Breastfeeding: Kidzco - celebrating childhood

Breastfeeding Back

Exclusive breastfeeding for 6 months has many benefits for the infant and mother. Chief among these is protection against gastrointestinal infections which is observed not only in developing but also industrialized countries. Early initiation of breastfeeding, within 1 hour of birth, protects the newborn from acquiring infections and reduces newborn mortality. The risk of mortality due to diarrhea and other infections can increase in infants who are either partially breastfed or not breastfed at all.

Breast-milk is also an important source of energy and nutrients in children aged 6–23 months. It can provide half or more of a child’s energy needs between the ages of 6 and 12 months, and one third of energy needs between 12 and 24 months. Breast-milk is also a critical source of energy and nutrients during illness, and reduces mortality among children who are malnourished.

Children and adolescents who were breastfed as babies are less likely to be overweight or obese. Additionally, they perform better on intelligence tests and have higher school attendance.

Longer durations of breastfeeding also contribute to the health and well-being of mothers: it reduces the risk of ovarian and breast cancer and helps space pregnancies–exclusive breastfeeding of babies under 6 months has a hormonal effect which often induces a lack of menstruation.

Let's start at the very beginning. A mother's milk usually takes 48 to 72 hours to come in, but can take a little longer, so there’s nothing to worry about if this happens. Hang in there, your milk will appear! Let baby come to the breast frequently for antibody-rich colostrums, which is very low in volume but essential for immunity. A baby's tummy at birth is the size of a small marble, so they really don't need very much. Giving supplements of formula because they 'appear hungry’ before a mum’s milk, really does jeopardize a baby being able to breastfeed effectively, so try to hold off unless it's deemed necessary by a health practitioner.

Once your milk is in, the supply-and-demand rule kicks in. Much your baby takes, that's how much your breast will learn to make. It's as simple as that. To know if your baby is getting enough, watch your baby, not the clock. Baby should suck one breast for at least 10-15 minutes because the fat riched milk comes only after 10 minutes. This milk which comes later gives the sensation of full stomach to the baby. Sucking is a tedious work for the baby, so they suck for a while and stops and again continues. There’s no need to worry. If baby stops sucking, give a few breast compressions (squeezing the breast by holding your hand in a C shape and pushing back into the tissue of the breast) which usually remind them to keep going. Then switch sides.

Changing the nappy between feeding on each breast helps a sleepy baby to wake up a bit, and the other side usually offers a fresh burst of milk to keep that active sucking going for longer

The frequency of feeding is what stimulates supply, rather than waiting for your breasts to fill up. It is very important to breast feed the baby at night because it stimulates the brain and further increases milk production. Stringing out a baby to three or four hours when they are hungry after two hours is often counter-productive and too much like hard work for the mum, with all the added patting and pacing that goes along with it.

If you are worried about supply, watch your baby's nappies. After a baby is 10 days old, they should be producing at least four to five heavily wet disposables in 24 hours, with lots of squirts of poo. If this isn’t happening, you’ll need a good management plan.

Remember any formula you give will affect your breast-milk supply and make your baby less hungry for the breast at the next feed, although mixed feeding can be an option. It doesn't have to be all or nothing – any breast-milk is beneficial. A call to your child doctor is a great way to work out how to manage your supply and give you confidence to continue breastfeeding, if that's what you'd like to do.

Frequently Asked Questions

How often should I breastfeed?

Your newborn should be nursing 8-12 times per day for about the first month. If you feel like you're feeding your little one more often than a friend whose baby is formula fed, you might be. Why? Because breast milk digests easier than formula, which means it moves through your baby's digestive system faster and, therefore, your baby is hungry more often. Frequent feedings also will help stimulate your milk production during the first few weeks. By 1 to 2 months of age, a breastfed baby will probably nurse 7-9 times a day. Before your milk supply is established, breastfeeding should be "on demand" (when your baby is hungry), which is generally every 1½ to 3 hours. As newborns get older, they'll nurse less often, and may develop a more reliable schedule. Some might feed every 90 minutes, whereas others might go 2 or 3 hours between feedings. Newborns should not go more than about 4 hours without feeding, even overnight.

Are feeding intervals counted from the time my baby starts or stops nursing?

You count the length between feedings from the time when your baby begins to nurse — rather than when he or she ends — to when your little one starts nursing again. In other words, when your doctor asks how often your baby is feeding, you can say "about every 2 hours" if your first feeding started at 6 a.m. and the next feeding was at around 8 a.m., then 10 a.m., and so on. This means that, especially at first, you may feel like you're nursing around the clock, which is completely normal. Soon enough, you'll both be on a more routine, predictable schedule.

Is it normal for my baby to spit up after feedings?

Sometimes, babies spit up when they:

have eaten too much
burp (the notorious "wet burp")
drool

Many infants will spit up a little after some — or even all — feedings or during burping because their digestive tracts are immature. That's perfectly normal. As long as your baby is growing and gaining weight and doesn't seem uncomfortable with the spitting up, it's OK. The amount of spit up often looks more than it actually is. But spitting up isn't the same as forcefully vomiting all or most of a feeding.

If you're concerned that your baby is vomiting, call your doctor. Try to keep a record of exactly how often and how much your baby seems to be vomiting or spitting up. In rare cases, there may be an allergy, digestive problem, or other problem that needs medical attention. The doctor should be able to tell you if it's normal or something that's cause for concern.

