In short: Breastfeeding is a physiologically natural process, but in the first weeks it requires patience and proper technique. The earlier you start and the more often you put your baby to the breast, the better lactation is established. Most difficulties can be solved with support and the right information.
Why breast milk is important for your baby
Breast milk is not just food. This is a living biological fluid, the composition of which changes depending on the age of the child, the time of day and even his state of health. It contains antibodies, hormones, enzymes, prebiotics and more than 200 unique bioactive components that no single mixture reproduces.
The World Health Organization recommends exclusive breastfeeding for up to 6 months, and then in combination with complementary foods for up to 2 years or longer. This is due to proven benefits for immunity, brain development, reducing the risk of allergies, obesity and diabetes in the child in the long term.
Breastfeeding is also useful for the mother: it reduces the risk of breast and ovarian cancer, helps the uterus contract faster after childbirth and promotes an emotional connection with the child. The hormone oxytocin released during feeding is called the "attachment hormone".
First attachment: when and how
Ideally, the baby should be attached to the breast in the first 30-60 minutes after birth. At this time, the newborn is especially cheerful and active, and the sucking reflex is most pronounced. Early attachment triggers the production of colostrum and signals the mother's body about the beginning of lactation.
Colostrum – the first milk, thick and yellowish – is secreted in small quantities, but it contains concentrated protection: immunoglobulins, lactoferrin and growth factors. The stomach of a newborn is tiny (volume about 5-7 ml on the first day), so even a few milliliters of colostrum are enough to saturate.
Important to know: If for medical reasons early attachment was not possible, this is not a disaster. Lactation can be established later by starting to express and latching on the baby at the first opportunity.
Proper latch: the basis of successful feeding
Proper latch is the foundation of breastfeeding. If the latch is incorrect, the baby does not receive enough milk, and the mother suffers from cracks and pain. Here are the signs of a good grip:
- The mouth is wide open, the lips are turned outward ("fish mouth")
- The baby grabs not only the nipple, but also most of the areola
- The baby's nose touches the breast slightly or is very close to it
- Chin pressed to chest
- The cheeks are rounded, without retractions
- Swallowing movements are heard, not smacking
If the grip is incorrect, you need to gently open the baby's gum with your finger and offer the breast again. It will take a few seconds, but it will prevent pain and cracks.
Feeding positions
There is no "one right" posture. The main thing is comfort for the mother and the correct grip for the child. Here are some popular positions:
- Cradle is a classic position, the baby's head lies on the bend of the elbow. It is convenient for well-established feeding.
- Cross cradle – the opposite hand supports the baby's head, which gives more control. It is good for newborns and with latch problems.
- From under the arm ("football") – the child lies along the mother's arm, the body goes back. It is convenient after a cesarean section, with flat nipples or large breasts.
- Lying on their sides, both lie on their sides, facing each other. Ideal for night feedings.
- Biological feeding (reclined position) – the mother is half-lying, the baby is lying on her stomach. It helps with a strong flow of milk.
How often to feed: feeding on demand
In the first weeks of life, the child can ask for the breast 8-12 or more times a day. This is physiologically normal. Feeding on demand is the main principle of maintaining lactation: the more often you apply, the more milk is produced.
Don't look at the clock — look at the child. Signs of hunger (early signals): turning the head in search of a nipple, opening the mouth, sucking a fist. Crying is already a late signal when the child is tired of waiting. How to understand that the child is full, we will tell you in a separate article.
How long to feed at one breast
It is not recommended to limit the feeding time. The child himself lets go of the breast when he is full. This usually takes 10-20 minutes, but it can be longer, especially in newborns who get tired quickly.
It is important to distinguish between "front" and "back" milk. At the beginning of feeding, the baby receives thinner foremilk, rich in carbohydrates and water. By the end, there is thick hind milk with a high fat content. It is it that gives a feeling of satiety. If the breast is changed frequently, the baby receives a lot of foremilk and may suffer from gas and colic.
The rule of one breast: Give one breast until it is completely empty, and only then offer the other. If the child does not take the second one, start the next feeding with it.
How lactation works: supply and demand
Lactation works on the principle of "demand creates supply". The breast produces exactly as much milk as is taken from it. Frequent attachments stimulate the production of prolactin, a hormone responsible for milk production.
"Mature" milk comes 3-5 days after birth, replacing colostrum. During this period, the breasts can become very full and painful – this is normal and is called "milk flow" or "engorgement". Frequent feedings will help to cope with discomfort.
