Breastfeeding

Providing good nutrition for your newborn is crucial. The best source of that nutrition, according to just about every medical source, is a mother's breast milk. Human milk contains just the right amount of fat, sugar, water and protein for human digestion, brain development and growth (Read about "The Brain"), according to the National Women's Health Information Center (NWHIC).

When to start

The best time to start breastfeeding is within a few hours of birth. The mother's breasts are not producing milk yet but what she will be producing is colostrum, a thick, yellowish fluid that is chock full of natural antibodies. It's nature's way of giving a child some protection from disease while the child's immune system (Read about "The Immune System") has a chance to develop. The Food and Drug Administration (FDA) reports that breastfed babies have fewer illness because of the antibodies passed on to the infant from the mother. Mother's milk is also sterile, so contamination from polluted water or dirty bottles is never passed on to the baby. A breastfed baby's digestive tract has larger numbers of Lactobacillus bifidus, a beneficial bacterium that prevents the growth of harmful bacteria according to FDA. (Read about "Microorganisms") The U.S. Surgeon General recommends that babies be breastfed exclusively for the first four to six months of life, preferably six months. The American Academy of Pediatrics (AAP) says breastfeeding is best way to feed your baby for the first 6 months of life. The slow introduction of other foods, especially iron-fortified ones, can complement breastfeeding in the second six months. But breastfeeding should continue for at least the first year and even longer if possible, according to AAP. In the first six months breast milk, for the most part, should be enough. Things like water, juice and other foods usually aren't needed. AAP recommends that vitamin D supplements be given to all breastfed babies starting in the first few days of life. If the child is bottle fed, it is important to make sure they are receiving in the formula. In addition, AAP says that some babies may need supplemental nutrition for iron. (Read about "Vitamins & Minerals")

Nutritional value

Human breast milk is easily digested because the ingredients have been perfected by nature. Human milk contains at least 100 ingredients not found in formula, according to NWHIC. In addition, a baby won't be allergic to their mother's milk. Sometimes they have a reaction but it is usually to something the mother has eaten. (Read about "Food Allergies") When she stops, the problem goes away. It's interesting to note that FDA says more than half the calories in breast milk come from fat. With all the publicity and push for adults to cut down on their fat intake, that may sound alarming but it's not. Infants have a much higher energy need and according to FDA fat is a good source. There have also been some recent studies that indicate fat is needed for brain development.

Bonding

Breastfeeding has some other positive points to go along with the nutritional ones. Many of them are good for the mother. There are many indications that the child gets more then just a meal from breastfeeding, that it is a great emotional comfort and bonding time. At first, a baby can only see about 12 to 15 inches. That's just about the distance from the breast to a mother's face. Also FDA says a child knows its mother smell. In studies, when nursing pads soaked in breast milk are placed in a crib a baby will turn to the ones soaked with their mothers milk. Nursing is also a good chance for a mother to stop and spend some time with her baby. And at night, she doesn't have to get up, prepare a bottle and then give it to the baby. She can make dad get the baby and bring the child to her. If she lies down, she can doze while she's nursing as long as someone else is present to ensure she doesn't roll over and hurt the baby. Breastfeeding can also help the mother in other physical ways. Lactation stimulates the uterus to contract back to its original size. Nursing also uses extra calories so it's easier to lose the baby fat as well. The Le Leche League also claims that recent studies show that by breastfeeding, a woman can reduce her risk of premenopausal breast cancer (Read about "Breast Cancer") by 20 percent.

Obstacles and challenges

There are problems a new mother will probably face when first starting to breastfeed. The two major issues will involve engorgement and painful nipples. Engorgement comes because a new mother's body wants to make sure it produces enough milk for the baby or babies. The breasts become big, hard and painful. As a feeding pattern develops, the body will adjust and begin producing the right amount of milk. Until then NWHIC recommends:

• feed the baby frequently and on demand to establish the pattern
• warm, wet compresses can be applied to the breast
• warm baths or showers may help
• express some milk before breastfeeding (known as let down), either manually or with a pump
• try different feeding positions
• gentle massaging from under the arm down toward the nipple

NWHIC also warns against taking any kind of pain reliever without consulting your healthcare provider (HCP). Many drugs are safe to take while breastfeeding but there are also many that are not. You should discuss your particular medical situation with your HCP in advance, making sure your raise the issue of medications you may be or have been taking. It is important for your health and the health of the baby.

