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Breastfeeding
Produced by Rebecca Canvin, Bupa Health Information Team, January 2012.
This factsheet is for women who are breastfeeding, or who would like information about it.
Breastfeeding is when a mother gives her baby breast milk to meet her child's nutritional needs for healthy growth and development.
About breastfeeding
Deciding to breastfeed
Special considerations
What are the alternatives to breastfeeding?
Your diet while you are breastfeeding
About breastfeeding
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 suckling baby will encourage 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, massaging your nipples or breast shields can help to draw out your nipples. If your breasts are very large, your midwife or health visitor can help you find suitable positions to breastfeed.
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. 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. However, breastfeeding can be good for you and your baby.
Advantages
Good for your:
• weight loss – producing breast milk uses up calories
• lower risk of breast cancer
• lower risk of ovarian cancer
Breastfeeding is also an effective contraceptive as it stops ovulation, so long as you're fully breastfeeding and your baby is under six months and you haven't had a period. However, don't rely on this alone, you should use another form of contraception.
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 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 may have to do all the feeding. Breastfeeding can make it difficult for you to have a break, and your partner may feel excluded. However, you can express breast milk so that your partner (or a babysitter) can feed the baby from a bottle.
• 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. Trying different feeding positions, taking warm baths, using nipple creams, shields or breast pads.
• 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.
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.
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 giving your baby 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.
Your diet 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 having a drink. 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 your baby is to stop smoking.
Medicines
If you take medicines, small amounts will 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.
Tags:
Published by Bupa's health information team, January 2010.
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
Isn't formula just as good as breast milk?
How do I express my breast milk?
Will I be able to continue breastfeeding when I return to work?
Isn't formula just as good as breast milk?
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 only 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.
Sources
• Parker S. The human body. London: Dorling Kindersley, 2007:215
• Hoddinott P Tappin D Wright C. Breast feeding. BMJ 2008; 336:881-87. www.bmj.com
• Advantages of breastfeeding. GP Notebook. www.gpnotebook.co.uk, accessed 18 September 2009
How do I express my breast milk?
Expressing milk means using your hands or a pump to squeeze milk out of your breast.
Explanation
You may want to express your breast milk for a variety 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 handpump or electric pump. If you choose to use a pump, there are a range of products available – different pumps suit different women better.
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. 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.
• 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.
Sources
• Bottle feeding with expressed breast milk. Better Health Channel. www.betterhealth.vic.gov.au, accessed 29 September 2009
• Becker GE, McCormick FM, Renfrew MJ. Methods of milk expression for lactating women. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD006170. DOI: 10.1002/14651858.CD006170.pub2.
Will I be able to continue breastfeeding when I return to work?
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.
Provide your employer with written notification that you intend to continue breastfeeding, ideally in advance of your return to work.
Sources
• A guide for new and expectant mothers who work. Health and Safety Executive. www.hse.gov.uk, accessed 18 September 2009
This information was published by Bupa’s health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: January 2010.
Breastfeeding factsheet
Visit the breastfeeding health factsheet for more information.
Related topics
Baby weaning
Breast cancer
Cot death and sudden infant death syndrome (SIDS)
Diabetes
Eczema
Giving up smoking
Healthy eating
Ovarian cancer
What to expect during pregnancy
Further information
• La Leche League International
www.llli.org
Sources
- The pregnancy book – feeding your baby. Department of Health, 2009. www.dh.gov.uk
- 10 facts on breastfeeding. World Health Organization. www.who.int, published July 2011
- Midwifery practice guideline: early breastfeeding. Royal College of Midwives. www.rcm.org.uk, published May 2008
- 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, Issue 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
This information was published by Bupa’s health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
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