, chills and generally feeling sick. If you suspect you have mastitis, consult your care team, because you may require an antibiotic.

What is a tongue tie?

A tongue tie (also known as ankyloglossia) is a condition where the short, tight stretch of tissue under the baby’s tongue tethers the tongue to the floor of the mouth, sometimes restricting its movement. In some cases, this can interfere with the breastfeeding latch. It’s important to get any tongue tie concern addressed with a pediatric ENT professional. In some cases, your baby might need a quick procedure to resolve this issue. Talk with your child’s pediatrician if you are concerned and want your child to be evaluated.

How can I increase my milk supply?

The best way to make more milk is to remove more milk — either by feeding your baby more often or adding pumping sessions. Every parent’s body is different, so what works for one might not work for another.

When should I start pumping?

There’s no one-size-fits-all answer. Some parents start pumping right away due to NICU stays or latch challenges, while others wait a few weeks until breastfeeding is established. Talk with your care team to decide what makes sense for your situation.

Is it OK to only pump and not nurse?

Yes, exclusive pumping is a valid and loving way to feed your baby. It might take some planning and routine, but many families make it work. Consider using a high-quality breast pump as your primary pump as they are the most effective. Wearable pumps can help make pumping more convenient if you are on the go, but usually shouldn’t be used as your main pump.

Do I need to have a big freezer stash of breastmilk?

No, you do not need to have a big freezer stash of extra pumped breastmilk, but having a comfortable amount saved in case you need be away from your baby can be helpful. If you are looking to start saving some extra frozen breastmilk, you can consider adding a pump session in the morning an hour after your first feed when your milk production is at the highest point of the day.

Having some saved milk can help ease some stress if your baby will be starting daycare, since you will have to send your child with enough milk for the following day. Daycares are required to follow state guidelines about storing, labeling and using breastmilk. Connect with your child’s childcare location to understand the rules and requirements regarding breastmilk. 

Can I still get pregnant while breastfeeding?

Yes, it is still possible to get pregnant while breastfeeding. You can start ovulating anytime and then your period will return. For some people this could be a few months postpartum, while for others, menstruation may not return until after weaning.

Is it OK to drink alcohol or smoke marijuana while breastfeeding?

There have been several studies are breastfeeding and alcohol indicating that if the alcohol is out of your blood stream, it’s also out of your breastmilk. If you have a drink right after you feed your baby, it should be fine to feed your baby two hours later.

“If you want to have more than one drink at a wedding or on New Year’s Eve, you should probably pump and dump that milk until you’re feeling normal again the next morning,” Bunik says.

Generally, marijuana use should be completely avoided while breastfeeding. A recent study Children's Hospital Colorado was part of found that THC was still present in breastmilk six weeks after using marijuana, longer than previously thought.

When should I ask for help?

Ask for help anytime you feel confused, uncomfortable or worried. A lactation specialist or your pediatrician can help with latch issues, pain, supply concerns or they can talk through what’s going on with you. You should not wait until things feel bad to get support.

How can a lactation specialist support my breastfeeding journey?

If you are struggling, it’s best to connect with a trusted expert. Meeting with a lactation specialist early can be an invaluable resource in your breastfeeding journey. They can provide personalized support for you and your baby to help you navigate any challenges you are experiencing. Check with your baby’s primary care provider or OBGYN to see if they have a lactation specialist  on staff, or Dr. Bunik shares that at Children’s Colorado’s Breastfeeding Management Clinic, patients can schedule a 45-minute appointment to have an expert evaluate the baby’s mouth and latch and do a weighed feed.

Call the team at Children’s Hospital Colorado at 720-777-3605 for more information.

Feeding your baby isn’t always easy, and it might not go exactly as planned. Be gentle with yourself, ask for help when you need it, and remember, you know what’s best for your baby and your family.