Breastfeeding is a unique and rewarding journey, but it can also bring many questions and challenges. In this article, you’ll find answers to the most common and important questions surrounding breastfeeding, along with some practical guidance to help you navigate this experience with confidence and ease.
Breastfeeding Basics
You will learn:
1. What is breastfeeding, and why is it important ?
2. What are the benefits of breastfeeding for both baby and mother ?
3. What is colostrum, and why is it significant in the early days ?
4. When does mature milk come in after birth ?
Breastfeeding is the process of a mother nourishing her infant with her own milk. It provides essential nutrition, strengthens the immune system, and plays a crucial role in early development.
Breastfeeding is important because it provides an immediate protection against infections through colostrum, otherwise known as the thick, yellowish milk produced by the mother in the first few days after birth, until about day three to five postpartum.
Colostrum is rich in antibodies, including IgA, which lines the newborns’ gut and helps protect the baby from harmful microbes. This is the first step in building immunity. After successful lactation, the baby’s gut absorbs the right fat, protein, and water from the mother’s “mature milk”.
The benefits of breastfeeding extend to both the infant and the mother. For babies, it lowers the risk of asthma, obesity, and type 1 diabetes. For mothers, it promotes faster postpartum recovery and reduces the risk of certain cancers, as well as complications from postpartum bleeding.
A key but lesser-known benefit of breastfeeding is the unique suckling motion infants use. This movement plays a crucial role in the future development of the jaw and facial structure-something that bottle-feeding does not require.
Feeding Frequency & Duration
You will learn:
1. How often should I breastfeed my newborn?
2. How long should each breastfeeding session last?
3. Is it necessary to wake my baby for feeds during the night?
4. What is responsive or on-demand feeding, and why is it recommended?
Newborns should be breastfed every 2 to 3 hours (8 to 12 times in 24 hours), especially during the first weeks of life.
Feeds generally last between 10 to 20 minutes on the breast, depending on the newborn, the latch, and whether the baby is feeding efficiently. In the early days, you may need to wake your baby during the first week if they have been sleeping longer than 3 hours. Regular feeds help to stabilize blood sugar for the newborn and establish your breast milk supply.
Responsive (or on-demand) feeding means offering the breast whenever the baby shows feeding cues (for example, rooting, sucking movements or fussiness) and not according to the clock. The World Health Organisation (WHO) recommend responsive feeding, as it will promote healthy weight gain, provides the newborns with enough breastmilk to meet their needs and promotes the parent-infant attachment relationship. Your baby will self-regulate their feeding pattern as they grow using responsive feeding.
Baby’s Hunger & Fullness Cues
You will learn:
1. How can I tell if my baby is hungry or full?
2. What are the signs of a good latch during breastfeeding?
3. How do I know if my baby is getting enough milk?
A hungry baby will provide early cues including rooting (turning the head toward breast), sucking on hands, or smacking lips-noises. Crying is a late hunger cue. A satisfied baby will relax their hands, turn away from the breast and show signs of satisfaction or sleepiness.
A good latch is essential for feeding effectively and comfortably. Signs of a good latch include mouth wide open, lips flanged out (fish lips), more areola above the top lip than below the bottom lip, and sucking rhythmically with audible swallowing as needed. The latch lacks pain and sensations, only tugging.
To help your baby latch, express 1–2 drops of breast milk, then gently touch your nipple to baby’s nose and upper lip. When your baby opens the mouth wide, guide baby’s chin into your breast to ensure a deep and comfortable latch.
You can ensure your baby is getting enough milk by documenting wet diapers: at least 6 wet diapers and 3–4 stools by day 5. Also, you can measure weight gain—most babies are back to their birth weight within 10-14 days. A satisfied baby is another indicator: your baby will feed actively, unlatch on their own, and (usually) show signs of satisfaction or sleepiness after feeds.
Breastfeeding Techniques & Positions
You will learn:
1. What are the different breastfeeding positions, and how do I choose the best one?
2. How can I ensure a proper latch to prevent nipple pain?
3. What should I do if breastfeeding is painful?
4. How can I make breastfeeding more comfortable for both me and my baby?
There are many positions for breastfeeding—like cradle hold, cross-cradle, football hold, side-lying and laid-back (biological nurturing)—that have different benefits depending on comfort, age of baby or medical needs.
When determining the best position to use, keep in mind your type of delivery, baby’s ability to latch, and comfort. Side-lying position is best after a C-section delivery. Football hold offers the best head control for a newborn or twins.
