An Easy Guide to

Breastfeeding for

African American

Women

U.S. Department of Health and Human Services,

Office on Women’s Health
An Easy Guide to

Breastfeeding for

African American

Women and Their

Families

This guide is a supportive tool for African American

women and their families who choose to breastfeed.
Dear Reader, 

This Guide is to support you and your family with breastfeeding so you

can succeed in every stage. It will help you learn that breastfeeding is a

very special way to give your baby the best start at life. We know that our

children are our future, and breast milk can give them a head start in their

lives. Yet, we sometimes find it hard to get the breastfeeding help we

need, and we might feel discouraged. This Guide can help you breastfeed

despite every day challenges.

You will learn about:

● benefits of breastfeeding for baby, mom, dad, and society 

● why it’s important to promote breastfeeding in the African American

community

● tips to get off to a good start and for breastfeeding success

● answers to the most common breastfeeding questions and challenges

● where to go for help

● breastfeeding questions to ask your health care provider

This booklet, the 1-800-994-9662 toll-free number, and the 

www.womenshealth.gov web site are designed to help you feel 

confident in your decision to breastfeed.

Wanda K. Jones, Dr.P.H.

Deputy Assistant Secretary for Health (Women’s Health)

U.S. Department of Health and Human Services

Director of the Office on Women’s Health

Katherine M. Barber, CLEC

Executive Director

African American Breastfeeding Alliance, Inc.

for African American Women 1
Babies were born to be breastfed.

For your baby

Breastfeeding is best for your

baby because:

● recent studies show that

babies who are exclusively

breastfed for 6 months are

less likely to develop ear

infections, diarrhea, and

respiratory illnesses. They

may also be less likely to

develop childhood obesity.

● breast milk has just the

right amount of fat, sugar,

water, and protein that is

needed for a baby’s growth 

● most babies find breast

milk easier to digest than

formula

● most babies are not allergic to the protein in breast milk because it is

a baby’s natural food

● premature babies are healthier when they are breastfed 

2 Easy Guide to Breastfeeding...
For Mom

Breastfeeding is best for you because:

● it delays the return of the menstrual cycle

● breastfeeding mothers return to their pre-pregnancy weight faster

● it helps the uterus to get back to its original size more quickly and

lessens any bleeding you may have after giving birth

● it reduces the chances of getting ovarian and pre-menopausal breast

cancer

● it creates a strong mother/child bond

● breastfeeding mothers have more self-esteem

For Dad

Breastfeeding is best for you because:

● it saves time and it’s free — it can save the family budget hundreds

of dollars

● you can enjoy the beauty of breastfeeding by simply sitting with

mom and baby to enjoy the special mood that breastfeeding creates

● you can still help to care for your baby by giving him or her a bottle

of pumped breast milk

For society 

Breastfeeding is best for society because:

● it saves on healthcare costs

● it adds to a more productive workforce since breastfeeding moms

often need less time off to care for sick babies

● it creates a healthier society

for African American Women 3
Why is breastfeeding important for 

African American women?

Nursing mothers and most health

care providers agree that the benefits

of breastfeeding are endless. Sadly,

millions of African American parents don’t take advantage of this

form of infant nutrition. The breastfeeding rates of African American

women are much lower than those

of Whites and Latinas. In fact, only

19% of African American women

breastfeed by the time their babies

are 6 months old. African American

teenage mothers are even less likely

to breastfeed. A hundred years ago, African women in America practiced a

tradition of breastfeeding. This tradition should not be forgotten.

Why are breastfeeding rates among African American

women so low? What can we do about it?

● Breastfeeding is not seen as “normal” in our community. But, what

could be more normal and natural than breastfeeding?

● Breastfeeding is thought to be painful. But, if it’s done the right way,

breastfeeding will not cause pain — it will bring joy.

● Our community is based on kinship. Our decision to breastfeed is

directly linked to influence from our peers, which includes a husband

or boyfriend, mother, grandmother, friend, or relative. It has been

found that we are very likely to breastfeed if our husband supports it.

So, we need to do more to help men understand breastfeeding.

4 Easy Guide to Breastfeeding...
● We don’t have access to helpful breastfeeding information. We often

go through an entire pregnancy without getting any information on

breastfeeding. Learning the benefits of breastfeeding should be a

standard part of prenatal care.

● We are not given a choice about how we want to feed our babies. We

are overloaded with coupons, samples, and booklets from infant formula companies.

● There are only a few booklets, posters, and other materials that show

pictures of us breastfeeding our babies. But, there are many materials

that show White women and Latinas breastfeeding. This lack of culturally sensitive images has helped support a belief that breastfeeding

is no longer a part of our culture.

Breastfeeding can be easy...

Here’s what you can do: 

● Get good prenatal care

to help assure that you

carry your baby to term

so he/she won’t need

special care.

● Before you give birth,

tell your health care

provider about any 

previous breast surgery

or injury. If your nipples

appear flat or inverted

(pulled inward), ask if it

will affect how your

baby latches on.

● Once you and your baby get started, breastfeeding can be easy.

Breastfeeding is natural, but you, your body, and the baby may need

time to get adjusted.

for African American Women 5
● Breastfeeding is not painful,

although your nipples may be

more sensitive at first. Ask for help

if it is painful for you.

