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Breastfeeding has many benefits for both baby and the mum.
There is nothing that will give your baby the benefits that breastfeeding gives, both physically and emotionally.
Breastmilk is naturally made only for your baby. It is her food individually made just for her and her needs. Breastmilk has every vitamin, mineral and nutritional elements your baby needs. Breastmilk changes throughout the day, the meal and the year to match all those changes in baby’s nutritional requirements.
Breastmilk contains living cells that are unique to your milk and the needs of your baby. They can inhibit the growth of harmful bacteria and viruses in your baby’s body. Interferon and interleukins that are found in breastmilk are both very strong anti-infectives.
Babies who are breastfed are less likely to develop ear infections, respiratory problems and intestinal issues. Allergies and dental problems are also less likely in breastfeeding babies. The immune system of breastfeeding baby responds better to vaccinations and risk for certain illnesses is much lower than with formula-fed babies.
Breastfeeding babies have a lower risk of SIDS and are much less likely to develop diabetes, Chron’s disease, ulcerative colitis, heart diseases and even certain cancers as older child or adult.
Colostrum or baby’s first milk that is produced in small amounts during the first few days has concentrated immunological properties that protect your baby during the first few months of her life.
Colostrum contains a high concentration of secretory immunoglobulin A or sIgA, an anti-infective agent that coats baby’s intestines to protect against the passage of germs and foreign proteins that could create allergic sensitivities. It also contains pancreatic secretory trypsin inhibitor or PSTI which protects and repairs the infant’s intestines. It is found in all human milk, but it’s seven times higher in colostrum, providing extra protection to newborn’s intestines.
Mature milk has ingredients that contribute to lifelong health. The breastfeeding baby gains a sturdy immune system thank to all ingredients of breast milk.
The way your baby is breastfeeding is also important and beneficial. When your baby breastfeeds the muscles in her jaws are exercised and massaged in a way that causes the bones in her face and jaw to develop more fully. This helps in developing her speech and chewing of food.
Breastfeeding is also very beneficial for the mother.
After birth, it helps to contract your uterus and slow down the bleeding. This means your uterus is getting back to its original size faster.
Breastfeeding mothers have a lesser risk of heart diseases and diabetes. Breastfeeding also protects against breast, uterine and cervical cancer and helps to protect against osteoporosis in later age.
Besides all the benefits that provide, breastfeeding is simple and practical. It makes life easier for mums in many ways.
It is also an invaluable bonding experience for mums and babies as it helps to deepen the attachment between mum and her baby.
How the Breastfeeding Works?
Your body begins preparing for breastfeeding even before you became pregnant.
During pregnancy, breasts prepare for lactation through a complex interaction of hormones that causes rapid growth of milk glands. Milk glands contain lobules, small round sacs that make milk and the pathways (ducts) for milk to flow out the nipple. Blood supply to the breasts supports this growth and delivers the nutrients in breastmilk.
During pregnancy, hormones prolactin and human placental lactogen stimulate your breasts to produce colostrum.
After birth, progesterone levels fall, and prolactin levels increase, triggering breast milk production.
Your breasts size doesn’t determine the quality or quantity of the milk you produce. Larger breasts simply have more fat tissue surrounding the milk-producing structures than smaller breasts have. Also, all sizes and shapes of breasts, areolae, and nipples are usually perfect for breastfeeding.
Milk production works on a system of supply and demand. That means that the amount of new milk produced depends on how much has been taken out. As the milk is being removed from the breast, the milk production continues.
The most important part of milk removal is during the first few weeks after birth. That is the time when milk production capability is established. It’s like calibration of milk supply that happens with every new baby. The more milk you remove during these weeks the more milk you will be able to produce for your baby.
When your baby nurses, nerves in the nipples and areola send a signal to the pituitary and she releases a hormone called oxytocin. Oxytocin causes those little muscles around the alveoli to squeeze, building milk pressure inside the breasts and creating milk release or let down. This might feel like tingling in your breasts and you might feel thirsty or sleepy.
Breastfeeding is natural and there is no preparation needed for it, just education. Your body does all the preparation during pregnancy and after birth.
First Feed After Birth
After you give birth to your baby, the best way to start your breastfeeding journey successfully is to have a non-interrupted skin-to-skin time with your baby. This should last at least an hour, but preferably two. Every other non-urgent procedure like measurements and bathing the baby can be done afterwards.
Skin-to-skin is extremely important for you and your baby as this is a very sensitive time when connections are made for the entire life.
Skin-to-skin helps to stabilise your baby’s heart rate, breathing and temperature.
