Breastfeeding

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Breast feeding

Breastfeeding and Breast Milk

Breastfeeding with breast milk provides an infant with essential calories, vitamins, minerals, and other nutrients for optimal growth, health, and development. Breastfeeding is beneficial to both a mother and her infant and also offers an important opportunity for the pair to bond.

About Breastfeeding and Breast Milk

Breastfeeding, also called nursing, is the process of feeding a mother's breast milk to her infant, either directly from the breast or by expressing (pumping out) the milk from the breast and bottle-feeding it to the infant. Breastfeeding and breast milk provide an infant with calories and nutrients, including macronutrients (fat, protein, and carbohydrates) and micronutrients (vitamins and minerals).1

According to the American Academy of Pediatrics (AAP) Policy Statement on Breastfeeding, women who don't have health problems should exclusively breastfeed their infants for at least the first 6 months after birth.2

The AAP suggests that, if possible, a woman should try to continue breastfeeding her infant for up to 12 months, while adding other foods, because of the benefits to both the mother and the infant.

What are the benefits of breastfeeding?

Research shows that breastfeeding offers many health benefits for infants and mothers, as well as potential economic and environmental benefits for communities.

Breastfeeding provides essential nutrition. Among its other known health benefits are some protection against common childhood infections and better survival during a baby's first year, including a lower risk of Sudden Infant Death Syndrome.1

Research also shows that very early skin-to-skin contact and suckling may have physical and emotional benefits.2

Other studies suggest that breastfeeding may reduce the risk for certain allergic diseases, asthma, obesity, and type 2 diabetes. It also may help improve an infant's cognitive development. However, more research is needed to confirm these findings.

What are the recommendations for breastfeeding?

In the United States, the American Academy of Pediatrics (AAP) currently recommends:1

  • Infants should be fed breast milk exclusively for the first 6 months after birth. Exclusive breastfeeding means that the infant does not receive any additional foods (except vitamin D) or fluids unless medically recommended.
  • After the first 6 months and until the infant is 1 year old, the AAP recommends that the mother continue breastfeeding while gradually introducing solid foods into the infant's diet.
  • After 1 year, breastfeeding can be continued if mutually desired by the mother and her infant.

The World Health Organization currently promotes as a global public health recommendation that:2

  • Infants be exclusively breastfed for the first 6 months after birth to achieve optimal growth, development, and health.
  • After the first 6 months, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond.
Correct breastfeeding

How do I breastfeed?

There are many mothers' groups, health organizations, and health care provider associations that provide very detailed information and support on how to breastfeed. The following overview is provided for information only—it is not meant to take the place of a health care provider or lactation consultant's advice or recommendation. Visit the Resources and Publications section to find the names of some breastfeeding organizations.

Infants who are hungry will nuzzle against their mother's breast and make sucking motions or will put their hands in their mouths. During the first weeks after birth, you may nurse your infant often, perhaps as often as eight to 12 times in 24 hours.1

After your infant is born, follow these tips for getting started:2

  • Breastfeed your infant for the first time as soon as possible after the infant is born.
  • Ask at the hospital whether an on-site lactation consultant is available to assist you.
  • Request that the hospital staff not feed your infant any other foods or formula unless it is medically necessary.
  • Allow your infant to stay with you throughout the day and night at the hospital so that you can breastfeed often. If this is not possible, ask the nurses to bring your infant to you each time for breastfeeding.
  • Avoid giving your infant pacifiers or artificial nipples so that the infant gets used to latching on to just your breast.

Infants will naturally move their head while looking and feeling for a breast to feed. There are many ways to start feeding your infant, and the best approach is the one that works for you and your infant. The steps below can help with getting your infant to "latch" on to the breast for feeding.2

  • Hold your infant against your bare chest. Dress your infant in only a diaper to ensure skin-to-skin contact.
  • Keep your infant upright, with his or her head directly under your chin.
  • Support your infant's neck and shoulders with one hand and his or her hips with your other hand. Your infant may try to move around to find your breast.
  • Your infant's head should be slightly tilted back to make nursing and swallowing easier. When his or her head is tilted back and the mouth is open, the tongue will naturally be down in the mouth to allow the breast to go on top of it.
  • At first, allow your breast to hang naturally. Your infant may open his or her mouth when your nipple is near his or her mouth. You also can gently guide the infant to latch on to your nipple.
  • While your infant is feeding, his or her nostrils may flare to breathe in air. Do not panic—this flaring is normal. Your infant can breathe normally while breastfeeding.
  • As your infant tilts backward, support his or her upper back and shoulders with the palm of your hand and gently pull your infant close.

A good latch is important for both effective breastfeeding and your own comfort. Review the following signs to determine whether your infant has a good latch:2

  • The latch feels comfortable and does not hurt or pinch. How it feels is a more important sign of a good latch than how it looks.
  • Your infant does not need to turn his or her head while feeding. His or her chest is close to your body.
  • You see little or no areola (pronounced uh-REE-uh-luh), which is the dark-colored skin on the breast that surrounds the nipple. Depending on the size of your areola and the size of your infant's mouth, you may see a small amount of areola. If more areola is showing, it should seem that more is above your infant's lip and less is below.
  • Your infant's mouth will be filled with breast when in the best latch position.
  • Your infant's tongue is cupped under the breast, although you might not see it.
  • You can hear or see your infant swallowing. Because some babies swallow so quietly, the only way of knowing that they are swallowing is when you hear or see a pause in their breathing.
  • Your infant's ears "wiggle" slightly.
  • Your infant's lips turn outward, similar to fish lips, not inward. You may not even see your infant's bottom lip.
  • Your infant's chin touches your breast.

