What is Breastfeeding?

Breastfeeding is how your baby gets to suckle milk produced by your body. Your baby puts their mouth on your breast and, through sucking, gets milk. Your baby should begin breastfeeding soon after birth, usually within hours.

Initially, your body will produce an early version of milk named colostrum. It's a thick, protein-rich liquid. It's packed with antibodies that protect your infant from infection. After three or five days of breastfeeding, your colostrum will soon turn into mature milk. Your baby will lose some weight during these days. This is normal. They will get it back after your milk comes in.

Breastfeeding is good for you and your baby in several ways. Among them are reducing your risk for postpartum depression and developing your baby's immune system.

If possible, breastfeed your baby exclusively for the first six months of life. Continue breastfeeding as you add solid foods to their diet. Because breastmilk has so many advantages, you can continue offering it until your baby is two or older.

Remember, there are various ways to nourish your baby. You may breastfeed exclusively. You may express milk and bottle-feed your baby. You can breastfeed and supplement with formula. You can use exclusively formula or donor breast milk. Your needs and your baby's needs may shift over time. Most importantly, your baby receives the necessary nutrients to grow and thrive. Your medical care provider can help you decide what is best for you.

How does breastfeeding work?

Milk travels from your body to your baby through a process:

Your baby nurses on your breast.
Your baby's suckling stimulates nerves instructing your body to release specific hormones (prolactin and oxytocin).
Prolactin instructs your alveoli (small sacs in your breasts) to produce milk.
Oxytocin triggers the release of milk (let-down) into your milk ducts and out through your nipple.

You may hear your provider use the term that lactation is supply and demand. This means that your body gets signals from your baby's "demand" about how much milk to make. If your baby is emptying your breast, your body will replenish. If your baby takes less milk because they're beginning solids, your body will decrease accordingly.

This is why pumping when you're not with your baby can help maintain your supply. When milk is expressed, your body realizes it needs to produce more. This is also why you don't want to pump to "empty out your breasts" to relieve engorgement if you have a problem with overproduction. Emptying your breasts simply informs your body to produce more milk.

How do I begin breastfeeding?

Your doctor will get you started soon after birth. If you and your baby are healthy, you will hold your baby against your skin for at least two hours. This is referred to as skin-to-skin contact. This close contact stimulates your baby to bond and breastfeed.

Your baby will eventually begin to move towards your breast. This is an instinct, and it's a special one for you to experience! Your provider can assist in ensuring your baby latches on and starts taking in the milk.

For each subsequent breastfeeding session, you will:

Discover a comfortable breastfeeding position for both your baby and you, bringing your baby in close to you.
Guide the baby's mouth to your nipple. The nipple must be facing the nose. Your baby's chin will be on the lower part of your breast.
Support your baby's latching on. Their mouth must be open wide and cover the majority of the lower part of their areola. Part of their areola must show above their top lip.
Let your infant suck to drain milk from your breast. They'll come into a rhythm of sucking and brief stops. You can hear your infant swallow as they suck in milk. Let your infant continue to nurse from this breast until they stop sucking and swallowing or release. Burp your infant for several minutes.
Present the other breast to your baby. If your baby had the fill to satisfy their tummy, they might turn away, and that's all right.
When you feed your baby again, begin with the breast that wasn't drained as much. It'll feel fuller since it has more milk.

Your baby could be hungry if they:

Act awake
Turn your head to look at your breast or move towards it
Suck on their fingers, smack their lips or protrude their tongue
Draw their fist to their mouth or suck on their fingers (although after the newborn period, this may be merely a sign of curiosity and not hunger)

Your baby is probably full if they:

Break their latch
Look relaxed
Unclench their fist
Turn away from your breast (but after the newborn period, this may simply mean they're distracted)

What foods, beverages, or substances should I limit or avoid while breastfeeding?

Similar to pregnancy, you would need to watch what you are consuming when you are breastfeeding. There aren't as many rules when you are breastfeeding as there are during pregnancy. There are, however, some things to limit or avoid:

