Breastfeeding - Low Carb Diet

A low-carb diet is a great option for some women because they can take off weight very quickly. However, diets like Atkins, South Beach and other Low-carb alternatives can cause some problems for a breastfeeding mom.

Most of these problems are related to what a very low carb diet can do to your body. During the early phases of these diets, you leave out carbohydrates in order to enter a fat-burning stage called ketosis. This burns fat, lessens hunger and flushes water out of the body. However, the ketones released into your breast milk WILL reach your nursing child and they have not yet determined if that is safe.


According to Atkins Health and Medical Information Services:“The reason for [recommending that breastfeeding mothers not follow the Atkins diet] is because the only studies that observe ketosis in pregnancy or breast feeding are in uncontrolled diabetics who are in ketoacidosis, not the same thing as ketosis.
There are NO studies that show the safety of burning ketones and its effect on babies (either in utero or breast feeding). We do know that ketones are found in breast milk. Babies may have a different threshold of tolerating ketones than adults, maybe not, but I'm sure you do not want your child to be the guinea pig!”



Having said that, as long as you only use the maintenance stage of a low card diet, you will still probably lose weight, but slower and without releasing ketones.

Tips for moms who still wish to try a low-carb diet:
•Wait until baby is at least 6 months old before dieting and has started solids foods.

•Avoid dehydration by drinking water, water and MORE WATER!


•Start gradually and avoid “phase one” of any of the diets.


•Do not drop below 1800 calories per day on a low carb plan.


•Keep an eye on baby's diaper output and weight gain. If you notice a decrease in your milk supply, stop immediately.

Neonatal circumcision: Effects on Breastfeeding

Neonatal circumcision: Effects on breastfeeding and outcomes associated with breastfeeding.

Aim: There have been recurrent claims made that neonatal circumcision disrupts the development and maintenance of breastfeeding in infants. The aim of the current study was to use a longitudinal birth cohort study to examine the associations between neonatal circumcision status and both breastfeeding outcomes, and health and cognitive ability outcomes associated with breastfeeding.

Method: Data were obtained from the Christchurch Health and Development Study, a longitudinal study of over 1000 individuals born in Christchurch New Zealand in mid 1977. Data were obtained for male cohort members (n = 635) on circumcision status, breastfeeding outcomes, health outcomes in infancy and cognitive ability outcomes later in life.

Results: Circumcision status was not significantly associated (P > 0.05) with breastfeeding outcomes in infancy, even following adjustment for covariate factors, including maternal age, family socio-economic status, ethnicity and birthweight. Also, circumcision status was not significantly associated (P > 0.05) with health in infancy and cognitive ability outcomes in later childhood, even after adjustment for covariate factors.

Conclusions: There was no evidence of an association between neonatal circumcision status and breastfeeding outcomes, or between circumcision status and health and cognitive ability outcomes associated with breastfeeding, and the findings do not support the view that neonatal circumcision disrupts breastfeeding.

Breastfeeding Pics

Photo courtesy of 007 Breasts


Breastfeeding pictures can be viewed on the link provided above.

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Cetirizine / Zyrtec® in Pregnancy and Breastfeeding

Cetirizine (Zyrtec®)
CATEGORY: B
Antihistamine. Metabolite of hydroxyzine. Molecular weight: 461.82.
"In mice, rats, and rabbits, cetirizine was not teratogenic at oral doses up to 96, 225, and 135 mg/kg, respectively (approximately 40, 180 and 220 times the maximum recommended daily oral dose in adults on a mg/m 2 basis)".

In a prospective, controlled, observational study of women exposed to either hydroxyzine or cetirizine during pregnancy 39 women were exposed to cetirizine during organogenesis. Most of the women had been treated with cetirizine for rhinitis or urticaria. There were no significant differences found between the cetirizine group and a control group in the rates of major or minor anomalies, spontaneous abortions, stillbirths, mean birth weight, mode of delivery, gestational age, or presence of neonatal distress.

In an observational study of newly marketed drugs prescribed in England cetirizine was taken during the first trimester in 20 pregnancies. One patient chose to have an elective abortion. There were 4 spontaneous abortions. The remaining mothers delivered 16 normal infants (one set of twins).

The American College of Obstetricians and Gynecologists (ACOG) and The American College of Allergy, Asthma and Immunology (ACAAI) recommend chlorpheniramine and tripelennamine as the antihistamines of choice for pregnant women. Cetirizine and loratadine may be considered (preferably after the first trimester) in patients who cannot tolerate or do not respond to maximal doses of topical therapy.

BREAST FEEDING: Excreted into human milk. Not considered compatible with breast feeding by the manufacturer.

Will Breastfeeding Confine Me to Home?

No! During the first months when babies need to be breastfed often you can carry on with your usual activities, just bring your baby along. Breastfed babies are very portable. You’ve already got your supply of milk handy, just grab your diaper bag when you leave! As your baby gets older and the time between feedings spaces out, you may be able to accomplish your errands between feedings. At other times you may need to leave your baby and some of your pumped breast milk with a caregiver. Either way, you can resume breastfeeding when you return home.

Breastfeeding - How do I know when it's time for a feeding?

At first, you're going to do a lot of feeding on demand, feeding your baby whenever she's hungry. This could mean up to every two to three hours. Typically, you can expect to breastfeed 8 to 12 times over a 24-hour period.

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.

Will Breastfeeding Cause Me to Lose My Figure?

No! Quite the contrary! Breastfeeding has the extra advantage of helping you get back to your pre-pregnancy figure faster. our body will “burn” approximately 500-700 extra calories each day in the production of breast milk for your baby.
While you may be concerned about losing the weight you gained during pregnancy, gradual weight loss over 6-12 months is recommended. Eating a well-balanced diet and avoiding the “empty calories” found in sweets and fatty foods should help you to lose weight. You can also participate in your favorite activities, sports and exercise programs of stretching and low impact aerobics when your physician gives the approval. Poor diet and lack of exercise can adversely affect your recovery.
Your breast size should increase during pregnancy and while breastfeeding. Breasts return to their pre-pregnancy state well after weaning. While your breasts may become less firm, this is a result of pregnancy - not breastfeeding.

Why is Breastfeeding Best for Me and My Baby?

Easy and convenient. Infant formulas require preparation, warming or sterilization of milk or bottles for feeding. When you breastfeed, you will always have just the right amount, at just the right temperature with no bottles to clean! Enhances bonding and helps encourage a close relationship with your baby.

Improves mom’s recovery time. The hormones released while breastfeeding cause the uterus to contract and return to its previous size. When you breastfeed immediately and frequently after delivery, bleeding is reduced since your uterus is already beginning to contract and reduce in size.

Helps prevent maternal illnesses. Mothers who do not breastfeed have a higher incidence of anemia (low iron levels), breast cancer, ovarian cancer, uterine cancer and osteoporosis in later life.

Improves baby’s future dental health. The type of suckling babies use with bottles leads to higher incidence of severe dental problems and more orthodontic corrections later in life.

Saves money. Using infant formula for the first year of your baby’s life can cost as much as $1,500-$1,800! That doesn’t even include the cost of bottles, artificial nipples.

Why is Breast Milk the Best Choice?

Your baby will most likely be healthier! Formula fed babies have more colds, diarrhea, ear infections, urinary infections
and hospital admissions. Research shows they also have a higher incidence of diabetes, obesity and certain kinds of
cancer in childhood. Formula fed babies also develop more allergies and asthma.
Your baby will most likely be smarter! Research shows that formula fed babies may have lower IQs.
Breast milk contains unique ingredients not found in infant formulas that are important for growth and development of your baby. Breast milk is all the nutrition your baby will need for the first six months of life. Cows milk, which is the basis of most infant formulas, is ideally suited for the needs of a newborn calf and is substantially altered in an attempt to mimic breast milk.

Breast milk provides your baby with immunities not found in infant formula. The milk you produce during pregnancy is called colostrum. Colostrum, baby’s first milk, is very high in immunity factors. This plays a major role in protection against
infection and disease in your newborn. These immunity factors continue to be found in mature breast milk as well.

Breastfeeding - Attaching Baby to the Breast

Latching the baby on correctly is the key to a pleasant, rewarding breastfeeding experience. Nursing behavior patterns are established early. Once set, bad habits are difficult to correct. Make sure you and your baby get off to a good start. A variety of reading materials and videos are helpful, but there is nothing like hands-on assistance from an experienced health care provider. Don't hesitate to ask for help the first few times. If you are still having difficulty by the time you leave the hospital, contact a breastfeeding specialist or a La Leche League leader.

