Breastfeeding

What is Breastfeeding?

Breastfeeding is when you feed your baby breast milk, usually directly from your breast. It’s also called nursing. Making the decision to breastfeed is a personal matter. It's also one that's likely to draw opinions from friends and family.

Many medical experts, including the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists, strongly recommend breastfeeding exclusively (no formula, juice, or water) for 6 months. After the introduction of other foods, it recommends continuing to breastfeed through the baby’s first year of life.

How often you should breastfeed your baby depends on whether your baby prefers small, frequent meals or longer feedings. This will change as your baby grows. Newborns often want to feed every 2-3 hours. By 2 months, feeding every 3-4 hours is common, and by six months, most babies feed every 4-5 hours.

You and your baby are unique, and the decision to breastfeed is up to you. 

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

Benefits of Breastfeeding for the Baby

Breast milk provides the ideal nutrition for infants. It has a nearly perfect mix of vitamins, protein, and fat -- everything your baby needs to grow. And it's all provided in a form more easily digested than infant formula. Breast milk contains antibodies that help your baby fight off viruses and bacteria. Breastfeeding lowers your baby's risk of having asthma or allergies. Plus, babies who are breastfed exclusively for the first 6 months, without any formula, have fewer ear infections, respiratory illnesses, and bouts of diarrhea. They also have fewer hospitalizations and trips to the doctor.

Breastfeeding has been linked to higher IQ scores in later childhood in some studies. What's more, the physical closeness, skin-to-skin touching, and eye contact all help your baby bond with you and feel secure. Breastfed infants are more likely to gain the right amount of weight as they grow rather than become overweight children. The AAP says breastfeeding also plays a role in the prevention of SIDS (sudden infant death syndrome). It's been thought to lower the risk of diabetes, obesity, and certain cancers as well, but more research is needed.

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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.

Will You Make Enough Milk to Breastfeed?

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

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What's the Best Position for Breastfeeding?

The best position for you is the one where you and your baby are both comfortable and relaxed, and you don't have to strain to hold the position or keep nursing. Here are some common positions for breastfeeding your baby:

  • Cradle position. Rest the side of your baby's head in the crook of your elbow with their whole body facing you. Position your baby's belly against your body so they feel fully supported. Your other, "free" arm can wrap around to support your baby's head and neck -- or reach through your baby's legs to support the lower back.
  • Football position. Line your baby's back along your forearm to hold your baby like a football, supporting the head and neck in your palm. This works best with newborns and small babies. It's also a good position if you're recovering from a cesarean birth and need to protect your belly from the pressure or weight of your baby.
  • Side-lying position. This position is great for night feedings in bed. Side-lying also works well if you're recovering from an episiotomy, an incision to widen the vaginal opening during delivery. Use pillows under your head to get comfortable. Then snuggle close to your baby and use your free hand to lift your breast and nipple into your baby's mouth. Once your baby is correctly "latched on," support the head and neck with your free hand so there's no twisting or straining to keep nursing.
  • Cross-cradle hold.  Sit straight in a comfortable chair that has armrests. Hold your baby in the crook of your arm that's opposite the breast you will use to feed them. Support their head with your hand. Bring your baby across your body so your tummies face each other. Use your other hand to cup your breast in a U-shaped hold. Bring your baby's mouth to your breast and cradle them close, and don't lean forward.
  • Laid-back position.  This position, also called biological nurturing, is a lot like it sounds. It's meant to tap into the natural breastfeeding instincts you and your baby have. Lean back, but not flat, on a couch or bed. Have good support for your head and shoulders. Hold your baby so your entire fronts touch. Let your baby take any position they're comfortable in as long as their cheek rests near your breast. Help your baby latch on if they need it.

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How to Get Your Baby to 'Latch on' During Breastfeeding

Position your baby facing you, so your baby is comfortable and doesn't have to twist their neck to feed. With one hand, cup your breast and gently stroke your baby's lower lip with your nipple. Your baby's instinctive reflex will be to open the mouth wide. With your hand supporting your baby's neck, bring the mouth closer around your nipple, trying to center your nipple in the mouth above the tongue.

You'll know your baby is "latched on" correctly when both lips are pursed outward around your nipple. Your infant should have all of your nipple and most of the areola, which is the darker skin around your nipple, in their mouth. While you may feel a slight tingling or tugging, breastfeeding should not be painful. If your baby isn't latched on correctly and nursing with a smooth, comfortable rhythm, gently nudge your pinky between your baby's gums to break the suction, remove your nipple, and try again. Good "latching on" helps prevent sore nipples.