It also stabilises your own temperature, prevents baby blues, reduces both yours and your baby’s stress and also increases the likelihood of breastfeeding.
You can offer the breast during this time, so your baby can nurse colostrum.
Some babies need more time and, until they are ready, skin-to-skin is all they need.
Correct Latch and How to Manage It?
Latching your baby correctly on to the breasts is the single most important thing after birth for successful breastfeeding.
Baby’s latch affects the amount of milk she receives. It also affects your comfort while breastfeeding. Getting a good latch may occur naturally or you may need to help your baby to latch-on well.
Some babies latch immediately onto the breast with no issues and a perfect latch. Others seem uninterested or sleepy or have difficulty to latch on. You will notice that the latch is bad by the discomfort and pain that bad latch can cause.
No matter if your baby latched immediately after birth or not, the stimulation of her nuzzling, licking and closeness to your body encourages milk production.
How to tell if your baby has a good latch?
It’s easy to spot a good latch.
Just before your baby latches on, she opens her mouth as wide as a yawn, with her tongue down and forward. She then draws your nipple and much of the areola into her mouth giving her a deep latch. Her chin indents your breast and her nose is close and touching your breast. Her lower lip is flanged outward and her tongue is extended over her lower gum.
Her body is positioned towards you, her belly touches yours.
Feeding begins with short, rapid sucks, her jaw is moving rhythmically as she suckles. After the milk has let down, she settles into a slower pattern, with bursts of sucking and short pauses. You can hear her swallow.
What to do if your baby doesn’t have a good latch?
When your baby doesn’t latch effectively onto your breasts, she might not get enough milk. Breastfeeding may become difficult and painful.
Signs of a bad latch:
- baby lips are pursed as though sucking on a straw
- her cheeks appear sunken because there’s not enough breast tissue to fill her mouth
- clicking noise sounds during the feed
- baby slips off the breast and then roots frantically
- nipple pain that continues after the first minute of feeding
How to help your baby latch correctly?
Here are a few tips on how to latch your baby correctly:
- Always use a comfortable breastfeeding position.
- Have your baby’s body touch your chest and her arms near your breasts instead of tucked between the two of you.
- Support your baby’s head lightly, don’t put the entire hand on her head. Light support allows your baby to move her head freely which helps to latch more easily.
- Bring your baby to the breast, not your breast to the baby. Allow your breast to remain where it naturally falls and avoid moving it. Keep your fingers away from the areola.
- Help the baby to get a nice and deep latch. Let her nose and upper lip be near your nipple, lightly press her back to encourage slight head tilt back. Place baby’s chin on your breast and her lower lip on the outer edge of the areola. This will encourage the baby to open her mouth and grasp the areola and nipple. Wait for her to open her mouth wide as if yawning, then bring her upper lip over the nipple.
- Make sure that baby’s chin indents your breast and her nose is near or barely touching your breast.
- Baby needs to have more areola in her mouth near the lower jaw. You should see more areola above her lips.
- Sound of swallowing is a sign of a good latch. You can also notice this visually.
- Look at your nipple after the feed is over. Your nipple should be evenly rounded or the same shape as it was before feeding. It should not look compressed or have a ridge in the middle or on one side.
- Make sure your baby is close to you during the feeding. Press on her upper back with your palm or lean back so your baby is naturally in a position close to your body. You can also add a pillow to support your baby’s body.
- If you are still having difficulties in latching your baby or feeding is painful and you suspect latch is still bad, consider finding professional help.
The best support and help with breastfeeding you can get comes from IBCLC or Board-Certified Lactation Consultant. IBCLC’s are breastfeeding experts who recognise the value of breastfeeding and dedicate their work to its promotion and protection. IBCLC is usually someone from the medical area who successfully passed an exam administered by the Board of Lactation Consultant Examiners.
To find an IBCLC person in your area:
- Ask for IBCLC in your hospital if there is one or check if they offer breastfeeding support
- Ask your childbirth educator or your local La Leche League group to refer you to one (https://www.llli.org)
- Search the International Lactation Consultant Association website (https://www.ilca.org)
- You can also ask for breastfeeding help from trained nurses and midwives, a doula, La Leche League Leader or group, or other breastfeeding groups in your area.
Is My Baby Getting Enough Milk?
During the first few days, most babies lose 5 to 8 per cent of their birth weight. After your milk comes in babies start to gain weight. Full-term babies usually regain the weight they lost and return to their birth weight by 10 to 14 days postpartum.
To make sure that your baby is getting enough milk watch for these signs:
- Baby is feeding on the breast at least 10-12 times in 24 hours. She feeds vigorously.
