An Easy Guide to

Breastfeeding for

American Indian

and Alaska

Native Families

U.S. Department of Health and Human Services

Office on Women’s Health 
Easy Guide to

Breastfeeding for

American Indian

and Alaska

Native Families

This guide is for all American Indian and Alaska Native 

women and their families who embrace life.

It is a supportive tool for all women who choose to breastfeed.

This Booklet, along with the 1­800­994 WOMAN (9662)

and www.4woman.gov website, are designed to help you feel

confident in your decision to breastfeed. Breastfeeding will help

your baby avoid many health problems.

Breastfed babies are less likely to have:

• Ear infections

• Diarrhea

• Colds

• Flu   

Breastfed babies may be less likely to become obese.

Research shows that obesity is part of the reason that 

many of our people suffer from type 2 diabetes.

Babies were born to be breastfed.

for American Indian and Alaska Native Families 3
3

Dear Reader,

The Department of Health and Human Services encourages all women to

exclusively breastfeed for 6 months before introducing solid foods and

continue to breastfeed for 12 months and thereafter for as long as desired.

Choosing to breastfeed honors the traditions of American Indian and

Alaska Native families. The practice of breastfeeding respects our heritage

and culture and strengthens our children, our

communities, and our future.

You will learn about:

• Benefits of breastfeeding

• Risks associated with not breastfeeding

• Answers to your breastfeeding questions

• Where to go for help

• Tips for breastfeeding success

The Easy Guide to Breastfeeding for American

Indian and Alaska Native Families is part of a series of Guides by the

Department of Health and Human Services’ Office on Women’s Health to

help all women breastfeed.  The Office on Women’s Health encourages all

women to breastfeed for at least 6 months. 

Breastfeeding is especially important for American Indian and Alaska

Native families. Many of our families and communities struggle with

serious health problems such as obesity and diabetes.  The people of Gila

River Indian Community in Arizona, working together with the scientists

from the National Institutes of Health (NIH) found that breastfeeding

lowers the risk of an infant becoming overweight and possibly developing

diabetes in later life.  The Breastfeeding Promotion Group of Arizona came

together to share this important message of hope with our communities.

The Easy Guide to Breastfeeding for American Indians and Alaska Native

Families is the result of the fruit of these partnerships and the generous

support of the Department of Health and Human Services’ Office on

Women’s Health, National Institutes of Health/National Institute of

Diabetes and Digestive and Kidney Diseases, and the Diabetes Center of

Excellence at Phoenix Indian Medical Center.

Breastfeeding Promotion Group of Arizona

Melinda Aguirre, CLE, Diabetes Center of Excellence, Phoenix Indian

Medical Center

Bernadette Anderson, Diabetes Program, San Carlos Apache Indian

Community

Sara Defelice, BS, RD, CLE, Inter­Tribal Council of Arizona

Gailyn Lewis, Genesis Program, Gila River Pima Indian Community 

Priscilla Lopez, MCH Coordinator, Tohono O'odham Nation

Deborah Morago, WIC Program, Gila River Pima Indian Community

Sue Murphy, RD, MPH, CDE, IBCLC, Diabetes Center of Excellence,

Phoenix Indian Medical Center

Janine Roumain, MD, MPH, NIH Research Specialist

Sandra Sangster, BS, CLE,  NIH Program Specialist

Roberta Seepie, CLE, Breastfeeding Program Coordinator, Salt River

Pima Maricopa Indian Community

Shona Stack, RD, CLC, Inter­Tribal Council of Arizona

A special thank you to the following for their tireless,

collaborative efforts, traditional wisdom, and talent:

John Molina, MD, Las Fuentes Clinic, Guadalupe, Arizona

Gila River Indian Community

Salt River Pima­Maricopa Indian Community

San Lucy Village

Tohono O’odham Nation

Ak­Chin Indian Community 

San Carlos Apache Indian Community

Inter­Tribal Council of Arizona, WIC

Native American Community Health Center, Phoenix, Arizona

William Daychild, the American Indian artist who created the

PIMC Breastfeeding Logo

National Institutes of Health/National Institute of Diabetes and 

Digestive and Kidney Diseases

4 5 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families
Babies are born to be breastfed

Breastfeeding has kept our people and traditions strong

since the beginning of time. 

“We are all one child

spinning through Mother Sky.”

~ Shawnee proverb

Is breastfeeding easy?