To ensure a good latch and avoid sore nipples- align your baby’s nose with your nipple, wait for your baby to open the mouth wide and then bring your baby to your breast-(not your breast to your baby). If breastfeeding is painful, it usually means your baby is not latching deep enough or your baby is not positioned properly. When you feel pain from latching/unlatching, break the suction gently with your finger and re-latch the baby.
If breastfeeding is painful, consult a lactation consultant right away to rule out tongue tie, mastitis, or thrush. You can use you breast milk or pure silver nipple cups, to accelerate healing. Aiming for comfort, support pillows, having relaxed shoulders, and ensuring that your baby’s head is in line with their body—nose to nipple, belly to belly can make all the difference. It’s a matter of working small details to enhance your breastfeeding experience.
Milk Supply & Expression
You will learn:
1. How does milk supply work, and how can I increase it?
2. What are the signs of low milk supply, and how can I address it?
3. How do I express and store breast milk safely?
4. What are the guidelines for pumping breast milk at work or while away from my
baby?
Breast milk supply is based on demand and supply. The more you breastfeed or pump, the more milk your body makes. If you want to increase the amount of milk you produce, make sure lots of sucking is happening – ideally every 2-3 hours (including during the night) with good, solid sucking (or pumping).
Staying hydrated, eating enough calories, and getting enough rest are also key to keeping a healthy supply. Some mothers may find some relief with the help of herbal supplements, like fenugreek or lactation teas, but always check with your midwife, lactation consultant or other health care provider before trying one.
Poor weight gains, fewer wet diapers, and constant baby’s fussiness at the breast are all possible indicators of low milk supply. If you have concerns, you would benefit from seeing a lactation consultant.
When expressing and storing breast milk, always wash your hands beforehand and use clean containers. Store milk in the refrigerator for up to 4 days or freeze it for up to 6 months. You can pump directly into BPA-free bottles and store the expressed milk in refrigerator/freezer bottles or storage bags.
When pumping at work or away from your little one, bring a reliable double electric pump. Having a picture of your baby or a familiar item can help stimulate milk flow and make the process more comfortable.
Common Breastfeeding Challenges
You will learn:
1. What is engorgement, and how can I relieve it?
2. How do I handle sore or cracked nipples?
3. What are plugged ducts and mastitis, and how can I treat them?
4. How can I manage oversupply or a strong let-down reflex?
Your breasts swell, feel full, and may even hurt, creating engorgement due to an overaccumulation of milk. This may occur mostly during the first week just after giving birth when the mature milk starts coming in.
When experiencing engorgement, breastfeed frequently and on demand, as emptying the breasts can help reduce excessive swelling. Gently massaging your breasts, using warm compresses, and hand-expressing before feeds can soften the breasts and improve latch. Applying cold compresses after feeding can help relieve discomfort and swelling.
Nipple pain or cracking often occurs in the first few weeks of breastfeeding due to poor latching. To alleviate this, ensure a proper latch, apply breast milk before and after feeding, and allow nipples to air-dry afterward. Many health professionals recommend lanolin cream, though it may cause contact dermatitis in some individuals. If the pain persists or worsens, it is advisable to consult a lactation specialist for guidance.
Plugged ducts occur when milk flow is obstructed, leading to a painful lump in the breast. To manage this, continue breastfeeding frequently, apply warm compresses, and gently massage the affected area. Changing breastfeeding positions can also help improve milk drainage from different ducts. If left untreated, a plugged duct may progress to mastitis, an infection characterised by redness, swelling, and flu-like symptoms. In such cases, bed rest, warm compresses, and regular breastfeeding can aid recovery. If symptoms persist or worsen, consult a doctor for potential antibiotics and seek guidance from a lactation consultant.
To manage overproduction or a strong let down, feed on one breast per session to allow your baby to fully drain it before switching. This helps regulate milk flow and reduces engorgement. Breastfeeding while lying down can also slow the flow and make feeding more comfortable. If challenges persist, consulting a lactation consultant is recommended for tailored guidance.
In all cases, a hospital-grade pump can be used as an alternative, but it is advisable to consult a lactation consultant beforehand for guidance and support to prevent further complications.
Supplementing & Weaning
You will learn:
1. When and how should I introduce solid foods to my baby?
2. Can I combine breastfeeding with formula feeding?
3. How do I know when it’s time to wean my baby from breastfeeding?
4. What are the best practices for weaning to ensure a smooth transition?
Solid foods can be introduced from the age of 4 months but nor earlier. Your baby shows signs of readiness such as sitting up with support, showing interest in food and losing the tongue thrust reflex.