● Even though you might have to

return to work even earlier than

you would like, and think you do

not have a place to pump your

milk to give to your baby when

you are together again, you can

find ways to make breastfeeding

work. This Guide will explain

things you can do.

● Being a mother is a new journey

with each baby. It is normal to

worry a little and wonder. If you

have questions or concerns, call us at 1-800-994-9662 (English and

Spanish Breastfeeding Helpline) or go to your health care provider.

Ask your health care provider to refer you to a lactation consultant.

Lactation consultants should be available at the hospital where your

baby was born but you may have to ask for someone who is trained

in breastfeeding to come and assist you while you are in the hospital.

How long you should breastfeed...

One of the best things that only you can do is to breastfeed your baby for

as long as possible. The longer a mom and baby breastfeeds, the greater

the benefits are for both mom and baby. Babies should be fed with breast

milk only — no formula — for the first 6 months of life. Ideally, though,

babies should receive breast milk through the first year of life. Solid foods

can be introduced, while you continue to breastfeed, when your baby is 6

months old.

6 Easy Guide to Breastfeeding...
Tips to get off to a good start...

● While you are pregnant, tell your health

care provider that you

want to breastfeed.

● Ask other women in

your community who

breastfed to share their

stories.

● After the birth of your

baby, you are excited

and exhausted at the same time. You also might be anxious about

whether your baby will catch on to breastfeeding. You might think

breastfeeding is difficult or wonder if your baby is getting enough

milk. Many new mothers have lots of questions. But with a little support and practice, breastfeeding can be a wonderful experience that

will make you feel very special and close to your baby.

● It’s important not to get frustrated if you are having problems. It is

important to seek out the breastfeeding help that is around you. What

works for one mother and baby may not work for you, so just focus

on finding a comfortable routine and positions for you and your baby. 

● Most breastfeeding counselors recommend avoiding bottle nipples

and pacifiers for about the first month because they may get in the

way of your baby learning to breastfeed. After you and your baby

have learned to breastfeed well, you can begin giving your baby your

expressed breast milk in a bottle.

● Your baby’s weight will be checked at the one week and two week

visits at the pediatrician. Both of these visits are important. If you

have any questions or are concerned about the baby’s weight, you

can go back for a weight check more often.

for African American Women 7
Here’s what will happen with you, your baby, and your

milk in the first few weeks:

8 Easy Guide to Breastfeeding...

Birth

First 12-24

hours

Milk

Your body makes

colostrum, a rich,

thick, yellowish

milk and in small

amounts. It gives

your baby a

healthy dose of

early protection

against diseases.

Your baby will

drink about 1 teaspoon of

colostrum at each

feeding. You may

not see the

colostrum, but it

has what the baby

needs and in the

right amount.

The Baby

Your baby will probably be

awake in the first hour

after birth and this is a

good time for him or her

to breastfeed.

It is normal for the baby

to sleep heavily. Labor

and delivery are hard

work for the baby. Some

babies like to nuzzle and

may be too sleepy to latch

on well at first. Feedings

may be short and not regular. As your baby wakes

up, he or she will have a

strong instinct to suck and

feed every 1-2 hours.

Many babies like to suck

or lick, pause, savor, doze,

then suck again. Ask the

nurses not to give your

baby any formula or water

unless needed for medical

reasons.

You (the mom)

You will be tired

and excited. This

is a good time to

feed the baby.

You will be tired

too. Rest and get

to know your baby.

Your breasts may

be a little tender

at first. If breastfeeding hurts, ask

for help from

someone who

knows about 

helping breastfeeding mothers.

Breastfeeding

should not hurt.

If you want to learn more about breastfeeding, or need

help with breastfeeding problems, call our Breastfeeding

Helpline (in English or Spanish) at 1-800-994-9662. 

We’re here for you, 9AM – 6PM EST!
How to hold your baby when you breastfeed... 

1. Support your breast with your thumb on top and four fingers underneath. Keep your fingers behind the areola (the darker skin around

the nipple). You may need to support your breast during the whole

feeding, especially in the early days or if your breasts are large.

2. Tickle the baby’s lip with your nipple to help get the baby’s mouth to

open wide.

for African American Women 9

Day 2-5

First 4-6

weeks

Milk

Your mature white

milk comes in. It is

normal for it to be

yellow or golden

at first.

Your milk may look

bluish-white at the

begining of a feeding and creamy

white towards the

end of a feeding.

The Baby

Your baby will feed a lot

(this helps your breasts

make plenty of milk), at

least 8-12 times or more

in 24 hours. Breastfed

babies don’t eat on a

schedule. Since breast

milk is more easily digested than formula, and your

baby’s stomach is little,

lots of feedings are normal. It is okay if your baby

eats every 1-2 hours.

Feedings will probably

take about 15-20 minutes

on each side, but all

babies are different. The

baby’s sucking rhythm will

be slow and long. You

might hear gulping.

Your baby will likely be

better at breastfeeding

and have a larger stomach to hold more milk.

Feedings may take less

time and will be farther

apart. 

You (the mom)

Your breasts will

feel full and may

leak. (You can use

disposable or cloth

pads in your bra to

absorb the milk). If

your breasts

become swollen

and hard, remove a

little milk from your

breasts before

feeding your baby.

Between feedings,

use ice packs to

reduce swelling

which will go away

in 1-2 days.

Breastfeeding your

baby helps reduce

swelling.

