What is breastfeeding?
Breastfeeding, or nursing, is the process by which human breast milk is fed to a child Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that breastfeeding begin within the first hour of a baby’s life and continue as often and as much as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months.
This means that no other foods or drinks, other than vitamin D, are typically given. WHO recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond.
Of the 135 million babies born every year, only 42% are breastfed within the first hour of life, only 38% of mothers practice exclusive breastfeeding during the first six months and 58% of mothers continue breastfeeding up to the age of two years and beyond.
Breastfeeding has a number of benefits to both mother and baby that infant formula lacks. Increased breastfeeding to near-universal levels in low and medium income countries could prevent approximately 820,000 deaths of children under the age of five annually.
Breastfeeding decreases the risk of respiratory tract infections, ear infections, sudden infant death syndrome (SIDS), and diarrhea for the baby, both in developing and developed countries. Other benefits have been proposed to include lower risks of asthma, food allergies, and diabetes. Breastfeeding may also improve cognitive development and decrease the risk of obesity in adulthood.
Benefits for the mother include less blood loss following delivery, better contraction of the uterus, and decreased postpartum depression. Breastfeeding delays the return of menstruation, and in very specific circumstances, fertility, a phenomenon known as lactational amenorrhea. ? Long-term benefits for the mother include decreased risk of breast cancer, cardiovascular disease, diabetes, metabolic syndrome, and rheumatoid arthritis. ?
Breastfeeding is less expensive than infant formula, but its impact on mothers’ ability to earn income is not usually factored into calculations comparing the two feeding methods.
Feedings may last as long as 30–45 minutes each as milk supply develops and the infant learns the Suck-Swallow-Breathe pattern. ? However, as milk supply increases and the infant become more efficient at feeding, the duration of feeds may shorten. ? Older children may feed less often.
When direct breastfeeding is not possible, expressing or pumping to empty the breasts can help mothers avoid plugged milk ducts and breast infection, maintain their milk supply, resolve engorgement, and provide milk to be fed to their infant at a later time. ?
Medical conditions that do not allow breastfeeding are rare. Mothers who take certain recreational drugs should not breastfeed, however most medications are compatible with breastfeeding. ? Current evidence indicates that it is unlikely that COVID-19 can be transmitted through breast milk. Smoking tobacco and consuming limited amounts of alcohol and/or coffee are not reasons to avoid breastfeeding.
Signs your baby is hungry
One of the most common ways your baby will let you know they’re hungry is to cry. Other signs your baby is ready to be fed include:
Licking their lips or sticking out their tongue, Rooting, which is moving their jaw, mouth, or head to look for your breast, putting their hand in their mouth, opening their mouth, Fussiness, Sucking on things
Breastfeeding benefits for the mother
Breastfeeding burns extra calories, so it can help you lose pregnancy weight faster. It releases the hormone oxytocin, which helps your uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth. Breastfeeding also lowers your risk of breast and ovarian cancer. It may lower your risk of osteoporosis, too. Since you don’t have to buy and measure formula, sterilize nipples, or warm bottles, it saves you time and money. It also gives you regular time to relax quietly with your newborn as you bond.
The first few days after birth, your breasts make an ideal “first milk.” It’s called colostrum. Colostrum is thick, yellowish, and there’s not a lot of it, but there’s plenty to meet your baby’s nutritional needs. Colostrum helps a newborn’s digestive tract develop and prepare itself to digest breast milk.
Colostrum is the first phase of breast milk, which changes over time to give your baby the nutrition they need as they grow. The second phase is called transitional milk. You make this as your colostrum is gradually replaced with the third phase of breast milk, called mature milk.
You’ll start to make transitional milk a few days after birth. By 10 to 15 days after birth, you’ll make mature milk, which gives your baby all the nutrition they need.
Most babies lose a small amount of weight in the first 3 to 5 days after birth. This is unrelated to breastfeeding.
As your baby needs more milk and nurses more, your breasts respond by making more milk. Experts recommend trying to breastfeed exclusively (no formula, juice, or water) for 6 months. If you supplement with formula, your breasts might make less milk.
Even if you breastfeed less than the recommended 6 months, it’s better to breastfeed for a short time than no time at all. You can add solid food at 6 months but also continue to breastfeed if you want to keep producing milk.
Is your baby getting enough milk?
