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Breastfeeding

Breastfeeding is when a mother gives her baby breast milk to meet her child's nutritional needs for healthy growth and development.

Your body will begin to prepare for breastfeeding during your pregnancy. Your breasts will grow in size as the milk ducts and milk-producing cells develop.

After giving birth, your baby suckling on your breast will stimulate the release of hormones called prolactin and oxytocin into your bloodstream. Prolactin causes milk to be produced, and oxytocin causes your breasts to secrete the milk (which is called 'let-down').

You can breastfeed whatever the size and shape of your breasts and nipples. If your nipples are flat or inverted, you can still breastfeed. Your midwife or health visitor will give you the help you need.

When to start breastfeeding

It's ideal to have close (skin-to-skin) contact with your baby early on after delivery. There are various opinions on when it's best to start breastfeeding. The World Health Organization recommends that you should try to breastfeed within an hour of giving birth. You’re more likely to be successful with breastfeeding if you begin immediately after delivery, when your oxytocin levels are high.

However, The Royal College of Midwives doesn't believe there is a critical period for starting to breastfeed. They advise that the pace and timing of the first feed should be left to mothers and their babies. Your baby will naturally root for your nipple and start to suckle when he or she is ready.

During the first few days of breastfeeding, your breasts will produce colostrum, a thick yellow fluid that's rich in antibodies. This will help to protect your baby against illness. After two to four days your breasts will produce larger amounts of milk. 

How to breastfeed

Find a comfortable position where your arms and back and your baby's head are supported. It's important that your baby latches on to your breast correctly. If your baby just takes your nipple in his or her mouth, this can give you sore nipples and may mean your baby is not taking in much milk.

Your midwife or health visitor can explain how to check your baby is feeding the right way.

How often to feed

Newborn babies need to feed little and often. The World Health Organization recommends that you feed 'on demand' – as often as your baby wants to.

How long a feed should last

The World Health Organization recommends unrestricted feeding, so your baby should feed for as long as he or she wants to. As a rough guide, each feed may be 10 to 20 minutes per breast, but every baby is different so it may be shorter or longer.

Your baby may feed for longer than half an hour, or want to feed more often than every one to one and half hours. This could be because he or she is not attaching properly to the breast. A midwife or health visitor can advise you on this.

How long to continue breastfeeding

Breast milk contains all the nutrients your baby needs for the first six months. After this time, you can gradually begin to introduce solid food whilst continuing to breastfeed or introduce bottle-feeds. You can supplement solid food with breast milk for as long as you want to. When you stop breastfeeding is a personal decision.

The World Health Organization recommends that babies are breastfed exclusively for the first six months of their life and that breastfeeding should continue, along with solid foods, for up to two years of age. Any length of time will benefit your baby – the longer you breastfeed, the greater the benefit.

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Details

  • Deciding to breastfeed Deciding to breastfeed

    It’s up to you whether you breastfeed your baby or not. However, breastfeeding can be good for you and your baby.

    Good for you

    There are a number of advantages for you including:

    • reduced bleeding after giving birth and faster return of the uterus to pre-pregnancy size
    • reduced risk of postnatal depression
    • weight loss – producing breast milk uses up calories
    • lower risk of breast cancer
    • lower risk of ovarian cancer

    Breastfeeding can be a contraceptive as it stops ovulation, as long as you’re fully breastfeeding, your baby is under six months and you haven’t had a period. However, you cannot be sure exactly when your fertility will return. You need to start using another form of contraception before your periods restart.

    Good for your baby

    There are also a number of advantages for your baby including those listed below. 

    • Good nutrition. Breast milk contains everything your growing baby needs, and is easy to digest.
    • Better health. Breast milk contains antibodies that help protect your baby against stomach upsets, and ear and chest infections.
    • Lower risk of severe eczema.
    • Lower risk of diabetes as a child.
    • Lower risk of asthma.
    • Lower risk of sudden infant death syndrome.
    • Lower risk of being overweight.

    There are certain things you may want to consider when deciding on breastfeeding.

