Patient education: Breastfeeding (The Basics)

Do doctors recommend breastfeeding for most babies? — Yes. Doctors recommend breastfeeding your baby for at least 1 year (12 months) if possible. For the first 6 months, breast milk is the only food that a baby needs. Most babies start eating other foods, in addition to breast milk, when they are 4 to 6 months old.

Breastfeeding has many benefits for both you and your baby. "Exclusive" breastfeeding means that your baby only drinks breast milk, and no formula or water. Any amount of breastfeeding is good for your baby. But exclusive breastfeeding gives the most benefits.

When should I start breastfeeding? — If possible, it's best to start breastfeeding immediately after giving birth, ideally within the first hour. During this time, most babies are awake and want to breastfeed. Also, the "skin-to-skin contact" can help your baby learn to breastfeed.

After you give birth, hormone changes in your body cause your breasts to fill with milk (figure 1). For the first few days after birth, you will make only a small amount of yellowish milk. This is called "colostrum." Colostrum has all of the nutrition that a newborn needs. You will start making more breast milk a few days later, usually 2 to 3 days after giving birth.

Breastfeeding frequently will help your body make more milk. If you want to keep breastfeeding, try not to give your baby any formula unless there is a medical reason. "Supplementing" with formula can make it harder for your body to make enough milk.

How should I hold my baby during breastfeeding? — There are different ways that you can hold your baby during breastfeeding (figure 2). You can try different positions to figure out which way works best for you and your baby.

Some people choose to wear a special bra called a "nursing bra." The cups of the bra have special flaps that open. This way, you can breastfeed your baby without having to take the bra off. Wearing a nursing bra might also give your breasts extra support.

What does "latch-on" mean? — Latch-on is another word for when a baby makes a tight seal with their mouth around the nipple and the areola (the dark skin around the nipple) (figure 3). A good latch-on helps the baby get enough milk and helps protect your nipples. You might feel a tugging or pulling at your nipples. If you feel pain or rubbing, you should take the baby's mouth off of your breast, then have them latch on again.

How often should I breastfeed, and how long should a feeding last? — You should breastfeed when your baby shows signs of being hungry. A baby can show that they are hungry by:

●Waking up from sleep

●Moving their head around as if they are looking for the breast

●Sucking on their hands, lips, or tongue

Babies can breastfeed on different schedules and for different amounts of time. For example, some babies finish a feeding in 5 minutes, but others might take 20 minutes or longer. Newborn babies feed about 8 to 12 times each day.

It's a good idea to let the baby finish breastfeeding on 1 side so that they get all of the milk from that breast. Then, you can see if your baby wants to drink from your other breast. The next time you breastfeed, try to remember which breast your baby started on the last time, and start on the other side. Switching the side you start with each time will help both your breasts continue to make milk.

How do I know if my baby is getting enough breast milk? — You can tell if your baby is getting enough breast milk by:

●Checking their diapers – By day 4 or 5 after birth, babies should have at least 4 or 5 wet diapers a day.

●Checking their bowel movements – Newborns should have at least 1 bowel movement every day. By day 5, they usually start to have more bowel movements, and their bowel movements should be yellow.

●Having your doctor or nurse check to see if your baby is gaining weight

Does my baby need any other food or drink? — For the first 6 months, most babies need only breast milk.

Babies who breastfeed also need to take extra vitamin D. This comes as a liquid that you give your baby using a dropper. Your baby's doctor can talk to you about how to do this and how much vitamin D to give. Vitamin D is important to build strong bones.

When a baby is between 4 and 6 months old, they can start eating and drinking other things, too. Ask your doctor or nurse which foods to feed your baby and when. You can still continue to breastfeed after your baby starts eating solid foods.

What problems can happen during breastfeeding? — Some people have problems during breastfeeding, like:

●Swollen, hard, and painful breasts

●Painful or cracked nipples

●Breast or nipple infections

●Blocked milk ducts, which can cause red and painful breast lumps

How are breastfeeding problems treated? — Breastfeeding problems are treated in different ways. Treatment will depend on the problem. For example, if you have swollen, hard, and painful breasts, you might feel better if you:

●Use your hand or a breast pump to let some milk out (figure 4).

●Use an ice pack or take pain-relieving medicine to treat the pain.

●Take a warm shower to start your milk flow and let some milk out.

Talk with your doctor or nurse if you are having problems with breastfeeding. Almost all breastfeeding problems can be treated. Some people also find it helpful to talk with a breastfeeding expert, called a "lactation consultant."

Should I see a doctor or nurse? — Call your doctor or nurse if you have:

●Pain that lasts for the whole breastfeeding session

●Blood leaking from the nipples

●A blocked milk duct that does not get better

●A fever of 100.4°F (38°C) or higher and a hard, red, or swollen area of the breast

●Flu-like symptoms, including muscle aches, chills, or feeling very tired

●Worries that you are not making enough milk

Do I need to change how I eat or drink when I am breastfeeding? — Maybe. You should eat a healthy diet and drink plenty of liquids. If you are trying to lose weight, breastfeeding might help. If you have a restrictive diet (for example, if you avoid meat or animal products), talk to your doctor or nurse. They might suggest taking iron or certain vitamins while you are breastfeeding to make sure that you get the nutrients you need.

If you choose to drink alcohol, most doctors recommend having only an occasional drink that has the amount of alcohol found in 1 glass of wine. They also recommend waiting 2 hours after having a drink before you breastfeed.

Can I keep taking my medicines while I am breastfeeding? — Some medicines are not safe to take while you are breastfeeding. But in most cases, it's possible to keep taking the medicines you need, or switch to different medicines. If you take any medicines, tell your doctor or nurse. They can make sure that those medicines are safe to take when breastfeeding.

Illegal or recreational drugs are harmful for a breastfeeding baby. Cannabis (marijuana) is legal in some places, but should be avoided if you are breastfeeding. There are studies that suggest it could cause problems in babies.

When should I stop breastfeeding? — If possible, it is a good idea to keep breastfeeding until your baby is at least 1 year old. But people choose to stop breastfeeding at different times and for different reasons.

When you do decide to stop, doctors recommend doing it gradually. You can drop 1 feeding every 2 to 5 days, or breastfeed for a shorter time each feeding. This will make it easier for your body to adjust. It will also give your baby time to get used to breastfeeding less.

More on this topic

Patient education: Deciding to breastfeed (The Basics)
Patient education: Health and nutrition during breastfeeding (The Basics)
Patient education: Common breastfeeding problems (The Basics)
Patient education: Pumping and storing breast milk (The Basics)
Patient education: Jaundice in babies (The Basics)
Patient education: Poor weight gain in babies and children (The Basics)
Patient education: Ear infections in children (The Basics)
Patient education: Diarrhea in children (The Basics)
Patient education: Weaning from breastfeeding (The Basics)
Patient education: Medicines and breastfeeding (The Basics)

Patient education: Breastfeeding guide (Beyond the Basics)
Patient education: Common breastfeeding problems (Beyond the Basics)
Patient education: Health and nutrition during breastfeeding (Beyond the Basics)
Patient education: Weaning from breastfeeding (Beyond the Basics)
Patient education: Pumping breast milk (Beyond the Basics)