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Breastfeeding

In this guide:
  • Why breast milk
  • How milk adjusts for your baby's needs
  • When and how often to feed?
  • Making breastfeeding easier
  • Increasing milk supply
  • What affects quality and quantity?
  • Breastfeeding mom's bill of rights
  • Where to get help

Breastfeeding infant

Overview

The prospect of breastfeeding can be daunting: What if my baby doesn't latch on? What if there's not enough milk? What if it hurts too much? The best way to handle the anxiety: Learn as much as possible about breastfeeding before you start. The American Academy of Pediatrics recommends that babies breastfeed exclusively for at least six months and at least partially, in combination with solids, until they turn 1. Not everyone can achieve that, but here's what you need to know - about getting your baby to latch on properly, how breastfeeding affects you, and more - so you both can get the best start.


Why Breast Milk

From the moment your baby is born, your body starts producing the perfect mix of nutrients in your breast milk for him. While formula contains essential vitamins and proteins that a baby needs, it doesn't have all the benefits of breast milk, such as antibodies that strengthen your baby's immune system.

It's good for your baby. Research shows that breastfed babies are significantly less likely to suffer from ear infections, vomiting, diarrhea, pneumonia, asthma, diabetes, and urinary-tract infections, as well as from food allergies and eczema if your family has a history of either. Nursing may also boost babies' brainpower. Mother's milk also helps protect babies from becoming obese later in life, and girls who are breastfed are also less likely to develop breast cancer as adults.

It's good for you. Oxytocin, a hormone released during nursing, helps to return your uterus to its regular size more quickly and reduces postpartum bleeding. Breastfeeding also burns about 500 calories a day, which can help you lose your baby weight faster. And women who nurse are at lower risk of developing breast cancer, rheumatoid arthritis, and possibly osteoporosis. Not to mention that breastfeeding is convenient (no bottles to wash or formula to mix) and cheaper than formula (you need only a few nursing bras and a breast pump).


How milk adjusts for your baby's needs

At birth: Your first milk is colostrum, a thick, yellowish pre-milk that's high in the fats and proteins your newborn needs and easy for her to digest. It's also extremely rich in the substances that protect her against infections.

Two to five days after birth: Your milk will begin to "come in" now. This transitional milk is thinner than colostrum but far more plentiful, and higher in lactose and fat, which help your baby's brain develop. Your breasts will feel their largest and firmest now. You'll begin to feel your milk "let down," or move through your breasts - often described as a pins-and-needles sensation.

Two weeks after birth: Your milk will become even thinner and more watery, but it's still rich in nutrients. Your breasts will probably feel smaller and softer now. Mature milk becomes fattier over the course of a feeding (the first part is mainly water), so allow your baby to drink for about ten minutes before you switch to the other breast.


When and how often should you feed

Day 1: Your first breastfeeding session should take place within an hour of your baby's birth, if possible. This timing takes best advantage of his instinct to suckle, kick-starts your milk, and is a great way to bond. It also helps your uterus contract, which reduces bleeding. Don't worry about getting the technique exactly right at this first feeding.

After that, make sure he's latching on correctly as early as possible. If he's not, he'll be hungry, your nipples will hurt (a lot), and both of you will get frustrated - and you may decide to throw in the towel. Signs that you're both doing it right:

  • His mouth is open wide, with his lips curled out.
  • His mouth covers the entire areola, not just the nipple.
  • He's swallowing regularly and seems content.
  • It doesn't hurt you (except maybe for the first few suckles).
  • If he doesn't seem to be latching on properly, ask to see the hospital's lactation consultant.

The first few weeks: Your baby may eat as often as once an hour. Some signs your baby is hungry: smacking his lips, suckling motions, moving his head around in search of your breast, kicking and squirming, and looking alert.

From around 1 month: Once a routine is established, most newborns feed every two to three hours during the day, and around every four hours at night. Your baby should have between 8 and 12 feedings a day - even if you have to wake him up.

Almost all moms worry that their babies aren't eating enough. But your baby's appetite will ebb and flow depending on his needs; the quantity of your milk will adjust in kind. He'll be hungrier during growth spurts, which often occur at 3 weeks, 6 weeks, 3 months, and 6 months.

