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Breastfeeding

Why breastfeed?

Sometimes mothers are advised not to breastfeed for health reasons, or they are unable to. But if you can breastfeed there is no doubt that this is best for the health of your baby. If your baby is born prematurely then it’s even more beneficial. And there are advantages for you too (see below).

Even if you only breastfeed for a few weeks, your baby will benefit, although the longer you can breastfeed for, the greater the benefits. So, if you are undecided about breastfeeding, why not give it a try?

Although you may not find it easy to start with, most difficulties can be overcome with patience and perseverance and, once breastfeeding is established, most mums find they really enjoy it. And you may, of course, find you have no problems at all.

Successful breastfeeding

Understanding how your breasts produce milk and how to deal with any problems  that may arise can help you to breastfeed successfully.  

Your milk supply

Your breasts produce milk in response to your baby feeding at your breast. The more your baby feeds, the more milk you produce provided that your baby is correctly positioned. So, if you let your baby feed whenever he or she wants to feed, you’re likely to produce the amount of milk your baby needs. This is known as demand feeding and at first you may find that your baby will want to feed at two-hourly intervals.

Don’t be tempted to give your baby a bottle at this stage, as this can reduce the time your baby spends sucking at your breast and therefore reduce the milk supply. Your baby may also get confused between sucking from a bottle teat and sucking from your nipple.

Best for you

  • The extra fat laid down by your body during pregnancy is used up when breast milk is made. This can help you get your shape back sooner. (But it is important not to diet when breastfeeding.)

  • Breastfeeding helps your womb to contract and return to its usual size more quickly.
  • Breastfeeding for three months or more may reduce the risk of developing breast or ovarian cancer later.
  • Breastfeeding is practical. There’s no cost of preparation and the milk is always available at the right temperature – even in the middle of the night.

Different kinds of breast milk

For the first few days after birth your breasts produce a special food called ‘colostrum’, which looks like rich creamy milk and is sometimes quite yellow in colour. This contains all the food your baby needs, as well as antibodies which pass your own resistance to certain infections on to your baby.

After about three days your breasts will begin to produce milk, which will be quite thin compared with colostrum. Two different kinds of milk are now produced each time you feed your baby. The fore milk, which your baby takes first, is thirst-quenching and means your baby gets a drink at the start of every feed. This is followed by the richer hind milk, which is the food part of the feed and contains the calories your baby needs.

The ‘let-down’ reflex

Your baby’s sucking causes the ‘let down’ of your milk. It makes your milk flow down and gather behind your nipple ready for feeding. Sometimes this happens even before your baby starts to feed. Maybe when you hear your baby cry, milk may start to leak from your breasts.

How your baby feeds

Unlike the teat of a bottle, there’s no milk in the nipple itself. The breasts are never empty, but the milk has to be let down so that it can gather behind the nipple and areola (the dark area around the nipple). A baby who only sucks on the nipple doesn’t get much milk (and may hurt your nipples).  

To make the milk flow out, your baby has to be in the right position at your breast. Make sure your baby’s mouth is wide open and covers most of the brown area around your nipple. Your baby’s tongue will press the milk out from the milk glands underneath the nipple. When your baby is correctly positioned and the milk begins to flow, you will usually see quick sucks change to deep swallows. Breastfed babies usually pause while they wait for more milk to be ‘delivered’ rather than sucking non stop.

Finding the right position 

For you
Make yourself comfortable. You’ll need to hold your baby close to your breast without strain and for some time too, so do make sure that your back is well supported all the way down. Try different chairs and different ways of sitting, and perhaps a footstool to raise your legs. Try lying down on your side with your baby up against you. Find what’s best for you.

Later, you won’t have to think about what position you’re in. You’ll be able to feed almost however and wherever you want to.

For your baby
Take your baby up to your breast rather than trying to bring your breast to your baby. Try using a pillow to raise your baby higher. 

Hold your baby close and turned towards you with the head and shoulders directly opposite your breast and the nose opposite your nipple. Your baby’s back should be in a straight line. Support your baby with a hand across the shoulders, not behind the head.

Next, move your baby’s lips gently against your nipple to get the baby to open his or her mouth. When the mouth is opened wide, draw the baby to your breast quickly. The baby’s bottom lip should reach your breast first. 

It’s important for your baby to take in your nipple and as much of the brown skin surrounding the nipple as possible. If your baby is correctly positioned, there will be more of your areola showing above the top lip than below the bottom lip, but this is not always easy to see.

Your baby’s chin should now be against your breast with the lower lip turned out. It’s the baby’s lower jaw which does the work of feeding.

If it doesn’t feel right, or if it hurts, slide one of your fingers into your baby’s mouth togently break the suction and try again. Keep trying until it feels right and you can see your baby taking deep swallows.

Your diet when breastfeeding

Eating well and resting when you can are important in making breast milk. Although your body uses up fat stored during pregnancy, you need extra calories, vitamins and minerals to keep up with the demands of your growing baby.

It is not wise to restrict your diet whilst breastfeeding even if you are very keen to get back into your normal clothes. Your body is working hard to make milk and needs easily available sources of energy (that is, your diet) to do so. Trying to diet will only make you feel more tired. Eating larger quantities at mealtimes and regular snacks will help meet the additional demands of breastfeeding. Rather than snacking on biscuits and cakes, try to eat foods that are more nutritious such as a sandwich or fruit.