Your body gets used

to breastfeeding so

your breasts will be

softer and the leaking will slow down.

Don’t worry. The

milk is still there.
3. Hug the baby in close with his or her whole body facing yours. Your

baby will take a mouthful of all of the nipple and most of the areola.

The baby should never be latched onto the nipple only.

4. Look for both of your baby’s lips to be turned

out (not tucked in or under) and relaxed — if

you can’t tell if the lower lip is out, press gently

on the lower chin to pull the lower lip out. The

tongue should be cupped under your breast.

5. You may see your baby’s jaw move back and

forth and hear low-pitched swallowing noises.

Your baby’s nose and chin may touch against your breast, but he/she

is getting enough air. Breastfeeding should not hurt. If it hurts,

take the baby off of your breast and try again. The baby may not

be latched on right. Break your baby’s suction to your breast by gently placing your finger in the corner of his/her mouth.

Breastfeeding Positions

Here are some positions in which you can hold your baby while breastfeeding. You can choose the one(s) that you and your baby feel most comfortable in. No matter which one you choose, make sure your baby’s

mouth is near your nipple and he or she doesn’t have to turn his or her

head to breastfeed. For most positions, your baby should be on his her side

with his or her whole body facing yours. This helps him/her to properly

“latch on” to the nipple. Try using pillows under your arms, elbows, neck

or back, or under the baby for support.

10 Easy Guide to Breastfeeding...
1. Cradle Hold: This is a commonly used position

that is comfortable for most mothers. Hold your

baby with his or her head on your forearm and his

or her whole body facing yours.

2. Cross Cradle or Transitional Hold: This is

good for premature babies or babies who are having problems latching on. Hold your baby along

the opposite arm from the breast you are using.

Support baby’s head with the palm of your hand at

the base of his or her head.

3. Clutch or “Football” Hold: Good for mothers

with large breasts or inverted nipples. Hold your

baby at your side, lying on his or her back, with his

or her head at the level of your nipple. Support

baby’s head with the palm of your hand at the base

of his or her head.

4. Side-Lying Position: This allows mothers to

rest or sleep while baby nurses. Good for mothers

who have had a cesarean birth. Lie on your side

with baby facing you. Pull baby close and guide

his or her mouth to your nipple.

for African American Women 11
Tips for breastfeeding success...

● Nurse on demand. Newborns need to nurse often, at least every 2

hours (the time from the beginning of one session to the next), and

not on a strict schedule. This stimulates your breasts to make plenty

of milk. Since breast milk is more easily digested than formula,

breastfed babies eat more often than bottle-fed babies. Babies nurse

less often as they get older and start solid foods. Watch your baby,

not the clock, for signs of hunger, such as being more alert or active,

mouthing (putting hands or fists to mouth and making sucking

motion with mouth), or rooting (turning head in search of nipple).

Crying is a late sign of hunger. Feed your baby only breast milk

for at least the first six months. Nursing babies don’t need water,

sugar water, or formula. Giving other liquids lowers the baby’s intake

of vitamins from breast milk. 

● Delay artificial nipples (bottle nipples and pacifiers). Most breastfeeding counselors recommend not using bottle nipples or pacifiers

for about the first month because they may interfere with your baby’s

ability to learn to breastfeed. After you and your baby have learned to

breastfeed well, you can give your baby some pumped breast milk in

a bottle or a pacifier. 

● Breastfeed your sick baby during and after illness. Many times,

sick babies will refuse to eat but will keep breastfeeding. Breast milk

will give your baby needed nutrients and prevent dehydration. 

● Air dry your nipples. This can help keep them from cracking, which

can lead to infection. If your nipples crack, coat them with breast

milk or lanolin to help them heal. You don’t have to wash your nipples with soap. This might remove helpful natural oils. 

● Watch for infection. Signs of breast infection include fever, irritation, painful lumps, and redness in the breast. You need to see a

health care provider right away if you have any of these symptoms. 

● Treat engorgement. It is normal for your breasts to become larger,

heavier, and a little tender when they start making lots of milk. But

12 Easy Guide to Breastfeeding...
sometimes, this normal fullness may turn into engorgement, when

your breasts might become hard and painful. Treat it by feeding the

baby often. You also can put warm, wet washcloths on your breasts

or take warm baths to relieve pain. If the engorgement is severe,

placing ice packs on the breasts between nursings may help. You can

help prevent engorgement by positioning your baby right, and making sure he/she is latched on well and breastfeeds often. Talk with a

health care provider if you continue to have problems. 

● Eat right and get enough rest. You now need a

healthy diet that includes 500 extra calories a day

(about 2700 calories total) and try to drink at

least eight cups of water per day to avoid dehydration. If you are on a strict vegetarian diet, you

should talk with your health care provider about

whether you need to increase your vitamin B12

intake. You also need to rest as much as you can,

so you stay strong and healthy and can care for

your baby. Breast infections also are worsened

by being very tired. 

for African American Women 13
Your breastfeeding questions answered...

What is colostrum? 

In the beginning, your breasts contain special thick, yellowish milk called

colostrum. Even though it seems like only a small amount of milk, there is

enough to make your baby feel full. No other fluid comes close to being

as good for your baby in the early days. Colostrum is special because it

contains a lot of antibodies, which protect your baby from infection and

from getting very sick. Colostrum also has a high amount of protein and is

very easy for your baby to digest. As the days go by, and your mature

(white) breast milk comes in, your baby still receives antibodies to fight

infection.