If the doctor says your baby's spitting up is normal, here are some things you can do to help ease it:

Burp your little one when he or she comes off of each breast or after every 1 to 2 ounces during bottle feeds. Sometimes giving smaller, more frequent feeds can help rather than large volume feeds.
Keep your baby upright after feedings — holding the baby is best, since the position of the baby in an infant seat may actually make spitting up more common.
Don't jiggle, bounce, or actively play with your baby right after feedings.
Keep your baby's head above his or her feet while feeding (in other words, don't hold your baby in a dipped-down position when feeding).
Raise the head of your baby's crib or bassinet. Roll up a few small hand towels or receiving blankets to place under (not on top of) the mattress. But don't use a pillow under your baby's head. Make sure the mattress doesn’t fold in the middle and that the incline is gentle enough so the baby doesn’t slide down.
If your baby also gets bottles of breast milk or infant formula supplements:
Don't give the bottle while your little one is lying down.
Make sure the hole in the nipple is the right size and/or flow for your baby. For example, fast-flow nipples may cause babies to gag or may simply give them more than they can handle. Many breastfed babies do well with the slow-flow nipple until they are 3 months old, or even older.
It's also important to keep in mind that this, too, shall pass. Many babies outgrow spitting up by the time they're sitting up. I think I'm getting sick.

I think I am sick, can I still breastfeed?

In most cases, yes — the majority of illnesses are not dangerous to a breastfeeding infant. If you aren’t feeling well, remember that as your body produces antibodies to fight an illness, those antibodies go to the baby through your breast milk. However, in rare cases (such as HIV), a mother's health may affect her ability to breastfeed her baby. Contact a doctor or specialist before you interrupt breastfeeding because of an illness or because of a medicine that you require. In most cases, interrupting breastfeeding is not necessary.

My baby bites during breastfeeding. Can I stop it?

Babies will often play with their mothers' nipples with their gums, not meaning to cause any harm. But once they start teething, a baby might bite, not knowing this is hurting mom. Giving the baby something hard and cold to chew on before the nursing will help the gums — then gums won't be as tender, which may reduce biting.

You often can tell when your baby's about ready to bite — usually when he or she is satisfied and starting to pull away from your breast. Watch for your baby to switch from nutritive nursing to playing. When it's playtime, take your baby off your breast before he or she has the chance to bite.

If there's still biting, pull your baby closer to you to make it more difficult for him or her to pull off easily. Or, break the suction by slipping your finger into the corner of his or her mouth. Try and react calmly and without raising your voice so the baby doesn't get scared.

In most cases, though, biting may be a sign that your baby is done with a nursing session, is distracted, or is just plain bored. These tips to help reduce the biting potential:

Offer your little one a teething toy or ring.
Try starting a new activity if your baby seems distracted and is pulling off your breast a lot.
Praise your baby — with a hug, kiss, or cuddle — whenever he or she nurses without biting or trying to bite.

Does my breastfed baby need extra vitamins?

Breast milk contains many vitamins as well as easily-absorbed iron. The iron from breast milk will be sufficient until your baby begins eating iron-rich foods (such as cereals) around 6 months of age.

All babies need vitamin D supplementation. Vitamin D is added to formula and babies who are breastfed need to get their vitamin D as a daily supplement. The nutrient can be produced by the body when the skin is exposed to sunlight, but it is not safe for infants under 6 months to be in direct sunlight. After 6 months, infants should use sunscreen when in the sun, which blocks the body's ability to make vitamin D. So, babies who are primarily breastfed should be given daily vitamins.

Also, the American Academy of Pediatrics (AAP) states that infants — whether breastfed or formula-fed — do not need fluoride supplements during the first 6 months. From 6 months on, babies require fluoride supplements only if the water supply is severely lacking in fluoride. Well water and bottled water, for example, may not contain fluoride and the tap water in some communities does not have fluoride.

It can be dangerous to give a fluoride supplement to a child already getting enough fluoride, so it's important to find out the fluoride content in whatever water source your child is using. Again, ask your doctor about your baby's needs.

My baby doesn't want to nurse. What's going on?

Breastfeeding "strikes" are very normal. Still, this can be worrisome, especially in a baby who usually breastfeeds with no problems at all.

So why might your child suddenly stop wanting to breastfeed? Here are some possible reasons:

Teething has made the baby's gums sore.
You've been stressed or have changed your nursing patterns lately.
You smell "different" to your baby because you switched your soap, perfume, deodorant, or lotion.
There is a different taste to your breast milk because of a change in your diet.
Something is making breastfeeding painful or uncomfortable, such as an ear infection, a stuffed-up nose, a cut in your little one's mouth, or an oral infection called thrush.
Your baby bit you and your reaction scared him or her.

As frustrating as nursing strikes can be, you and your little one can work through them. Here are some more tips for breastfeeding moms that may help get you past the hump:

Try stimulating your milk let-down by pumping or hand expressing before starting to breastfeed so your baby gets the milk right away.
Breastfeed in a quiet room with few distractions.
Nurse while you're rocking your baby or walking around while carrying him or her in a sling.
Try nursing when your baby is sleepy and may be more willing to cooperate.
Make the experience as enjoyable for your baby as possible — hugging, caressing, and kissing your little one, and stopping to comfort whenever he or she gets upset or frustrated
Try to spend more time with your baby so you can devote some extra time to getting your breastfeeding back on track. Ask a family member, friend, or a babysitter to come over to help out with the chores and any of your other children.

Until your nursing schedule is back to normal, you'll need to pump or hand express to keep your milk supply up and to make sure the baby is getting enough to eat. And if your child is really ready to stop breastfeeding (or wean), he or she will probably do it over a period of weeks or months.

In the meantime, both you and your baby can enjoy the special closeness and bonding that breastfeeding can offer.

Reviewed by: Dr Roshma Gurung

This information is not a substitute for professional advice and does not create a doctor-patient relationship. If you have any concerns about your child's health or wellbeing it is important that you seek help from your doctor or a health professional.