• Once breastfeeding is established, it is easy.

Breastfeeding is natural, but you, your body,

and the baby may need time to get adjusted. 

• Breastfeeding makes you part of a miracle

that you can share with your baby.

Breastfeeding is not painful, although your

nipples may be sensitive at first. 

• Since before anyone can remember,

American Native and Alaska Native women have made enough breast

milk for their children, often more than one child at a time.  Villages,

communities, and entire nations have thrived and grown strong from

mother’s milk.  Trust your body, you will have enough.

• You are giving your baby a gift that only you can give. We are here today

because our ancestors breastfed.  All of our great leaders were breastfed.

Our ability to breastfeed has not changed. You can do this.

• Being a mother is a new journey with each baby.  It is normal to worry a

little and wonder. Talking to an Elder, friend, mother, or aunt can help

you begin this most sacred passage into motherhood.  

• Nurture yourself as you would nurture your baby.  Be patient with

yourself as you and your baby learn together. 

How do I get started? 

While you are pregnant, tell your health care provider that you want to

breastfeed. Ask women in your community who breastfed to share their

stories. They will tell you how breastfeeding is a special gift that only a

mother can give to their child.

6 Easy Guide to Breastfeeding...  for American Indian and Alaska Native Families 7
How do I get started?   continued 

The mom Milk The baby

thick, and in small amounts. 

This

This is a good time to feed

in the right amount.

12­ 24

hours

2­5

days

eating again. 

and leak.

4­6

will be softer and the leaking

For the first several days after birth, your body

makes colostrum.  Colostrum is rich, yellowish,

It gives your baby a

healthy dose of early protection against diseases.

Birth Your baby will probably be awake the first hour after being born, then go to sleep.  

is a good time to feed your baby.

You will be tired and excited.

the baby.

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

First It is normal for the baby to sleep heavily. Labor and delivery is hard work for the baby.

Some babies like to nuzzle and may be too sleepy to latch well at first. Feedings may be

short and irregular. 

As your baby wakes up, take advantage of your baby’s strong instinct to suck and feed

every 1­2 hours.  Your baby will love the flavor of your breast milk. Many babies like to

eat or lick, pause, savor, doze and then eat again.

Ask the nurse not to give your baby any formula or water unless medically indicated.

You will be tired too. Rest. 

Your white milk comes in. It is normal for it to be

yellow or golden at first. It may look thin in the

beginning and then becomes thick & creamy at

the end. It’s natural that your baby will like it.

Next  Your baby will feed a lot, 8­12 times or more in 24 hours.  Your baby’s stomach is little

and your milk is easy to digest, so it is normal for your baby to eat often. Expect your

baby to take at least 15­20 minutes on each side.  Breastfed babies don’t eat on schedule.

It is okay if your baby eats every 1­2 hours and then sometimes sleeps 2­3 hours before

As your baby grows, the feedings will be shorter and less often.

The baby might take only one side at a time or seem to like one side better. Don’t worry,

the baby will get enough from one side and will learn to eat on both sides soon. 

After delivery, it is normal for a baby to lose a little weight. Your baby will regain his or

her birth weight by two weeks.

Your breasts will feel full

First White breast milk, lots of it.

weeks

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

Feedings will take less time and will be farther apart.

Your body gets used to

breastfeeding so your breasts

will slow down. Don’t worry,

the milk is still there.

Don’t let challenges in the first few weeks keep you from sharing the gift of

breast milk with your baby.  The beating of your heart, the rhythm of your

rocking, and the sweetness of your special milk teaches your baby to love the

world they are now part of.

How do I hold the baby when I breastfeed? 

There are 3 common ways to hold your baby. Use the positions that are

comfortable for you and your baby.  Keep your baby's face, belly button,

and knees close, next to your body. Tummy to tummy. Use pillows,

rolled up towels, or blankets to keep your back, arms, and shoulders

comfortable.

8 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 9
To latch:

1. Support your breast with thumb

on top and four fingers

underneath.  Keep your fingers

behind the areola (the darker

skin around the nipple).

2. Brush or tickle the baby’s lip

with your nipple to help get the

baby's mouth open wide.

3. Hug the baby in close. Your

baby will take a mouthful of all

of the nipple and most of the

areola. Keep your baby close.