Limiting your diet

There should be no need to avoid eating any foods, but if you, your baby’s father or any previous children have a history of hayfever, asthma, eczema or other allergies, avoid eating peanuts and foods containing peanut products (e.g. peanut butter, unrefined groundnut oils and some snacks). Read food labels carefully and, if you are still in doubt about the contents, you should avoid these products.

Some breastfed babies seem to react to foods that their mother has eaten and may cry more as a result. Foods commonly blamed for this include onions, garlic, citrus fruits and grapes. If you think it might help to cut out these foods, check with your health visitor first. It is important to seek advice before omitting food from your diet, as it is possible to become deficient in certain vitamins and minerals if you don’t know which foods to replace them with.

Drinks containing caffeine can unsettle your baby so keep your intake of tea and coffee low. Small amounts of alcohol pass into breast milk, making it smell different to your baby, and may affect his or her feeding, sleeping, or digestion.  

So it is best to keep well below the daily limits of two to three units for women, and avoid drinking before you feed your baby. 

Milk and dairy products are sometimes said to make breastfed babies upset, but don’t cut these out of your diet without medical advice, as they provide the calcium you and your baby need.

Some suggested snack foods

  • Sandwiches or pitta bread filled with salad vegetables, grated cheese,
    mashed salmon or sardines
  • Yoghurts and fromage frais
  • Hummus and bread or vegetable sticks
  • Ready-to-eat apricots, figs or prunes
  • Vegetable and bean soups
  • Fortified unsweetened breakfast cereals, muesli and other wholegrain
    cereals with milk
  • Milky drinks or unsweetened fruit juices
  • Fresh fruit
  • Baked beans on toast or baked potato

Hunger or thirst?

Breast milk is drink and food in one. If the weather is hot, your baby may want to feed more often. There’s no need to give your baby drinks of water, even in a very hot climate.

How often, how long?

Some babies settle into a pattern of feeding quite quickly. Others take longer. In the early weeks, you may find that your baby’s feeds are sometimes long, sometimes short, sometimes close together, and sometimes further apart. Try to follow what your baby tells you.

Feed when your baby asks to be fed, and for as long as your baby wants.

Once you’ve put your baby to your breast, let the feed go on until your baby wants to stop. Then, either straight away or after a pause, offer the other breast to see if your baby wants more. If you swap from one breast to the other before your baby is ready, you may only be giving your baby the thinner fore milk from each breast. The hind milk which comes later is richer and contains calories that your baby needs.

Allow your baby to decide when he or she has had enough. Both breasts might not always be wanted at each feed. Your baby will show that he or she has finished by either letting go of your breast or falling asleep. Start each feed on alternate breasts so that your breasts are stimulated to make milk equally – this should prevent engorgement.

You could remind yourself which breast was used last by tying a ribbon or pinning a safety pin to the bra strap on the side you last used. Some mothers can tell simply by feeling to see which breast is more full.

If you feed as often and for as long as your baby wants, you’ll produce plenty of milk and give your baby what he or she needs. While your baby is very young, this may mean quite lengthy feeds. But if you’ve got your baby in the right position at your breast, you shouldn’t become sore.

At first it may seem that you’re doing nothing but feeding. Remember that this stage will not last very long. In time you’ll find that your milk supply increases and so will the speed with which your baby feeds. Babies have growth spurts at approximately ten days, six weeks and three months.

Your baby may feed more frequently at these times until your milk supply increases to meet the bigger demand.

How much is enough?

Since it’s impossible to see how much milk your baby is taking from your breast, you may wonder whether your baby is getting enough. If you feed as frequently and for as long as your baby wants, you’ll find that your baby will stop feeding when he or she is full-up.

You can be sure your baby is getting enough milk if he or she:

  • has plenty of wet nappies each day and is having nothing but breast milk;
  • is growing and generally gaining weight, and it is overall weight gain that is important – some babies gain weight steadily, other perfectly healthy babies gain little or no weight one week, then feed more often and make up for it
    over the next week or two;
  • is awake and alert for some of the time.

If you notice that your baby isn’t growing in length or generally gaining weight, and is very sleepy or lethargic with no alert times, then he or she may not be getting enough milk. Persistent green stools may also be an indication that your baby is getting too much fore milk and not enough of the high-calorie hind milk.

Always make sure that your baby empties one breast completely before offering the other breast. If you are concerned, talk to your midwife or health visitor. Night feeds are important. A small baby can receive as much milk at night as during the day and night feeds encourage the body to make more of the hormone that produces breast milk. When your baby is small it’s important for night feeds to continue.

If your baby seems unusually sleepy and is slow to start feeding, he or she may be ill, so contact your GP.

Twins

Twins can be breastfed successfully. If you have twins it may help to start feeding each of your twins separately until feeding is well established. Then it may be more convenient to try to encourage them to feed at the same time. Your milk supply will increase to meet this extra demand, but you may need help putting your babies to the breast at the start.

Hints for breastfeeding

  • Eat when you feel hungry, and choose healthy snacks.
  • Ensure you drink plenty especially in hot weather.
  • Eat a wide variety of foods.
  • Try not to restrict your diet unless you think a food is upsetting yourbaby and then talk to your health visitor or doctor before cutting out foods.
  • Keep your intake of alcohol low – it can unsettle your baby.
  • Avoid drinking shortly before a baby’s feed.
  • Avoid drinking too much strong tea or coffee.

As well as your midwife or health visitor, breastfeeding counsellors from organisations such as La Lèche League, the National Childbirth Trust, and the Association of Breastfeeding Mothers can provide help and support. 


We are indebted to Health Promotion England for their help in compiling this section.