Step 1

For most women, sitting up in bed or in a comfortable chair is easiest for breastfeeding. Make sure you are relaxed before you put the baby to breast. Use pillows on your lap, under your arms and behind your back. Putting your feet on a footstool to raise your knees slightly above your hips will eliminate back strain and put your body at the right angle.

Make sure your baby is comfortable and feels secure and supported. Nestle the baby in your arm at the level of your breast with his head and shoulders supported by your forearm just below your elbow, with your other hand holding his bottom. A nursing pillow can also help support your baby comfortably, while providing a resting place for your arms. The baby should be turned toward you, chest to chest, his head and trunk in a straight line, so that he doesn't have to strain or turn his head to attach to the breast. Tuck the baby's lower arm into the pocket between the two of you; if necessary, hold his upper arm down gently with the thumb of your supporting hand. Be careful not to tilt the baby's head down, as it will be difficult for him to swallow in that position. A very slight extension of the baby's head, with his chin touching your breast, will help keep his nose clear without your having to press on your breast tissue.

The proper way to hold the baby is chest-to-chest, at the level of the breast. Baby's head should
be in the crook of your arm and your hand should hold baby's buttocks.

The football hold is a good position for latch-on problems, or for premature or Cesarean birth babies.

The lying down position is especially useful after a Cesarean birth.


Two alternative positions are the clutch (football) hold, and lying down. The clutch is especially helpful if you are having difficulty getting the baby attached to the breast or if you have had a Cesarean birth.

Step 2

Hold your breast with your fingers underneath and thumb on top, making sure all of your fingers are placed well away from the areola. It is sometimes helpful if you roll your nipple between your fingers for a couple of seconds to help it become more erect. Then manually express a couple of drops of colostrum to entice the baby to take the breast. A woman with large breasts may find it comfortable to help support the weight with a rolled washcloth or diaper under the breast.

Step 3

Gently tickle the baby's lower lip with your nipple to encourage him to open his mouth wide. The moment he opens wide, almost like a yawn, quickly pull him in close to you. Do not lean forward, trying to put your breast into the baby's mouth. Instead, pull the baby toward you so that he has a large mouthful of breast tissue. His chin should be pressing into your breast; his nose should be just touching your breast. Keep supporting your breast with your hand until the baby is latched-on and is sucking well. Women with large breasts may have to support their breast throughout the entire feeding; smaller-breasted women may not need support.

The key to successful latch-on and preventing nipple soreness is to teach your baby to take a large portion of the areola into his mouth.

Breastfeeding - Getting Enough Milk

Most new mothers are concerned about their babies getting enough milk. In the first few days, when you're in the hospital your baby should stay with you in your room if there are no complications with the delivery or with your baby's health. The baby will be sleepy. Don't expect the baby to wake you up when he or she is hungry. You will have to wake the baby every one to two hours to feed him or her. At first you will be feeding your baby colostrum, your first milk that is precious thick yellowish milk. Even though it looks like only a small amount, this is the only food your baby needs. In the beginning, you can expect your baby to lose some weight. This is very normal and is not from breastfeeding. As long as the baby doesn't lose more than 7 to 10% of his or her birth weight during the first three to five days, he or she is getting enough to eat.

You can tell your baby is getting enough milk by keeping track of the number of wet and dirty diapers. In the first few days, when your milk is low in volume and high in nutrients, your baby will have only 1 or 2 wet diapers a day. After your milk supply has increased, your baby should have 5 to 6 wet diapers and 3 to 4 dirty diapers every day. Consult your pediatrician if you are concerned about your baby's weight gain. You should visit your pediatrician between three to five days after your baby's birth and then again at two weeks of age.

This chart shows the minimum number of diapers for most babies.
It is fine if your baby has more.

Day 1 (birth) 1 Thick, tarry and black
Day 2 2 Thick, tarry and black
Day 3 3 Greenish yellow
Day 4 5 - 6 Greenish yellow
Day 5 5 - 6 Seedy, watery mustard color
Day 6 5 - 6 Seedy, watery mustard color
Day 7 5 - 6 Seedy, watery mustard color

After you and your baby go home from the hospital, your baby still needs to eat about every one to two hours and should need several diaper changes. You still may need to wake your baby to feed him or her because babies are usually sleepy for the first month. In the early weeks after birth, you should wake your baby to feed if four hours have passed since the beginning of the feeding. If you are having a hard time waking your baby, you can try undressing or wiping his or her face with a cool washcloth. If your baby falls asleep while breastfeeding, you can try breast compression. As your milk comes in after the baby is born, there will be more and more diaper changes. The baby's stools will become runny, yellowish, and may have little white bumpy "seeds."

Overall, you can feel confident that your baby is getting enough to eat because your breasts will regulate the amount of milk your baby needs. If your baby needs to eat more or more often, your breasts will increase the amount of milk they produce. To keep up your milk supply when you give bottles of expressed breast milk for feedings, pump your milk when your baby gets a bottle of breast milk.

Other signs that your baby is getting enough milk are:


Steady weight gain, after the first week of age. From birth to three months, typical weight gain is four to eight ounces per week.

Pale yellow urine, not deep yellow or orange.

Sleeping well, yet baby is alert and looks healthy when awake.

Remember that the more often and effectively a baby nurses, the more milk there will be. Breasts produce and supply milk directly in response to the baby's need or demand.

Breastfeeding - Breast Compression

Breast compression is a technique made popular by pediatrician and breastfeeding expert Dr. Jack Newman and helps a baby get more milk at each feeding. Once your baby is latched-on well, breast compression will keep him or her feeding actively for a longer time and to “finish” the first breast offered. This is especially helpful for babies who tend to fall asleep at the breast in the middle of a feeding. Despite what many mothers in the hospital are told, this technique does not raise your risk of getting plugged ducts.

When the baby is drinking milk, you do not need to use any breast compression, but once the baby is no longer drinking and is just nibbling, you can start the technique.

Once your baby has finished the first breast and still wants more milk, you can offer the other breast. Signs that your baby has finished with the first breast are falling asleep at the breast and doing no more opening wide, pausing, then sucking. If the compression does not work at first, it does not mean that you have to switch breasts right away. If your baby comes off the breast by him or herself, you might want to try offering the first breast again to see if he or she will drink more. If not, or if your baby is getting fussy or sleepy because the milk flow is slow, you can change your baby over to the other breast. You can experiment with this technique and do a variation of it that works best for you.

Breastfeeding - Tips for Making It Work

Breastfeeding can be a wonderful experience for you and your baby. It's important not to get frustrated if you are having problems. What works for one mother and baby may not work for another, so just focus on finding a comfortable routine and positions for you and your baby. Here are some tips for making it work:

1. Get an early start. You should start nursing as early as you can after delivery (within an hour or two if it is possible), when your baby is awake and the sucking instinct is strong. At first your breasts contain a kind of milk called colostrum, which is thick and usually yellow or golden in color. Colostrum is gentle to your baby's stomach and helps protect your baby from disease. Your milk supply will increase and the color will change to a bluish-white color during the next few days after your baby's birth.

2. Nurse on demand. Newborns need to nurse often. Breastfeed at least every 2 hours and when they show signs of hunger, such as being more alert or active, mouthing (putting hands or fists to mouth and making sucking motion with mouth), or rooting (turning head in search of nipple). Crying is a late sign of hunger. Most newborn babies want to breastfeed about 8 to 12 times in 24 hours.

3. Feed your baby only breast milk. Nursing babies don't need water, sugar water or formula. Breastfeed exclusively for about the first six months. Giving other liquids reduces the baby's intake of vitamins from breast milk.

4. Delay artificial nipples (bottle nipples and pacifiers). A newborn needs time to learn how to breastfeed. It is best to wait until the newborn develops a good sucking pattern before giving her or him a pacifier. Artificial nipples require a different sucking action than real ones. Sucking at a bottle can also confuse some babies when they are first learning how to breastfeed. If, after birth, your baby needs to be taken away from you for a length of time and has to be given formula, ask the nurse to use a syringe or cup when feeding him/her to avoid nipple confusion.

5. Breastfeed your sick baby during and after illness. Oftentimes sick babies will refuse to eat but will continue to breastfeed. Breast milk will give your baby needed nutrients and prevent dehydration.

6. Air dry your nipples. Right after birth, you can air-dry your nipples after each nursing to keep them from cracking. Cracking can lead to infection. If your nipples do crack, coat them with breast milk or a natural moisturizer, such as lanolin, to help them heal. It isn't necessary to use soap on your nipples, and it may remove helpful natural oils that are secreted by the montgomery glands, which are in the areola. Soap can cause drying and cracking and make the nipple more prone to soreness.