A new mother's nipples are bound to be sensitive in the beginning. There may be some soreness until the nipples toughen up. NWHIC says it's important that when nursing, the baby's mouth latch onto the areola, not just the nipple. Many hospitals and birthing centers have a nurse lactation consultant who can give you advice. Don't be afraid to ask for help. When you are finished nursing, let the nipple air dry to help prevent cracking. If cracking does occur, natural moisturizers or breast milk itself can help. Be aware however, that your baby could have a reaction to any lotion you apply to your breast. If there is an infection, it is imperative that a woman see her HCP right away. Clogged milk ducts can cause an infection called mastitis. This too requires immediate medical attention. (Read about "Breast Diseases and Conditions")

Breast pumps

For women who can't be with their child throughout the day, due to work or other reasons, a breast pump can be helpful. Breast pumps consist of a breast shield that fits over the nipple, a pump that creates a vacuum to express the milk, and a detachable container for collecting the milk. There are many options, including double pumps, manual pumps, and electric or battery-powered pumps.

The Food and Drug Administration (FDA) suggests that mothers talk to a lactation consultant about the best pump for their needs. Things to consider include:

• will the pumps be used exclusively, or in addition to breastfeeding
• where will the pump be used
• does the pump need to be easily transported
• will it be easy to find an outlet when you express milk

When using the pump, it is essential to keep it clean. FDA says to read the directions carefully, and to do the following:

• Rinse each piece that comes into contact with breast milk in cool water as soon as possible after pumping.
• Wash each piece separately using liquid dishwashing soap and plenty of warm water.
• Rinse each piece thoroughly with hot water for 10-15 seconds.
• Place the pieces on a clean paper towel or in a clean drying rack and allow them to air dry.

Supplements needed

AAP recommends that children get vitamin D supplementation to prevent rickets (Read about "Osteomalacia & Rickets") and vitamin D deficiency. Concerns are growing as recent studies are showing an increase of rickets, particularly in urban areas. Rickets is a result of insufficient exposure to sunlight and inadequate vitamin D intake. By the time rickets is diagnosed the damage is often done. Sunlight can be a major source of vitamin D, but sunlight exposure is difficult to measure. Factors such as the amount of pigment in a baby's skin, and skin exposure, affect how much vitamin D the body produces from sunlight. (Read about "Children and Sun") Sun exposure is, of course, a double edged sword. Too much sun in a person's childhood years can result in skin damage and even skin cancer (Read about "Skin Cancer") later in life. AAP says children should wear sunscreen (Read about "Sunscreen") when they are out in the sun. Sunscreen, however, prevents the skin from making vitamin D. Exclusively breastfed infants are at increased risk of vitamin D deficiency and rickets, according to AAP. This is because human milk typically contains only small amounts of vitamin D, insufficient to prevent rickets.

For children over the age of one, the Institute of Medicine (IOM) recommends 600 international units (IUs) of vitamin D per day to maintain health. You should discuss with your healthcare provider what your child's needs are. For those over the age of one, IOM also says the upper intake level for vitamin D is between 2500 and 4000 IUs per day. Once again, it depends on age and other health factors how much vitamin D your child should be getting. Upper intake levels represent the upper safe boundary and should not be misunderstood as amounts people need or should strive to consume, according to IOM.

Reasons to avoid breastfeeding

There are some medical conditions that would keep a mother from breastfeeding. Women with AIDS, or who are infected with HIV, should not breastfeed. In addition, it's recommended by NWHIC that women with human T-cell leukemia virus type 1 (HTLV-1) not breastfeed. There are other diseases, such as herpes, Hepatitis C and active tuberculosis, that could keep you from breastfeeding. (Read about "Herpes" "Hepatitis C" "Tuberculosis") You should discuss your options with your doctor if you have any of these infections.

Choices

If you are unsure if breastfeeding is the way to go, you can always try it at first and then switch to a bottle. But remember if you start with a bottle, it's difficult then to try breastfeeding and many of the early immune system benefits are lost.

Learning about breastfeeding is easy. Ask your doctor or other healthcare professional. They'll be happy to assist you. The nurses and others at the hospital where your baby is born will be glad to help you get started breastfeeding your newborn. In addition, Le Leche League is an international organization that provides breastfeeding information.

If a woman is unable to breastfeed her infant, she should not consider this a failure. Love and good parenting are always important no matter how the infant receives nutrition.

Related Information:

    Baby and Young Child Care

    Immune System Glossary

    Pregnancy Resource Center