    • You will do all the feeding. Breastfeeding can make it difficult for you to have a break, and your partner may feel excluded. You can express breast milk so that your partner (or a babysitter) can feed your baby from a bottle. Using an artificial teat or a dummy can make it harder to establish breastfeeding, so it’s best to wait around three to four weeks until breastfeeding is well established.
    • Your breasts may feel heavy and uncomfortable. You shouldn’t have any breast pain but your breasts may feel over-full (engorged) at times and your nipples may become sore and leak milk. Check your baby is properly attached for feeding to prevent nipple pain. To prevent engorgement feed as often as your baby wants or express some milk, and try breast massage.
    • You may feel embarrassed to breastfeed in public. However, it’s important to remember breastfeeding is natural and if you need a quiet area, most department stores have a mother and baby room where you can feed your baby without being disturbed.
  • Eating and drinking while you're breastfeeding Eating and drinking while you're breastfeeding

    Small amounts of whatever you eat or drink will be passed on to your baby through your breast milk. You don’t need to eat a special diet while breastfeeding, but it’s important to eat a healthy, balanced diet and drink enough fluids (such as water, milk and unsweetened fruit juices). It’s also recommended that all pregnant and breastfeeding women take a daily supplement of 10 micrograms of vitamin D.

    Alcohol

    If you have an alcoholic drink, small amounts will be passed on to your baby. The effect alcohol has on your baby depends on how much you drink. It can make your baby drowsy and cause problems with his or her digestion. It could also affect the amount of milk you produce. It’s best not to drink alcohol if you’re breastfeeding, but if you do want a drink, have no more than one to two units once or twice a week.

    You can plan to minimise the impact of drinking alcohol. For example, if you know you're going to be drinking, consider expressing your breast milk in advance and don’t breastfeed for at least two to three hours after drinking.

    Smoking

    If you smoke, your baby is at an increased risk of sudden infant death syndrome, asthma, ear and chest infections.

    Some nicotine will also be passed on to your baby through your breast milk. The best thing you can do for you and your baby is to stop smoking.

    Medicines

    If you take medicines, small amounts may be passed on to your baby through your breast milk. Always check with your GP or pharmacist which medicines you can safely take while you’re breastfeeding. If you have to take a painkiller paracetamol is safe to take when breastfeeding.

  • Alternatives What are the alternatives to breastfeeding?

    Breastfeeding isn’t the only option for feeding your baby. You can bottle-feed your baby with infant formula, which is designed to be as close to breast milk as possible. It comes either as a powder that you make up with boiled water, or as a ready-made liquid formula.

    Powdered infant formula isn't sterile so it’s important to follow the instructions on the pack and take care with sterilising and cleaning bottles to prevent your baby getting an infection.

    Cow’s milk isn’t suitable for newborn babies as it doesn’t provide enough nutrition for babies and is difficult for them to digest.

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  • Considerations Special considerations

    Certain medical problems can make breastfeeding risky for your baby. For example, if you have HIV, there is a possibility that you could pass this on to your baby through breastfeeding. Therefore, it's safer to avoid breastfeeding if you are HIV positive. In parts of the world where there is less reliable access to safe drinking water for bottle-feeds, the advice may be different.

    Breastfeeding may not be appropriate if you have other conditions or take certain medicines. Talk to your GP, obstetrician, midwife or health visitor if you think you may have a problem that could affect your decision to breastfeed.

  • FAQs FAQs

    Isn't formula just as good as breast milk?

    Answer

    No. Although formula preparations aim to be as similar to human breast milk as possible, they can't be exactly the same. Human breast milk is always better for your baby in terms of nutritional benefits.

    Explanation

    Human breast milk is a complex, nutritional fluid containing hormones, essential fatty acids and antibodies. Formula milk is designed to resemble breast milk as closely as possible. However, it lacks many of the useful components that breast milk contains, such as antibodies that help to protect your baby against illness and infections. Babies who are fed formula are known to have a higher risk of getting infections and some medical conditions, such as obesity, diabetes and asthma, than babies who are breastfed for the first six months.

    The nutritional content of your breast milk constantly changes, and some of these changes are stimulated by the needs of your breastfeeding baby. Your breast milk will contain the right balance of nutrients for your baby, at the right temperature and in the right quantities. 

    How do I express my breast milk?