7. Watch for infection. Signs of breast infection include fever, irritation, and painful lumps and redness in the breast. You need to see a doctor right away if you have any of these symptoms. Click here for more information.

8. Promptly treat engorgement. It is normal for your breasts to become larger, heavier, and a little tender when they begin making greater quantities of milk on the 2nd to 6th day after birth. This normal breast fullness may turn into engorgement. When this happens, you should feed the baby often. Your body will, over time, adjust and produce only the amount of milk your baby needs. To relieve engorgement, you can put warm, wet washcloths on your breasts and take warm baths before breastfeeding. If the engorgement is severe, placing ice packs on the breasts between nursings may help. Talk with a lactation consultant if you have problems with breast engorgement. Click here for more information.

9. woman sleeping with baby Eat right and get enough rest. You may be thirstier and have a bigger appetite while you are breastfeeding. Drink enough non-caffeinated beverages to keep from being thirsty. Making milk will use about 500 extra calories a day. Women often try to improve their diets while they are pregnant. Continuing with an improved diet after your baby is born will help you stay healthy. But, even if you don't always eat well, the quality of your milk won't change much. Your body adjusts to make sure your baby's milk supply is protected. Get as much rest as you can. This will help prevent breast infections, which are worsened by fatigue.


If you are on a strict vegetarian diet, you may need to increase your vitamin B12 intake and should talk with your health care provider. Infants breastfed by women on this type of diet can show signs of not getting enough vitamin B12.

Adult lactation- Breastfeeding of an Adult

Adult lactation means breastfeeding of an adult partner or re-lactation for primarily erotic reasons. Depending on the context, other terms are used such as adult suckling, adult nursing, adult breastfeeding, Adult Nursing Relationship (ANR), or nursing couple(s). The scientific-sounding terms Milk fetishism or Lactophilia as well as paraphilia (in this context) are incorrect according to the definitions of ICD-10 and DSM-IV. In scientific terminology, these would be disorders – the diagnoses of which should be based on precise criteria. One non-exclusive element of said criteria is that an individual is suffering from such a disorder. Therefore Milk fetishism or Lactophilia should also be avoided in colloquial speech.[1]

Breasts, and especially nipples, are highly erogenous zones (both for men and women). One hypothesis assumes that during evolution, those women prevailed who were motivated by physical pleasure to nurse their babies in the best possible way. The same holds true for the lips, also erogenous zones where pleasure may have lead to "kiss feeding", in which mothers chew food before passing it on to the child.[2]

Because female breasts and nipples are normally an important part of sexual activities and perception, it is not surprising that couples may proceed from intensive kissing of the nipples to actual breastfeeding. In lesbian partnerships, mutual breastfeeding has been regarded as a familiar expression of affection and tenderness.[3]

In its Sunday issue of March 13, 2005, the London daily The Times gave a report of a scientific survey (comprised of 1690 British men) revealing that in 25 to 33% of all couples, the male partner had suckled his wife's breasts. Regularly the men gave a genuine emotional need as their motive.[4]

Beyond these, there exist hardly any reports or investigations. Nevertheless, from European Middle Ages a multitude of subliminally erotic visionary experiences of saints have been passed on in which breastfeeding plays a major role. One prominent example is the Lactatio of Saint Bernard of Clairvaux[5]. Generally speaking this was a rather strong taboo, and it can be concluded that an adult man suckling for milk is in contradiction to well established images of masculinity.

Unintended milk flow (Galactorrhea) is often caused by nipple stimulation and it is possible to reach normal milk production exclusively by suckling on the breast.

Breastfeeding - How Breast Milk is Made

Knowing how the breast is made and how it works to produce milk can help you understand the breastfeeding process. The breast actually begins developing in the first few weeks of gestation, before birth. But the mammary gland, the gland that produces milk, does not become fully functional until lactation begins. When a woman's breasts become swollen during pregnancy, this is a sign that the mammary gland is getting ready to work. The breast itself is a gland that is composed of several parts, including glandular tissue, connective tissue, blood, lymph, nerves, and fatty tissue. Fatty tissue is what mostly affects the size of a woman's breast. Breast size does not have an effect on the amount of milk or the quality of milk a woman produces.

Milk is secreted from the alveoli cells. When the alveoli cells are stimulated by a hormone, they contract and push the milk into the ductules and down into larger milk ducts underneath the nipple and areola. When the baby's gums press on the areola and nipple, milk is squeezed into the baby's mouth. The nipple tissue protrudes and becomes firmer with stimulation, which makes it more flexible and easier for the baby to grasp in the mouth. In the diagram, you can see that each mammary gland forms a lobe in the breast. Each lobe consists of a single branch of alveoli and milk ducts that narrow into an opening in the nipple. Each breast has about seven to ten lobes.
The Role of Hormones

Hormones play a key role in breastfeeding. The increase of estrogen during pregnancy stimulates the ductules to grow. After delivery, estrogen levels drop and remain low in the first several months of breastfeeding. The increase of progesterone during pregnancy also causes the alveoli and lobes to grow. Prolactin, also called the "mothering hormone," is another hormone that is increased during pregnancy and adds to the growth of breast tissue. Prolactin levels also rise during feedings as the nipple is stimulated. As prolactin is released from the brain into the mother's bloodstream during breastfeeding, alveolar cells respond by making milk. Oxytocin is the other hormone that plays a vital role because it is necessary for the let-down, or milk-ejection reflex to occur. It stimulates the alveoli cells to contract so the milk can be pushed down into the ducts. Oxytocin also contracts the muscle of the uterus during and after birth, which helps the uterus to get back to its original size and lessens any bleeding a woman may have after giving birth. The release of both prolactin and oxytocin may be responsible in part for a mother's intense feeling of needing to be with her baby.

Breastfeeding - Human Milk Banks

Ideally, breast milk comes from a baby's own mother. But when this is not possible, you can give your baby breast milk from donors (other women's breast milk), which provides the same precious nutrition and disease fighting properties as your own breast milk. If your baby has special needs, such as intolerance to formula, severe allergies, is failing to thrive on formula, is premature or has other health problems, he or she may need donated human milk not only for health, but also for survival.

There are several reasons why a mother may not be able to breastfeed her own baby:

* In a premature delivery, a mother's milk supply may not become established enough to provide milk for her baby. Sometimes the stress of caring for a very ill infant prevents the milk supply from developing.
* A mother who delivers twins or triplets might not have enough milk supply to nourish all of the babies.
* Some medicines taken by the mother for a health problem, such as chemotherapy for cancer, can harm a baby.
* A mother might have an infection that could be spread to her baby through breastfeeding, such as HIV or hepatitis.
* A mother might have a health problem that prevents her from breastfeeding or makes it impossible for her to produce milk.

Breast milk from donors is stored in human milk banks. At this time, there are only six human milk banks in the United States. While the number of infants and children who depend upon donor milk for health or survival is small, their numbers are greater than is the supply available from these milk banks.

Human milk banks screen the donors, and collect, screen, process, and dispense donor human milk. Because babies who use donor milk are not related to the donors, every possible step is taken to ensure the milk is safe. And the milk is only dispensed by a prescription from your health care provider. The prescription must show how many ounces of processed milk are needed per day, and for how many weeks or months. The milk bank also needs your name, the baby's name, and your address and phone number. Then, you or your health care provider can contact a milk bank to order the milk. If the milk bank is close to you, you can pick up the milk there. If you live out of the area, the milk bank can ship the frozen milk in coolers every few days.

The cost of donor milk is about $3 per ounce. Sometimes there is another fee for shipping. Most health insurance companies cover the cost of donor milk if it is medically necessary. To find out if your insurance will cover the cost of the milk, call your insurance company or ask your health care provider. If your insurance company does not cover the cost of the milk, talk with the milk bank to find out how payment can be made later on, or how to get help with the payments. A milk bank will never deny donor milk to a baby in need.

Breast Feeding - Shared Breastfeeding

It is sometimes common for more than one woman to feed a child, such as in developing nations within Africa. This shared breastfeeding has been highlighted as a source of HIV infection in infants. A woman who is engaged to breastfeed another's baby is known as a wet nurse. Islam has codified the relationship between this woman and the infants she nurses, and also between the infants when they grow up, so that milk siblings are considered as blood siblings and cannot marry.

