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Breastfeeding


Expert reviewer, Mr Paul McArdle, Registered Dietitian
Next review due March 2022

Breast milk is the natural food for your baby and has everything they need. Breastfeeding is good for you and it’s good for your baby. Over three-quarters of new mothers in the UK choose to start breastfeeding.

If you’re thinking about breastfeeding, you’ll find lots of information here to help you make your decision.

A woman holding her newborn baby

About breastfeeding

Whether you’re planning to breastfeed or not, 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.

Hormone changes after childbirth and the suckling of your newborn baby will stimulate your breasts to produce milk. If you’ve decided to breastfeed or you just want to try breastfeeding, your midwife will help you get started. This may be during a period of skin-to-skin contact with your baby straight after they’re born.

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

Breast milk is all your baby needs for about the first six months. After this time, you can gradually begin to introduce solid food while continuing to breastfeed. You can carry on breastfeeding for as long as you and your baby want to — it’s your decision when to stop.

Although breastfeeding is natural, you and your baby may take some time to learn how to get it right. You can ask your midwife or health visitor for help. And there are lots of organisations which provide advice and support. See our section ‘Other helpful websites’ for contact details.

Benefits of breastfeeding

If you choose to breastfeed, there are lots of benefits for both you and your baby.

It’s good for you

If you breastfeed your baby, it will help you to:

  • bond with your baby
  • reduce the risk of bleeding after delivery and help your uterus (womb) contract back to its pre-pregnancy size
  • lose any excess weight you gained during pregnancy
  • save money – breastfeeding costs less than bottle feeding
  • reduce the risk of getting breast cancer, ovarian cancer and diabetes

It’s good for your baby

Breastfeeding your baby will:

  • give them all the nutrition they need for their first six months in an easily digestible form
  • help protect them from infections – breast milk contains antibodies that help protect your baby against stomach upsets, and ear infections and chest infections
  • reduce the chance that they’ll be overweight in later life
  • lower their risk of sudden infant death syndrome
  • reduce the chance of getting severe eczema and possibly also asthma

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Bottle-feeding — the alternative to breastfeeding

Breast milk is the best food for your baby but it isn’t the only option. You can bottle-feed your baby with infant formula, which is designed to be as close to breast milk as possible. Cow’s milk isn’t suitable for newborn babies because it doesn’t provide enough nutrition for babies and is difficult for them to digest.

Infant formula comes either as a powder that you make up with boiled water or as a ready-made liquid. 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.

If you choose to bottle-feed your baby, no one should make you feel guilty about this. You are entitled to get the support and advice you need, just like those who choose to breastfeed.

Can anyone breastfeed?

Some women worry that they won’t be able to breastfeed because their breasts are too small or they won’t be able to make enough milk. But the good news is that most women can breastfeed. The amount of milk your breasts make relates to how much your baby takes when they feed, not to how large your breasts are. Most women make more than enough milk.

Medical conditions and breastfeeding

Certain medical problems can make breastfeeding risky for your baby. For example, if you have HIV, there’s a chance you could pass this on to your baby through breastfeeding. So, it’s safer to avoid breastfeeding if you’re HIV positive. In parts of the world where safe drinking water for bottle-feeds isn’t easy to find, the advice may be different.

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

Taking medicines and breastfeeding

If you take regular medicines, you may wonder if it’s going to be OK to breastfeed. Small amounts of any medicines you take may pass on to your baby through your breast milk. If a doctor recommends a medicine for you, always tell them that you’re breastfeeding. And always read the information that comes with your medicines carefully. A pharmacist will be able to answer any questions you have about whether specific medicines or supplements are safe to take while breastfeeding.

Lifestyle and breastfeeding

A healthy diet

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). Try not to have very much caffeine as this will pass to your baby in your milk. And it’s recommended not to eat more than two portions of oily fish (like salmon) a week.

It’s also recommended that all pregnant and breastfeeding women take a daily supplement of 10 micrograms of vitamin D. If you’re a vegan, you may need vitamin B12 supplements while you’re breastfeeding.

Alcohol

If you drink alcohol, small amounts will be passed on to your baby. This can affect your baby’s sleep pattern and cause digestive problems. So, 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. And avoid breastfeeding for at least two to three hours after drinking.

Smoking

If you smoke, the best thing you can do for you and your baby is to stop smoking. Secondhand smoke harms your baby, making them more at risk of allergies, asthma and sudden infant death syndrome. If you smoke, you may produce less milk and your baby may not gain weight as they should.

However, even if you continue to smoke, breastfeeding is still the best option for your baby. Make sure you don’t smoke near your baby and ask other people not to either. After smoking, wait a few minutes before going back to your baby to give time for the tobacco smoke to clear from your breath.

Returning to work

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

  • ask for flexible hours to fit around feeding times
  • express milk so someone else can feed your baby while you’re at work
  • arrange childcare nearby, so you can breastfeed in breaks from work
  • combine breastfeeding with bottle (formula) feeding

Your employer should support you if you wish to continue breastfeeding once you have returned to work. Give your employer written notification that you intend to continue breastfeeding, ideally before you return to work.

Problems with breastfeeding

Breastfeeding is natural, but sometimes it can cause problems. Ask for help from your midwife, health visitor of GP if you have difficulties, including any of the following.

