Many medical groups recommend that women feed their infants only breast milk for the first 6 months of life when possible. Babies may start with some solid food at 6 months but breastfeeding should continue. Most groups encourage breastfeeding until after the baby’s first birthday. It is recommended because research shows that:
Breastmilk is easy on a baby’s tummy. It is easily broken down in a baby's brand new digestive system.
Breastmilk has enzymes, antibodies, and other things that boost the immune system. Babies who are breastfed are less likely to have ear infections, diarrhea, respiratory infections,
or severe infection in digestive tract.
Children that were breastfed are less likely to develop allergies,
asthma, eczema, and diabetes later in life. They were also less likely to be obese.
Babies and parent benefit from bonding during breastfeeding.
Benefits for Mom, Too
Those who breastfeed return to their pre-pregnancy weight quicker than moms who don’t breastfeed. Nursing burns about 500 extra calories per day. Breastfeeding also stimulates the uterus to contract. This will help it return to its normal size, and reduce postpartum bleeding.
There are long-term benefits as well. The risks of
ovarian cancers, and type 2 diabetes are lower among those who breastfed their babies.
Breast milk is also free. The cost of formula and supplies can add up to $1,000 per year. Breast milk is always available and needs no preparation. Formula, on the other hand, needs to be bought, made, put into bottles, warmed up, and properly stored.
Think of breastfeeding as a skill that needs to be learned. Take a class or read books on this new skill while pregnant. To get off to a good start, follow these guidelines:
Nurse early and often. Begin feeding your baby shortly after birth, ideally within the first hour. Each day, feed every 1 to 3 hours, except during one longer sleeping stretch. The first milk produced is called colostrum. This is a thick yellowish liquid that is rich in protein and antibodies. It gives your baby’s immune system a quick boost. Within a few days, your mature milk comes in.
Feed from both breasts at each feeding. If you don’t feed from each breast, you may get a plugged milk duct. During the first 24 hours, your baby should nurse at least 5 minutes on each breast. Alternate which breast you begin feeding on. Increase to 15 minutes on each side over time.
Breastfeed on demand. Your baby will likely want to eat every 2 to 4 hours. Watch your baby for hunger signals such as:
Being more alert or active
Rooting—turning their head in search of a nipple
Mouthing—putting hands in his or her mouth and/or making a sucking motion with the mouth
Crying is a late sign of hunger
Find a comfortable position for you and baby. There are 4 main positions. Try each to find what works for you. It is also a good idea to vary the positions.
Cradle hold—Sit with your arm bent across your lap. The baby’s head rests in your elbow and her or his body along your forearm and lap. The baby’s chest should be against your skin so they does not have to turn their head to reach the nipple.
Cross-cradle hold—Sit with your arm bent across your lap. This time, the baby’s head is in your hand and their body extends toward your elbow. This is helpful in learning to get the baby latched on, as you can control their head better.
Football hold—Sit with your arm bent alongside your body. The baby’s head rests in your hand, with their head facing your breast and their body extended along your forearm next to your body. This position is more comfortable if you have engorged breasts, sore nipples, or plugged ducts. It is also good after a c-section, so the baby is not resting on the stomach. If you are able to multitask, this is a good position for nursing twins.
Lying down—Lie on your side with the baby on their side facing you. Put the baby’s face to your breast. Make sure the baby is breathing through their nose. Use pillows for support. This is a good position for night feedings or if you have had a cesarean section.
Make sure the baby is properly latched on. This means that the baby has both the nipple and the colored area around the nipple in their mouth. If the baby sucks on only the nipple, you will have pain. The baby will not get enough milk. Here are some tips for latching on:
Hold your baby in a comfortable position. With your free hand, cup your breast with your fingers underneath and your thumb on top. This is called a C-hold. Or, try the U-hold, where your fingers are on one side of the breast and your thumb on the other. Support your breast in this way for the first 6 weeks of breastfeeding.
Bring your baby close to your breast. Stroke their cheek with your finger or brush their bottom lip with your nipple. It will stimulate the baby’s rooting reflex so they turn their head and open their mouth.
When your baby opens their mouth, put your nipple and areola far into the mouth, while pulling their body towards you. If the baby does not have a good grasp on both the areola and nipple, try again. Press your finger on the corner of the baby’s mouth to break the suction and move them off the nipple.
Check that the baby is able to breathe through their nose. If the breast is blocking the nose, push down on your breast to allow breathing room.
Take care of mom.