Breastfeeding - Tandem Breastfeeding

Feeding two infants simultaneously is called tandem breastfeeding (Sidenote: Feeding a child while being pregnant with another can also be considered a tandem breastfeeding condition for the nursing mother, as she also provides the nutrition for two[58]). The most common need for tandem breastfeeding is after the birth of twins where both babies are fed at the same time. The appetite and feeding habits of each baby may not be the same, which could mean feeding each according to their own individual needs, while also trying to get them to breastfeed together to minimize time spent breastfeeding.

In cases of multiple births with three or more children, it can be extremely difficult for the mother to organise feeding around the appetites of all the babies. While breasts can produce large quantities of milk, according to the demand placed upon them,[59] it is common for women to use alternatives, although many mothers have been able to breastfeed their infants successfully without them.

Tandem breastfeeding may also occur when a woman has a baby while breastfeeding an older child. During the late stages of pregnancy the milk will change to colostrum, and some older nurslings will continue to feed even with this change, while others may wean due to the change in taste or drop in supply.

Breastfeeding - Mixed Feeding

Predominant or mixed breastfeeding means feeding breast milk along with infant formula, baby food and even water, depending on the age of the child. Babies feed differently with artificial teats than from a breast. When feeding from the breast, the tongue massages the milk out rather than sucking, and the nipple does not go as far into the mouth; when feeding from a bottle, an infant will suck harder and the milk may come in more rapidly. Therefore, mixing breastfeeding and bottle-feeding (or using a pacifier) before the baby is used to feeding from its mother can induce the infant to prefer the bottle to the breast. Orthodontic teats, which are generally slightly longer, are closer to the nipple. Some mothers supplement feed with a small syringe or flexible cup to reduce the risk of artificial nipple preference

Breast feeding - Expressing breast milk

When direct breastfeeding is not possible a baby can still be fed breast milk. By expressing (artificially removing and storing) her milk, a mother can enable her child to be fed with her milk while she is away. With manual massage or the use of a breast pump a woman can express her milk and keep it in freezer storage bags, a supplemental nursing system, or a bottle ready for use. This container may be kept at room temperature for up to ten hours, refrigerated for up to eight days or frozen for up to four to six months. Research suggests that antioxidant activity in expressed breast milk decreases over time but it still remains in higher levels than in infant formula.

Expressing breast milk can keep up a mother's milk supply when she and her child are apart for long. If a sick baby is unable to feed, expressed milk can be fed through a nasogastric tube.

Expressed milk can also be used when a mother is having trouble breastfeeding, such as when a newborn causes grazing and bruising. When an older baby grows teeth and bites the nipple, the mother's reaction - a jump and a cry of pain - is usually enough to discourage the child from biting again. Babies or toddler that are truly feeding cannot physically bite the nipple, if they are, they arent' feeding but playing.

It is generally advised to delay using a bottle in feeding expressed breast milk until the baby is about 4-6 weeks old and is good at sucking directly from the breast. This is to avoid nipple confusion and nursing strike, when the baby prefers to suck from bottle, which takes less effort, and so loses its desire to suck from the breast. If feeding expressed breast milk (EBM) must be done before 4-6 weeks of age, it is recommended that it be given by other means such as feeding spoons or feeding cups. Also, EBM should be given by someone other than the breastfeeding mother (or wet nurse), so that the baby can learn to associate direct feeding with the mother (or wet nurse) and associate bottle with other people.[citation needed]

Some women donate their expressed breast milk (EBM) to others, either directly or through a milk bank. Though some dislike the idea of feeding their own child with another woman's milk, others appreciate being able to give their baby the benefits of breast milk. Feeding expressed breast milk—either from donors or the baby's own mother—is the feeding method of choice for premature babies.

Breastfeeding - Exclusive breastfeeding

Exclusive breastfeeding is when an infant receives no other food or drink, or even water, besides breast milk (whether expressed or through breastfeeding).

International guidelines recommend that all infants be breastfed exclusively for the first six months of life. While each country has its own policy regarding infant feeding, it is generally accepted that newborns should be exclusively breastfed for around 6 months, and that breastfeeding should continue with the addition of appropriate foods, for two years or more. The practice of exclusive breastfeeding has dramatically reduced infant mortality in developing countries due to a reduction in diarrhea and infectious diseases.

Exclusively breastfed infants feed, anywhere from 6 to 14 times a day. Their requirements vary greatly. Newborns consume from 30 to 90 ml (1 to 3 US fluid ounces). After the age of four weeks, babies consume about 120ml (4 US fluid ounces) per feed. Each baby is different, and as it grows the amount will increase. It is important to recognise the baby's hunger signs and it is advised that the baby should dictate the number, frequency, and length of each feed, based on the assumption that it knows how much milk it needs. The supply of milk in the breast is determined by the frequency and length of these feeds or the amount of milk expressed. The birth weight of the baby may affect its feeding habits, and mothers may be influenced by what they perceive its requirements to be. For example, a baby born small for gestational age may lead a mother to believe that her child needs to feed more than if it larger; they should, however, go by the demands of the baby rather than what they feel is necessary.

It can be hard to accurately measure the amount of food a breastfed baby consumes, but babies normally feed to meet their own requirements. Babies that fail to eat enough may exhibit symptoms of failure to thrive. If necessary, it is possible to estimate output from wet and soiled nappies (diapers): 8 wet cloth or 5–6 wet disposable, and 2–5 soiled per 24 hours suggests an acceptable amount of input for newborns older than 5–6 days old. After 2–3 months, stool frequency is a less accurate measure of adequate input as some normal infants may go up to 10 days between stools. Babies can also be weighed before and after feeds.

Breastfeeding Your Adult Baby

Throughout human history there have been infants both young and old who have been nursed by wet nurses or surrogate mothers. During the medieval period, it was not uncommon for physicians to prescribe human milk for direly ill patients. Since sanitation and storage was poor to non-existent, the best type of feeding was directly from the breast of the wet nurse.

The Victorian distress (which has continued until today) with exposed body parts and breast-feeding wasn’t an issue at that period. Many men suckled at their wife’s breasts during pregnancy to induce a healthy flow of milk for their expected son. Non-maternal lactation supplements ordinary occurred at that period as a result of maternal death or illness, or because of the feudal position and duties of the birth-mother, or because of simple adoption. Usually, the wetnurse was already breastfeeding another baby, (either hers or another baby of the noblewoman) and her milk supply simply increased due to additional demand to meet the growth needs of two (or more) babies. If the father was poor and could not find or afford a lactating woman to serve as a wet nurse for the baby, goat’s milk was usually substituted in societies that raised sheep. Goats were usually raised with sheep to provide a substitute mother for an orphaned lamb in need. It is interesting to note that goat’s milk is the more similar to human milk than any other milk among the animal world.

Many women who have never had babies of their own immensely enjoy the intense physical pleasure of breastfeeding, even if the volume of milk they produce is relatively small in volume. The pleasure of breastfeeding is hard-wired into the Limbic area of the brain and is strongly tied to the sex drive of the R-brain. In the most concise words possible, it is entirely natural and normal for a woman to achieve climax by virtue of breast feeding alone.

The volume of milk produced varies considerably from individual to individual and it is difficult to predict the results of induced lactation. It is unusual in the United States to find women who can express a full supply of milk from induced lactation, but it is also rare to find women who cannot produce any milk at all.

Preferably, a woman should be able to induce lactation through mere manipulation or stimulation of her breasts. Playing with, manipulating or sucking on her nipples will usually produce an increase in both prolactin and oxytocin without having to resort to chemical or medicinal therapy. The volume of milk that is produced will not be as great as that produced after a pregnancy and delivery, but lactation will usually begin in and of itself. Mechanical stimulation via hospital grade breast suction pumps have also shown themselves to be effective in producing lactation without medication.

How does induced lactation work? Lactation is governed by two pituitary (not ovarian) hormones; prolactin and oxytocin. Therefore, even if a woman has had a hysterectomy, she can lactate, assuming her over-all health is good. Note that estrogen, in the form of birth control pills or for hormone replacement therapy, is a lactation suppressant.

Hormonal therapy to induce lactation generally consists of administration of estrogen to resemble the high-estrogen state of pregnancy. The estrogen is then abruptly withdrawn to mimic the rapid hormonal changes following delivery. A course of a prolactin-enhancing drug such as metaclopromide is then started. Once the prolactin, the milk-making hormone, is at a high enough level, then oxytocin, the milk-releasing hormone, will be produced in response to nipple stimulation. Sucking stimulation by the baby (or by a mechanical breast pump) is begun at this point. One study of induced lactation using medications describes beginning of milk production as occurring between 5-13 days.