How do I know my baby is getting enough milk?

In the first few days, when you’re in the hospital your baby should stay

with you in your room if there are no problems with the delivery or with

your baby’s health. The baby will be sleepy. Don’t expect the baby to

wake you up when he or she is hungry. You

will have to wake the baby every 1 to 2 hours

to feed him or her. At first you will be feeding

your baby colostrum. In the beginning, you can

expect your baby to lose some weight. This is

very normal and is not from breastfeeding. As

long as the baby doesn’t lose more than 7 to

10% of his or her birth weight during the first

three to five days, he is getting enough to eat.

You can tell your baby is getting enough milk by keeping track of the

number of wet and dirty diapers. In the first few days, when your milk is

low in volume and high in nutrients, your baby will have only 1 or 2 wet

diapers a day. After your milk supply has increased, your baby should

have 5 to 6 wet diapers and 3 to 4 dirty diapers every day. Consult your

pediatrician if you are concerned about your baby’s weight gain.

14 Easy Guide to Breastfeeding...
This chart shows the minimum amount of diapers for healthy, fullterm babies. It is fine if your baby has more.

After you and your baby go home from

the hospital, your baby still needs to eat

about every 1 to 2 hours and should need

several diaper changes. You still may

need to wake your baby to feed him or

her because babies are usually sleepy for

the first month. If you are having a hard

time waking your baby, you can try

undressing or wiping his or her face with a cool washcloth. As your milk

comes in after the baby is born, there will be more and more diaper

changes. The baby’s stools will become runny, yellowish, and may have

little white bumpy “seeds.”

You can feel good that your baby is getting enough to eat because your

breasts will know how much milk your baby needs. If your baby needs to

eat more or more often, your breasts will increase the amount of milk they

produce. To keep up your milk supply when you give bottles of pumped

breast milk for feedings, pump your milk when your baby gets the bottle.

for African American Women 15

Baby’s Age Wet Diapers Dirty Diaper’s Color and Texture

Day 1 (birth) 1 Thick, tarry and black 

Day 2 2 Thick, tarry and black 

Day 3 3 Greenish yellow 

Day 4 (or when milk increases) 5-6 Greenish yellow 

Day 5 5-6 Seedy, watery mustard color 

Day 6 5-6 Seedy, watery mustard color 

Day 7 5-6 Seedy, watery mustard color
Why does my

baby want to eat

so often?

It is normal and important for new babies to

breastfeed often. Your

milk is the perfect

match for what your

baby needs. It is easily

digested and your

baby’s stomach is

small, so your baby needs to “refill” often. After the first few weeks, your

baby will be better at breastfeeding and will have a larger stomach to hold

more. Feedings will spread out and begin to take less time. Staying close

to your baby in the beginning helps you and your baby to learn together.

When it is time for a growth spurt, your baby will eat more often. Growth

spurts happen about every 2 weeks in the beginning, and then less often as

the baby gets older. Remember, extra feedings tell your body to make

more milk for your growing baby.

Can I breastfeed if my breasts are small?

Of course! Breast size is not related to the ability to produce milk for a

baby. Breast size is determined by the amount of fatty tissue in the breast,

not by the amount of milk. Most women, with all sizes of breasts, can

make enough milk for their babies.

Can I breastfeed if my nipples are too big, too small, too

short, or inverted?

Of course! The type of nipples you have are not as important as how you

get your baby to latch on for breastfeeding. For breastfeeding, your baby

does not latch on only to the nipple. The proper way to latch your baby on

to your breast is to make sure his or her lips are around the areola (the

darker area around the nipple) as much as possible. As long as rubber or

16 Easy Guide to Breastfeeding...
artificial nipples are not given to your baby in the first 4 weeks, he or she

will likely adjust to whatever size and shape nipple you have. If you have

concerns about your nipples, consult a breastfeeding specialist or lactation

consultant since inverted or flat nipples can sometimes get in the way with

breastfeeding in the beginning. Let your midwife, nurse, or doctor know

that you want to breastfeed, and try to do it within the first hour after birth

(if your baby has no complications). When introduced to your breast soon

after birth, your baby will naturally know your nipples and breast, remember them, and will feel comfortable with them.

Will breastfeeding change the shape of my breasts?

When you breastfeed, your breasts are naturally larger and fuller because

they are making plenty of milk for your baby. After you wean your baby,

your breasts may return to your pre-pregnancy size or sometimes a little

bigger than that size. If you notice that your breasts sag more than they

did before you got pregnant, this is natural too. But sagging breasts are not

caused by breastfeeding alone. They can be caused by many different factors, such as aging, gravity, and stretching of the skin from pregnancy.

Does breastfeeding hurt?

Some mothers at first have some tenderness that disappears as the days go

by. Breastfeeding shouldn’t hurt once that tenderness has passed. Your

breasts and nipples are designed to deliver milk to your baby. When your

baby is breastfeeding the right way, it should be calming and comfortable

for both of you. If breastfeeding becomes painful, seek help from a breastfeeding specialist or a lactation consultant.

After the initial tenderness, breastfeeding should not hurt. If your baby is

latched on and positioned properly, you should not feel pain. The baby’s

mouth should be wide open, with as much of the areola as far back into

his/her mouth as possible. This reduces the chance of soreness for you.

