Breastfeeding Basics

Calories and expressing milk

Still Eating for Two: the Nursing Diet

To maintain your milk supply, avoid dehydration, and get the nutrients you and your baby need, you need to eat and drink more (and more carefully) while nursing than you usually do. Follow these guidelines:

• Eat 500 more calories a day than you normally would.
• Maintain a well-balanced diet, high in protein.
• Avoid very spicy foods, which may give your baby an upset stomach.
• Drink plenty of fluids (between two and three quarts a day). Fluids with caffeine or alcohol, both of which dehydrate the body, don't count-and in fact require additional fluid supplementation.
• Drink extra milk or take calcium supplements to up your calcium intake.
• Drink little or no alcohol.
• Ask your doctor whether you should take iron or vitamin supplements.

As long as you are still eating for two, these dietary guidelines will keep you-and your baby-thriving.

Pumping Up: Expressing Breast Milk

Some breastfeeding mothers find it convenient to "express" milk from their breasts between feedings. Expressing your milk allows you to store your breast milk for later bottle feedings. You can maintain your baby's primary or exclusive diet of breast milk and still manage to take a break while other caregivers feed her.

You can express breast milk manually or with a manual breast pump. (Many women find the suction of electric breast pumps painfully strong.) Whichever you choose, you will want a quiet, private, relaxing place to do it. No matter how comfortable you feel breastfeeding with other people around, expressing milk will definitely not be something you want to do in public. So if you have returned to work and want to continue feeding your child primarily breast milk, ask your employer whether it's possible to arrange for the time (one or two 20-minute breaks) and space (ideally a quiet room) you need to express your milk.

To express milk by hand:

1. Cup one breast in both hands with your thumbs on top.
2. Massage your breast with gentle but firm squeezes to stimulate the flow of milk. Start with the outer part of your breast, and then massage closer to your areola. After placing the thumb and fingers of one hand near the areola, press them gently and rhythmically against your ribs. This pumping action should stimulate a flow of milk.
3. Continue pumping for about five minutes, collecting the breast milk in a bowl or small pitcher. Then start all over again with the other breast.
4. Continue expressing milk until the flow slows down from a stream to drops.

To express milk using a manual pump:

1. Place the funnel-shaped shield over your nipple.
2. Rhythmically squeeze and release the handle to create a vacuum that should draw out a flow of milk and transfer it directly into a bottle. If the pump is painful or doesn't seem to work, try another kind. Not all pumps work alike.

Whether using your hands or a pump, it may help stimulate the flow of milk if you first take a warm bath or shower or place a warm washcloth over your breast. Whichever method you use, stop and try again later if expressing your milk causes any pain. It should be a painless procedure.

As soon as you have finished, put the milk into a sterile jar or bottle and seal it to keep it germ-free. Refrigerate or freeze it immediately so that it won't spoil. (Breast milk lasts up to 24 hours in a refrigerator; frozen milk lasts up to six months.) When you need a bottle, thaw or warm the milk by running it under warm water or letting it sit in a pan of warm water.