If only manual or mechanical stimulation is employed, milk production typically begins between 1-4 weeks after initiating breast manipulation or vacuum evacuation and stimulation by breast pump. During the time that milk production is building, the woman may notice a darkening in the color of their nipples and areolar tissue. This is normal. Women who breastfeed may expect the areolas to double in size as well as darken in color. It is not abnormal for a woman’s breasts to become very tender and somewhat fuller or several sizes larger. Some women report increased thirst, and changes in their menstrual cycle or libido. All of these symptoms are normal and to be expected as a consequence of lactation.

Breastfeeding - Latching on, feeding and positioning

Latching on, feeding and positioning

When the baby's cheek is stroked with the nipple, the baby will open its mouth and turn towards it. So that the baby will latch on well, the nipple should be pushed into its mouth so that the baby has a mouthful of nipple and areola. The nipple should be at the back of the baby's throat, with the baby's tongue lying flat in its mouth. Inverted or flat nipples can be massaged so that the baby will have more to latch onto.

Many women wear nursing brassieres for easier access to the breast, but these are not always necessary and certainly not required. In the very early days a nursing bra can make breastfeeding complicated and uncomfortable. Wearing a bra at any time after birth will not affect how the breast changes with pregnancy and breastfeeding. Many women find that the size of their breasts change dramatically and so fitting a bra is better done after childbirth rather than before. An ill-fitting bra, whether designed for nursing or otherwise, can cause plugged ducts or mastitis.

Pain in the nipple or breast is linked to incorrect breastfeeding techniques. Failure to latch on is one of the main reasons for ineffective feeding and can lead to infant health concerns. A 2006 study found that inadequate parental education, incorrect breastfeeding techniques, or both were associated with higher rates of preventable hospital admissions in newborns.

The baby may pull away from the nipple after a few minutes or after a much longer period of time. Normal feeds at the breast can last a few sucks (newborns), from 10 to 20 minutes or even longer (on demand). Sometimes, after the finishing of a breast, the mother may offer the other breast.

The length of feeds varies a lot. Regardless of the time taken, the breastfeeding mother should be comfortable.

* Upright: The sitting position with the back straight and leaning back comfortably.
* Mobile: The mother carries her nursling in a sling or other baby carrier while breastfeeding. Doing so permits the mother to incorporate breastfeeding into the varied work of daily life
* Lying down: Good for night feeds or for those who have had a caesarean section
o On her back: Mother is usually sitting slightly upright; particularly useful for tandem breastfeeding (nursing more than one child)
o On her side: The mother and baby lie on their sides
* Hands and knees: The mother is on all fours with the baby underneath her (not usually recommended)

While most women breastfeed their child in the cradling position, there are many ways to hold the feeding baby. It depends on the mother and child's comfort and the feeding preference of the baby. Some babies prefer one breast to the other, but the mother should offer both breasts at every nursing with her newborn.

* Cradling positions:
o Cradle hold: The baby is held with its head in the woman's elbow horizontally across the abdomen, "tummy to tummy", with the woman in an upright and supported position image
o Cross-cradle hold: As above but the baby is held with its head in the woman's hand
* Football hold: The woman is upright and the baby is held securely under the mother's arm with the head cradled in her hands. This position is especially useful for feeding twins simultaneously image
* Feeding up hill: The baby lies stomach to stomach with the mother who is lying on her back; this is helpful for babies finding it difficult to feed
* Lying down:
o On its side: The mother and baby lie on their sides
o On its back: The baby is lying on its back (cushioned by something soft) with the mother on her hands and knees above the child (not usually recommended)

When tandem breastfeeding, the mother is unable to move the baby from one breast to another and comfort can be more of an issue. As tandem breastfeeding brings extra strain to the arms, especially as the babies grow, many mothers of twins recommend the use of more supporting pillows. Favoured positions include:

* Double cradle hold
* Double clutch hold image
* One clutched baby and one cradled baby
* Lying down

Breast Feeding - Time and Place

Breastfeeding at least once every two to three hours helps to keep up the milk supply. For most women, a target of eight breastfeeding or pumping sessions every 24 hours keeps their milk supply high. It is common for newborn babies to feed more often than this: 10 to 12 breastfeeding sessions every 24 hours is common, and some may even feed 18 times a day. Feeding a baby on demand (sometimes referred to as "on cue"), which may mean breastfeeding many times more than the recommended minimum, feeding when the baby shows early signs of hunger, is the best way to maintain milk production and ensure the baby's needs for milk and comfort are being satisfied.However, it may be important to recognize whether a baby is truly hungry, as breastfeeding too frequently may mean the child receives a disproportunately high amount of foremilk, and not enough hindmilk, potentially creating problems.

Babies usually show they are hungry by waking up (newborns), mouthing their fists, moaning or fussing. Crying is a late indicator of hunger. When babies' cheeks are stroked, the rooting instinct makes them move their face towards the stroking and open their mouth.

Breastfeeding can make mothers thirsty, especially at first, when both mother and baby are inexperienced and when feeding sessions can last for up to an hour or more (there is no time limit for breastfeeding). Having water readily available helps mothers maintain proper hydration.

Breastfeeding - Infant gains Weight

Breastfed infants generally gain weight according to the following guidelines:

0–4 months: 170 grams per week†
4–6 months: 113–142 grams per week
6–12 months: 57–113 grams per week

† It is acceptable for some babies to gain 113–142 grams (4–5 ounces) per week. This average is taken from the lowest weight, not the birth weight.

The average breastfed baby doubles birth weight in 5–6 months. By one year, the typical breastfed baby will weigh about 2½ times birth weight. At one year, breastfed babies tend to be leaner than bottle fed babies. By two years, differences in weight gain and growth between breastfed and formula-fed babies are no longer evident.

Breastfeeding - Infant Formula

Infant formula is an artificial substitute for human breast milk. Formulas are designed for infant consumption, and are usually based on either cow milk or soy milk. Use of infant formula has been decreasing in industrial countries for over forty years as a result of antenatal education, increased understanding of the risks of infant formula, and social activism. Most major medical and health organizations strongly advocate breastfeeding over the use of infant formula except in unusual circumstances.

Breastfeeding - Is my baby is getting enough milk?

How do I know that my baby is getting enough milk from breastfeeding?

In the first few days, when you're in the hospital your baby should stay with you in your room if there are no complications with the delivery or with your baby's health. The baby will be sleepy. Don't expect the baby to wake you up when he or she is hungry. You will have to wake the baby every one to two hours to feed him or her. At first you will be feeding your baby colostrum, your first milk that is precious thick yellowish milk. Even though it looks like only a small amount, this is the only food your baby needs. In the beginning, you can expect your baby to lose some weight. This is very normal and is not from breastfeeding. As long as the baby doesn't lose more than 7 to 10% of his or her birth weight during the first three to five days, he is getting enough to eat.

You can tell your baby is getting enough milk by keeping track of the number of wet and dirty diapers. In the first few days, when your milk is low in volume and high in nutrients, your baby will have only 1 or 2 wet diapers a day. After your milk supply has increased, your baby should have 5 to 6 wet diapers and 3 to 4 dirty diapers every day. Consult your pediatrician if you are concerned about your baby's weight gain. You should visit your pediatrician between three to five days after your baby's birth, and then again at two to three weeks of age.

This chart shows the minimum number of diapers for most babies.
It is fine if your baby has more.
Baby’s Age Wet Diapers Dirty Diapers Color and Texture
Day 1 (birth) 1 Thick, tarry and black
Day 2 2 Thick, tarry and black
Day 3 3 Greenish yellow
Day 4 5 - 6 Greenish yellow
Day 5 5 - 6 Seedy, watery mustard color
Day 6 5 - 6 Seedy, watery mustard color
Day 7 5 - 6 Seedy, watery mustard color

Breastfeeding - How long should I breastfeed?

Babies should be fed with breast milk only – no formula – for the first six months of life. The longer a mom and baby breastfeed, the greater the benefits are for both mom and baby. Ideally, babies should receive breast milk through the first year of life, or for as long as both you and your baby wish. Solid foods can be added to your baby’s diet, while you continue to breastfeed, when your baby is six months old. For at least the first six months, breastfed babies don't need supplements of water, juice, or other fluids. These can interfere with your milk supply if they are introduced during this time. One of the best things that only you can do is to breastfeed your baby for as long as possible.

Breastfeeding - Why should I Breastfeed?

