Nipple flow rate affects how fast milk comes out. Wrong flow causes problems: Too slow = frustration, long feeds, giving up. Too fast = choking, gulping, gas, overfeeding, bottle preference over breast. Flow levels: Preemie/newborn (slowest), Level 1 (slow, 0-3 months), Level 2 (medium, 3-6 months), Level 3+ (fast, 6+ months). Breastfed babies should usually stay on slow flow longer. Nipple shape also matters: Standard, wide-base (like breast), orthodontic, angled. May need to try different brands to find what baby prefers.

Baby won't take bottle even when hungry. Common when breastfed baby needs to take bottle (return to work). Also happens during teething, illness, or developmental leaps. Tips: Have someone else give bottle (baby may refuse if they smell milk on you), try different nipples/bottles, try when baby is calm (not starving), try different positions, don't force it.

Engorgement: Breasts become overly full, hard, painful, and swollen (usually days 2-5 postpartum when milk comes in). Makes latching difficult for baby. Normal engorgement resolves in 24-48 hours with frequent feeding. Mastitis: Breast infection, often starts with clogged duct. Symptoms: Red, hot, painful wedge-shaped area on breast, fever >101°F, flu-like aches, chills. Requires antibiotics. Mastitis is urgent - untreated can lead to abscess. Usually affects one breast, most common in first 3 months of breastfeeding.

Newborns typically breastfeed every 2-3 hours (8-12 times in 24 hours). Feed on demand when baby shows hunger cues. Cluster feeding (every hour) is completely normal, often followed by a longer 4-5 hour sleep. Signs baby is eating enough: growing well and producing plenty of wet diapers.

A good latch is crucial for successful breastfeeding. Baby should have wide mouth (like a yawn) with both lips flanged out, chin touching breast, more areola visible above than below lip. Signs of poor latch: painful nursing, nipple damage, clicking sounds, baby constantly hungry, poor weight gain, baby pulling off breast frequently. Most latch issues can be resolved with positioning adjustments and practice.

Burp baby during and after feedings to release swallowed air. Hold upright against shoulder or seated on lap, gently pat back. Try burping when baby pauses nursing or every 2-3 ounces during bottle feeding. Changing positions can help if baby is hard to burp. Some babies need more burping than others. If baby seems comfortable and not gassy, they may not need to burp every time.

Formula-fed babies typically eat every 3-4 hours (6-10 times in 24 hours). Feeding amounts: • Newborn: 1-3 ounces per feeding • By 1 month: 3-4 ounces per feeding • By 2 months: 4-5 ounces per feeding • By 6 months: 6-8 ounces per feeding Formula digests slower than breast milk, so babies may go longer between feeds. Watch for hunger cues and don't force baby to finish bottles - they know when they're full.

All babies have gas - it's normal as their digestive system matures. Signs: pulling legs up, arching back, crying during or after feeds, hard tummy, passing gas frequently. Causes: swallowing air while feeding, immature digestion, food sensitivities (rare), or normal digestion process. Gas usually improves by 3-4 months as digestive system matures.

NEW guidance: Introduce common allergens EARLY (around 6 months) to reduce allergy risk. Common allergens: peanuts, eggs, milk, soy, wheat, tree nuts, fish, shellfish. Introduce one allergen at a time, in small amount, at home (not restaurant/daycare). Wait 3-5 days before next allergen. For peanuts: Mix smooth peanut butter with puree (never whole peanuts under 4 years).

AAP recommends introducing open cup around 6 months with solid foods. Straw cups can be introduced around 9 months. Transition from bottle to cup by 12-15 months (bottles after 12 months linked to tooth decay, overeating). Cup types: Open cup (best for development), straw cup (easier transition, good for motor skills), 360/sippy cup (less messy but may delay speech development if used long-term). Learning cups is messy! Part of development. Expect spills - totally normal.

Start solids around 6 months (not before 4 months). Signs baby is ready: sits with support, has good head control, shows interest in your food, can move food from front to back of mouth. Start with single-ingredient purees or baby-led weaning. Introduce one new food every 3-5 days to watch for allergies. Common first foods: iron-fortified infant cereal, pureed vegetables (sweet potato, carrots), pureed fruits (banana, avocado, apple).

Most parents worry about milk supply, but true low supply is rare. Real signs: baby not gaining weight, fewer than 6 wet diapers per day after day 5, dark concentrated urine, or dry mouth. Perceived low supply (often false alarms): softer breasts after first weeks, baby feeding frequently, baby fussy in evening, can't pump much (pumping output doesn't equal what baby gets). Milk production is supply and demand - more nursing = more milk.

Nursing strike: Baby suddenly refuses breast after breastfeeding well for weeks/months. Different from natural weaning (which happens gradually after 12 months). Common causes: Teething pain, ear infection, cold/stuffy nose, change in mom's smell (new soap, perfume, foods), overstimulation, strong letdown, biting incident with mom's reaction, schedule changes, stress. Usually temporary - lasts 2-10 days. Can be very stressful for mom and baby.

While rare (especially in breastfed babies), overfeeding can happen. Signs: spitting up large amounts frequently, rapid weight gain (crossing multiple percentile lines upward), hard belly, excessive gas, discomfort during feeding. Bottle-fed babies at higher risk (parents may encourage finishing bottle). Breastfed babies typically self-regulate well. Babies know when they're full - watch for fullness cues.

Paced bottle feeding is technique that mimics breastfeeding - baby controls flow and pace. Helps prevent overfeeding, gas, and bottle preference. Especially important for breastfed babies taking bottles. Traditional bottle feeding: Baby reclined, milk flows continuously (baby swallows fast or chokes). Paced feeding: Baby upright, bottle horizontal, pause frequently (baby controls pace). Benefits: Prevents overfeeding, reduces gas/spit-up, easier transition between breast and bottle, baby recognizes fullness cues.

About half of babies under 3 months spit up regularly. It's usually 1-2 mouthfuls of gentle dribbling, often with a burp. This is different from forceful/projectile vomiting. Most babies outgrow it by 12 months. To reduce: keep baby upright after feeds, avoid overfeeding, and burp during/after feeding.

Restricted tongue or lip movement from tight frenulum. Signs: poor latch, nipple pain, clicking sounds while nursing, poor weight gain, prolonged feeds, milk leaking from mouth. Not all need treatment. Frenotomy (quick snip procedure) often resolves breastfeeding issues. Consult lactation consultant and pediatrician for evaluation.

Vitamin D: 400 IU daily for breastfed babies and formula-fed babies drinking <27 oz/day. Breast milk lacks adequate vitamin D (prevents rickets). Iron: Breastfed babies may need from 4 months; preterm babies need earlier. Most formula has added iron. Always consult pediatrician for proper dosing and timing.