Karen Kassel, MS, RD, Med
Learn about the benefits and keys to success for giving your baby the ultimate natural food.
During pregnancy, a woman’s body prepares to make milk. Breasts expand, adding an extra one to one-and-a-half pounds on each side. The nipples enlarge and darken in color. The blood vessels in the breast also enlarge and become more visible. After the baby is born and the placenta is delivered, hormonal changes signal the breasts to begin milk production. Each time the infant suckles at the breast or cries, hormones are activated that cause the breasts to release their milk to the baby. This is called the let-down reflex. These hormones also lead to the production of more breast milk. In this way, a mom’s breasts produce milk in response to her infant’s needs. Breastfeeding, also called nursing, is considered the best and most natural way to feed a baby.
You may have heard that “breast is best.” This refers to the many health benefits associated with breastfeeding. The benefits are so great that the American Medical Association, American Academy of Pediatrics, and World Health Organization recommend that women feed their infants only breast milk for the first six months of life. At six months, you may begin to supplement with food, but are encouraged to continue breastfeeding until after your baby’s first birthday.
So, what is so great about breast milk? It is easy on a baby’s tummy. All of its ingredients are easily digested by an infant’s young digestive system. It also provides enzymes, antibodies, and other factors that boost immunity. In fact, babies who are breastfed are less likely to develop ear infections, diarrhea,
inflammatory bowel disease, respiratory infections, meningitis, allergies,
sudden infant death syndrome, and
later in life. Breastfed babies may also have better mental development. There is even research to suggest that people who were breastfed are less likely to become obese.
Babies who are fed infant formulas are more likely to have infections. They are also more likely to be admitted to the hospital than babies who are fed breast milk. In addition, both mom and baby benefit from the bonding that occurs with skin-to-skin contact during breastfeeding.
Women who breastfeed return to their pre-pregnancy weight quicker than moms who don’t breastfeed. Nursing burns about 500 calories per day. The amount of calories is more than that burned during pregnancy, which demands an extra 300 calories daily. Breastfeeding also stimulates the uterus to contract back to its normal size, and reduces bleeding. There are long-term benefits as well. The risks of
breast, and ovarian cancers, as well as type 2 diabetes risk are lower among women who breastfeed their babies.
Financially speaking, breast milk is free. The cost of formula and supplies can add up to $1,000 per year. Preparing formula also takes time which is precious in those early days. Breast milk is always available and requires 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 and practiced. During pregnancy, take a class or read books on this new skill. To get off to a good start, follow these guidelines:
Like pregnancy and delivery, each woman’s experience with breastfeeding is different. Common concerns and difficulties include worry that your baby is not eating enough, planning for times away from your baby, sore nipples, and breast engorgement.
Instead of measuring the ounces going in, as you would with a baby drinking formula, breastfeeding moms count what is coming out. In the first few days of life, your baby will have one to three wet diapers per day. From day four on, your baby should have five to six wet diapers and one to three dirty diapers every 24 hours. In addition, your pediatrician will weigh and measure your baby regularly. All babies lose weight after they are born. A breastfed baby should be back at birth weight by two weeks.
Many women continue breastfeeding when they return 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 difficulty 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. You should still pump your breasts during the work day to relieve the pressure and maintain your milk supply.
If possible, wait two to three weeks before giving your baby a bottle. Because it is easier for a baby to get milk from a bottle than from your breast, she may develop a preference for the bottle. Also, your milk supply will decrease if you do not feed often. Allow at least two to three 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 beneficial to your baby, even if it’s only a few weeks.
You can rent or buy a breast pump to help express your milk. Manual pumps cost about $50 and electrical pumps can cost $200 or more. The pricier versions include a carrying case and an insulated section for storing milk. Many hospitals have pumps for rent so ask your care providers when you deliver your baby.
Once pumped, 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 (if you have a deep freezer, milk will stay good for 12 months). Thaw frozen milk in the refrigerator or under lukewarm running water. Do not leave breast milk at room temperature for a long time, expose it to 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 ten days, you may have some tenderness at the beginning of a feeding. If this pain is severe, lasts throughout the feeding, or persists for more than a week, talk with your doctor or a lactation consultant. Sore nipples are most likely due to poor latching on. Steps to prevent or minimize nipple soreness include the following:
Breast engorgement normally occurs around the second to fifth day 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 and your milk supply gets in synch with your baby’s needs. But if your baby does not remove enough milk from your breasts, your breasts may feel hard, painful, and hot. The best way to resolve engorgement is to keep feeding. Breastfeed every two to three 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.
EBSCO DynaMed website. Available at:
https://dynamed.ebscohost.com/about/about-us. Updated June 3, 2013. Accessed June 10, 2013.
Breastfeeding. US Department of Health and Human Services Women's Health website. Available at:
http://www.womenshealth.gov/breastfeeding/index.html. Updated April 5, 2013. Accessed June 10, 2013.
Breastfeeding: helpful hints for you.
Am Fam Physician. 2000;61(7):2103-2014. Available at:
http://www.aafp.org/afp/20000401/2103ph.html. Accessed June 10, 2013.
Breastfeeding vs. formula feeding. Nemours Foundation website. Available at:
http://www.kidshealth.org/parent/food/infants/breast_bottle_feeding.html. Updated January 2012. Accessed June 10, 2013.
Feeding your newborn. Nemours Foundation website. Available at:
http://www.kidshealth.org/parent/food/infants/feednewborn.html. Updated September 2011. Accessed June 10, 2013.
Nutrition in infants. The Merck Manual of Diagnosis and Therapy website. Available at:
http://www.merckmanuals.com/professional/pediatrics/approach_to_the_care_of_normal_infants_and_children/nutrition_in_infants.html. Updated July 2012. Accessed June 10, 2013.
Tips for breastfeeding success.
Am Fam Physician. 2001;64(6):991-992.
10/9/2009 DynaMed's Systematic Literature Surveillance
https://dynamed.ebscohost.com/about/about-us: Barclay AR, Russell RK, Wilson ML, Gilmour WH, Satsangi J, Wilson DC. Systematic review: the role of breastfeeding in the development of pediatric inflammatory bowel disease.
J Pediatr. 2009;155(3):421-426.
10/21/2011 DynaMed's Systematic Literature Surveillance
https://dynamed.ebscohost.com/about/about-us: Guxens M, Mendez MA, Moltó-Puigmartí C, et al. Breastfeeding, long-chain polyunsaturated Fatty acids in colostrum, and infant mental development.
7/15/2013 DynaMed's Systematic Literature Surveillance
https://dynamed.ebscohost.com/about/about-us: Vieira F, Bachion MM, Mota DD, et al. A systematic review of the interventions for nipple trauma in breastfeeding. J Nurs Scholarsh. 2013 June;45(2):116-125.
Last reviewed June 2013 by Andrea Chisholm, MD; Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.