4. Look for both of your baby’s

lips to be flanged out and

relaxed– if you can’t tell if the

lower lip is out, press on the

lower chin to gently nudge the

mouth open and lower lip out.

Courtesy of Paul Torgus,  La Leche League International

Football Hold

Reclining

Sitting

Pictures courtesy of the Tohono O'odham

Department of Human Services, Community

Health Services Branch

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

Trust yourself to do what our women have always done. In the first few

days, expect the baby to eat every 1­2 hours and have several diaper

changes. As your white milk comes in,  there will be more and more

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

have little white “seeds.”  By the end of the first week, 5­6 or more diaper

changes and 8 to 12 feedings every 24 hours will tell you that the baby is

getting enough.

This chart shows the minimum number of diapers for healthy, fullterm babies. It is fine if your baby has more. 

Baby’s Age Wet Diapers Dirty Diapers 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)

5­6 Greenish yellow

Day 5 5­6 Seedy, watery mustard color

Day 6 5­6 Seedy, watery mustard color

Day 7 5­6 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 an expert breastfeeder and

have a larger stomach to hold more. Feedings will spread out and begin

to take less time.

10 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 11
• In some American Indian and Alaska Native communities, it is

traditional for women to be secluded with their babies for several weeks.

Staying close to your baby in the beginning encourages 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 less

often as the baby gets older. Extra feedings tell your body to make more

milk for your growing baby.  

My breasts are full, hard, painful and my baby can’t latch.

What is wrong?

When the mature, white breast

milk comes in at 2­5 days, your

breasts may swell. This is called

engorgement. This swelling can

happen even if the mom is not

breastfeeding. The tender fullness

will go away in 1­2 days.  To help

engorgement:

• Use heat packs before feeding, to

get the milk flowing. Use cold

packs after feeding, to reduce

swelling.

• Before feeding, release a little milk. It will soften the nipple area, so the

baby can latch. 

• This is not a good time to quit breastfeeding.  The key to relief is

removing the milk, so keep breastfeeding your baby. It will get better in

1­2 days. If it doesn't get better or if you have a fever, contact your

health care provider.

What do I do if I have sore nipples?

Sore nipples go away quickly. 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 a putting little breast milk or lanolin on

the nipple and let it air­dry.

• Don’t tug if clothing or pads stick to your

nipples. Wet the clothing or pads before gently peeling them off. 

• If sore nipples start after the first three weeks, ask your baby’s health care

provider to check 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. Be sure to see your healthcare provider

for treatment.

Is it okay to use formula, bottles, pacifiers, and water?

No, it is not recommended in the

first 6 months. In the early weeks,

formula, plastic nipples, pacifiers,

and water can easily interrupt

breastfeeding. New babies quickly

get used to the simple way of

sucking from plastic nipples and

pacifiers and then will refuse to

latch. 

Exclusive breastfeeding means

feeding your baby only breastmilk

­ no formula, water, rice cereal, or

baby food. Exclusively breastfeeding for 6 months is linked with many

important health benefits for you and your baby. Your milk has everything

12 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 13
your baby needs for the first 6 months. Regular use of formula and

pacifiers can stop the benefits by breaking the natural cycle of

breastfeeding.

Your baby does not need extra food or water.  If you are worried that your

baby is thirsty or not getting enough to drink, you can drink more water,

count diaper changes, or call your clinic or WIC.  Trust all the generations

Consider some of these combinations:

• The caretaker brings the baby to you 1 or 2 times each day or you go to

the baby at nearby childcare.

• Check with your work or school.  Many schools and worksites have

breastfeeding areas for breastfeeding moms or onsite day care.

that came before us.  We are here because they could breastfeed.  You can

too.

If you need to be away from your baby, leave bottles of pumped milk. Be

proud because while you are gone, your baby still receives your special gift. 

Remember:  The early weeks of breastfeeding are a learning time for you,

your baby, and your family.  It will get easier, and you will feel more

confident. Your baby will be healthier because you mothered with your

milk. Breastfeeding has touched all of our people’s yesterdays and will

touch all of your baby’s tomorrows. 

What about cereal, juice, and solids? 

Wait until the baby is 6 months old. By then, the baby’s stomach is more

grown up and can handle more complex food. Your baby will breastfeed

less when solids start.

Can I still breastfeed if I go back to work or school?

Yes, you can do it!

Breastfeeding keeps you connected

to your baby, even when you are

away. Employers and co­workers

benefit because breastfeeding

moms need less time off for sick

babies.

