Breastfeeding is the natural way of feeding babies with milk that comes from a woman’s breast. It is the recommended way of feeding especially from birth up to six months of life because breastmilk contains the perfect mixture and quantity of nutrients that are necessary to sustain the growth of an infant. In fact, exclusive breastfeeding—giving only breastmilk and nothing else—is encouraged and considered adequate in the first six-18 months of life.
Breastfeeding should be started in the first few hours of life and can be started in the delivery room. Early initiation of breastfeeding is crucial because it is during the first few days of life that colostrum is produced. Colostrum is the clear yellowish breastmilk produced in the first 2 to 3 days of life. It might seem small in quantity but it is rich in nutrients enough to sustain the newborn for the first few days. More importantly, colostrum has the mother’s antibodies that will protect her infant from illnesses in the first few months of life. After the first few days, the quantity of colostrum will gradually decrease, but the mother’s breastmilk will still contain the vital nutrients and antibodies that are beneficial for the growing infant.
How to breastfeed
There are various ways of positioning the infant during breastfeeding. The most common positions are the cradle, cross-cradle, side-lying, and football carry. Each position has its advantages and suitability. Mothers are encouraged to find the position that works best for her and her baby.
Regardless of the position chosen by the mother, it is important that she is comfortable in the chosen position and that her infant has a good latch to her breast. The signs of a good latch are:
- The baby’s mouth is wide open and most of the areola is covered
- The baby’s lips are flanged outward
- The baby’s tongue is over the lower gum
- The baby’s chin touches the mother’s breast
A good latch with a tight seal is essential for the baby to get enough milk from the mother’s breast. A good latch prevents the development of sore nipples, although it is not unusual for mothers to get sore nipples even with a good latch especially when initiating breastfeeding.
Timing and Duration
It is recommended for babies to be fed on demand—that is, they should be fed when they show signs of hunger such as smacking or licking lips, sucking on fingers or tongue, rooting, getting fussy, or crying. The duration and frequency of feeding varies with every infant. In general, most babies feed from 8 to 12 times a day and each feeding lasts from 5 to 20 minutes. Instead of timing the feeding, it is recommended to let the baby feed and empty one breast first before offering the other breast. On the next feeding, latching should be started on the other breast. By switching sides every feeding and by emptying the breast each time, both breasts are stimulated to produce more milk.
Feeding is considered adequate if the infant has at least 6 wet diapers a day and at least 4 bowel movements a day by the 4th or 5th day of life. A continuous weight gain is also a good indicator of adequate breastfeeding. From birth to six months, breastmilk alone is enough to sustain the needs of the growing infant. Beyond six months, complementary food should be started, but breastfeeding can be continued even after six months and beyond.
Breastfeeding can be a painful task, especially for first-time mothers. Some of the common problems encountered during breastfeeding are:
- Painful or cracked nipples often due to improper latch
- Painful, red, warm, engorged breasts due to the sudden increase in production of milk
- Milk plugs or blocked milk ducts due to delayed emptying of milk or long intervals between feeds
- Breast or nipple infections
- Low milk production
To remedy these problems, the following steps can be done:
- Practice proper latching to prevent sore nipples and to prevent milk plugs.
- Express milk either by hand or by pump to relieve the engorged breasts.
- Take a warm shower or apply warm compress over milk plugs to stimulate milk flow.
- Drink plenty of fluids and eat extra calories to ensure adequate milk production.
- Take vitamins and supplements to help increase milk supply.
- Pain relievers or antibiotics can also be taken but with the guidance of a doctor because some medications can be passed to the baby through breastfeeding.
Most of the problems encountered during breastfeeding can be remedied at home. However, if any of these problems persists, a consult with a doctor is warranted. In particular, a visit to a doctor or a "lactation consultant" is recommended if:
- The milk plug persists.
- The mother has fever.
- Blood leaks from the nipples.
- There is a non-healing wound on any part of the breast.
- Pain persists and lasts during the entire feeding session.
Women discontinue breastfeeding at different times and for different reasons. Some mothers choose to breastfeed for more than a year; some for just six months; and some do not breastfeed at all. Whatever the length of time is chosen by the mother to breastfeed, it is important that breastfeeding be discontinued in a gradual manner. This can be done by prolonging the interval between feedings or by shortening the duration of each feeding. By the doing this, the milk supply will gradually decrease until it stops completely.