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.

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

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.

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.

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.
• You're using an illegal drug, such as cocaine or marijuana.
• Your baby has a rare condition called galactosemia and cannot tolerate the natural sugar, called galactose, in breast milk.
• You're taking certain prescription medications, such as some drugs for migraine headaches, Parkinson's disease, or arthritis.

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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