Tips for New Breastfeeding Moms

Some things help you prepare for breastfeeding: 

  • Get regular prenatal care to help you avoid preterm birth.
  • Tell your doctor you plan to breastfeed and ask what support the facility you plan to deliver in offers to help you breastfeed after birth.
  • Take a breastfeeding class.
  • Ask your doctor to connect you with a lactation consultant, who can teach you breastfeeding basics and help you if have issues.
  • Talk to your doctor about any health conditions you have or medications you take that could interfere with breastfeeding.
  • Tell your doctor and hospital health care providers that you want to breastfeed as soon as possible after delivery.
  • Talk to friends who breastfeed or join a support group for breastfeeding.
  • Stock up on the supplies you need for breastfeeding, such as nursing bras and other items.

These tips, called the ABCs of breastfeeding, will help you and your baby get comfortable with the process:

  1. 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.
  2. 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.
  3. 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.

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Are There Medical Considerations With Breastfeeding?

In a few situations, breastfeeding could cause a baby harm. Here are some reasons you should not breastfeed:

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.

Also, the AAP suggests that -- starting at 4 months of age -- exclusively breastfed infants, and infants who are partially breastfed and receive more than half of their daily feedings as human milk, should be supplemented with oral iron. This should continue until foods with iron, such as iron-fortified cereals, are introduced in the diet. The AAP recommends checking iron levels in all children at age 1.

Discuss supplementation of both iron and vitamin D with your pediatrician. Your doctor can guide you on recommendations about the proper amounts for both your baby and you, when to start, and how often the supplements should be taken.

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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.
  • Blocked ducts. A single sore spot on your breast, which may be red and hot, can signal a plugged milk duct. This can often be relieved by warm compresses and gentle massage over the area to release the blockage. More frequent nursing can also help.
  • 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.
  • Stress. 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. It can also be triggered just by hearing your baby cry or thinking about your baby. Stay as relaxed and calm as possible before and during nursing -- it can help your milk let down and flow more easily. That, in turn, can help calm and relax your infant.
  • Premature babies may not be able to breastfeed right away. In some cases, mothers can release breast milk and feed it through a bottle or feeding tube.
  • Warning signs. Breastfeeding is a natural, healthy process. But call your doctor if:
    • Your breasts become unusually red, swollen, hard, or sore.
    • You have an unusual discharge or bleeding from your nipples.
    • You're concerned your baby isn't gaining weight or getting enough milk.

Where Can I Get Help With Breastfeeding?

Images of mothers breastfeeding their babies make it look simple -- but some women need some help and coaching. It can come from a nurse, doctor, family member, or friend, and it helps mothers get over possible bumps in the road.

Reach out to friends, family, and your doctor with any questions you may have. Most likely, the women in your life have had those same questions.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on September 14, 2020

Sources

SOURCES:

News release, American Academy of Pediatrics.

Baker, R. Pediatrics, November 2010.

American Academy of Pediatrics: "Policy Statement: Breastfeeding and the Use of Human Milk."

American College of Obstetricians and Gynecologists: "Breastfeeding Your Baby."

CDC: "Proper Handling and Storage of Human Milk."

National Women's Health Information Center: "Benefits of Breastfeeding."

National Women's Health Information Center: "Questions and Answers About Breastfeeding."

National Women's Health Information Center: "How Lifestyle Affects Breast Milk."

La Leche League International: "How Do I Position My Baby to Breastfeed?"

American Academy of Family Physicians: "Breastfeeding: Hints To Help You Get Off to a Good Start."

National Library of Medicine: "Overcoming Breastfeeding Problems."

KidsHealth.org: "Feeding Your Newborn."

American College of Nurse-Midwives, GotMom.org: "Breastfeeding with Confidence."

National Institute of Child Health and Human Development: “Breastfeeding and Breast Milk.”

USDA: WIC Breastfeeding Support: US Department of Agriculture: “The Phases of Breast Milk.”

Healthychildren.org (American Academy of Pediatrics): “How Often and How Much Should Your Baby Eat?” “How to Tell if Your Breastfed Baby is Getting Enough Milk.”

Mayo Clinic: “Breastfeeding Positions.”

La Leche League USA: “Lie Back and Relax! A Look at Laid-Back Breastfeeding.”

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