From 6 months on: Once he starts solids at around this age, he'll need less breast milk. But as long as you choose to breastfeed -even if it's in combination with food and/or formula - your milk will provide your baby with important nutrients and protection against illness.


How to make breastfeeding easier

Nursing can be physically draining. So rest as often as you can, and drink lots of water. Consider letting your baby sleep in your bedroom in a crib, bassinet, or co-sleeping attachment (a low crib right next to your bed) so you don't have to go far to feed her. Initially, nursing can be painful. A topical moisturizing cream for your nipples may help - just ask your doctor which kinds are safe for your baby. And, of course, support from your partner, family, or friends can make the process easier.


Mastitis

If you have a sore breast and a fever while breastfeeding, you may have an infection called mastitis. Flulike symptoms are typical - fever, chills, headache, body aches, and fatigue - along with an area of the breast that's tender, red, and firm. Mastitis is often preceded by engorgement, an infected cracked nipple, or simply exhaustion. Ibuprofen can help reduce inflammation and pain, and ice or warm packs can also provide comfort. But you'll want to call your doctor immediately. He may prescribe an antibiotic or another treatment.


How to increase your milk supply

The key to stimulating production is to empty the breasts. So if your newborn doesn't nurse vigorously, expressing with a breast pump for about ten minutes immediately after each feeding can drain most of the remaining milk. It can also help relieve engorgement and coax flat or inverted nipples to protrude more.


What affects the quality and quantity?

Medication

Effect:

Most drugs pass through breast milk to some degree.

What to do:

Ask your doctor about the safety of any medication you want to use, including herbal supplements. Follow directions for pain relievers like ibuprofen and acetaminophen, but avoid aspirin. Most OTC antihistamines/decongestants are safe but may lower milk production. If your supply decreases, drink lots of fluids and talk to your doctor about alternatives.

Vegetarian diet

Effect:

Infants breastfed by vegetarian moms may be lacking in vitamin B12, since meat, poultry, and seafood are big sources.

What to do:

Get at least 2.8 micrograms (mcg) of vitamin B12 daily through a multivitamin or food. If you eat eggs and dairy foods regularly, you may be fine - a cup of skim milk has 1 mcg, and one egg has .5 mcg.

Alcohol

Effect:

Alcohol transfers to breast milk and changes its odor and taste. Two drinks a week can decrease your supply or make your baby less alert.

What to do:

It's best not to drink. If you do, limit yourself to a very occasional celebratory drink, after nursing.


The breastfeeding mom's bill of rights

  • If you have a right to be somewhere with your baby, you have a right to breastfeed there. It's the law, says La Leche League International. While there are a few places, such as courtrooms, where babies aren't permitted, you can legally nurse in most public places - stores, restaurants, parks, and malls.
  • You have a right to ask for pumping accommodations at work. Some states require that workers be given break time and a space to pump that isn't a bathroom stall. The key to successful pumping at work is clear communication with your supervisor. Ask for a room with a lockable door, a place to sit, and an electrical outlet for the pump.
  • You have a right to breastfeed for as long as you see fit. That could be well into toddlerhood for some kids. In fact, breastfeeding until kids are 3 or 4 is common in other countries. Do what you feel is best for your child, and try to ignore any criticism from others.


Where to get help

Call your doctor with any concerns regarding breastfeeding. Other helpful resources:

La Leche League International has long been a trusted resource for nursing moms. Its website provides a city-by-city directory of lactation support groups and volunteers, forums for online chats, and info on state breastfeeding laws.

The International Lactation Consultant Association's site allows you to find a certified lactation consultant in your area.

The breastfeeding section of the American Academy of Pediatrics's website offers further helpful information. There's also an online store of brochures and books written by experts on nursing.


Summary

Breastfeeding is a wonderful way to start your lifelong bond with your child, and it has benefits for both of you. Keep in mind, though, that the choice of whether to nurse or use formula is totally up to you. If you do decide to breastfeed, be patient and get help if you think your baby isn't latching on properly. As you and your baby get used to the process, you'll get into a rhythm that's right for both of you.


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