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Breastfeeding: Embracing Imperfection and Finding Support

By Boulder Medical Center Pediatrics
With assistance from Rebecca Harris, RN, IBCLC (International Board of Lactation Consultants)

Breastfeeding TipsIn August, the U.S. Breastfeeding Committee sponsors National Breastfeeding Month to support families who want to learn more about breastfeeding their babies.

For this article, we have collaborated with Rebecca Harris, a Lactation Consultant, Registered Nurse, and mother of three. With over 20 years of breastfeeding experience, Rebecca possesses an encyclopedic knowledge of all things breastfeeding.

We developed this guide to offer a compassionate, evidence-based, and practical approach to helping parents confidently navigate breastfeeding.

Embracing Imperfection in Breastfeeding

In today’s world, many new parents navigate early feeding experiences without the close, in-person support of extended family or a built-in community. While every family dynamic is unique, it’s common to feel pressure to “get it right,” especially when so much advice is available online and from well-meaning sources. For those used to setting goals and solving problems efficiently, it can be surprising that breastfeeding doesn’t always follow a predictable path. And that’s completely normal.

The most important message to keep in mind: there is no “perfect” way to breastfeed. Every journey is unique, and each parent should be given the space to find what works best for them, without judgment. Whatever path you choose will be right for you, even if it differs from what you originally imagined.

Benefits of Breastfeeding

Breastfeeding offers numerous health benefits for both the baby and the breastfeeding parent:

For babies:

    • Lower risk of asthma, ear infections, Type 1 diabetes, and SIDS
    • Fewer stomach bugs and infections
    • Immune system support through antibodies in breast milk

For parents:

    • Reduced risk of breast and ovarian cancers
    • Lower risk of Type 2 diabetes and high blood pressure

It’s also important to recognize that some parents are unable or choose not to breastfeed, and that’s okay too. Safe, high-quality formulas and donor breast milk are excellent alternatives. Whatever feeding method you select, the goal is to nourish the baby and support the parents’ physical and emotional health.

Building your Support Team

Having a support team makes a world of difference. This may include:

    • A pediatrician or family doctor
    • A certified lactation consultant (IBCLC)
    • Nurses or doulas
    • Trusted friends, partners, or family members

Parents should trust their instincts when it comes to feeding their babies. Every feeding experience is unique—some parents find breastfeeding easy, while others may need to try various methods before discovering what works best for them. Some choose to formula-feed or supplement, prioritizing their mental health in the process. All of these decisions are valid, and prioritizing the well-being of parents is essential for nurturing a thriving baby.

What to Expect in the First Week

Breastfeeding Help Boulder Medical CenterWhen your baby is born—whether in a hospital, birth center, or home—a lactation consultant will visit to help you start breastfeeding. If you’re not offered this service right away, request it. Most hospitals and birth centers have lactation nurses available for follow-up visits after you leave..

Some parents choose to set up an appointment with a lactation nurse before they leave the hospital and continue to see them at least weekly until they feel entirely comfortable with breastfeeding. The Lactation Network is a national organization that contracts with insurance providers to allow breastfeeding parents six free lactation support appointments.

Breast milk typically arrives 3 to 5 days after birth, though it may take longer in some cases. Factors like stress, cesarean delivery, diabetes, or thyroid conditions can contribute to delays.

Babies don’t require large amounts of milk in the first few days of life. They are born with ample glycogen stores in their liver, which help maintain stable blood sugar levels. During the first week, milk volume increases rapidly, often doubling daily.

The table below outlines typical feeding volumes for full-term newborns. These guidelines can be helpful if you’re considering supplementation with pumped breast milk, donor milk, or formula. While supplementation is often unnecessary, it can be a helpful tool when needed, and that’s perfectly okay. Your pediatrician or lactation consultant can help you decide what’s best for your baby and feeding goals.

Average Feeding & Diaper Output (Per Day of Life)

Day Amount per Feeding Wet Diapers Stools
1 2–10 ml 1+ 1+
2 5–15 ml 2+ 1+
3 15–30 ml 3+ 1+
4 30–60 ml 4+ 1+
5 40–60 ml 5+ 1+
6+ 50–60 ml 6+ 1+
    • Notes for intake: 30ml = 1 ounce
    • Notes for output: Between days 2 and 3, baby’s stool changes from black to green, then to yellow, with a yellow “seedy” look by day 5

A Breast Milk-Making Plan

making breast milk - boulder medical center

Breastfeeding plans are adaptable and can change over time. With guidance from a pediatrician or lactation consultant, parents can modify their approach as milk supply and feeding patterns evolve.