• Pump and save your breast milk.

Pumps vary in  effectiveness and price.

Hand pumps often work for short

term, occassional separations. If you

will be missing 2 or more feedings on

a daily basis, consider a hospital grade

electric pump. They will keep your

milk supply going and make pumping

easy and quick. 

• Hospital grade electic pumps are usually purchased or rented from a

lactation consultation, hospital, or  breastfeeding organization.  Try the

yellow pages under "breastfeeding," to find a pump.  Sometimes local

hospitals will let moms have access to their pumps. Also, check with

WIC. They may have hospital grade pumps to loan.

The following are tips for pumping

and storing.

• After washing your hands, pump into a clean plastic bottle or storage bag.

• Store the milk in the refrigerator or freeze. Try 2­3 oz portions to start with.

• Label the portion containers with the  date, and use the oldest milk first.

You  can store your breast milk:

• At room temperature ­ for up to 6 hours 

• In the refrigerator ­ for up to 8 days

• In the freezer ­ for 2 weeks or longer

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. Microwaving breast milk will kill the

14 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 15
antibodies and may be so hot it will burn your baby. Do not refreeze your

breast milk. It needs to be used within 24 hours.

Your breast milk might look different each time you pump or after it is

cold or frozen. Breast milk changes in color, consistency and odor

depending on what the mother eats. The cream and any colostrum will

separate and rise to the top. Just stir or shake and it will be fine. Don’t

worry. It is safe, perfect, and the baby will still drink it. 

Remember: You are a wise mother to give your baby the gift of mother’s

milk. You, and others will benefit from your decision to continue

breastfeeding. 

What foods do I need to eat while I am breastfeeding?

The same kinds of healthy foods that 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, 1­2 cups  a day is

usually okay. If you drink several cans of

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. If you do not eat

well, your milk will still be good. Your body will adjust to make sure your

baby’s milk supply is protected.

How long should I breastfeed?

The longer a mom and baby breastfeeds, the greater the benefits are for

both mom and baby. Exclusive breastfeeding for 6 months before

introducing solid foods gives you and your baby the most benefits. Every

time you breastfeed, you give the gift of life.

Traditionally, our babies were kept healthy

by breastfeeding over a year. Breastfeeding

is such an important part of a healthy start

that the goal of the Department of Health

and Human Services is for all babies to

receive only breast milk for the first 6

months.  Ideally, babies should receive

breast milk through their first year of life.

Although our lives are different from our

great­grandparents, our babies can be

breastfed exclusively for the first 6 months.  If you need help or ideas, see

the “Where to Get Help” section starting on page 19. 

Can I breastfeed if I use street drugs, alcohol or tobacco?

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

once while breastfeeding. Street drugs go into the breast milk and can stay

there for many days, harming the baby.   

When you breastfeed and drink alcohol, your baby does too.  Alcohol

does not honor you or your baby’s future. 

If you choose to drink alcohol while breastfeeding, it is important to limit

the amount of alcohol. If you regularly binge drink and cannot stop,

formula feeding the baby will be a better choice. 

Recreational tobacco, smoked or chewed is harmful to you and your baby.

Whether your baby breastfeeds or bottlefeeds, second hand smoke will

damage your baby’s lungs. Do not let your baby be around smoke.  If you

or others smoke, smoke outside, away from the baby.   In their most

recent statement, the American Academy of Pediatrics announced that

newer reserach shows that the benefits of breastfeeding outweigh the

negative effects from the mother’s smoking. If you smoke, try cutting

down. The less that you smoke, the better for you and your baby.

16 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 17
I have diabetes, can I still breastfeed?

YES!  Breastfeeding is especially

important for families with diabetes.

American Indian and Alaska Natives

have the greatest risk of any

population group for this disease.  If

you have diabetes while you are

pregnant, your baby may have an even

greater risk of developing diabetes

early in life. Breastfeeding will help

lower your baby’s risk of becoming

diabetic. Breastfeeding helps you too.  Your blood sugars will be lower and

you may lose weight. Your milk will be fine, even if your blood sugars are

high. It will be important to let your diabetes health care provider know

that you are breastfeeding.

I have heard that some babies may not get enough

vitamin D. Does my baby need vitamins? 

In April 2003, the American Academy of

Pediatrics (AAP) noted that some babies are at

risk for vitamin D deficiency and rickets.