Restrict caffeine. It's fine to continue to have some, but not more than 300 milligrams (mg) daily. That's roughly two 12-ounce cups of coffee. Be sure to include tea (around 37 mg of caffeine per 12-ounce cup), sodas (23 to 83 mg per can) and chocolates.
Restrict alcohol. There are no known dangers of having up to one standard drink daily while breastfeeding. However, you should have it at least two hours before breastfeeding. This allows the alcohol to leave your system.
Skip fish with high mercury content. Mercury from the fish you consume enters your breastmilk. It can damage your baby's brain and nervous system. Don't consume any fish with high mercury, such as king mackerel, marlin, orange roughy, shark and swordfish.
Avoid nicotine. Smoking or vaping reduces the nutritional value of your breastmilk and lowers your supply. Secondhand smoke raises your baby's risk for allergies, upper respiratory infections and sudden infant death syndrome.
Avoid marijuana. Experts don't know how marijuana exposure might affect your baby. It may cause harm. So, it's a good idea to avoid using any marijuana or being exposed to secondhand smoke.
Avoid nonprescribed substances. Substances like opioids, benzodiazepines, stimulants, cocaine and phencyclidine (PCP or "angel dust") can harm your baby. If you're living with a substance use disorder, your provider can offer treatment to help.
Avoid some medications. Most standard medications are okay to use while nursing. But some can hurt your baby or suppress milk supply. It's always best to check with your provider or pharmacist before you take any medication or supplements.

Am I allowed to use birth control while breastfeeding?

Yes, but you must discuss with your doctor what is best for you and when to begin it. Generally, it's okay to use:

Barrier methods (such as a condom or vaginal diaphragm)
IUDs (these can usually be inserted immediately after giving birth)
Progestin-only hormonal methods (such as the "mini-pill")
Estrogen-based hormonal birth control pills (such as some pills, patches and vaginal rings) can decrease milk production. Therefore, your health provider might advise you not to use them or wait for at least one month after giving birth (and use the lowest amount necessary).

Remember that you can remain pregnant while breastfeeding — even without having had a period yet.

Are there any reasons I shouldn't breastfeed?

Babies are advised to be breastfed in the majority of circumstances. But you should not breastfeed if:

Your baby has galactosemia (a disorder that makes it difficult for the body to break down sugar in breastmilk)
You have some infections that may pass through your breastmilk, such as HIV (with some criteria such as having a detectable viral load), HTLV-1, HTLV-2, brucellosis or Ebola virus disease
You have herpes blisters on your breast
You have hepatitis C and cracked or bleeding nipples

Some of these conditions are short-term. Your doctor will inform you whether and when it's okay to breastfeed. They'll also discuss other feeding alternatives for your baby, such as formula and donated breast milk.

What difficulties may I encounter while breastfeeding?

If you encounter difficulties breastfeeding — or struggling to get started — you're not alone. It's normal to encounter problems like:

Breast engorgement
Oversupply of milk (hyperlactation)
Low milk supply
Blocked milk ducts
Inflammation of the breast (mastitis)
Nipple blebs
Sore, cracked or painful nipples
Discomfort or bleeding from your baby's teeth/biting
Difficulty latching, which may be more likely if your baby has tongue-tie or cleft lip/cleft palate
Difficulty due to your nipple shape (flat or inverted nipples)
Problems with hand expressing or pumping with a breast pump
Trouble weaning

The key is to know that help is there. Many times, these problems can be corrected. Your doctor can assist you in overcoming any difficulties so you can breastfeeding as long as you want.

Who can assist with breastfeeding?

When you're struggling to learn how to breastfeed or fix a problem, you may wonder where you can go for assistance. You can always speak with your primary physician or obstetrician and start from there. Or you may prefer to visit a provider with special breastfeeding expertise. Some examples are:

Breastfeeding medicine expert. This is a board-certified doctor who has specialized training in breastfeeding support. They can diagnose and treat all kinds of lactation disorders, ranging from bleb nipples to mastitis. They also provide education and counseling.
International Board Certified Lactation Consultant (IBCLC®). A lactation consultant can provide clinical care. This involves taking your health history, hearing your child's feeding history and developing a plan to assist.
Breastfeeding and Lactation Educator or Counselor. This is a provider who provides general education and counseling. They can educate you about lactation and breastfeeding and respond to your questions. There are roughly 20 various positions within this category. They include Certified Breastfeeding Counselor (CBC) and Certified Lactation Educator (CLE).
Breastfeeding Peer Supporter. They have personal breastfeeding experience and would like to share their experience with you. They provide education and support from a peer's point of view. You might see titles such as Breastfeeding Peer Counselor (BPC) and La Leche League Leader (LLLL).

Other times, you don't need an expert but rather a simple extra pair of hands. That's where your support system comes in and acts as a backup. Don't hesitate to ask your partner or a loved one to sit with you while breastfeeding. They can get supplies, burp the baby, or simply sit and keep you awake (and company) when you're feeling a pick-me-up.