One of the basic needs of a baby is, of course, food. As everyone knows, a newborn does not have much use for roast chicken and potato salad and will need a steady supply of milk. For some people it seems to be almost a religious matter, others find it difficult and inconvenient.

Any doctor will tell you that breastfeeding is the most healthy option for a baby. The World Health Organisation recommends exclusively breastfeeding a baby for the first six months of its life, as this is most beneficial for their health. They even recommend continuing to breastfeed until the child is two years old or more.

Until the baby eats a considerable amount of food/puree it is not necessary to give any additional drinks. Health authorities in different countries may advise to give babies different vitamins.

The First Milk

Even during pregnancy women notice their body prepares for feeding the baby. The breasts grow noticeably – but the size of a breast says nothing about the ability of a mother to nurse. They can even already leak a fluid which isn't quite milk yet – colostrum. It is slightly yellowish and of a different composition than 'real' milk. The colostrum is rich in proteins, helps to build the baby's immune system, contains antibodies and helps the newborn's digestive system. It is generally seen as important that the baby gets to drink this fluid during the first few hours after birth because later the milk gradually changes its composition.

For the first days after birth, the mother only produces a very small amount of milk, which is usually enough to feed the newborn. Breastfeeding during this time also helps the mother's body. The production of the hormone oxytocin while breastfeeding helps the uterus shrink back to its normal size. This can be felt as afterpains, which get stronger while nursing.

At the start when the breasts are not yet used to the nursing baby, breastfeeding often hurts and is uncomfortable. It may feel like the baby bites into the breast with 100 tiny shark teeth – even if the majority of babies have no teeth at birth¹. This pain or discomfort, however, usually soon changes to become a pleasant experience with the baby.

Breastfeeding

On day three or four after the birth the mother produces mature milk for the first time. Unfortunately for her this comes with swollen, hurting breasts and a surge of hormones, which often lead to her feeling quite depressed for a few hours. It is advisable to keep ice packs ready for this day and let the baby drink often to take away the pressure that builds up.

From this time on the amount of milk which is produced will adapt to the baby's need, so the more a mother breastfeeds, the more milk will be there. This is also true for the individual breasts. Just because there is much milk in the left breast does not mean this is true for the right, and vice-versa. The baby has to feed from both sides to reduce the pressure being felt from a 'full' breast and to stimulate them. Usually, a baby will want to be fed at regular intervals. Generally the baby should feed whenever it wants to and will soon develop its personal feeding schedule. A healthy baby should not be 'forced' to feed just because the clock says a certain amount of time has passed.

It is not uncommon that babies feed more or more often at a certain time of the day and then take a longer break to sleep. This can, for instance, happen in the evening and give the mother (and baby) a longer time to sleep peacefully during the night.

If the baby does not feed for too long, this can bring discomfort to the mother as the breast gets swollen and sore, and may also start to leak quite a bit of milk. Also, if the baby suckles from one side, the other side often starts leaking at the same time. It is generally advisable to wear nursing pads in the bra, which soak up any leaking milk. It is also advisable to wear dark and patterned clothing. Sometimes sore nipples are also an issue, for which there are special creams, which do not have to be washed off before the baby feeds again.

It should also be noted that breastfeeding can delay a woman's period or make it irregular. There may be no menstruation for several months until the baby weans. This varies from person to person and others may get their first period as soon as six weeks after birth.

Some women have the impression that their milk is too watery or otherwise not right. This, however, is only a matter of wrong perception. During one feeding (or pumping) session the milk coming from the breast gradually increases in fat, being most watery at the start. Only a small percentage of women actually have too little milk.

Benefits

Breastmilk does not only supply the baby with all necessary nutrients, vitamins and minerals. It also helps to build up the digestive system through digestive enzymes and bacteria. Additionally, breastmilk helps the baby's immune system by transmitting antibodies from the mother to the child to protect it from illness. Breastfed babies also have a lower risk of Sudden Infant Death. Even later in life children who have been fed with breastmilk have health benefits. For instance, it can reduce the risk of becoming obese or diabetic.

Babies fed only with their mother's milk are usually not as heavy as formula fed babies, but this isn't always the case. This is absolutely no reason to be worried and completely normal. It doesn't mean they're not getting enough milk.

Milk Production

Milk is produced in the mammary glands in the breast. To produce milk, the mother needs to eat enough and healthily, because she has a slightly higher demand on calories. This way the mother will often naturally lose some of the weight she may have gained during pregnancy. The mother shouldn't go a diet while she breastfeeds. A healthy, well rounded choice of food and enough proteins are important. Stress has a negative influence.