Here are just some of the many good reasons why you should breastfeed your baby: photo of woman breastfeeding

Breast milk is the most complete form of nutrition for infants. Breast milk has just the right amount of fat, sugar, water, and protein that is needed for a baby's growth and development. Most babies find it easier to digest breast milk than they do formula.

There are health risks to your baby if you do not breastfeed. Breast milk has agents (called antibodies) in it to help protect infants from bacteria and viruses. Babies who are not exclusively breastfed for 6 months are more likely to develop a wide range of infections diseases including ear infections, diarrhea, and respiratory illnesses. They are sick more often and have more doctor's visits. Infants who are not breastfed have a 21% higher postneonatal infant mortality rate in the U.S.

Breastfed babies score higher on IQ tests in childhood, especially babies who were born prematurely.

Nursing uses up extra calories, making it easier to lose the pounds of pregnancy. It also helps the uterus to get back to its original size and lessens any bleeding you might have after giving birth.

Breastfeeding lowers the risk of breast and ovarian cancers and possibly the risk of hip fractures and osteoporosis after menopause.

Breastfeeding can help you bond with your baby. Physical contact is important to newborns and can help them feel more secure, warm and comforted.

Breastfeeding - Bonding Between Mother and Child

Bonding

The hormones released during breastfeeding strengthen the mother's nurturing feelings towards the child. Strengthening the maternal bond is very important as up to 80% of mothers suffer from some form of postnatal depression, though most cases are very mild. The woman's partner and other caregivers can support her in a variety of ways and this support is an important factor in successful breastfeeding. Teaching partners how to manage common difficulties is associated with higher breastfeeding rates.

Breastfeeding can have an impact on the personal relationship between a mother's partner and the child. While some partners may feel left out when the mother is feeding the baby, others see it as an opportunity for strengthening family bonds. Looking after a new baby and breastfeeding take time. This can add pressure to the partner and the family, because the partner has to care for the mother as well as performing tasks she would otherwise do. However, as partners are often very willing to give this support, this pressure can help to strengthen family bonds.

If the mother is away, an alternative caregiver may be able to use expressed breast milk (EBM) to feed the baby. The various breast pumps available for sale and rent make it possible for working mothers to breastfeed their babies for as long as they want. However, the mother must produce and store enough milk to feed the child for the time she is away and this may not always be practical. Also, the other caregiver must be comfortable in handling breast milk. These two factors may prompt the mother - perhaps against her wishes - to switch to artificial feeding, either temporarily or permanently.

Breastfeeding - Benefits the Mother

Breastfeeding benefits the mother. It releases hormones such as oxytocin and prolactin that have been found to relax the mother and make her feel more nurturing toward her baby. Breastfeeding within a short time after giving birth increases levels of systemic oxytocin. This makes the uterus contract more quickly and decreases maternal bleeding.

As the fat accumulated during pregnancy is used in milk production, prolonged breastfeeding can help mothers to return to their previous weight. Frequent and exclusive breastfeeding can cause lactational amenorrhea, a delay in the return of menstruation and therefore fertility. Sometimes this is deliberately used as a birth control method, which has a 98% success rate[34] if certain criteria are met:

* Breastfeeding must be the infant’s only (or almost only) source of nutrition. Feeding formula, pumping instead of nursing, and feeding solids all reduce the effectiveness of LAM.
* The infant must breastfeed at least every four hours during the day and at least every six hours at night.
* The infant must be less than six months old.
* The woman must not have had a period after 56 days post-partum (when determining fertility, bleeding prior to 56 days post-partum can be ignored).

Breastfeeding is possible throughout pregnancy, but generally milk production will be reduced at some point during the pregnancy.

Breastfeeding mothers have less risk of many diseases including breast cancer, ovarian cancer, decreased insulin requirements in diabetic mothers, stabilizing maternal endometriosis, less risk of post-partum hemorrhage, less risk of endometrial cancer, less risk of osteoporosis and beneficial effects on insulin levels of mothers with polycystic ovary syndrome.

Mothers who breastfeed longer than eight months have better bone re-mineralisation.

On the other hand, some breastfeeding women have pain from thrush or staph infections of the nipple.

From a financial standpoint, breastfeeding is roughly half the cost of infant formula.

Breastfeeding - Several Anti-Infective Factors

Breast milk has several anti-infective factors. These include the anti-malarial factor para-amino benzoic acid (PABA),1] the anti-amoebic factor BSSL, lactoferrin, the second most common protein in human milk, that binds to iron and inhibits the growth of intestinal bacteria like E. coli and Salmonella, and IgA which protects breastfeeding infants from microbial infection.]

Breast milk contains the right amount of the amino acids cystine, methionine and taurine that are essential for neuronal (brain and nerve) development.A New Zealand study tracking over 1000 children for 8 to 18 years found small but measurable increases in cognitive ability and education achievement. This remained even after adjusting for other factors (such as maternal education level).

One study suggests that in resource-poor settings where safe infant formula is unavailable, exclusive breastfeeding (as compared with "mixed" feeding where breastfeeding is combined with formula, solids or animal milk) may reduce the risk of HIV transmission from mother to child in infants less than 6 months old.

Unlike human milk, the predominant protein in cow's milk is beta-lactoglobulin, an important factor in cow milk allergies.

Breastfeeding - Lower Risks of SIDS

Breastfed babies have a lower risk of sudden infant death syndrome (SIDS) and other diseases Suckling at the breast encourages the proper development of the infant's teeth and speech organs. Suckling also helps prevent obstructive sleep apnea Also, breast milk is at the right temperature and is immediately available from the breast.

Breastfeeding is associated with lower risk of the following diseases:

Allergies
Asthma
Autoimmune thyroid diseases
Bacterial meningitis
Breast cancer
Celiac disease
Crohn's disease
Diabetes
Diarrhea
Eczema
Gastroenteritis
Hodgkin's lymphoma
Necrotizing enterocolitis
Multiple sclerosis
Obesity
Otitis media (ear infection)
Respiratory infection and wheezing
Rheumatoid arthritis
Urinary tract infection

Breastfeeding - Breast Milk is Best Milk

The exact properties of breast milk are not entirely understood, but the nutrient content of mature milk is relatively stable. Its ingredients come from the mother's food supply and the nutrients in her bloodstream at the time of feeding. If that is not enough, nutrients come from the mother's bodily stores. Some studies estimate that a woman who breastfeeds her infant exclusively uses 500–600 more calories a day just producing milk for her offspring.

The exact composition of breast milk varies from day to day, and even hour to hour, depending on both the manner in which the baby nurses and the mother's food consumption and environment, so the ratio of water to fat fluctuates.

Foremilk, the milk released at the beginning of a feed, is watery, low in fat and high in carbohydrates; hindmilk, which is increasingly released as the feed progresses is creamier. There is no sharp distinction between foremilk and hindmilk, the change is very gradual. Research from Peter Hartmann's group tells us that fat content of the milk is primarily determined by the emptiness of the breast—the less milk in the breast, the higher the fat content. The breast can never be truly "emptied" since milk production is continuous.

Breastfeeding - Benefits For Mother

Breastfeeding benefits both mother and child physically and psychologically. Nutrients and antibodies are passed to the baby while hormones are released into the mother's body.The bond between baby and mother can also be strengthened during breastfeeding.

Breastfeeding - Benefits for the infant

The health benefits of breastfeeding are well documented. According to the American Academy of Pediatrics, Extensive research, especially in recent years, documents diverse and compelling advantages to infants, mothers, families, and society from breastfeeding and the use of human milk for infant feeding. These include health, nutritional, immunologic, developmental, psychological, social, economic, and environmental benefits.

Breastfeeding - Lactation

The production, secretion and ejection of milk is called lactation. It is one of the defining features of being a mammal.

Breastfeeding - The Law of Supply and Demand

Milk production works on the principle of supply and demand. The more your baby breastfeeds, the more milk you will produce, totally meeting your baby's needs. It is the frequency of breastfeeding, as well as the milk removed from the breast, that stimulates further milk production. Babies who are given supplemental bottles of water or formula breastfeed less frequently, ultimately decreasing the milk supply. Supplements, unless medically indicated, should be avoided for three to four weeks, until your milk supply is well-established and your baby is latching-on to the breast without difficulty. Babies need to be breastfed at least 8 to 12 times in 24 hours the first two to four weeks, or until they are well above birth weight.

