Breastfeeding

Breast milk is the best food you can offer your new baby. The Canadian Paediatric Society recommends exclusive breastfeeding for the first 6 months of life. At 6 months, your baby will be ready for other foods. You can continue to breastfeed until your child is two years of age and beyond.

Since breast milk is naturally and uniquely produced-by each mother for her own baby-your baby is less easily exposed to foreign allergenic material. Breast milk also contains antibodies and other immune factors that help him prevent and fight off illness better.

Breast milk has the right amount and quality of nutrients to suit your baby's first food needs. It is also the easiest on her digestive system, so there's less chance of constipation or diarrhea.

Not long ago, many people in western countries like Canada believed that bottlefeeding was better than breastfeeding. Today, we know that breastfeeding offers your baby the best start. If you experience problems, don't be surprised if some people encourage you to give up. But before you do, ask for help and support-it's out there (see below, Who should I ask if I have questions about breastfeeding?)

You can access directly the different sections in this document:

What should breastfeeding mothers eat?
What is colostrum?
How do I know when it's time for a feeding?
How will I know if my baby is feeding well?
How will I know if my baby isn't feeding well?
How will I know if my baby is getting enough to eat?
What else should I know about nursing?
When should mothers express their breast milk?
How should expressed breast milk be stored?
How do I prepare expressed breast milk for a feeding?
Does my baby need anything else besides breast milk?
Are there ever reasons not to breastfeed?
What do I feed my baby when I cannot breastfeed?
Who should I ask if I have questions about breastfeeding?

Breastfeeding mothers need to eat a variety of nutritious foods without restrictions. You should avoid dieting while you are breastfeeding.

Colostrum is the milk first produced in the early days after your baby is born. It's usually yellowish in colour and is very rich in proteins, vitamins, minerals and immunity factors that are found only in breast milk. These help protect your baby against infections.

After the first week, colostrum changes into milk that is whitish in colour. The milk at the beginning of each feeding is called foremilk. Foremilk is watery to satisfy your baby's hunger and fluid needs.

As the feed continues, foremilk gains fat content until it becomes hindmilk, which is much whiter and looks richer. Hindmilk gives your baby a feeling of being full and satisfied.

Feed your baby from each breast for as long as she wants. Alternate the breast you begin with at each feeding. This allows each breast to produce the proper amount of milk at each feeding. Sometimes babies may want to feed more frequently and for very short periods of time. This is called "cluster feeding" and often occurs in the evening. This may mean your baby is going through a growth spurt. These usually happen around 2 weeks, 4 to 6 weeks, 3 months, and 6 months. Let your baby set the pace.

Your baby is feeding well when:

• You hear short swallowing sounds (making a "K" sound) which gradually lengthen and deepen as your milk is released.
• Your areola, the area around your nipple, and your baby's jaw muscles move evenly as he sucks. And you'll be able to see the movement of his jaw right up to his ears.
• He is content after feeding.
• The nursing process doesn't hurt you.

Your baby isn't feeding well when:

• You hear a lot of lip smacking.
• You notice there's very little swallowing.
• She isn't content after a feeding.
• The nursing process is painful for you.

Signs that tell you your baby is getting enough to eat include:

• Six to eight wet diapers in a 24-hour period.
• One or more loose yellowish stools per day during the first month. Early on, these may come after every feeding. After the first month, stools may not be as frequent (one every 2 to 7 days), but they will still be loose and yellowish.
• Weight gain (your baby's doctor will check at each visit).

• Always wash your hands before you offer your breast to your baby.
• If you experience cracked or sore nipples, try exposing them to the air after each feeding, allowing them to dry naturally. You can also apply lanolin.
• Try to avoid using soap on your nipples. Soap will wash away your breasts' natural lubricants.
• Some women get mastitis, a bacterial infection which causes swelling of the breasts, along with soreness and fever. If you have these symptoms, you need to see a doctor. It can be treated with antibiotics and will clear up if you continue to breastfeed.

If your breasts are engorged (larger, sore, and feeling extremely full), your newborn may have difficulty latching on. You can express some milk by gently massaging or pushing by hand or with a breast pump. This may help your baby latch on.

Once you've got a breastfeeding routine, you can express your breast milk by hand or with a breast pump if you're away from your baby during feeding time. This will allow your baby to have breast milk from a cup or a bottle (depending on the baby's age). It is also a way for your partner or others to feel a part of your baby's life.

Expressed breast milk is also a way to keep breastfeeding while your baby is in child care facility. Make sure the centre or home has a refrigerator, as milk has to be kept chilled until feeding time.

Expressed breast milk should be kept in a sterilized glass bottle or plastic container with the date marked on it. Plastic polyethylene bags, such as commercial bottle liners, are not recommended. Breast milk contains essential antibodies (IgA) that help protect your baby. Using plastic bags to freeze expressed breast milk could cause some of these antibodies to be lost.

Store expressed breast milk in the refrigerator for up to 48 hours. You can also store it for two weeks in your refrigerator freezer (not in the door) or for up to six months in a a deep freezer with a temperature below -18°C.

When you are freezing breast milk, do not add warm expressed milk to milk that has been already chilled or frozen. This may encourage bacteria to grow.

• First prepare clean bottles and commercial nipples.
• Thaw frozen milk in the refrigerator and keep it there until you're ready for it. Do not use a microwave to thaw or warm frozen expressed milk. The milk can contain hot spots that can harm your baby. Also, the quality of the milk may suffer if it boils.
• When it's time for feeding, put the thawed milk into a feeding bottle. You may want to warm up the milk again by placing the bottle of expressed milk into a container of warm water before the actual feeding.
• Shake the bottle of thawed expressed breast milk well to mix any separated layers.
• After each feeding, throw away any leftover milk.

Like all kinds of milk, breast milk is not a dependable source of vitamin D. Babies who are breastfed should receive a daily supplement, which is available as drops.

Your baby won't need any other vitamin supplements while you are breastfeeding.

Rarely. A few women may be advised not to breastfeed, including those receiving long-term chemotherapy, or women who have HIV disease. If this applies to you, talk to your doctor.

If you are sick, ask your doctor for information about nursing your baby. You can still breastfeed even if you are taking prescription drugs. Only small amounts will pass through breast milk, and there are usually no problems for the baby. There are only a few exceptions, such as cyclosporine, methotrexate, bromocriptine, cyclophosphamide, doxorubicin, ergotamine, and phencyclidine. Ask your doctor about nursing your baby while you are sick.

If you smoke, consider quitting or at least cutting back. You should also limit your use of alcohol.

• If breastfeeding is not an option, use a store-bought iron-fortified infant formula for the first 9 to 12 months. The formula should be cow's milk-based.
• Use soy-based formulas only if your baby can't take dairy products for health, cultural or religious reasons.
• Babies who are fed formula won't need a vitamin D supplement, since it's already added.
• At 6 months, you can begin to introduce solid foods to your baby's diet.

Breastfeeding is the natural way to feed your newborn. Still, you may need time to practice it. Like all aspects of motherhood, you'll learn through experience, and not through instinct. Don't be afraid to ask for help or advice from health professionals or experienced friends and relatives.

Your doctor or midwife can counsel you about the principles and practice of breastfeeding. There are also many community-based programs that support breastfeeding families, such as the La Leche League Canada.

You may also contact a lactation consultant, public health nurse, and/or breastfeeding coordinator. These health care professionals are listed in your phone book.

Source: Developed by the Canadian Paediatric Society. Last updated December 2006

For more information or for support :

La Leche League Canada

lalecheleaguecanada.ca