The baby should not nurse on the nipple only. If you feel pain, the baby is

not latched onto your breast properly. You can loosen the baby’s suction

by inserting your finger gently into the corner of his or her mouth and then

re-positioning the baby on your breast.

for African American Women 17
What if I have sore nipples?

Once you are sure the latch and position are okay, try these tips:

● Start feeding on the least sore side first and try a different position

with each feeding.

● Try putting a little breast milk or

lanolin on the sore nipple and let it

air dry.

● Don’t tug if clothing or bra pads

stick to your nipples. Wet clothing

or pads before gently peeling 

them off.

● If sore nipples start after the first 3 weeks, ask your baby’s doctor to

check your baby for thrush. Thrush is a fungal infection that grows

quickly in warm, damp places. If you or your baby has thrush, both

you and your baby need to be treated at the same time. Be sure to see

your health care provider for your treatment.

What about lumps in my breast?

Lumps are common with early breastfeeding. As your body gets used to

the milk being there, the lumps will likely go away. If the lump stays for

more than a day or is uncomfortable, it might be a plugged milk duct. Use

a heat pack before feeding, massage the lump and offer the side with the

lump first. Breastfeed on that side often. It is important to also rest. In 1 or

2 days, the lump or plugged duct should go away. If it does not, see your

health care provider.

Once in a while, a plugged duct can become a breast infection (mastitis).

A breast infection will make you feel like you have the flu and give you a

fever. Call your health care provider. He or she will prescribe antibiotics

and you should feel much better in 1 or 2 days. You can still breastfeed

while being treated for a breast infection. Be sure to use heat packs and

massage the area, breastfeed often, and rest.

18 Easy Guide to Breastfeeding...
My breasts are full,

hard, painful and my

baby can’t latch. What

is wrong?

It is normal for your breasts to

become larger, heavier, and a

little tender when they start

making lots of milk. But

sometimes, this normal fullness may turn into engorgement, when your breasts might

become hard and painful.

Treat it by feeding the baby

often. You also can put warm, wet washcloths on your breasts or take

warm baths to relieve pain. If the engorgement is severe, placing ice packs

on the breasts between nursings may help. You can help prevent engorgement by positioning your baby right, and making sure he or she is latched

on well and breastfeeds often. Talk with a health care provider if you continue to have problems, especially if you get a fever.

What is jaundice? Why does it happen?

Jaundice is a health problem in which there is extra bilirubin stored in the

baby’s body tissues and blood. Bilirubin is an orange-yellowish pigment

that comes from the body’s process of breaking down extra blood cells.

All babies’ bodies break down extra red blood cells after being born as

part of getting used to life outside the womb. The liver gets rid of extra

bilirubin, but many times a newborn’s liver cannot get rid of it as fast as it

is made. Jaundice is common in babies during the first weeks after birth

— about half of all newborns appear jaundiced (the whites of the eyes and

skin have a yellow cast) during this time. Therefore, this kind of jaundice

is called “normal” or “physiologic jaundice.” In most cases, it is harmless

and the baby does not need treatment. It will usually go away by itself in 2

to 3 weeks.

for African American Women 19
If you are told that your baby needs treatment for jaundice, you might

become very worried. Some doctors suggest feeding a jaundiced baby

with formula for a couple of days, but this is not needed. Breastfed babies

tend to have higher bilirubin levels, but breastfeeding itself does not cause

jaundice. In fact, frequent breastfeeding will help lower bilirubin levels

since it leaves the body in the baby’s stools. So breastfeeding can be part

of your baby’s treatment plan. Tell your doctor that breastfeeding is important to you. Your doctor might treat the baby with phototherapy, or putting

your baby under special lights to speed up getting rid of the bilirubin.

If your baby is jaundiced and sleepy, you should wake your baby for

breastfeeding. High bilirubin levels can make babies more sleepy. So, frequent breastfeeding will help prevent your baby from losing weight too. 

If you go home from the hospital and your baby still looks jaundiced after

2 to 3 weeks of age, talk with your baby’s doctor about other tests your

baby might need.

Can I breastfeed if I have to

go back to work or school?

Yes! You can do it! Breastfeeding

keeps you connected to your baby,

even when you are away. Many

places of work are willing to set up

special rooms for mothers who

pump. After you have your baby,

try to take as much time off as you

can, since it will help you get used

to breastfeeding and also reduce

the number of months you may

need to pump your milk while you

are at work. 

If you plan to have your baby take a bottle of expressed breast milk while

you are at work, you should start giving your baby to a bottle close to 4

weeks old. Otherwise, the baby might not accept the bottle later on. Once

20 Easy Guide to Breastfeeding...
your baby is comfortable taking a bottle, it is a good idea to have dad or

another family member offer a bottle of pumped breast milk on a regular

basis so the baby stays in practice.

Let your employer and/or human resources manager know that you plan to

keep breastfeeding once you return to work. Before you return to work, or

even before you have your baby, start talking with your employer about

breastfeeding. Don’t be afraid to ask for a clean and private area where

you can pump your milk. If you don’t have your own office space, you

can ask to use someone else’s office during certain times. Or you can ask

to have a clean, clutter free corner of a storage room. All you need is a

chair, a small table, and an outlet if you are using an electric pump. Many

electric pumps also can run on batteries and don’t need an outlet. You can

lock the door and place a small sign on it that asks for some privacy. You

can pump your breast milk during lunch or other breaks. You could suggest to your employer that you are willing to make up work time for time

spent pumping milk.

