Definition of Breastfeeding

The process of nourishing an infant with milk the mother’s breasts produce. Health experts recommend breastfeeding at least for the first six months of life when possible. Breast milk provides the ideal nutritional balance for the infant.

It also conveys important antibodies to the infant, helping provide immune protection while the infant’s own immune system is developing. Breastfeeding, also called nursing, further supports a strong physical and emotional connection between mother and baby.

Though breastfeeding suppresses a woman’s normal hormonal cycle to some extent, breastfeeding is not a reliable method of contraception (birth control). It is still possible for a nursing mother to get pregnant.

First Milk: Colostrum

The first milk the mother’s breast produces after birth is colostrum, often called premilk. Colostrum is more concentrated than mature breast milk and contains primarily carbohydrate and protein with little fat. This composition is very easy for the infant to digest in the first use of the gastrointestinal system; its concentration delivers more nutrition with less volume.

Colostrum also contains a higher concentration of antibodies than mature breast milk. The infant should breastfeed about every two hours in its first few days of life, both to provide sufficient nutrition and to encourage adequate milk production.

Milk Production

The hormones of pregnancy establish the initial environment for milk production. The stimulation of the infant’s sucking induces the hormonal responses that cause the lactiferous glands of the breasts to produce milk. The lactiferous ducts store some breast milk, though the lactiferous glands actively produce milk as the infant nurses. The breasts will continue producing milk after pregnancy for as long as the baby nurses regularly.

The breast releases mature milk in two surges. The first surge, the foremilk, is thin, bluish, and contains primarily lactose (a simple carbohydrate) and proteins. The second surge, which releases after the infant has nursed for three to five minutes, is hindmilk. Hindmilk is thicker, yellowish, and contains a higher concentration of fats that are essential to supply the infant with a source of energy. The infant may nurse 10 to 30 minutes on hindmilk.

Let the Infant Take the Lead

Lactation and nutrition experts currently recommend that the mother allow the infant to nurse completely at one breast before switching to the other, even if the infant becomes satiated before switching or before finishing the second breast. The infant generally will pull away from one breast when ready to switch. Following the infant’s lead in this way, rather than breastfeeding by the clock, allows the infant to receive maximum nutritional benefit from breastfeeding.

Though conventional wisdom has long held that the mother should switch the infant from one breast to the other to provide equal time at each breast under the premise that this practice would to stimulate and sustain the most ideal milk production, recent research suggests the infant may not receive balanced nutrition with such an approach. As well, sucking provides emotional comfort for the infant.

Though breastfeeding is a natural process, the process of breastfeeding does not come naturally for most women. It takes time and patience for the mother to synchronize with the baby’s needs and preferences. Birthing centers have lactation specialists who can help new mothers establish effective breastfeeding. New mothers often worry the infant is not receiving enough nourishment.

The most accurate measure of this is the infant’s steady and appropriate weight gain and development. The breasts seldom drain completely of milk, and the infant may nurse more aggressively at some feedings than others.

Care of the Breasts

The mother’s breasts, especially the nipples, are often tender during the first few weeks of breastfeeding. It is important for the infant to latch around a good portion of the areola as well as the nipple when nursing, which properly stimulates the lactiferous glands as well as eases chafing and soreness of the nipples. A lactation specialist can help a new mother find the nursing positions that are most effective.

Washing the breasts with warm water after breastfeeding and allowing them to air dry helps prevent irritation and chafing. A nursing bra provides extra support for the breasts, which are quite heavy and enlarged during breastfeeding. Nursing pads inserted inside the bra protect leaking milk from staining clothing. Because many substances pass from the mother’s body into the breast milk, the woman should check with her health-care provider before taking over-thecounter (OTC) medications. Certain foods appear to bother some infants, probably altering the taste or smell of the breast milk.

Expressing and Storing Breast Milk

Many women express (pump) milk from their breasts to store for feeding the baby when breastfeeding is not possible, such as after the woman returns to work. This allows other people to use a bottle to feed breast milk to the baby.

Expressed breast milk will remain fresh for one week when refrigerated and for four months when frozen. Breast pumps simulate the rhythmic pressure of nursing, initiating the letdown reflex and releasing milk.

It may take longer to express full breasts when pumping than when the baby nurses, though it is important to get as much milk as possible so milk production remains constant. The breasts adjust how much milk they produce according to the demand for milk.

See also ANTIBODY; BREAST HEALTH; MASTITIS.

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