Sometimes mothers have the feeling that there is "not enough" milk or it is "gone". Most often, this is a lactation crisis - a temporary phenomenon associated with a growth spurt in the child. During this period, you just need to apply to the breast more often, and after 2-4 days there will be enough milk again.
Pain when feeding: when it's normal
A slight tingling or sensitivity in the first seconds of attachment at the very beginning of feeding is acceptable and usually disappears after 1-2 weeks. Acute pain, cracked nipples, soreness throughout breastfeeding are signs of improper latching or another problem that needs attention.
Cracked nipples heal if the grip is corrected. Between feedings, you can apply drops of your own milk to the nipples and let them dry in the air. Special creams with lanolin are also safe for use during breastfeeding.
Frequent attachments and cluster feeding
Frequent attachments to the breast are the norm for newborns. Cluster feeding (several short feedings in a row with minimal breaks) usually occurs in the evening hours and is associated with a surge in activity and growth of the child. This is not a sign that there is not enough milk.
What affects lactation
Many factors affect milk production:
- Frequency of feedings is the main stimulus of lactation
- Stress – Chronic stress and anxiety can make it difficult to produce oxytocin and "give" milk
- Fatigue – Lack of sleep lowers prolactin levels, so rest is critical
- Nutrition and drinking regime – mom should drink enough water and eat a variety of foods
- Certain medications – a number of medications can reduce lactation, always tell your doctor about feeding
Read more about mother's nutrition while breastfeeding and what to eat and what to refrain from.
Night feedings
Night feedings are an important part of breastfeeding in the first months. It is at night that prolactin is produced most actively. Removing night feedings too early means risking a decrease in lactation. Read more about how this is related to the baby's sleep in the material Night Feedings in a Newborn.
Expressing and storing milk
Sometimes there is a need to express milk - when engorgement, separation from the baby, returning to work or to build a reserve. We talk about how to properly express milk manually and manually, and about the rules for storing breast milk in separate articles.
When to see a doctor
- The baby does not gain weight or loses more than 10% of body weight after the first 2 weeks
- Less than 6 wet diapers per day after 4-5 days of life
- Mom has a fever, her breasts are hot, reddened and painful (signs of mastitis)
- Cracked nipples do not heal despite grip correction
- The child is yellow (jaundice), lethargic, refuses to breastfeed
- Mom experiences severe pain during each feeding
Frequently Asked Questions
Can I breastfeed with flat or inverted nipples?
Yes, in most cases it is possible. The baby grasps not only the nipple, but also the areola, so the shape of the nipple is not as critical as it seems. Special nipple formers that are worn between feedings, as well as proper latching technique, can help.
Do I need to wash my breasts before every feeding?
No. A daily shower is enough. Frequent washing with soap dries out the skin of the areola and disrupts the protective microflora, which is important for the child. Montgomery's glands (small bumps on the areola) secrete substances with antibacterial properties.
When does milk "come" after childbirth?
Colostrum is present from the last months of pregnancy. Mature milk usually "comes" 3-5 days after birth. In multiparous mothers, it is often earlier. For mothers after a cesarean section, sometimes a little later, but this does not mean that there will be no milk.
Conclusion
Breastfeeding is a skill that both mother and child learn. The first 4-6 weeks are usually the most difficult. Most of the difficulties are temporary and solvable. The main thing is to feed on demand, monitor the correct latch and do not hesitate to seek help from a lactation consultant or doctor. When lactation is established, breastfeeding becomes a comfortable and enjoyable experience for both of you.
Bibliography
- World Health Organization. Breastfeeding. https://www.who.int/health-topics/breastfeeding
- American Academy of Pediatrics. Breastfeeding and the Use of Human Milk (2012, reaffirmed 2022). Pediatrics.
- UNICEF UK Baby Friendly Initiative. Guide to breastfeeding. https://www.unicef.org.uk/babyfriendly/
- Riordan J, Wambach K. Breastfeeding and Human Lactation. 4th ed. Jones & Bartlett Learning; 2010.
- Victora CG, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387(10017):475–490.
- National Program for Optimizing Feeding of Children in the First Year of Life in the Russian Federation. Union of Pediatricians of Russia, 2019.
- Lawrence RA, Lawrence RM. Breastfeeding: A Guide for the Medical Profession. 8th ed. Elsevier; 2015.
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If a child has alarming symptoms, a pronounced deterioration in health, problems with breathing, feeding or weight gain, it is necessary to contact a qualified medical specialist as soon as possible, and not rely only on information from the Internet.