After pumping, you can refrigerate your milk, place it in a cooler, or

freeze it for the baby to be fed later. You can even leave it at room temperature for up to 6 hours if you don’t have access to a refrigerator. Many

breast pumps come with carrying cases that have a section to store your

milk with ice packs. 

for African American Women 21

Many employers are NOT aware of state laws that say 

they have to allow you to breastfeed at your job. Under these

laws, your employer is required to set up a space for you to

breastfeed and/or allow paid/unpaid time for breastfeeding

employees. To see if your state has a breastfeeding law for

employers, go to http://www.lalecheleague.org/LawBills.html

or call us at 1-800-994-9662. 
How much do breast pumps cost, and what kind is best?

Breastfeeding mothers

have many options

when it comes to

pumps. Some pumps

work better than others.

Their prices vary also.

Manual pumps (that you

pump with your hand)

cost under $50. Electric

pumps that include a

carrying case and an

insulated section for

storing milk sell for over $200. You can rent some pumps for either a short

or long time from some hospitals, pharmacies, or pump companies. You

can buy some pumps at baby supply stores or general department stores.

Most high-grade, automatic pumps have to be bought or rented from a lactation consultant at a local hospital or from a breastfeeding organization. 

Many mothers with jobs decide to buy or rent pumps with the ability to

pump both breasts at once (double pumping). Double pumping is faster

and can give you more milk each time, so you don’t need as much time

from your workday to pump. Compared to the cost of formula, which may

be more than $100 a month, even a top-of-the-line pump is easy to afford.

If you are a WIC participant, you local WIC agency may provide one for

free. Ask other mothers or a breastfeeding counselor about which pumps

they like or have tried. You also can learn to express milk by hand.

How do I store my pumped breast milk?

You can store your breast milk:

● at room temperature for up to 6 hours (in a bottle or breast milk 

plastic storage bag)

● in the refrigerator for up to 8 days (in a bottle or breast milk plastic

storage bag)

22 Easy Guide to Breastfeeding...
● in the freezer for 2 to 6 months (in

a breast milk plastic storage bag)

To thaw and warm frozen breast milk,

leave it in the refrigerator overnight or

put it under warm, running water or in a

bowl of warm water. It will thaw quickly. Don’t microwave it. Microwaving

breast milk will kill the antibodies and it

may be so hot it will burn your baby. Do

not refreeze your breast milk. It needs to be used within 24 hours after

thawing.

How do I breastfeed outside my home? 

There are ways you can easily breastfeed in public, although you don’t

have to breastfeed in public if you don’t want to. Many mothers often feel

strange about it at first, but feel better as they gain experience. Most of the

time, other people don’t even notice mothers who are breastfeeding their

babies. If you breastfeed when you are out in public, you won’t have to

carry feeding supplies, and your baby’s milk is always fresh. 

Here are some ideas to try:

● If your trip will be short, time it so you can breastfeed just before

leaving and right after you return home.

● Breastfeed before your baby becomes fussy so that you can get into a

comfortable position for feeding.

● Sit in your car to feed your baby.

● Wear clothes that allow your baby to breastfeed while you stay well

covered up, such as button-down shirts. You also can buy breastfeeding clothes, a nursing cover, or baby sling at maternity stores, some

department stores, through mail order, and through online stores.

● Use a blanket to cover your baby and your breast.

● Find a women’s lounge or sitting area (shopping malls and larger

department stores often have these).

for African American Women 23
● Go to a women’s changing room in a clothing store.

● Turn your chair so you are facing slightly away from other people. If

you are at another person’s home, ask your host if you can use another room.

After you and your baby have learned to breastfeed well (after 4 weeks),

you can give your baby a bottle of pumped breast milk when you are out.

If you have confidence in what you are doing, other people’s reactions

won’t bother you as much. You get to decide what to do with your baby,

and you are the only who knows what will make you comfortable.

Should I give my baby water, formula, or cereal?

No. Your milk is all your baby will need for the first 6 months, even in hot

weather. You don’t need to give your baby water, juice or a breast milk

substitute. Research shows that babies are healthier if other foods are

delayed. A newborn baby’s digestive system is very sensitive. Waiting 6

months helps protect your baby from food allergies and from diseases that

cause diarrhea. You can start giving your baby solid food at 6 months old. 

If you are worried that your baby is thirsty or not getting enough milk,

count diaper changes or call your health care provider or the Breastfeeding

Helpline (in English or Spanish) at 1-800-994-9662.

What foods do I need to eat?

The same kinds of foods you ate during your pregnancy are ideal to eat while breastfeeding. If you

notice that your baby is fussy after you eat certain

foods, avoid them and then try eating them again

several weeks later. There are no foods that need

to be avoided, unless it is part of your tradition or

customs to do so. If you drink coffee, 1 to 2 cups a

day is okay. Or, if you drink soda with caffeine or

several ounces of chocolate, it will probably not

bother the baby either. But, if you notice that your

baby is sleeping less and seems fussy, try cutting

back on foods and beverages that have caffeine.

