Wearing plastic breast shells (see Breastfeeding Basics) during the last months of pregnancy may help your nipples project outward. However, some authorities suggest that a baby who is attached to the breast correctly (see When and How to Start Breastfeeding, Positioning) will breastfeed effectively regardless of the size or shape of mother's nipples. Either way, it will be helpful for you to understand proper positioning and talk to a breastfeeding counselor or healthcare provider about this issue before your baby is born.

Weight gain is the most accurate way to tell if your baby is getting enough milk, so weigh your baby. A normal weight gain is approximately four to eight ounces per week. As your baby becomes a little older, the increase in weight will become more obvious. If you're concerned about your baby, talk to your healthcare provider or a breastfeeding counselor.

Also, keep track of your baby's diaper changes since what goes in must come out. At first your baby will have only one or two wet diapers per day. After your milk supply increases, baby should have five to seven wet diapers (six to eight if using cloth diapers) and three to five bowel movements every day. Some babies may have a small bowel movement with every diaper change.

The first bowel movements will be dark black, with a tarry consistency. Both color and consistency will change within a day or two of your milk supply increasing. The color of a breast milk stool is most often a mustard-yellow, but it can vary from tan to yellow to yellow-green. The consistency is loose and seedy and will remain this way as long as your baby is receiving only human milk. In addition, while nursing, your baby should swallow after every couple of sucks, so listen for swallowing. Other indicators include your breasts becoming softer after feedings, your baby's skin feeling smooth and firm, and baby seeming satisfied after feedings.

However, if your baby shows any of the following signs, contact your healthcare provider immediately:
Weak cry
Skin with no resiliency (when pinched it stays pinched looking)
Dry mouth and dry eyes
Less than the usual amount of tears
Minimal urine output (less than two wet diapers in 24 hours)
Fever
Fontanel (soft spot) on the baby's head is sunken or depressed

If you previously had breast surgery, be sure to tell your healthcare provider. Many mothers have been able to fully breastfeed their babies after breast surgery. However, it is important that your healthcare provider be aware of your history and past breast surgery(ies) so that you and your baby can be monitored closely to make sure your milk production is good and baby is gaining weight.

The amount of milk you produce is dependent on how much and how frequently milk is removed from your breasts. As baby's demand increases, your body will increase its supply, but you might find the following suggestions helpful if you are concerned about your milk supply:
Nurse baby at both breasts at every nursing session.
Nurse baby twice at each breast at each nursing session.
Use the lying down hold occasionally so you rest while baby nurses.
Nurse at baby's earliest cues.
Drink plenty of fluids (based on your individual needs).
Use a breast pump between feedings.
Refer to a certified lactation consultant for a complete breastfeeding evaluation.

The possible risks of a medication, whether a doctor's prescription or bought over the counter, should be weighed against the risks of weaning and providing artificial milk.

You may have heard that babies react to foods in their mothers' diets but this is fairly rare. Infant formula is far more likely to cause some type of problem rather than a reaction to mother's diet.

Infant massage often helps soothe a baby who appears to have gas, so you might read books on infant massage to find a technique that your baby likes. You also might try the colic hold to see if it helps baby become more comfortable. Drape your baby face down over your forearm with his head at the crook of your elbow, your hand supporting his midsection, and his legs dangling down.

Avoid artificial nipples and pacifiers because they can confuse your baby when he's learning how to breastfeed. A baby uses mouth and tongue differently when taking a bottle or pacifier versus a human breast. Among other things, artificial nipples are firmer than your breast, and a baby holds them in the front of his mouth. If baby does the same thing while breastfeeding, he may not use enough suction and he won't get as much milk. Your nipples may become sore in the process. Some very sensitive babies even refuse to breastfeed after using artificial nipples.

Since there is no way to tell ahead of time whether your baby will be able to switch back and forth easily, it's best to avoid artificial nipples until your baby has been nursing well for at least three or four weeks and the likelihood of confusion is reduced. If you need to feed your baby other than at the breast, use an alternative to bottles, such as a spoon, eyedropper, or small feeding cup. Consult a knowledgeable breastfeeding counselor about these options.