Breastfeeding Basics

What and how you feed your baby is especially important during the first year. The average baby doubles birth weight within five months after birth, and weight triples by the first birthday. A smaller than average baby often grows more rapidly. Breast milk or iron-fortified formula is baby’s most important food in the first year, and should be the only food for the first four to six months of life. Health professionals recognize breastfeeding as the best choice for most infants.

The World Health Organization ranks food choices for babies as:

  1. breastfeeding;
  2. the mother’s own milk expressed and given to her child through a bottle or syringe;
  3. the milk of another human mother; and
  4. iron-fortified formula.

There are, however, instances when a woman physically cannot breastfeed such as hormonal and glandular deficiency or other medical reasons.

There are a few infectious diseases that can be transmitted through human milk to a baby, including HIV and untreated tuberculosis. Mothers with HIV are advised not to breastfeed. Similarly, mothers with tuberculosis should not breastfeed until appropriate treatment has been started. Mothers with hepatitis B can breastfeed their infants if the infant receives the hepatitis B vaccine in the first few days after birth.

There is no evidence that hepatitis C is transmitted by breastfeeding. Mothers with chronic hepatitis C are often advised that they can nurse their infants, but they should discuss this with their physician. Other types of infections need to be evaluated by the obstetrician and pediatrician, but nearly all will be found to be safe for breastfeeding.

Talk with your physician or midwife if you are wondering if a medical condition or a medication you are taking would affect your breastfed baby.

Breastfeeding is an excellent way to meet your baby’s nutritional and emotional needs. Advantages to breastfeeding for babies include:

  • Fewer allergies
  • Fewer gastrointestinal tract diseases
  • Fewer respiratory tract diseases
  • Less inflammation of the ear
  • Lower chance of childhood obesity

Breastfeeding usually takes some practice for both mother and newborn. The best approach is to relax and be patient during the initial period when you and your infant are learning.

Get help early. Your nurse can answer your questions and assist you with feedings while you are in the hospital. If necessary, she can also refer you to the on-site lactation consultant who specializes in breastfeeding issues.

Proper emotional support is important for breastfeeding mothers. You may want to join a support group such as the La Leche League or Nursing Mother’s Council, talk with friends and relatives who have had successful breastfeeding experiences, or find a local lactation consultant. It is a good idea to do this even before your baby is born so that you are familiar with local resources by the time your baby arrives.

It is best to have the first feeding shortly after birth, preferably within your baby’s first hours of life. This is possible even after a Cesarean birth with the assistance of a nurse or partner while you are in the recovery room. Breastfeeding must begin after childbirth. Your body will not continue to make milk if your baby is not nursing or if you are not pumping.

Great Start
Nursing immediately after delivery when your baby is wide awake is the best way to begin. It is also a quiet and special time for you. Be sure to tell your nurse and partner that you want to begin nursing your baby as soon after the birth as possible. Your baby will want and need close skin-to-skin contact for warmth and comfort. A full-term newborn has a sucking reflex that will enable her or him to feed right away. The following information and advice will guide you as you begin nursing your baby.

Breast Milk
Baby’s sucking stimulates the release of two hormones, oxytocin and prolactin. Oxytocin signals your uterus to contract and return to its pre-pregnancy size. This is why many women experience uterine cramping during the first few days of nursing. Oxytocin also contracts tiny muscles in the breast to release milk to the baby. This is called the “let down” reflex.

The hormone prolactin stimulates your breast to produce milk. The “first milk” is a substance called colostrum, which is a highly nutritive fluid with protective antibodies that are very beneficial to newborns. Colostrum is produced in very small quantities (perfectly designed for a newborn’s small stomach). Colostrum provides all the nutrition your baby needs for her/his first days of life. Colostrum varies in color and consistency and transitions into a thinner liquid called transitional milk before becoming mature milk about two weeks postpartum. Mature milk is thin and white in color and resembles the appearance of skim milk.

The more your baby nurses, the more milk your body will produce. The amount of milk removed from the breast determines the amount of milk produced. A pattern of supply and demand is established with each feeding. Drink a glass of water, juice or milk at every feeding to insure that you are adequately hydrated. It is also important for you to maintain a healthy diet by eating a variety of fresh, nourishing foods like fruits, vegetables, proteins, and grains. It is not necessary for your baby to drink water, formula, or other liquids in addition to breast milk unless prescribed by your health care provider.