To break the suction and end a breastfeeding session, insert a clean finger between your breast and your infant's gums. After you hear a soft pop, pull your nipple out of your infant's mouth.1

You should allow your infant to set his or her own nursing pattern. Many newborns will feed for 10 to 15 minutes on each breast. If your infant wants to nurse for a much longer period—say 30 minutes or longer on each breast—he or she may not be getting enough milk.

What is weaning and how do I do it?

Weaning is the process of switching an infant's diet from breast milk or formula to other foods and fluids. In most cases, choosing when to wean is a personal decision. It might be influenced by a return to work, the mother's or infant's health, or just a feeling that the time is right.1

Weaning an infant is a gradual process. The American Academy of Pediatrics (AAP) recommends feeding infants only breast milk for the first 6 months after birth. After 6 months, the AAP recommends a combination of solid foods and breast milk until the infant is at least 1 year old.2 The Academy advises against giving cow's milk to children younger than 1 year old.3

You may have difficulty determining how much to feed your child and when to start introducing solid foods. The general guidance below, as reported by the National Library of Medicine, demonstrates the process of weaning for infants up to 6 months of age.4 You should speak with your infant's health care provider before attempting to wean your infant to make sure that he or she is ready for weaning and for complete guidance on weaning.

  • Birth to 4 months of age
    • During the first 4 to 6 months, infants need only breast milk or formula to meet their nutritional needs.
      • If breastfeeding, a newborn may need to nurse eight to 12 times per day. By 4 months of age, an infant may need to nurse only four to six times per day.
      • By comparison, formula-fed infants may need to be fed about six to eight times per day, with newborns consuming about 2 to 3 ounces per feeding. The number of feedings will decrease as the infant gets older, similar to breastfeeding.
  • 4 to 6 months of age
    • At 4 to 6 months of age, an infant needs to consume 28 to 45 ounces of breast milk or formula per day and often is ready to start being introduced to solid food.
    • Starting solid foods too soon can be hazardous, so an infant should not be fed solid food until he or she is physically ready.
    • Start solid feedings (1 or 2 tablespoons) of iron-fortified infant rice cereal mixed with breast milk or formula, stirred to a thin consistency.
    • Once the infant is eating rice cereal regularly, you may introduce other iron-fortified instant cereals.
    • Only introduce one new cereal per week so that intolerance or possible allergies can be monitored.

When breastfeeding, how many calories should moms and babies consume?

Many new mothers wonder if they need to consume more calories (also called energy) during breastfeeding, but the answer is no. You can take in the same number of calories that you did before becoming pregnant. This strategy helps with weight loss after birth.1

The Dietary Guidelines for Americans (DGAs) for caloric intake for all women 19 to 50 years old are based on activity level, as follows:2

  • Sedentary: 1,800 to 2,000 calories per day
  • Moderately active: 2,000 to 2,200 calories per day
  • Active: 2,200 to 2,400 calories per day

The increased caloric need for women who are breastfeeding is about 450 to 500 calories per day.3 Women who are not trying to lose weight following pregnancy should supplement the above DGA calories per day by 450 to 500 calories. Often an increase in a normally balanced and varied diet is enough to meet your body's needs. Whether or not to increase caloric intake during breastfeeding is a decision that should be made with the assistance of a health care provider.

Poorly nourished mothers, those on vegan diets or other special diets, and those with certain health conditions may require a supplement of docosahexaenoic acid (DHA) in addition to multivitamins to ensure complete nutrition for breastfeeding.4

Women who are breastfeeding may have additional requirements for vitamins and minerals. Learn more about your specific nutritional needs during breastfeeding at ChooseMyPlate.gov.

Women also can use the U.S. Department of Agriculture's (USDA's) My Plate Daily Checklist for Moms to develop a personalized food plan based on their activity level, amount of breastfeeding, age, and other characteristics.

The estimated energy requirements (in calories per day) for infants are based on their age, size, and sex. Estimated energy requirements developed by the USDA are as follows:5

Males

  • 1 to 3 months: 472 to 572 calories per day
  • 4 to 6 months: 548 to 645 calories per day
  • 7 to 9 months: 668 to 746 calories per day
  • 10 to 12 months: 793 to 844 calories per day

Females

  • 1 to 3 months: 438 to 521 calories per day
  • 4 to 6 months: 508 to 593 calories per day
  • 7 to 9 months: 608 to 678 calories per day
  • 10 to 12 months: 717 to 768 calories per day

The above daily calorie ranges are for infants of a specific weight and length. The USDA has information on how to find out the daily calorie needs of your infant based on his or her size (PDF - 237 KB).

The USDA also has determined the daily protein, carbohydrate, and fat requirements for infants (PDF - 237 KB).

Visit the Office on Women's Health's Breastfeeding page to learn what signs to watch for to determine whether your baby is getting enough breast milk.

The DGAs for infants increase as the infants get older. By the time that children are 2 to 3 years of age, daily calorie needs are 1,000 to 1,400 calories per day, depending on the child's activity level. For children who are older, see the 2015–2020 DGAs.

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