The most important thing for milk production is probably drinking enough water. It is good to set a goal of about two litres of water and even more during warm weather. Hydration is probably the most essential thing if the milk does not seem to flow. Apart from water, fruit or herbal infusions are a good option. Special nursing teas have no additional benefit. Coffee and other drinks containing caffeine should only be consumed in small amounts, sugary drinks should be avoided. Drinking alcohol is also not a good idea as it is transmitted to the baby through the milk, just like many other bad, as well as healthy, substances.

The amount of milk the mother produces does not have to be the same as the amount of formula recommended for a baby of a certain age, simply because the composition is not the same. A smaller amount of breastmilk will be enough.

How do you Breastfeed a Baby?

Some may expect that nursing just comes naturally and a woman just takes her baby in her arms and it works. This is usually not the case for first time mothers. There are different possible ways to hold a baby while nursing: it pays to study these ways during pregnancy. On the other hand, breastfeeding is not rocket science. It is important to not get stressed about it and just calmly learn together with the baby.

At the start the mother needs some peace and quiet and a comfortable place to sit with the baby. This can, for instance, be a sofa or chair with cushions. What a new mother certainly also doesn't need is a lot of visiting relatives with 'helpful' advice. However, it does pay off to have a professional (for instance a midwife) show how it is done and help if there actually are any problems.

A good trick is to squeeze the nipple gently between the outstretched index and middle fingers of the opposite hand. This reduces the size of nipple that the baby needs to take into its tiny mouth and stops the bulk of the breast covering its tiny nose, thus allowing it to breathe.

With a little bit of practice breastfeeding is possible anytime and anywhere: in the car, on a bench in the park, even while standing up if need be, or while carrying the baby in a sling. During the night it is comfortable to just lie down with the baby and doze off while nursing.

Still, there are cases in which breastfeeding just doesn't work out. The mother is willing, the baby is hungry, but for some reason the two of them just never manage to get it together, even with professional help. Everyone gets increasingly stressed and worked up, which makes things worse! In the end the baby will probably be fed with a bottle.

Pumping

It is always good to be prepared. That's the reason why it pays off to buy a breast pump and suitable set of bottles even before the baby is born. There are various options here, different shapes, glass bottles, plastic bottles. Glass bottles may seem like the healthiest option; on the other hand babies can learn to hold their own plastic bottles after a few months. If plastic bottles are bought it is essential that the material is free of BPA – if it isn't already banned in your country.

A breast pump basically does what it says: it pumps the milk from the mother's breast into a bottle. There are hand pumps, which are ok for occasional use. If pumping is necessary more often, an electric pump is the better option. With a pump the baby can get its mother's milk even if breastfeeding doesn't work as expected. It also gives the option of other people taking care of the baby for a while and still keeping your breast stimulated to continue producing milk in adequate quantities. Pumping milk is not as comfortable as nursing the baby directly. Breastmilk can be stored for a few days in the fridge and even longer in the freezer. However, it is essential to warm it up to body temperature before feeding to the baby.

Formula

For the first time in history we now have a good substitute for breastmilk, even if it can't reproduce all the beneficial aspects of breastmilk. Formula is not as easy to digest for babies as breastmilk is. However, in some cases formula is the mother's only option. Medical reasons – for instance different kinds of medication – can keep a mother from breastfeeding. Even a breastfeeding mother will find her milk isn't flowing as well as usual in some cases, such as times of stress, and may have to feed a bottle of formula every now and then.

Different kinds of formula are available for babies of different ages to simulate the varying composition of breastmilk as the baby grows. The feeding instructions on the package can only be seen as vague guidance. While the proportions of water and formula should be followed, babies do not necessarily have the same feeding schedule, and may require more, but smaller, portions.

Formula doesn't only have to be fed in cases of chronic illness but also if the mother gets sick while the baby is still breastfeeding. As medication gets to the baby through the mother's milk, a doctor should always be consulted. Sometimes it will be necessary to feed the baby formula for a while until the mother's milk is safe to drink again – for instance if antibiotics are required. The mother will have to keep her breasts stimulated by pumping and throwing the pumped milk away.

In many cases mothers will choose to feed the baby formula alongside breastmilk after a few months. At this time it may seem like the baby is hungrier than the amount of milk the mother produces, and just one feeding of formula per day can reduce the stress and worry.

Cows' milk and other animals' milk does not have the right composition for human babies and can harm them.

Conclusion

It is indisputable that breastmilk is the most healthy nutrition for a baby. The health benefits can't be reproduced by formula, while on the other hand it is absolutely possible to raise a baby on formula alone. Even if a mother cannot feed her baby on breastmilk alone, it does pay to give the baby as much as she can. However, nobody should get too worked up about it if breastmilk alone is not possible.

Breastmilk is usually instantly available and always comes at the right temperature. It doesn't have to be warmed up or cooled down – unless it is fed from a bottle. In theory the baby can be nursed by the mother wherever she goes, and during the night it doesn't even require getting up or completely waking up if the baby is close enough.

Image courtesy of Library of Congress