    • Skin-to-skin contact helps boost prolactin and oxytocin levels, encouraging milk production and let-down.
    • Breastfeed 8–12+ times per 24 hours, roughly every 0–3 hours.
    • Babies often feed more at night in the first six weeks—this is normal.
    • Cluster feeding around days 2–4 is standard.

Sample Breastfeeding Plan:

The “Triple Feed” Method

Triple feeding may be recommended if:

    • The baby loses more than 10% of birth weight
    • Milk removal from the breast is inefficient
    • The parent is working to build a milk supply

Triple Feed Steps:

  1. Breastfeed every 2–3 hours
  2. Pump for 10–15 minutes afterward
  3. Feed expressed milk to the baby via syringe, cup, or bottle

Record times, lengths of feeds, and the amount of expressed milk you feed to the baby for at least the first two weeks.

Note: To shorten this cycle, have a helper feed your baby the pumped breast milk (from your previous pump session) while you are pumping new fresh milk. Pumped breast milk is safe to store at room temperature for 4 to 6 hours, so sitting on the counter and using it for the next feeding is fine.

Tips for Nipple Pain or Mild Engorgement

    • Visit this website for an overview of mastitis and engorgement.
    • If you can, breastfeed on demand at least every three hours. Try using reverse pressure softening or a little hand expression to help soften the areola, which relieves discomfort and makes it easier for the baby to latch.
    • Watch this video showing reverse pressure softening.
    • If needed for missed feedings or in place of a breastfeeding session, pump your breasts for up to 10 minutes.
    • Give your breast milk to your baby via bottle, a finger feeder, or a cup.

What to Avoid While Breastfeeding

These may negatively affect milk supply:

    • Smoking
    • Caffeine
    • Birth control pills and injections
    • Decongestants, antihistamines
    • Severe weight loss diets
    • Mints, parsley, sage (excessive amounts)

Cleaning Pump Parts

    • Rinse in hot water after use; let air dry away from the kitchen/bathroom
    • Wash thoroughly once daily
    • Do not wash the tubing
    • Between sessions, pump parts can be stored in the fridge to reuse later

Helpful Pumping Accessories

    • Photo of baby, item of baby’s clothing, or the recorded sound of baby crying (these stimulate the milk let-down reflex)
    • Hands-free pumping bra
    • High-quality breast pump or hospital-grade pump with breast milk storage bags
    • Insulated tote with cooler packs to cool, store, and transport breast milk

Storing Breast Milk: The Rule of Fives

A general rule of thumb is that breast milk lasts:

    • Five hours at room temperature
    • Five days in the refrigerator
    • Five months in the freezer

How to Warm Breast Milk

    • Refrigerated milk: Place it in a bowl of warm tap water, adding more warm water if necessary, until the chill is removed. Never microwave breast milk.
    • Frozen milk: To thaw frozen breast milk, use a bowl of warm water, adding more warm water as it cools. You can also thaw frozen milk in the refrigerator. Once the last ice crystals have melted, it should be used within 24 hours. Remember, breast milk should never be refrozen.
    • For convenience, it’s a good idea to store some milk in feeding-size portions, with others in 1-2 ounce increments to defrost as needed.

breastfeeding - boulder medical centerTrusted Breastfeeding Resources

Websites

Recommended Books

    • Happiest Baby on the Block by Harvey Karp, MD (sleep and soothing)
    • Baby411 by Ari Brown and Denise Fields
    • What to Expect the First Year by Heidi Murkoff

Local Breastfeeding Support (Boulder County and Surrounding Areas)

References

    • Diana West, IBCLC, Diane Wiessinger, and Teresa Pitman from La Leche League International. The Womanly Art of Breastfeeding.   July 13, 2010
    • Diana West, IBCLC, and Lisa Marasco, M.A., IBCLC. Making More Milk: The Breastfeeding Guide to Increasing Your Milk Production. November 18, 2019
    • World Health Organization. Breastfeeding. Available at: https://www.who.int/health-topics/breastfeeding (Accessed on December 18, 2020)

Pediatrics at Boulder Medical Center

Boulder Medical Center Pediatrics provides comprehensive, compassionate care for infants, children, and teens. With Boulder, Longmont, Louisville, and Erie clinics, our board-certified pediatricians support families through every stage of development—from newborn care and preventive checkups to illness visits and adolescent health. We’re here to partner with you in your child’s health and well-being.

Learn more and make an appointment

 

Family Medicine, Pediatrics
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