- During the feed, you hear swallowing. Sometimes, the baby swallows after every suck. Sometimes baby sucks a few times before swallowing. Baby fully extends her jaw when swallowing.
- Your breasts are softer after the feed.
- Baby is happy and satisfied most of the time.
- Baby has plenty of wet diapers. Look for at least 6 wet diapers in 24h.
- Your baby has plenty of poop diapers. Look for at least 3 poop diapers daily for the first 6 weeks. Sometimes it can be even more or with every feed. The poop is usually yellow and seedy.
- Your baby has returned to her birth weight at around 14 days postpartum. If not, consider asking for help. Some of the issues could be that your baby has trouble getting enough milk or you may need to increase your milk supply. To be sure you are weighing your baby correctly, always use the same scale.
Here are some ideas about what to do if you suspect your baby is not getting enough milk:
Your baby’s latch is not effective
If a baby can’t latch on well, she can’t get enough milk. Try to improve latch with tips from the previous lesson. If that doesn’t seem to work, ask for professional help. Latch problems can be solved! The sooner you get help the sooner you can fix the problem.
Make sure you are feeding on demand, not on the schedule
Babies need to feed more frequently than once every three hours. Make sure not to skip night feeds. Night feeds are especially important for your supply.
Feed your baby on demand – that means every time she is nervous, upset or about to start crying. Don’t wait until she starts to cry. Maintain this feeding schedule during the day and night. Let your baby feed for as long as she wants, don’t move her from the breast after 20 min. Some babies can feed for an hour or longer in the early days.
Offer the other breast too
Let her empty the first and then always offer the other one. On the next feed always start with the one she had last.
Be careful with pacifiers
Pacifiers can lead to faulty sucking patterns and may shorten the duration of breastfeeding. Pacifiers interfere with establishing supply so avoid getting one for your baby until your supply is not established or for at least 2-3 months.
Maintain the feeding schedule
Babies can sometimes be sleepy during the first days. If they don’t wake up for a feed it is easy to decrease the overall number of feeds. If your baby is sleepy make sure to wake her up every 2-3 hours for a feed, including during the night.
Check if your baby still has jaundice
If she is yellowish on her face and chest, and the whites of her eyes are yellowish, she might have it. Jaundice can make babies sleepier. Frequent feeding helps relieve jaundice so make sure to wake baby frequently and make sure she is feeding well on the breast.
To help your baby feed more while she is on the breast, to make feeds longer and to help baby to empty the breast better, you can try breast compressions.
Here’s how:
- Hold your breast with your hand, placing your thumb and one to two fingers near the outer part of your breast.
- Compress your breast by squeezing your fingers and thumb together and slightly pressing into your breast then out toward your nipple.
- When your baby begins to suckle less, hold your breast in another position and compress again.
Your Nutrition During Breastfeeding
During pregnancy, your body prepares for lactation by storing extra fat to support milk production. After birth, you will lose a lot of weight gained during pregnancy, but this extra fat may stay as long as you breastfeed. This is your body making sure you produce enough breastmilk.
Your body will also draw from your vitamin and mineral reserves to produce milk. A poor diet can affect your health so make sure you are eating healthy and nutritious food.
We have covered nutrition in more detail as part of our Nutrition course so make sure to check it out.
During breastfeeding, be sensitive to caffeine and alcohol intake.
It is usually fine to take up to two cups of caffeinated drinks per day. This level will not affect your baby.
When you drink an alcoholic beverage, the concentration of alcohol in your blood equals the alcohol content in your milk. Keep this in mind.
Although it is not harmful to have a drink occasionally it is generally best to avoid it or drink only occasionally until the baby is weaned.
If you drink alcohol consume it in moderation. Wait to have your drink until just after the baby has nursed. That way you allow time for the reduction of the alcohol in your bloodstream and breastmilk before the baby needs to nurse again.
During breastfeeding, it is not necessary to avoid any specific food.
In rare cases, food that a mother ate affects the baby.
If you think a certain food bothers your baby, eliminate it from your diet for a few weeks to a month to see if your baby improves. Consult your doctor or lactation consultant if you’re worried.
Breastfeeding Concerns
Here are some of the most common breastfeeding concerns that most women have at the beginning of their breastfeeding journey. I provided some basic information on each and ideas on how to solve them.
Breasts fullness and pain
This often happens when your milk comes in a few days after birth.
The initial fullness also comes from the retained fluid caused by your breast’s response to the increased milk supply.
Feeding frequently may help to prevent discomfort.
Breast fullness usually lasts for a few days. After several days you might notice your breasts appear smaller and softer, but you still produce plenty of milk.
