Breastfeeding

Published by Bupa's Health Information Team, January 2010.

This factsheet is for women who are breastfeeding, considering breastfeeding, or who would like information about it.

Breastfeeding is giving breast milk to infants to meet their nutritional needs for healthy growth and development.

About breastfeeding

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

After giving birth, your suckling baby 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. Breast size depends on fatty tissue, which isn't involved in milk production, so the size of your breasts won't affect your ability to breastfeed. Your midwife or health visitor can help you find suitable positions to breastfeed if you have large breasts. If you have flat or inverted nipples, nipple massage or breast shells (that help to draw out your nipples) can help.

When to start breastfeeding

It's ideal to have close 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. However, The Royal College of Midwives doesn't believe there is a critical period for starting to breastfeed, and thinks 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, which will help to protect your baby against illness.

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 and doesn't just take your nipple in his or her mouth, because this can give you sore nipples.

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

As a rough guide, each feed may be 10 to 20 minutes per breast, but every baby is different so it may be longer.

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. 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 to continue breastfeeding along with solid foods for up to two years of age. However, breastfeeding for any length of time will benefit your baby, so don't worry if you have to stop earlier for any reason.

Deciding to breastfeed

It's up to you whether you breastfeed your baby or not. The advantages and disadvantages of breastfeeding are listed below.

Advantages

Benefits for your baby's health include:

• good nutrition - breast milk contains everything your growing baby needs, and is also easy for your baby to digest
• fewer infections - breast milk contains antibodies that help protect your baby against infections such as ear infections, stomach upsets and pneumonia
• reduced risk of eczema
• reduced risk of diabetes as a child
• reduced risk of asthma
• reduced risk of sudden infant death syndrome
• less chance of your baby becoming obese as a child

Benefits for your health include:

• less bleeding after the birth - your womb shrinks back to its normal size more quickly
• weight loss - breastfeeding uses up calories
• reduced risk of breast cancer
• reduced risk of ovarian cancer

Other advantages of breastfeeding for you and your baby include those listed below.

• Breast milk is the right temperature for your baby so there is no need to worry about cleaning and sterilising bottles and teats.
• It's convenient - you can feed your baby anywhere as soon as he or she is hungry.
• It helps you to form a close bond with your baby and can be a rewarding, relaxing experience for you.
• Breastfeeding can be effective as a contraceptive, if your baby is under six months, you're fully breastfeeding (with your baby not eating or drinking anything else) and you haven't had a period. However you shouldn't rely on this.

Disadvantages

There are some potential difficulties with breastfeeding. For example, it relies on you to do all the feeding, which can make it difficult for you to have a break, and some fathers may feel excluded. However, you can extract (express) breast milk so that your partner can do some feeds from a bottle, or so that a babysitter can feed your baby.

Pain isn't a regular part of breastfeeding, but you may have some discomfort to begin with. Your breasts may feel over-full (engorged) at times and your nipples may become sore. Your breasts may also leak milk. There are ways to relieve these problems, such as positioning your baby correctly for feeding, taking warm baths, massage, using nipple creams, shields or breast pads. However, some women find these problems make them feel less attractive, which can affect their desire to have sex.

You may feel uncomfortable breastfeeding in public, although it's becoming more acceptable to do so. Often there are mother and baby rooms where you can feed your baby without being disturbed.

Special considerations

Certain medical problems can make breastfeeding risky for you or your baby. For example, if you have an infection such as HIV, there is a possibility that you could pass this on to your baby through breastfeeding.

Breastfeeding may not be appropriate if you have a serious heart or kidney problem. Talk to your GP, midwife or health visitor if you think you may have a problem that could affect your decision to breastfeed.

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.

It's important to follow the instructions on the powder formula pack as it may harm your baby if you mix the formula incorrectly. Also, take care to sterilise bottles to prevent giving your baby an infection. Powdered infant formula isn't sterile so should be made using water that is hotter than 70°C, before being cooled to body temperature.

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.

Your diet while you're breastfeeding

You don't need to eat a special diet while breastfeeding, but it's important, just as it is for everybody else, to eat a healthy balanced diet. 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, some alcohol can be passed on to your baby through your breast milk. The effect it has on your baby depends on how much you drink. If you drink large amounts, it can make your baby drowsy or weak, and can result in growth problems. It could also affect the amount of milk you produce. If you do want to drink alcohol, it's best to do so only occasionally and not in large amounts.

You can plan to minimise the impact of having a drink. For example, if you know you're going to be drinking, consider expressing your breast milk in advance. To help reduce your baby's exposure to alcohol:

• try not to breastfeed for at least two to three hours after drinking
• don't drink just before you feed
• have your drink after the last feed of the day (if it's possible to predict this)

Smoking

Some nicotine is passed on to babies in your breast milk. It's therefore best not to smoke while you're breastfeeding.

Medicines

Some medicines can be passed on to your baby through breastfeeding. Always check with your doctor or pharmacist which medicines you can safely take while you're breastfeeding.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.