24 Easy Guide to Breastfeeding...
Is it safe to take medications while breastfeeding? 

Always talk with your health care

provider before taking any medications. Most medications pass

into your milk in small amounts.

If you take medication for a

chronic condition such as high

blood pressure, diabetes, or asthma, your medication may already

have been studied in breastfeeding women, so you should be able to find information to help you make an

informed decision with the help of your health care provider. Newer medications and medications for rare disorders may have less information

available. The American Academy of Pediatrics has information about

many prescription and over-the-counter medications posted on their web

site at: www.aap.org .

Can I breastfeed if I get sick?

If you get sick, keep breastfeeding. Your baby is exposed to the germs

before you know that you are ill, whether you are breastfeeding or not. If

your baby gets sick, breastfeeding will help your baby get better quicker.

Should I breastfeed if I am living with HIV/AIDS?

No. You should not breastfeed your baby if you are living with HIV/AIDS

because you can pass the virus to your baby through your breast milk. You

might want to purchase donor breast milk from a milk bank to feed your

baby. Call the Human Milk Banking Association of North America at 919-

350-8599 for help. 

Can I breastfeed if I use street drugs? 

It is important not to breastfeed if you will be using street drugs, even

once in a while, while breastfeeding. Street drugs go into the breast milk

and can stay there for many days, harming your baby.

for African American Women 25
Can I breastfeed if I smoke or drink alcohol?

In their most recent statement on the subject, the American Academy of

Pediatrics announced that newer research seems to show that the good

effects of breastfeeding outweigh the bad effects from the mother’s smoking. For example, babies who are exposed to second-hand smoke (smoke

from people around them) have a higher rate of upper respiratory infections, but breastfeeding helps protect babies from these illnesses. It is

always better to quit smoking. If you can’t quit, try cutting down during

the time you are breastfeeding. You and your baby will both be healthier.

Light drinking by a breastfeeding mother has not been found to be harmful

to a breastfeeding baby. Larger amounts of alcohol may make your baby

sleepy or dizzy and may affect his or her growth over time.

I’ve heard that breastfed babies may not get enough 

vitamin D. What does this mean for my breastfed baby? 

The American Academy of Pediatrics (AAP)

published a statement in April 2003 saying

that some babies are at risk for vitamin D

deficiency (not having enough vitamin D in

their bodies) and rickets. Rickets is a bonesoftening disease caused by not getting

enough sunlight and/or vitamin D in the

body. 

Vitamin D helps your baby build strong

bones. Sunlight can be a major source of

vitamin D, but it is hard to measure how much sunlight your baby gets.

Things like where you live, the amount of pigment in your baby’s skin,

how much time your baby is in the sun, and the use of sunscreens all

affect how much vitamin D your baby’s body can make from sunlight. 

The AAP suggests that all infants, including those who are exclusively

breastfed and those who are fed formula, have at least 200 International

Units (IU) of vitamin D per day, starting during the first 2 months of life.

26 Easy Guide to Breastfeeding...
This amount of vitamin D should be continued throughout childhood and

adolescence. You can buy vitamin D supplements for infants at a drug

store or grocery store. Talk with your baby’s doctor to make sure your

baby gets the right amount of vitamin D.

How can my husband or boyfriend help? 

Fathers play an important role in

breastfeeding, and if you prepare

him in advance, he should support

your decision to breastfeed. He can

be there to support and encourage

you while you and the baby are

learning to breastfeed. Explain that

you want and need his support.

Invite him to go with you to your

prenatal visits so that you both can

learn together about pregnancy and

taking care of the baby. Attend a

breastfeeding class together.

Explain to him the important benefits of breastfeeding. You can tell

him that breastfeeding will give his

child the best start in life, with benefits that will last well into childhood. Tell him he won’t have to get up in

the middle of the night to make bottles, which means he can get more rest.

Be sure to say how much money he’ll save. Tell him it will cost hundreds

of dollars to pay for formula — money that could go to bills, savings,

shopping, or a vacation. He can help by dating and freezing the breast

milk you pump. When you’re ready to give your baby a bottle of breast

milk, he can feed the baby while you run an errand or take time for yourself. He can help with changing and burping the baby, and sharing chores.

He can enjoy the beauty of breastfeeding by simply sitting with you and

the baby to enjoy the special mood that breastfeeding creates.

for African American Women 27
Why should I talk to my doctor or health care provider

about breastfeeding?

Talking to your health care provider will help you learn his or her views

on breastfeeding and find out what kind of support for breastfeeding he or

she offers. Most pediatricians in the United States agree that human milk

is superior for infant feeding.

Your health care provider or your child’s pediatrician should offer you

accurate, easy-to-understand breastfeeding information. Some clinics and

doctor’s offices offer the services of a board certified lactation consultant

to help with breastfeeding. See the section on page 31 for questions to ask

at your next doctor or health care provider visit.

What is being done to educate African American parents

about breastfeeding?

It is clear that there is a need for more breastfeeding programs in the

African American community.

African American Breastfeeding Alliance, Inc. (AABA)

— AABA is the first organization whose sole purpose is

to promote breastfeeding to African American mothers,

fathers and families. AABA’s goals are to: improve the

overall health status of African American babies; increase

access to breastfeeding information for African American

parents; and create a breastfeeding-friendly culture within

the African American community. AABA’s programs include: the African

American Breastfeeding Campaign, Peer Counselor Training,

Breastfeeding Hotline, Breastfeeding Drop-In Clinic, Roundtable

Discussions and Comprehensive Research Initiatives. An emphasis is

placed on producing publications and videos that show African American

women breastfeeding their babies. Call toll-free 1-877-532-8535 for more

information.