Many breastfeeding moms wonder whether their babies get enough milk for good nutrition. If your baby is getting enough breastmilk they should:
Not lose more than 7% of their birth weight in the first few days after delivery
Seem content for about 1-3 hours between feedings, have at least 6 diapers a day wet with very pale or clear pee by the time they are 7-10 days old
These tips, called the ABCs of breastfeeding, will help you and your baby get comfortable with the process:
Awareness. Watch for your baby’s signs of hunger, and breastfeed whenever your baby is hungry. This is called “on demand” feeding. The first few weeks, you may be nursing eight to 12 times every 24 hours. Hungry infants move their hands toward their mouths, make sucking noises or mouth movements, or move toward your breast. Don’t wait for your baby to cry. That’s a sign their too hungry.
Be patient. Breastfeed as long as your baby wants to nurse each time. Don’t hurry your infant through feedings. Infants typically breastfeed for 10 to 20 minutes on each breast.
Comfort. This is key. Relax while breastfeeding, and your milk is more likely to “let down” and flow. Get yourself comfortable with pillows as needed to support your arms, head, and neck, and a footrest to support your feet and legs before you begin to breastfeed.
Are there medical considerations with breastfeeding?
In a few situations, breastfeeding could cause a baby harm. Here are some reasons you should not breastfeed:
You are HIV positive. You can pass the HIV virus to your infant through breast milk, You have active, untreated tuberculosis, You’re receiving chemotherapy for cancer.
Talk with your doctor before starting to breastfeed if you’re taking prescription drugs of any kind. Your doctor can help you make an informed decision based on your particular medication.
Having a cold or flu should not prevent you from breastfeeding. Breast milk won’t give your baby the illness and may even give antibodies to your baby to help fight off the illness.
What are some common challenges with breastfeeding?
Sore nipples
You can expect some soreness in the first weeks of breastfeeding. Make sure your baby latches on correctly, and use one finger to break the suction of your baby’s mouth after each feeding. That will help prevent sore nipples. If you still get sore, be sure you nurse with each breast fully enough to empty the milk ducts. If you don’t, your breasts can become engorged, swollen, and painful.
Holding ice or a bag of frozen peas against sore nipples can temporarily ease discomfort. Keeping your nipples dry and letting them “air dry” between feedings helps, too. Your baby tends to suck more actively at the start. So, begin feedings with the less-sore nipple.
Dry, cracked nipples
Avoid soaps, perfumed creams, or lotions with alcohol in them, which can make nipples even more dry and cracked. You can gently apply pure lanolin to your nipples after a feeding, but be sure you gently wash the lanolin off before breastfeeding again. Changing your bra pads often will help your nipples stay dry. And you should use only cotton bra pads.
Worries about producing enough milk
A general rule of thumb is that a baby who’s wetting six to eight diapers a day is most likely getting enough milk. It’s best not to supplement your breast milk with formula, and never give your infant plain water. Your body needs the frequent, regular demand of your baby’s nursing to keep producing milk. Some women mistakenly think they can’t breastfeed if they have small breasts. But small-breasted women can make milk just as well as large-breasted women. Good nutrition, plenty of rest, and staying well hydrated all help, too.
Pumping and storing milk
You can get breast milk by hand or pump it with a breast pump. It may take a few days or weeks for your baby to get used to breast milk in a bottle.
So, begin practicing early if you’re going back to work. Breast milk can be safely used within 2 days if it’s stored in a refrigerator. You can freeze breast milk for up to 6 months. Don’t warm up or thaw frozen breast milk in a microwave. That will destroy some of its immune-boosting qualities, and it can cause fatty portions of the breast milk to become super-hot. Thaw breast milk in the refrigerator or in a bowl of warm water instead.
Inverted nipples
An inverted nipple doesn’t poke forward when you pinch the areola, the dark skin around the nipple. A lactation consultant — a specialist in breastfeeding education — can give you tips that allow women with inverted nipples to breastfeed successfully.
Breast engorgement
Breast fullness is natural and healthy. It happens as your breasts become full of milk, staying soft and pliable. But breast engorgement means the blood vessels in your breast have become congested. This traps fluid in your breasts and makes them feel hard, painful, and swollen. Alternate heat and cold, for instance using ice packs and hot showers, to relieve mild symptoms. It can also help to release your milk by hand or use a breast pump.
Breast infection (mastitis)
This occasionally results when bacteria enter the breast, often through a cracked nipple after breastfeeding. If you have a sore area on your breast along with flu-like symptoms, fever, and fatigue, call your doctor. Antibiotics are usually needed to clear up a breast infection, but you can most likely continue to breastfeed while you have the infection and take antibiotics. To relieve breast tenderness, apply moist heat to the sore area four times a day for 15 to 20 minutes each time.
Being overly anxious or stressed can interfere with your let-down reflex. That’s your body’s natural release of milk into the milk ducts. It’s triggered by hormones released when your baby nurses.