Rickets is a bone softening disease caused by

too little exposure to sunlight, dark skin

coloring or inadequate vitamin D intake.  The

AAP now recommends that all infants,

including those who are breastfed, have at least

200 International Units (IU) of vitamin D per

day beginning during the first 2 months of life and through childhood

and adolescence.  You can get vitamin D supplements, in drop or tablet

form, at your local clinic or drug store.

Can I take medicine if I’m

breastfeeding? 

There are a few medications that make it

necessary to stop breastfeeding.

Medicines that require stopping

breastfeeding include anti­rejection

medicines, ergotomine, methotrexate,

radioactive isotopes, and chemotherapy

drugs.  Drugs for anti­anxiety, anti­depressant, and anti­psychotic

concerns can be of special concern for nursing mothers also.  Be sure that

your health care provider or pharmacist knows that you are breastfeeding.

It is also important to mention any traditional medicines, herbs, and teas

that you are using.

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.

What about traditional medicines, like herbs and teas?

Ask a person that you trust to provide traditional medicine. Be sure that

they know you are breastfeeding.

If you are taking other medicines, be sure that both your health care

provider and traditional healer know about all medicines, herbs and teas

you are taking. If you have questions, ask your traditional healer, health

care provider, breastfeeding counselor, pharmacist, or Helpline. 

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 go away. If the lump stays for more

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

pack before feeding, massage, and offer the side with the lump first;

18 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 19
breastfeed often.  Rest.  In a day or two, the lump or plugged duct will

go away.

Once in a while, a plugged duct can become a breast infection. A breast

infection will make you feel like you have the flu and give you a fever.

Call your health care provider. Your provider will prescribe antibiotics and

you will feel amazingly better in 1­2 days. Be sure to use heat packs and

massage, nurse often, and rest.

Can I breastfeed more than one child at one time ?  

Yes. “Tandem” nursing has worked for centuries in American Indian and

Alaska Native country. It is usually okay to breastfeed your older child

throughout your pregnancy and then breastfeed both after delivery. Try to

give the newborn first choice each time you nurse or nurse both at the

same time.  Your milk supply will adjust to meet your newborn’s early

needs. 

If you have twins, you will have enough milk to feed both. Some moms

like feeding both babies at the same time because it saves time and helps

keep up the milk supply.

Can I breastfeed if I have HIV or AIDS?  

No, you should not breastfeed. The HIV virus that causes AIDS can pass

through your breast milk. Babies can get HIV and then AIDS this way. 

Where can I go for help?

If you have questions or would like more information on breastfeeding,

call the National Women’s Health Information Center’s (NWHIC)

Breastfeeding Helpline at 1­800­994 WOMAN (9662); TDD 1­888­

220­5446 (9am ­ 6 pm, 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

staffed with trained peer counselors. For serious problems, they will refer

you to a lactation consultant organization or association or will advise that

you follow up with your healthcare provider. They do not give medical

advice. 

The Helpline also offers a breastfeeding packet with pamphlets on basic

breastfeeding issues as well as special breastfeeding situations.  You also can

find more information on the NWIC web site: www.4woman.gov. 

NWHIC can also provide you with a copy of the HHS Blueprint for

Action on Breastfeeding by the Department of Health and Human Services’

Office on Women’s Health. This concise, current, scientifically based

publication was compiled by the Office on Women’s Health with the

support of many other governmental agencies including the Office of the

Surgeon General, Food and Drug Administration (FDA), Environmental

Protection Agency (EPA), Centers for Disease Control (CDC), and the

US Department of Agriculture (USDA). Use this publication for

information about the benefits of breastfeeding, managing breastfeeding

in the health care system, supporting breastfeeding at work or school, and

how increased breastfeeding will help our communities’ futures.

WIC

The Supplemental Nutrition Program for Women, Infants and Children

(WIC) provides nutrition education, breastfeeding promotion and

support, and supplemental foods to pregnant, breastfeeding and

postpartum women, and to infants and children up to age 5.  Some WIC

offices have special breastfeeding peer counselors and professional

breastfeeding counselors to help you.  You can usually find WIC by asking

the staff at your local clinic, health department, or social services. You can

also check the national WIC web site at www.fns.usda.gov/wic/ for local

and state WIC programs.