To help yourself with initial fullness, continue to breastfeed on demand and if your breasts are really sore you can apply cold clothes in between the feeds.
Plugged ducts and mastitis
Most breastfeeding mums will face plugged ducts or worse, mastitis.
Plugged ducts can be a result of milk not being taken out, maybe because the baby slept the entire night, or you missed a feed. It also can be caused by a pressure on the ducts from a bra or carrying your baby.
Most plugs are thickened milk. A plugged duct can result in mastitis, but they do not have to.
Mastitis is inflammation. It mostly happens because of the damaged nipples that let bacteria in or weakened immune system that can’t deal with plugged ducts. Mastitis always comes with chills and fever, warm red and sensitive area on one breast.
To help yourself it is the most important thing to empty the breast the best you can. This means plenty of breastfeeding or expressing. The goal is to take the milk out. Breastfeed often. Before feeds apply a warm pack or immerse your breasts into the hot water to ease the milk flow. In-between feeds apply ice packs.
In the case of plugged ducts, massage helps. In case you are not feeling better in a period of 24-48h see the doctor as you might needs antibiotics for mastitis.
Problems with milk supply
If you think you have issues with milk supply and try to increase it, be sure that you really do have it. Sometimes mums have a fear that they don’t have enough milk when, in reality, they do have plenty and the baby is gaining weight nicely.
If your baby is not gaining weight as she should be, first try to figure out where is the problem.
Is it that you don’t produce enough milk? Or your baby is not taking enough milk? Or you are not producing enough milk because your baby is not taking enough?
You should find an expert in breastfeeding like IBCLC and try to find out where is the problem and how to solve it. It can be the latch that is just wrong or issues with tongue-tie so baby can’t take enough milk.
Or there are maybe other problems like hormones issues or thyroid issues that can cause problems with milk release, or some other issues with either your baby or yourself.
Best is to find yourself supportive help so together you can resolve the issues.
Sore nipples
Breastfeeding should never hurt. If you’re experiencing nipple pain, there is often a very good reason for it.
During the early days, most mums experience nipple pain because of the bad latch.
When a baby has a bad latch, this can make nipples sore.
Sometimes breast engorgement during the first few days can make hard for a baby to latch correctly and can make latch shallow. If this is the case, your nipple will look creased after the feed and will have a white stripe or be flattened on the side.
To help yourself you will have to work on improving the latch. Usually, when the latch is better, the pain will go away. In case you still have problems with nipple pain, ask for help as nipple pain can be caused by other things as well like baby’s tongue-tie or thrush.
To ease the pain and heal the nipples use lanolin nipple creams or hydrogel pads for nipples. Air-dry your nipples and express a little bit of your milk on the nipples to make healing faster.
Introducing Solids
The World Health Organization says that infants should be exclusively breastfed for the first 6 months of their life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond.
With these recommendations, many seem to agree, like The American Academy of Paediatrics, The Canadian Paediatric Society and The United Kingdom’s Minister for Public Health.
Nothing except breastmilk and required medicines should be offered to infants before they are at least 6 months old.
Most babies are ready for solids around 6 months of age and some even later.
This is the time when the baby’s digestive tract is mature enough for food that is not breastmilk. If baby’s digestive tract is not mature and you give her food other than breastmilk, there can be a greater risk for allergies as lining in the intestines is not sealed and some of the substances can slip into the baby’s bloodstream. This can cause allergies and eczemas.
A baby’s system is less likely to have an allergic reaction around 6 months and her digestive enzymes are up and running at this age too. She can eat food all by herself, grasping it and chewing.
For the first baby food choose healthy and unprocessed food like fruits and veggies, chicken, ground beef, pork, lamb or fish. After this, you can also introduce grains like rice, rice cakes, whole-grain bread, homemade muffins.
Go with food that you are using daily and slowly introduce it to your child. Offer sticks and chunks so the baby can feed itself. Don’t forget to enjoy the process.
Continue with breastfeeding on demand.
Weaning
It is up to you and your baby to decide when is the right time for weaning.
WHO recommends breastfeeding for 2 years and beyond if a mum and the baby want it.
Remember that sometimes your baby will be ready to wean and sometimes this can be you. If you are feeling ready to stop breastfeeding and you believe your baby got enough from you, then go for it. Your baby will adapt to new situations.
Sometimes, you will be the one to adjust as stopping breastfeeding can often be hard on mums if they are not ready. Before you are sure that you want to stop breastfeeding, consider slowly decreasing the number of feeds during the day (using distraction methods or weaning). Or decrease the number of feeds during the night first.