Breastfeeding - Avoiding Artificial Nipple Preference/Confusion

Your baby begins to learn and practice the correct breastfeeding suck with the very first nursing experience. When both breast and bottle are offered in the early days, your baby may become "nipple confused" or may simply prefer the bottle nipple. Breastfeeding is an active process for the baby; bottlefeeding, however, is passive and requires a different type of suck. A baby who is bottle-fed early can have difficulty transferring learning to the breast. Avoid using any rubber teats (nipples) or pacifiers (soothers, dummies) during the first weeks. If your baby needs supplementation for a medical reason, use a cup. Even a tiny baby can drink from a small medicine or paper cup!

Breastfeeding Immediately

Successful breastfeeding is the combined result of practice, patience, and proper positioning. Breastfeeding as soon as possible -- preferably within an hour after birth -- will get you and your baby off to a good start. Prompt breastfeeding can also help prevent engorgement -- an uncomfortable, "full" feeling in the breasts caused by swollen lymph nodes, extra blood and excess milk. Keeping your infant with you during your hospital stay will help you get to know and immediately respond to baby's cues. In addition to beginning the important cycle of milk supply and demand, early breastfeeding allows your baby to receive the benefits of colostrum. Rich in nutrients and antibodies, colostrum is the first milk you produce and is your baby's perfect starter food.

Immediately after birth, your baby will be in a quiet alert state and generally receptive to breastfeeding. (If your baby isn't ready the very first time you try to breastfeed, try again within the next half hour or so.) Within a couple of hours, your baby will become quite sleepy; drowsiness may last for several days.

Breastfeeding - How Your Breasts Produce Milk?

Milk is produced and stored in the glandular tissue (alveoli) of your breasts. It collects in pockets (lactiferous sinuses) located beneath the areola (the dark area around the nipple) until it is released by a baby's sucking. Stimulation of the nipples causes the mother's pituitary gland, located in the brain, to secrete prolactin, which initiates and maintains milk production. The first milk your baby receives at each feeding is the milk that has collected in the pockets between feedings. This low-fat foremilk is high in protein and satisfies the baby's thirst. As breastfeeding continues, a second hormone called oxytocin is secreted. Oxytocin causes the tissue around the alveoli to contract, thus squeezing the high-fat hindmilk down the ducts and into the pockets where it is available to satisfy your baby's hunger.

Many mothers experience a tingling or rushing sensation in the breasts as this "let down," or milk ejection reflex (MER), occurs. Other mothers notice only that sucking becomes longer and slower, and that baby begins to swallow rhythmically. Keys to establishing a quick let-down are relaxation and confidence that your body is doing exactly what it was designed to do: feeding your baby the world's best baby milk -- produced by you!

Breastfeeding - A Simple Nipple Test

Flat or inverted nipples can make it difficult for your baby to latch-on properly, you might want to find out if you have this condition by doing this simple test. Place your thumb and index finger on the areola, the dark area surrounding the nipple. At the base of the nipple, compress gently but firmly. If your nipple flattens or retracts (inverts) into the breast, you can begin wearing breast shells during the last couple weeks of pregnancy. These plastic shells are worn under the bra and create slight pressure at the base of the nipple, drawing it out. It is important to do this "pinch test" because although some nipples appear erect, they will invert when the areola is compressed.

Breastfeeding - Bottle Feeding

If you bottle feed your baby, ask your doctor what kind of formula is best for her. There are three ways formula is sold:

Powdered formula is the cheapest. You have to mix the powder with sterilized water.

Concentrated formula is a liquid, but it is thick and must be mixed with sterilized
water. It costs more than powdered formula.

Ready-to-feed formula comes already mixed with water. It costs the most but is the easiest to use.

Follow formula mixing instructions carefully. There is a date on the formula.
Don't use the formula after this date. The formula will not be safe to give
to your baby after this date.

Wash reusable bottles made of plastic or glass. Also wash all equipment used to prepare formula. Use hot soapy water. Rinse the bottles in clean tap water. Then boil them five minutes in a covered pot or sterilizer.

To prepare formula, boil water for five minutes and cool it before mixing it with powdered or concentrated formula. If you are using bottles with disposable liners, throw away the liner after use. Store prepared formula in the refrigerator and use it within 48 hours.

Heat a bottle of formula by running hot water over it. Never heat formula in the microwave. It can get too hot. Check the temperature by shaking a few drops on your wrist. When it feels warm (not hot) on your wrist, it is cool enough to give to your baby.

Breastfeeding - After Breastfeeding

After feeding, rub a few drops of breast milk onto your nipples. Let them air dry. Then cover the nipple with nursing pads, a bra or clothing.

This will help keep them from getting too dry.

Your nipples may be tender in the first few days of breastfeeding. This is common. By and large, tenderness goes away once the milk begins to flow. If you have a lot of pain, call a breastfeeding counselor or your doctor. Your doctor or counselor can also help if you have cracked or bleeding nipples. If it doesn’t feel right, then it probably isn’t right. If you are out with your baby, you can still breastfeed.

You may want to take along a receiving blanket or shawl with which to cover up.
If you have to be away from your baby, you can still give her breast milk. You can withdraw or “express” breast milk by hand or with a breast pump into a sterile container. Then someone else can give it to her in a bottle.

It is important for you to have adequate, high-quality nutrition and drink enough water. You should avoid drugs while breastfeeding unless the doctor specifically tells you to take a certain medication even though you are breastfeeding.

Breast Milk is Best Milk

Breast milk is best for your baby’s health. Breastfed babies don’t get sick as often, and they usually don’t have as many allergies. They may even be smarter! Also,
breastfeeding seems to protect mothers from certain types of health problems. Mothers often find that breast milk is the easiest way to feed their babies. Also, there is no cost. You don’t have to wash and sterilize bottles and nipples when you breastfeed.

This leaves more time for other things. Breastfeeding your baby can even help you lose some of the weight you gained when you were pregnant. Breastfeeding can be a pleasing experience for baby and mom.

Breast Milk a Perfect Food

Breast milk is the perfect food for your baby. It is the only food your baby needs during her first six months. A baby is not ready for other foods, except formula, during the first few months of life. A breastfed baby usually doesn’t need water.
However, you may give her water if the weather is hot and your home is not airconditioned. Don’t add sugar or honey to the water. Don’t give flavored drinks or
soda pop to your baby. Don’t give fruit juice to a newborn baby.

Breastfeeding - Few more Tips

Make sure your baby’s mouth covers your entire nipple and much of the darker part
around the nipple. Your baby’s upper and lower lips should be rolled out. If the lips are not rolled out, break the suction by slipping your finger between the baby’s gums and your breast. Then latch the baby on again.

Offer your baby both breasts at each feeding. Your baby will tell you when she is finished by “falling off” the breast.

Breastfeeding - Few Tips

Hold your baby’s tummy to your tummy, baby’s chin to your breast. You
can do this sitting or lying down. Hold your breast in a “C-hold,” with
your thumb on top and fingers underneath. Tickle your baby’s lips with
your nipple until her mouth opens wide. Quickly bring her onto the
breast. Allow the tip of your baby’s nose and chin to touch the breast.

Breastfeeding - Natural Feed for New Born

Breastfeeding is natural, but it takes a little time for babies and mothers to
learn what works best for them. You may have sore nipples when you first
start breastfeeding. The pain can be reduced if your baby is held properly
when attached to the breast.

Breastfeeding - Feed your Baby

Babies need to eat often — every 90 minutes to two hours. Feed your
baby when she begins to show signs of hunger, such as rooting or sucking
on her lips, fingers or fist. Try to feed her before she cries. Feeding your
baby often won’t spoil her. It will help you learn to become more aware of
your baby’s needs.


Don’t limit feeding times. Babies need different amounts of food at different
times of the day, just as grown people do.
Relax! Take your time. The more you nurse your baby, the more milk you
will have. Do not give your baby formula or water. If you do, you will make
less milk. If you think you do not have enough

Breastfeeding - Strategies to Enhance Childhood Development and Parenting Through Breastfeeding

Given that breastfeeding promotes optimal health, cognitive development, and bonding of infant-mother pairs, it is critical that implementation of Proposition 10 include strategies to increase breastfeeding initiation and duration rates. The California Policy Research Center and the U.C.L.A. Center for Healthier Children, Families and Communities recently released the report, "Building Bridges for California’s Young Children: A 12 Point Agenda to Enhance Proposition 10," which identifies breastfeeding promotion and support as an essential component for child development services, as follows:

"Those who provide prenatal services must also begin to support and encourage important postnatal behaviors such as breastfeeding. National data suggest that women who receive prenatal education about and encouragement of breast-feeding are much more likely to initiate this important health-and-development-promoting behavior."

In addition, their report recommends that mothers have access to breastfeeding support groups, lactation support; family friendly workplaces and communities which support practices that promote optimal development of children (i.e., breastfeeding).