28 Easy Guide to Breastfeeding...
U.S. Department of Health and Human Services’ Office on Women’s

Health — In October of 2000, U.S. Surgeon General David Satcher

issued The HHS Blueprint for Action on Breastfeeding, the first comprehensive framework to increase breastfeeding rates and promote the best

breastfeeding practices. The Blueprint states, “Significant steps must be

taken to increase breastfeeding rates in the United States and to close the

wide racial and ethnic gaps in breastfeeding. This goal can only be

achieved by supporting breastfeeding in the family, community, workplace, health care sector, and society.” Visit www.womenshealth.gov, 

or call the National Breastfeeding Hotline at 1-800-994-9662,

TDD: 1-888-220-5446.

Where to find help with breastfeeding... 

One of the most important things to remember about breastfeeding is to

ask for help if you need it. Here are resources to help you answer breastfeeding questions:

African American Breastfeeding Alliance

1-877-532-8535 (toll-free)

National Women’s Health Information

Center (NWHIC)—Breastfeeding Helpline

and Web Site

PHONE: 1-800-994-9662 (in English and Spanish)

TDD: 1-888-220-5446

INTERNET: www.womenshealth.gov/breastfeeding

We are available 9 a.m.– 6 p.m., Monday through Friday, EST. If you call

during times that the Helpline is not staffed, leave a message and you will

be called back on the next working day. The Breastfeeding Helpline is a

project of the U.S. Department of Health and Human Services and is

for African American Women 29
staffed with trained breastfeeding peer counselors. For serious problems,

you will be referred to a health care provider. We do not give medical

advice. The Helpline also offers a breastfeeding pamphlets on basic breastfeeding issues and on special breastfeeding situations. You also can order

Easy Guides to Breastfeeding in Spanish or Chinese, and for African

American and American Indian and Alaska Native women and their 

families.

Lactation Consultants or Breastfeeding Counselors

A breastfeeding counselor or lactation consultant is a professional health

worker trained to help new families be successful with breastfeeding. If a

breastfeeding counselor or lactation consultant uses the initials “IBCLC,”

they have been certified by the International Board of Lactation

Consultant Examiners. To find an IBCLC nearby, check the IBCLC organization web site at www.ibclc.org for a list of all the currently certified

IBCLCs who are registered in the United States. You can also look in your

local yellow pages under “Breastfeeding.”

La Leche League International

Phone: 1-800-LA LECHE or 1-847-519-7730 (the number

for the LLLI business office to find a Leader near you using

your zip code)

La Leche League International (LLLI) also offers valuable

breastfeeding information. LLLI leaders are volunteers who give one-onone help to breastfeeding mothers on the phone or at monthly group meetings. To find a LLLI leader in your area, find the listing for your state or

territory on the LLLI web site at www.lalecheleague.org. You may also

find information about your local group in local phone listings or at the

library, or watch for announcements in your local newspaper. The LLLI

web site has a lot of breastfeeding information, such as FAQs and many

personal stories from mothers. The LLLI catalogue offers books and pamphlets on breastfeeding, childbirth, nutrition and parenting. Call us to

receive a copy of the catalogue by mail or check out the online version at

our web site.

30 Easy Guide to Breastfeeding...
Questions to ask your health care 

provider about breastfeeding...

How do I prepare myself for breastfeeding at home, at work, and at the

hospital?

Home

__________________________________________________________

__________________________________________________________

Work 

__________________________________________________________

__________________________________________________________

Hospital 

__________________________________________________________

__________________________________________________________

Do you know of any support groups for African American breastfeeding

mothers?

__________________________________________________________

__________________________________________________________

__________________________________________________________

Can I speak to your other patients who have breastfed?

__________________________________________________________

__________________________________________________________

__________________________________________________________

for African American Women 31
What will hospital staff do to help me with breastfeeding? Are there lactation

consultants there to help me? If so, how do I set up a time to meet with them?

__________________________________________________________

__________________________________________________________

__________________________________________________________

Can my baby stay in my room at the hospital instead of the nursery?

__________________________________________________________

__________________________________________________________

__________________________________________________________

What are your suggestions for breastfeeding with flat or inverted nipples?

__________________________________________________________

__________________________________________________________

__________________________________________________________

Do I need to give my baby any vitamin supplements?

__________________________________________________________

__________________________________________________________

__________________________________________________________

Editors:

Katherine M. Barber, CLEC, Executive Director, African American Breastfeeding Alliance, Inc.

Suzanne G. Haynes, Ph.D., U.S. Department of Health and Human Services, 

Office on Women’s Health

Joyce Cusack, M.H.S.

Designer:

Adrienne Barnes

September 2006

32 Easy Guide to Breastfeeding...

U.S. Department of Health and Human Services 

Office on Women’s Health

200 Independence Ave,. S.W. Room 712 E

Washington, DC 20201

www.womenshealth.gov

1-800-994-9662 • TDD 1-888-220-5446

African-American Breastfeeding Alliance, Inc.

P.O. Box 117

Joppa, MD 21085

1-877-532-8535

aaba@att.net

www.aabaonline.com