  • Cracked or sore nipples. This is common in the first few weeks and may be due to your baby not latching on properly, so check their position. Try to keep your nipples dry between feeds, changing your breast pads regularly.
  • Breasts feeling over-full (engorged). This may happen when your milk first comes in at about day three, or if you have a long gap between feeds. It may help to breastfeed your baby more often or express some milk to soften your breasts. Cold compresses may relieve the discomfort.
  • A blocked milk duct; this may cause a lump in your breast. The blockage may be due to poor drainage of your breast caused by pressure, such as from a tight bra or seatbelt. You should continue to feed your baby, massaging the lump towards your nipple.
  • Mastitis (inflammation of the breast). This may cause pain, swelling and redness of your breast, and you may have a raised temperature. It’s caused by a bacterial infection getting into your breast. If left untreated, it may develop into a breast abscess. You may need to take antibiotics.

The organisations listed in our section ‘Other helpful websites’ have lots more information on coping with these and other problems you may encounter with breastfeeding.

Getting help and support

If you want to breastfeed you should get lots of help and support from your midwife and health visitor.

It’s also important for you to have the support of your partner, friends and family. Explain why you want to breastfeed and ask them to help. It might help for them to read about the benefits of breastfeeding. Make sure they know you’ll need rest and time to concentrate on feeding your baby in the early weeks.

You may also find that there are local groups with other breastfeeding mothers who can chat to you about their experience. Online forums, articles and helplines can be a rich source of advice and support too – see our section ‘Other helpful websites’.

Frequently asked questions

  • It’s very common for mothers who breastfeed to be concerned that their baby isn’t getting enough milk. In fact, most women can produce all the milk their baby needs and more.

    A healthy and thriving breastfed baby will:

    • have at least six wet nappies every 24 hours from day five onwards
    • pass loose, yellow stools at least twice a day
    • seem content after feeds, and come off the breast on their own
    • gain weight

    Although your baby will probably lose weight at first, after day three to five they will start to put on weight. Most babies regain their birth weight within two weeks

    Talk to your midwife, health visitor or GP if you’re concerned your baby isn’t getting enough milk.

  • Yes — if you have two or more babies you can still breastfeed them. In fact, since it’s more likely that twins or triplets will be born prematurely, it’s even more important that they have the benefits of breast milk.

    You may find it easier to breastfeed one baby at a time at first. But in time you’ll become more confident and you may well be able to breastfeed both babies at the same time. Your breasts will produce the amount of milk your babies need. If you have more than two babies, you may need to supplement breastfeeding with formula feeding.

    Your midwife or health visitor will be able to help you get started with breastfeeding your twins. You may also like to contact TAMBA, The Twins & Multiple Birth Association, who will have lots of helpful advice on feeding two or more babies. See our section ‘Other helpful websites’ for contact details.

  • Breastfeeding delays the time when your ovaries begin to release eggs (ovulation) after your pregnancy. You can’t get pregnant if no egg is released, so breastfeeding acts as a form of natural contraception.

    You may choose to rely on breastfeeding as a form of contraception but be aware that it’s uncertain how long ovulation will be delayed. You’re less likely to get pregnant if:

    • you’re fully breastfeeding
    • your baby is under six months
    • you haven’t had a period

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Related information

    • Birth to Five. Health and Social Care. Public Health Agency, 2018. www.publichealth.hscni.net
    • Infant feeding. PatientPlus. patient.info/patientplus, last edited July 2016
    • Child health. Oxford Handbook of General Practice (online). Oxford Medicine Online. www.oxfordmedicine.com, published April 2014
    • Infants and preschool children. Oxford Handbook of Nutrition and Dietetics (online). Oxford Medicine Online. www.oxfordmedicine.com, published January 2012, updated December 2015
    • Breastfeeding matters. Best Start Resource Centre. en.beststart.org, revised 2017
    • Counseling the breastfeeding mother. Medscape. emedicine.medscape.com, updated February 2015
    • Human milk and lactation. Medscape. emedicine.medscape.com, updated February 2015
    • Contraception – natural family planning. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised April 2016
    • Prescribing in breast-feeding. NICE British National Formulary. bnf.nice.org.uk, accessed March 2019
    • Position statement: breastfeeding in the UK. Royal College of Paediatrics and Child Health. www.rcpch.ac.uk, last modified May 2018
    • Breastfeeding policy statement. BDA, The British Association of UK Dietitians. www.bda.uk.com, published January 2018
    • Breastfeeding. BDA, The Association of UK Dietitians. www.bda.uk.com, published January 2018
    • Breastfeeding your baby. The American College of Obstetricians and Gynecologists. www.acog.org, published November 2016
    • New and expectant mothers. Health and Safety Executive. www.hse.gov.uk, accessed March 2019
    • Breastfeeding and returning to work. Public Health Agency. www.publichealth.hscni.net, published March 2019
    • Invernizzi G, Ruprecht A, De Marco C, et al. Residual tobacco smoke: measurement of its washout time in the lung and of its contribution to environmental tobacco smoke. Tob Control. 2007; 16(1):29–33. doi: 10.1136/tc.2006.017020
    • Personal communication, Mr Paul McArdle, Registered Dietitian, March 2019
  • Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, March 2019
    Expert reviewer, Mr Paul McArdle, Registered Dietitian
    Next review due March 2022



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