Breastfeeding - Strategies for Proposition 10 Implementation

"Breastfeeding is the most precious gift a mother can give her infant. When there is illness or malnutrition, it may be a lifesaving gift; when there is poverty, it may be the only gift." - Ruth Lawrence, M.D.

Purpose

To review the relationship between breastfeeding and early childhood health and development;
To provide effective strategies for increasing breastfeeding initiation and duration rates; and,
To provide guidelines for how to obtain 50/50 matching funds for breastfeeding efforts through the U.S.D.A.’s California Nutrition Network for Healthy, Active Families (Network).
Intent of Proposition 10

Proposition 10 is intended to establish comprehensive early childhood development and smoking prevention programs. The goal for early childhood development programs are to promote proper parenting, nurturing, and health care during the early years to provide the means for children to enter school: 1) in good health; 2) ready and able to learn; and 3) emotionally well developed.

Breastfeeding Saves Lives, Reduces Illness, and Fosters Optimum Child Development and Parenting

As we enter the new millennium, we must ensure the physical and emotional health of our children for the future. Once thought to be "no longer worth the bother," breastfeeding has been rediscovered by modern science as a means to save lives, reduce illness, foster optimum development and protect the environment. Policy makers are increasingly recognizing that breastfeeding promotion efforts can reduce health care costs that enhance maternal and infant well being. Human milk remains the single most important nutritional and bioactive substance available to the neonate. Breastfeeding also remains the first and best way to form a secure bond between mother and child, nurturing communication and emotional development. While many women in California initiate breastfeeding, too few women continue breastfeeding after the first few weeks.

Breastfeeding Saves Lives and Reduces Illness

Significantly lower rates of diarrhea, ear infections, lower respiratory illness, and childhood lymphomas occur among breastfed infants and children in the United States. Breastfeeding has also been reported to protect against necrotizing enterocolitis, bacteremia, meningitis, botulism, sudden infant death syndrome, urinary tract infection, early childhood caries, juvenile diabetes, and inflammatory bowel disease. Health care costs to federal and state governments, and private healthcare systems because of NOT breastfeeding run into billions of dollars.

Breastfeeding Fosters Optimum Cognitive Development

Research has determined that a child’s first three years are the most critical in brain development. "Nutritional programming" is the concept that nutrition during these critical periods in early growth and development permanently effects the structure and function of organs and tissues.

For a child, optimal nutrition starts in utero and continues with breastfeeding, often called the "fourth trimester." Through thousands of years, human milk has been tailored to meet the challenging needs of the human infant and child; all substitute feeding options differ markedly from it.

The mixture of nutritional factors and growth hormones in human milk has been linked to enhanced cognitive development. In fact, a recent long term study of 1000 children found breastfed children had consistent and statistically significant increases in:

intelligence quotient (IQ) at age 8 and 9 years of age;
reading comprehension, mathematical ability, and scholastic ability assessed during the period from 10-13 years of age;
teacher ratings of reading and mathematics assessed at 8 and 12 years; and,
higher levels of attainment in "high school leaving examinations."

Breastfeeding - Saves Lives and Reduces Illness

Significantly lower rates of diarrhea, ear infections, lower respiratory illness, and childhood lymphomas occur among breastfed infants and children in the United States. Breastfeeding has also been reported to protect against necrotizing enterocolitis, bacteremia, meningitis, botulism, sudden infant death syndrome, urinary tract infection, early childhood caries, juvenile diabetes, and inflammatory bowel disease. Health care costs to federal and state governments, and private healthcare systems because of NOT breastfeeding run into billions of dollars.

Breastfeeding - Fosters Optimal Parenting

Breastfeeding is the ideal way to begin, establish and nurture a close bond between mother and infant. The infant learns trust in early human closeness as well as cooperation with another human being. Mothers who breastfeed successfully often have an increased sense of self worth and empowerment. Mothers with less children, spaced further apart, can devote the appropriate amount of time to nurturing and responsible parenting. Breastfed infants are rarely, if ever, victims of child abuse and neglect.

Oxytocin released during breastfeeding may provide a biological basis for human attachment and bonding. Studies shows that mothers who breastfeed in the first hours of life, choose to keep their infants longer in their hospital rooms than mothers who have later contact. In addition, mothers who breastfeed have less anxiety, more mother-infant harmony, and are more engrossed in the feeding interaction than mothers who bottle feed. In several countries throughout the world, the rate of abandonment was reduced significantly after hospitals implemented "the Baby Friendly Hospital Initiative," which increased the use of rooming in and early breastfeeding.

Breastfeeding - Introducing solid foods

At 6 months, most babies cannot get everything they need from breast milk or formula alone. Though you can continue to breastfeed until your baby is 2 years and beyond, at 6 months you’ll start to introduce your baby to other foods. Your baby is ready to start other foods when he:

Seems hungry earlier than usual.
Can sit up without support, and has good control of his neck muscles.
Holds food in his mouth without pushing it out on his tongue right away.
Shows interest in food when others are eating, and opens his mouth when he sees food coming his way.
Can let you know he doesn’t want food by leaning back or turning his head away.
There are many ways to introduce solid food. The first foods usually vary from culture to culture and from family to family.

Start with foods that contain iron, which babies need for many different aspects of their development. It’s common to start with a single grain, iron-fortified infant cereal such as rice or barley. Meat, poultry, cooked egg yolk and well cooked legumes (beans, lentils, chick peas) are also good sources of iron.

Introduce new foods one at a time, waiting about 3 to 5 days before trying another. That way, if your baby develops a reaction, you’ll have a better idea of what food might have caused it.
Healthy foods that your family eats are good to start with as long as they are plain, with no added salt, sugar or spices. You can also use commercial baby foods, as long as you check the label to ensure there is no added salt or sugar.

Grain products. At 6 to 9 months, offer your baby up to 30 to 60 mL (2 to 4 tbsp.) of iron-fortified infant cereal, twice a day. Then try other grain products such as small pieces of dry toast or unsalted crackers. At 9 to 12 months, offer other plain cereals, whole grain bread, rice and pasta.

Vegetables. At 6 to 9 months, offer your baby puréed cooked vegetables—yellow, green or orange. At 9 to 12 months, progress to soft, mashed cooked vegetables.

Fruits. At 6 to 9 months, offer puréed cooked fruits, very ripe mashed fruits (such as bananas). At 9 to12 months, try soft fresh fruits, peeled, seeded and diced or canned fruit, packed in water or juice (not syrup).

Meat and alternatives. At 6 to 9 months, offer puréed cooked meat, fish, chicken, tofu, mashed beans, egg yolk. At 9 to 12 months, mince or dice these foods.

Milk and milk products. At 9 months, you can offer dairy foods like yogurt (3.25% or higher), cottage cheese or grated hard cheese. Wait until your baby is 9 to 12 months old before introducing whole cow’s milk (3.25%). After 12 months of age, your baby should not take more than 720 mL (24 oz.) of milk products per day. Too much milk can lead to iron deficiency anemia.

Breastfeeding - The first 6 months

For the first 6 months of life, breastfed babies will get what they need from their mother’s milk. Breast milk has the right amount and quality of nutrients to suit your baby's first food needs. It is easiest on her digestive system, so there's less chance of constipation or diarrhea. Breast milk also contains antibodies and other immune factors that help your baby prevent and fight off illness better.

Babies who are exclusively breastfed should get a daily supplement of vitamin D, which is available as drops.

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.

Breastfeeding - Feeding your baby in the first year

Feeding your baby in the first year of life is an exciting adventure for parents and babies alike. It’s about development, nutrition, exploration, sharing and learning. You can help your baby develop a lifetime of healthy eating habits with the right start. This pamphlet will help show you when and how to introduce new foods and how to make feeding an enjoyable part of your baby’s life.

Breastfeeding - Who should I ask if I have questions about breastfeeding?

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.

Breastfeeding - What do I feed my baby when I cannot breastfeed?

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 solids to your baby's diet.

Breastfeeding - Are there ever reasons not to breastfeed?

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.

Breastfeeding - Does my baby need anything else besides breast 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.

Breastfeeding - How do I prepare expressed breast milk for a feeding?

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.

Braestfeeding - How should expressed breast milk be stored?

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.

Breastfeeding - When should mothers express their breast milk?

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.

Breastfeeding - How will I know if my baby isn't feeding well?

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.

Breastfeeding - How will I know if my baby is feeding well?

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.

Breastfeeding - What is colostrum?

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

Breastfeeding - What should breastfeeding mothers eat?

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