20 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 21
Indian Health Service Hospital /Clinic, Local

County/Community Health Department, or Tribal

Health Clinics

Many local clinics and health departments have breastfeeding support

staff and hotlines.  Phoenix Indian Medical Center, Diabetes Center

of Excellence has a toll­free breastfeeding support hotline

1­877 ­TOT­WISE (1­877­868­9473). 

La Leche League

La Leche League is recognized by many as a leading authority on

breastfeeding. The La Leche League helps new mothers with monthly

group support meetings. Most groups have large lending libraries. La

Leche League also does free phone counseling.  Like the Helpline, they

will refer you to a doctor for serious problems and they do not give

medical advice.  For more information call 1­800­La­Leche

(1­800­525­3243).  Visit their website at www.lalecheleague.org.

Breastfeeding Counselors or Lactation Consultants

A breastfeeding counselor or lactation consultant is a professional health

worker.  Counselors and consultants are trained to help families succeed

with breastfeeding.  If a consultant has “IBCLC” written after her name,

she’s 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”.

In summary, for breastfeeding success from the beginning

Before birth – Let your family and provider know that you will

be breastfeeding. Consider these questions:

1. What will help me to be successful with breastfeeding? 

2. If I need help, where can I go for breastfeeding support?

3. How do I want the family, health care providers, and hospital to

help me with breastfeeding?

4. If I will be going back to work or school, what are my options?  

22 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 23
At the hospital 

• Be sure the hospital staff knows that you want to breastfeed.  

• Let the nurses and nursery staff know that you are exclusively

breastfeeding.  Have your doctor also let them know.

• Plan to feed the baby within an hour after birth. 

• Ask to keep the baby with you as much as possible, instead of the in

nursery.

At birth

• Latch after delivery.  The baby’s suck is usually strong in the first hour

after birth.

While you are in the hospital 

• Keep the baby near you. 

• Breastfeed as often as possible;

cuddling helps. 

• Keep in mind that babies and

moms are often sleepy and

feedings can be disorganized. It

is ok for babies to nuzzle, lick

and not latch well in the first 24

hours. 

• If the baby needs to go to the

nursery, ask the nurse not to give

a pacifier,  water or formula without consulting with you first. Let the

nurse know that you will feed the baby when the baby is hungry.

When you go home 

• Breastfeed every 2 hours, around the clock. Feedings

usually take at least 20 minutes. 

• Your baby becomes a better eater by practicing and gets just

what is needed from the colostrum that your body makes.  

• Soon your white milk will come in. Breastfeed every 2­3

hours or at least 8­12 times in 24 hours. The more you

breastfeed, the more milk you will have. As you and your baby learn the

art of breastfeeding, it will become easier.

• Safe bedding practices and back to sleep:

­ Place your baby on his/her back on a firm tight­fitting mattress in

a crib that meets current safety standards.

­ If you are using a blanket, put your baby with feet at the foot of the    

crib. Tuck a thin blanket around the crib mattress, reaching only as 

far as your baby’s chest.

­ Try dressing your baby in sleeper instead of using a blanket.

­ Do not place your baby on a water bed, sofa, soft mattress, pillow, 

or other soft surface. 

After the first few weeks

• The feedings will likely begin to spread out and may not take as long. 

• Congratulate yourself; You are doing what no one else can do for all

your child’s tomorrows.

Notes 

24 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 25
Breastfeeding is a timeless thread in our cloth of life. All

American Indian and Alaska Native children are precious.

We honor them by blessing their tomorrows with mother’s milk.

We can help our families to choose breastfeeding by sharing

information about the benefits of mother’s milk and by

encouraging new families as they learn about breastfeeding. 

The proud tradition of breastfeeding is part of our tomorrows.

The generations ahead will be ready for challenges in their lives

because they were breastfed. As our families pass the gift and

wisdom of mother’s milk to their children and families; our

leaders, communities and futures will be stronger and healthier. 

The message is hope and it begins with mother’s milk.

“All things are connected,

whatever befalls

the earth, befalls the children

of the earth.” 

~ Chief Seattle

26 Ea sy Guide to Breastfeeding...  for American Indian and Alaska Native Families 27
U.S. Department of Health and Human Services 

Office on Women’s Health 

200 Independence Avenue, SW, Room 712E 

Washington, D.C., 20201 

www.4woman.gov 

1-800-994-9662 

TDD: 1-888-220-5446 

October, 2004