Patient education: Deciding to breastfeed (The Basics)

Do doctors recommend breastfeeding? — Yes. Doctors recommend breastfeeding your baby for at least 1 year (12 months) if possible. For the first 6 months, breast milk is the only food a baby needs. Most babies start eating other foods, in addition to breast milk, when they are 4 to 6 months old.

You might be unsure if breastfeeding is right for you, but it is the best choice for most mothers and babies. More and more people are making the choice to breastfeed because of its health benefits. Some people are unsure because they don't have many family members or friends who have breastfed their babies. You might be thinking that it's easier to use formula. Or maybe you are worried that you won't be able to keep breastfeeding after going back to work. But there are usually ways to make breastfeeding work for you.

Breastfeeding has many benefits for both you and your baby. This is true even if you breastfeed for only a short time. Also, these benefits can last even after you stop breastfeeding. Aside from the health benefits, breastfeeding also helps you bond with your baby, which is very rewarding.

If you are thinking about breastfeeding, that's great. This article will help answer some of the questions you might have.

What are the benefits for my baby? — In babies, breastfeeding can:

●Help prevent stomach infections that can cause vomiting or diarrhea

●Help prevent ear or lung infections

●Help lower the risk of SIDS, which is when a baby younger than 1 year old dies suddenly for no known reason

Breastfeeding might also help babies gain weight at a healthy rate as they grow.

What are the benefits for me? — Breastfeeding has benefits for you, too. Compared with people who feed their babies formula, people who breastfeed usually:

●Have less bleeding from the uterus after giving birth

●Have less stress

●Lose more weight after pregnancy

●Don't spend as much money to feed their baby

●Don't spend as much money on healthcare or miss as much work, because their babies get sick less often

●Have a lower chance of getting breast, ovarian, or endometrial (uterine) cancer

How do the breasts make milk? — Breast milk is made by the "milk glands" in the breasts (figure 1). During pregnancy, these glands get ready to make breast milk.

After you give birth, substances in your body called "hormones" cause your breasts to fill with milk. For the first few days after birth, you will make only a small amount of yellowish milk called "colostrum." Colostrum has all of the nutrition a newborn needs. You will start making more breast milk a few days later, usually 2 to 3 days after giving birth.

Will I make enough milk? — If you are healthy, you will most likely make enough breast milk. Each time a baby feeds and empties the breasts, the body makes more milk. After a few weeks of breastfeeding, most people make about 3 cups (or 24 ounces) of milk a day.

Certain things can cause you to have trouble making enough milk. This can happen if:

●You don't breastfeed often enough

●Your baby has trouble getting milk during breastfeeding

●You are tired, sick, or under a lot of stress

●You take certain medicines

●You smoke cigarettes

●You have had certain types of breast surgery

If you have trouble making enough milk, or if you are having other problems with breastfeeding, talk with your doctor or nurse. You might also find it helpful to work with a breastfeeding expert called a "lactation consultant."

When should I start breastfeeding? — If possible, it's best to start breastfeeding immediately after delivery. "Skin-to-skin contact" can help your baby learn to breastfeed. It's best to start breastfeeding as soon as possible after giving birth, ideally within the first hour. During this time, most babies are awake and want to breastfeed.

If you can't be with your baby right after birth, there are things you can do so that you can still breastfeed. You can use a device called a breast pump to collect breast milk for your baby to drink later. Using a breast pump also helps your breasts continue to make milk.

Can I breastfeed if I had breast surgery? — Maybe. If you have had breast surgery, you can try to breastfeed and see if you make enough milk. Most people who had surgery to make their breasts bigger can make enough milk. If you have had a breast reduction (surgery to make your breasts smaller), you are more likely to have trouble making enough milk. But it's not the same for everyone.

When is breastfeeding not recommended? — Doctors do not recommend breastfeeding if you:

●Have an infection, such as HIV, that you could pass to your baby through breastfeeding. Ask your doctor if you are concerned about risk of infection.

●Are getting treated for cancer.

●Take certain medicines – Some medicines are not safe to take while you are breastfeeding. But in most cases, it's possible to keep taking the medicines you need, or switch to different medicines. If you take any medicines, let your doctor or nurse know. They can make sure that those medicines are safe to take when breastfeeding.

●Drink a lot of alcohol – When you drink alcohol, a small amount is passed to your baby through your breast milk. Doctors do not know exactly how much alcohol is "safe" to drink during breastfeeding, so they suggest avoiding or limiting it. If you do choose to drink, most doctors recommend having only an occasional drink that has the amount of alcohol found in 1 glass of wine. They also recommend waiting 2 hours after having a drink before you breastfeed.

●Use certain drugs – Illegal drugs are harmful for a breastfeeding baby. Marijuana (along with other forms of cannabis) is legal in some places, but should be avoided if you are breastfeeding. There are studies that suggest it could cause problems in babies.

Also, doctors do not recommend breastfeeding for babies who are born with a medical condition called "galactosemia." Talk to your doctor or nurse if you're not sure if you should breastfeed.

Do I need to do anything or buy anything to get ready? — Most people do not need to do anything or buy anything to get ready for breastfeeding. You might want to get a breast pump to use later, especially if you will be returning to work. This will allow you to pump milk for times when you need to be away from your baby.

What if I have questions about breastfeeding? — If you have questions about breastfeeding, ask your doctor or nurse. You might also find it helpful to talk to a breastfeeding expert called a "lactation consultant."

More on this topic

Patient education: Breastfeeding (The Basics)
Patient education: Common breastfeeding problems (The Basics)
Patient education: Health and nutrition during breastfeeding (The Basics)
Patient education: Pumping breast milk (The Basics)
Patient education: Weaning from breastfeeding (The Basics)

Patient education: Breastfeeding guide (Beyond the Basics)
Patient education: Deciding to breastfeed (Beyond the Basics)