Start with single ingredient purees like rice cereal or mashed fruits and vegetables. Introduce new foods one at a time to watch for any allergic reactions. You can do mixed feeding if you want. Many mothers do mixed feeding for flexibility or when breastfeeding alone isn’t enough. Make sure to offer the breast first to maintain milk supply and consult a health provider to ensure your baby is getting enough nutrition.
The recommended age for introducing solid foods varies depending on the baby’s milk intake. While many begin weaning around 12 months, the timing can differ based on individual needs. Signs that it may be time to wean include a reduced interest in breastfeeding, an increased intake of solid foods, and the ability to drink from a cup.
For a smooth weaning process, gradually reduce the number of breastfeeding sessions over weeks or months. Introduce a bottle or cup for milk or water. Be patient and gentle, abrupt weaning can be stressful for both mom and baby. You can consult a midwife or lactation consultant for a smoother transition. Also, remember to continue to offer comfort through other means like cuddling and bonding activities.
Health & Nutrition
You will learn:
1. What dietary considerations should I keep in mind while breastfeeding?
2. How much water should I drink during breastfeeding?
3. Are there foods or substances I should avoid while breastfeeding?
4. How does breastfeeding affect postpartum weight loss?
While breastfeeding, make sure to eat a balanced diet with lots of fruits, vegetables, whole grains, lean proteins and healthy fats for your own health and milk production.
You need extra calories—about 300-500 more per day while breastfeeding. Foods high in calcium, iron and omega 3 like leafy greens, fish and fortified cereals can be good for you and baby too.
Drink plenty of water—about 8-12 cups a day—to stay hydrated and support milk production. Breastfeeding increases your body’s need for fluids so keep a water bottle nearby during feeding sessions.
There are foods and substances to avoid while breastfeeding like alcohol, caffeine (more than 300mg a day) and certain fish high in mercury. Some strong spices or foods like garlic can also change the taste of breast milk and may affect a baby’s willingness to breastfeed.
Breastfeeding helps with postpartum weight loss since it burns extra calories—about 300-500 per day. But don’t focus on weight loss during this time, focus on your nutritional needs and overall well-being. Gradual weight loss is normal, many women lose weight in the first 6 months postpartum but it varies from person to person.
Special Circumstances
You will learn:
1. Can I breastfeed after a cesarean section?
2. Is it safe to breastfeed if I have an illness or am taking medication?
3. How do I breastfeed multiples (twins, triplets)?
4. What support is available for breastfeeding mothers?
Yes, you can breastfeed after a cesarean section. While the initial recovery from surgery may be more challenging, skin-to-skin contact and breastfeeding can still begin in the first hour after birth if you’re stable. Positioning your baby in a way that avoids pressure on the incision, such as the football hold, can make breastfeeding more comfortable.
It is generally safe to breastfeed while ill or taking medication, but it’s important to consult with a healthcare provider about specific medications or conditions. Some medications can pass into breast milk, but many are safe or have alternatives that won’t affect your baby. Always check with your health provider before taking any new medication.
Breastfeeding multiples (twins, triplets) is possible with the right support and practice. You can breastfeed both babies at the same time using the football hold or tandem feeding positions. It may take some practice to find a routine, but with patience and support, it can be successfully managed.
At Femiliarise you can find personalised support to make your breastfeeding journey smoother.
Nikoletta Lis
Midwife, MPH, IBCLC
World Health Organisation (WHO). Nurturing young children through responsive feeding. Nurturing care for early childhood development.
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Marrazzu A., Sanna M., Dessole F., et al. Evaluation of the effectiveness of a silver – impregnated medical cap for topical treatment of nipple fissure of breastfeeding mothers. Breastfeed Med. 2015;10:232-8.
Gonzales Jr A., Tejero L. Concept analysis of maternal-infant attachment during weaning process. Belitung Nurs J. 2022;8:381-388.
Nutrition during Lactation. Meeting maternal nutrients needs during lactation. Institute of Medicine Committee in nutritional status during pregnancy and lactation. National Academic Press 1991.
Cwiek D., Zimmy M., Szymoniak K., et al. The effect of breastfeeding on women’s weight loss after childbirth and body mass composition-a preliminary study. Eur J Midwifery. 2023;7: A78.
