Expert Q&A: Tips for Successful Breastfeeding
An interview with Laurel Schultz, MD.
What do you suggest if your newborn is really sleepy? Should mothers wake babies up to breastfeed them?
It depends on how old the baby is. I tell new parents that every day is
different, and my advice changes every day.
On the first day of life, I tell parents not to worry if their baby sleeps.
The usual pattern with a newborn is to nurse a little right after birth and
then go to sleep -- sometimes for 24 hours.
After that, my advice depends on how much weight your baby has lost. If the
baby has lost a lot of weight, I encourage parents to be more aggressive. If
the baby is still really sleepy by the second or third day of life, when the
mother's milk in, I advise the mom to get the baby undressed and feed her or
him tummy against tummy. You have to get the baby out of the swaddle.
After those first few days, if a baby is really sleepy and has lost more
than 10% of its body weight, we advise supplementation: baby formula or pumped
breast milk. New parents often resist giving their baby formula, but at that
point I really start to push because it's a medical issue. Usually, after a
couple of days, the baby's weight is back up, and we can stop
How can you tell if your baby is getting enough milk?
I judge that by keeping an eye on the baby's weight.
When do you recommend that parents introduce bottle-feeding? And is nipple confusion a real problem?
I recommend that parents start a bottle between 21 and 28 days. It's a
mistake to wait too long after that, or you may have trouble getting your baby
to accept a bottle at all.
I encourage new parents to introduce a bottle. I think it's great for dads
to have an opportunity to feed the baby and for moms to get a break, and for
parents to be able to have a date night, so they can nourish their
relationship. When I advise parents to introduce a bottle, I often turn to the
dad and say, "Wouldn't you like to have a chance to feed you baby?"
They always say, "Yes."
Nipple confusion is actually pretty uncommon. Only a small percentage of
babies have it. Having said that, you don't want to introduce a bottle too soon
in case your baby is part of that small percentage that do have nipple
In my experience, it's usually the parents who give up nursing, not the
child, because the bottle can be such a convenience. Once they see how
convenient it is, it can be a slippery slope if parents aren't really clear
about what they want. Parents have to be committed to breastfeeding to keep it