    Answer

    Expressing milk means using your hands or more commonly a pump to squeeze milk out of your breast.

    Explanation

    You may want to express your breast milk for a number of reasons. For example, you may want your partner or a childminder to feed your baby if you're going back to work, or will be away from your baby for some time. Or you may want to express your milk because your baby isn't feeding well from your breast.

    You can express milk by hand, or with a hand pump or electric pump. Use the following guide to help you express your milk by hand.

    • Cup your breast and feel from the end of your nipple back to where the texture of your breast feels different. This is where your milk ducts are.
    • Gently squeeze behind this nipple area using your thumb and index finger. Your thumb and forefinger will be opposite each other about 4cm from the nipple. This shouldn't hurt.
    • Release the pressure and then repeat squeezing until milk starts to flow. Move your fingers around your breast so that you express milk from all the ducts.
    • When the flow of milk slows down, express from your other breast. Keep changing breasts until the milk stops or drips very slowly. This may mean expressing from each breast five or six times.
    • If the milk doesn't flow, try moving your fingers slightly towards the nipple or further away. Or try a gentle breast massage.

    Learning how to express milk can be a challenge, and it's common to only be able to express a few drops at first. You need to find a technique that suits you. Make sure you're relaxed and in a comfortable setting with no distractions before you try to express. Some mothers find it helps to connect with their baby in some way, for example by looking at a photo of their baby or keeping a piece of his or her clothing with them. This can cause the release of oxytocin, which helps milk to flow.

    Will I be able to continue breastfeeding when I return to work?

    Answer

    Yes. Employers have a legal obligation to support mothers who wish to continue breastfeeding once they have returned to work.

    Explanation

    Returning to work after having a baby doesn't mean you have to stop breastfeeding.

    You have several options for continuing breastfeeding when you go back to work. You could arrange childcare close to your work so that you can breastfeed during breaks or before and after work. You could ask your employer if you can work flexible hours to fit in around the times you need to breastfeed. Alternatively, you can express milk so that someone else can feed your baby while you're at work.

    Although it isn't a legal requirement, the Health and Safety Executive recommends that employers provide women who are breastfeeding with a safe, healthy environment where they can express and store milk. The toilets aren't suitable for this purpose. Check with your employer whether they provide a suitable place.

    If you plan to express milk when you're at work, it's a good idea to practise a few weeks before you return to work. You may also find it helps to build up a store of expressed milk as a 'reserve', to take the pressure off you during your first few days back at work. Expressed milk can be stored in a freezer for up to three months.

    Give your employer written notification that you intend to continue breastfeeding, ideally before you return to work.

  • Resources Resources

    Further information

    Sources

    • American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Pediatrics. 129(3):827–41. doi: 10.1542/peds.2011-3552
    • Counseling the breastfeeding mother. Medscape. emedicine.medscape.com, published 18 September 2012
    • 10 facts on breastfeeding. World Health Organisation.www.who.int, published July 2011
    • Breastfeeding. Map of Medicine. eng.mapofmedicine.com, published 23 November 2012
    • Berne RM, Koeppen BM, Levy MN, Stanton BA. Physiology. 6th edition. Mosby Elsevier: 794–795
    • Midwifery practice guideline: early breastfeeding. Royal College of Midwives.www.rcm.org.uk, published May 2008
    • Infant Feeding. Patient UK Professional Resource. www.patient.co.uk, published 7 July 2013
    • Horvath T, Madi BC, Iuppa IM et al. Interventions for preventing late postnatal mother-to-child transmission of HIV. Cochrane Database of Systematic Reviews 2009 (1). doi:10.1002/14651858.CD006734.pub2
    • Reducing exposure to secondhand smoke. Department of Health. www.dh.gov.uk, published October 2008
    • A guide for new and expectant mothers who work. Health and Safety Executive. www.hse.gov.uk, published May 2009
    • Infant and young child feeding. Model Chapter for textbooks for medical students and allied health professionals. World Health Organisation. www.who.int 2009.
    • Breastfeeding problems. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published February 2011
  • Related information Related information

  • Author information Author information

    Reviewed by Jane McQueen, Bupa Health Information Team, April 2014.

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