Sleep when your baby sleeps. Drink a glass of water while you are nursing and eat a well-balanced diet. Limit caffeine to 300 mg per day (1 to 3 cups of coffee).
Minimize intake of alcoholic drinks. If you have a drink, wait at least 2 hours to breastfeed. Avoid drugs including nicotine.
Talk to your doctor before taking prescription and over-the-counter medications, as well as herbs and supplements.
Some medications can pass through the breast milk to your baby and may not be safe. Drugs can also interfere with how much milk you produce.
Like pregnancy and delivery, each woman’s experience with breastfeeding is different. It is common to worry about your baby is not eating enough, planning for times away from your baby, sore nipples, and breast engorgement.
Is Your Baby Getting Enough?
A good measure of feeding is how much is passing out of the baby. In the first few days of life, your baby will have 1 to 3 wet diapers per day. From day 4 on, your baby should have 5 to 6 wet diapers and 1 to 3 dirty diapers every 24 hours. The pediatrician will also weigh and measure your baby regularly. All babies lose weight after they are born. A breastfed baby should be back at birth weight by 2 weeks.
What If I Go Back to Work?
You can pump your milk and store it for your baby’s caretaker to feed when you are away. Many employers will provide a clean, private place for you to pump during the work day. If you have a hard time pumping enough to store, another option is to supplement with formula. You can breastfeed the times you are with your baby and use formula for times you are not there. Pumping during the day will still be needed to relieve the pressure and maintain your milk supply.
If possible, wait 2 to 3 weeks before giving your baby a bottle. It is easier for a baby to get milk from a bottle than from your breast. They may grow to prefer the bottle. Your milk supply will also decrease if you do not feed the baby often. Allow at least 2 to 3 weeks to establish your milk supply before making changes.
The longer you are able to breastfeed your baby, the better. But also remember that any length of time is helpful to your baby.
A breast pump can be rented or bought. Manual pumps cost about $50 and electrical pumps can cost $200 or more. The pricier versions include a carrying case and an section for storing milk. Many hospitals have pumps for rent. Ask your care providers when you deliver your baby.
Breast milk can be stored in sterile glass or plastic containers in a refrigerator for up to 7 days. In the freezer, it will keep for 6 months longer if you have a deep freezer. Thaw frozen milk in the refrigerator or under lukewarm running water. Do not leave breast milk at room temperature for a long time, soak it in very hot water, or put it in the microwave. Once thawed, milk can stay in the refrigerator for 24 hours. It cannot be refrozen.
Breastfeeding should not hurt. For the first week to 10 days, you may have some tenderness at the beginning of a feeding. If this pain is severe, lasts throughout the feeding, or lasts for more than a week, talk with your doctor. A lactation consultant can also help. Sore nipples are most likely due to poor latching on. Steps to prevent or minimize nipple soreness include the following:
Ensure that your baby is positioned correctly and latched on. Try the football or cross-cradle holds for more control of your baby’s head.
Babies suck harder at the beginning of a feeding, so begin on the less sore nipple.
If one nipple is extremely sore, try feeding for a shorter time (10 minutes), but more often.
Keep your nipples dry. After a feeding, air dry or pat your nipples dry.
If your skin is cracked, keep your nipples covered. Try lanolin cream, expressed breast milk, breast shells, or gel pads.
If the pain prevents you from nursing, use a pump to express your milk. Pumping is gentler on your nipples, allows you to feed your baby breast milk, and maintains your milk supply. Pump for 2 to 3 days to allow your nipples to heal.
Watch for signs of a breast infection. Call your doctor immediately if you have chills, fever, headache, flu-like symptoms, or pain or redness in your breast.
Call your doctor if you have blisters, cracking, bleeding, or pain that continues during or between feedings.
Breast engorgement normally occurs around 2 to 5 days after birth. This is when breasts produce large amounts of mature milk to replace colostrum. Your breasts will feel heavy, firm, and tender. Your breasts will feel more comfortable as your baby feeds. Your milk supply will get in synch with your baby’s needs. If your baby does not remove enough milk from your breasts, your breasts may feel hard, painful, and hot. Feeding will help ease engorgement. Breastfeed every 2 to 3 hours. If you miss a feeding, pump your breast.
Breastfeeding is a great way to get your baby’s life off to a healthful start. Take advantage of breastfeeding classes, lactation consultants, support groups, and other people who can help make breastfeeding a wonderful experience for you and your new baby.
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