If you want to continue breastfeeding and let your baby/child wean when she’s ready, remember you are doing what is best for you and your child.
Don’t bother with other people’s comments. Breastfeeding is a relationship between your baby and yourself.
Every relationship is different and what works for some, doesn’t work for others.
Listen to yourself and your baby and ignore everything else.
Expressing Milk & Storage
Many mums must express milk for a number of reasons.
Some have premature babies, some babies can’t latch, some mums must go back to work, or just want to have a milk stash for just in case.
If you are considering full-time milk expressing than consider buying a consumer-grade electronic pump. These have more strength than manual pumps and are getting better and better. The good ones have a double pumping option and allow you to customise suction and speed. These are great for working moms when supply is well established.
If you have a newborn or premature baby, try to find or rent hospital grade pump as these are the ones strong enough for when your supply is not established and when you need to work on it.
For occasional pumping manual pumps can work, as well as hand expressing.
How often you pump will depend on what you want.
If you have a newborn baby and trying to establish your supply then you should aim to pump at least 8 to 12 times a day, including the night. After your supply is established, 6 to 8 times should be enough.
Listen to your body and adjust based on what your body is saying to you.
Milk Storage Guidelines
Here are some guidelines on storing your milk:
- At room temperature (19-26℃ or 66-79℉):
- Store for 4 to 8 hours
- Cover containers with milk and keep them on the coolest place possible
- Insulated cooler bag (-5 to +4℃ or 23-39℉):
- Store for 24 hours
- Put ice packs in contact with milk container and limit opening the bag
- Refrigerator (4℃ or 39℉):
- Store for 3 to 8 days
- Store in the back of the main part of the refrigerator.
- The freezer compartment of the refrigerator (-15℃ or 5℉):
- Store for up to 2 weeks
- Keep the milk in the back part of the freezer
- The freezer compartment of the refrigerator with separate doors (-18℃ or 0℉):
- Store for up to 3-6 months
- Try to open the freezer as little as possible
- Deep freezer (-4 to -18℃ or 25 to 0℉):
- Store for 6 to 12 months
Breastfeeding When You Are Ill
When your baby is sick it is perfectly fine and very beneficial for her to breastfeed. But what happens when you are ill or taking medication?
In most cases, you can continue to breastfeed your baby when ill. It is fine to breastfeed with colds or flu, with fever, tummy bug, food poisoning and with many other viral and bacterial infections.
If you have a special chronic illness, it is best to check with your doctor, but a large number of chronic illnesses are compatible with breastfeeding.
Always ask for medication that is breastfeeding friendly.
There are very few situations where there is no available medication. If you are taking medication always check that it’s breastfeeding friendly.
For more information on medication during breastfeeding check these resources:
- LactMed, the U.S. National Institute of Health’s Drugs and Lactation Database
- Infant Risk Center by Thomas Hale, Ph.D., R.Ph
- Book by Dr Thomas Hale: Medications and Mothers Milk
Going Back to Work
Returning to work is something that must happen for many mums. And a lot of them are not sure how, or if, breastfeeding can even work if they spend most of the day separated from their baby.
But it is perfectly possible to keep breastfeeding even when you are back to work.
The most important factor is carefully planning your return to work and your baby’s day-care.
Try to use the maximum time you can to be with your baby. When going back to work, try to find day-care that will suit your needs. Explain that you are breastfeeding and that your baby will receive breastmilk while in day-care. It is very important to find someone supportive and understanding as this can make your life much easier.
Before going back to work, you will have to prepare a milk stash for your baby to take while you are working. It is important to start expressing earlier so you can increase your milk supply to manage your baby feeds while you are away, along with the regular feeds.
It is best to pump after every feed. It can appear that you are not getting any milk in the beginning but eventually, your supply will increase, and you will be able to make a stash of milk.
When you start working during the day-care your baby can drink your milk from a bottle and when she is home with you she can breastfeed as much as she wants. Feed her in the morning before day-care, in the afternoon when you pick her up and, in the evening, as much as she wants.
Continue with at least one nightly feed as they are very important for your supply.
Expect to pump during work at least 2 to 3 times. This is normally in the morning, soon after you arrive, at lunchtime and in the afternoon. This is the milk that your baby will drink in the day-care and by expressing regularly you are also keeping your supply up.
Where to ask for help?
Breastfeeding is an amazing journey for many moms but can be very hard and sometimes even complicated.
If you have any breastfeeding issues, don’t hesitate to ask for help. There are many solutions and even problems that appear to be huge can be solved with the right kind help.
Here are some websites and books that can be helpful during your breastfeeding journey:
Recommended Books:
