Breastfeeding can be a special time for both mother and baby and can be good for the health of babies. Breastmilk meets all your baby's nutritional requirements from birth to around six months. It is specially made for your baby and there are lots of things in breast milk that are good for your baby, that are not found in formula milk.

Benefits

• It is safe for your baby, and easily digested.
• It contains all the food and drink your baby needs for the first six months of life.
• Together with other foods, it is very good for the next six months and into the second year.
• It is always ready when your baby needs it.
• Your baby will be less likely to get infections, allergies and many other diseases.
• Your baby may grow and develop better.

Breastfeeding is good for you too

• It does not cost anything and does not take time to prepare.
• It may be a way you and your baby feel close to each other and developing a bond with your baby.
• It helps your body return to normal more quickly after the birth.
• It may give protection against some diseases (such as cancer of the breast or ovaries).

How soon after birth can you start breastfeeding?

Ideally your baby’s first feed will be as soon as they show they are ready after their birth, usually within the first hour. A newborn baby is usually very alert and responsive at this time and has a strong urge to suck.

As soon as your baby is born have your baby placed on your chest, skin-to-skin, while they begin to get to know you and the outside world. Skin-to-skin contact is important for babies and it helps to keep them warm, regulates their heart rate and may reduce a need for oxygen.

If you and your baby are well, it is a good time to give your baby the first breastfeed while you are still in the birthing or delivery room.

• Some babies will latch on and suckle straight away.
• The inborn instincts of a newborn baby can result in a baby crawling and wriggling to find the breast and self-attaching. This can be an amazing experience.
• Others may take a little longer and some may need help.
• All mothers and babies are different. This is something that you and your baby will learn to do together.

The midwives will be there to guide you if you need it as you learn to breastfeed. They will also want you to let them know every time you are about to feed your baby in the first day or two. This is so they can help you and your baby learn the correct position and attachment technique.

For the first few days after the birth, your breasts produce colostrum.

• Colostrum is yellow and thicker than the milk you produce later.
• You will only produce a small amount but it is enough for a normal baby and is exactly what your baby needs for the first few days of life.
• Colostrum contains antibodies that protect your baby against germs and sickness.

After a few days your milk ‘comes in’; this is when your breasts start to produce lots of milk. This milk looks different from colostrum and is perfect for your growing baby.

Breastfeeding is a partnership between you and you baby and it takes time to establish successful breastfeeding; it may take up to six weeks for you to feel confident. It is a learned art - don’t worry - most problems can be overcome.

How often?

You can breastfeed your newborn baby whenever they seem to want to.

• As you get to know your baby you will learn the signs that your baby is ready for a breastfeed. When your baby is very young, this will be quite often.
• Frequent feeding is good for you and your baby. It helps your milk to come in sooner and can prevent some problems happening.
• A young baby will want between eight and ten feeds over a 24-hour period.
• There may not be a pattern to your baby’s feeds, especially in the first few weeks.
• During the first few days at home your milk supply may appear to lessen, and your baby may demand more frequently.
• Short frequent feeds will stimulate your breasts and increase your supply.
• By six to twelve weeks your baby may start to have a bigger gap between feeds and a feeding pattern may become more predictable.
• Your baby may sometimes want to breastfeed again, only a short time after a feed.

Take your cues from your baby. Babies may want a breastfeed because they are hungry, thirsty or need comfort and closeness.

Attaching to the breast

You will not get sore nipples from feeding your baby often, but your nipples can become very sore if your baby is not properly attached to your breast during feeds.

That is why it is important to learn how to position and attach your baby on the breast properly right from the start. Ask your midwife to help you if your nipples are getting sore. Once your baby is attaching well and emptying your breasts there is much less chance of developing nipple and breast problems.

Positioning your baby

• Unwrap your baby so you can hold them close with their whole body facing you and their nose opposite your nipple.
• Support their head with a hand behind their shoulders. Use your other hand to support your breast.
• Make sure your baby is opening their mouth widely with their tongue down and forward.The nipple needs to be aimed at the roof of your baby’s mouth. You will need to have your fingers well back, away from the nipple.
• The first contact point, when you bring baby to the breast, should be the chin on to the areola or below the areola, well away from the nipple.
• Once attached:
• Your baby needs to be able to draw all of the nipple and much of the areola (the coloured skin around your nipple) into their mouth.
• Their tongue will be out, over their gums, their lower lip rolled out and their chin against your breast.
• Their jaws will be positioned over the ends of the ducts and will be able to compress them well.
• After a few rapid sucks they should start to suck and swallow in a regular rhythm, as they starts to get milk.
• After a few minutes they may stop for a little rest before sucking again.
• If your nipples hurt they may not be on correctly. Put your finger in the corner of their mouth to break the suction. Take them off and try again.

Ask your midwife if you need help with attaching your baby.

Even though it may take a while to get the hang of breastfeeding, most mothers find it a very enjoyable experience. The more you breastfeed the easier and quicker it is.

Are complementary feeds needed?

Complementary feeding means giving baby formula in addition to breast milk.

• Breastfeeding works on a supply and demand basis, which is the more you breastfeed, the more milk your breasts make.
• When your baby has a complementary feed (of formula) your breasts will make less milk.

Complementary feeds are not recommended when you are breastfeeding as they can reduce your chances of establishing successful breastfeeding habits.

Complementary feeds should only be given if you have been advised to by your midwife, child health nurse or your doctor.

Engorged breasts

When the milk first comes in, your breasts may feel hot, swollen, lumpy, heavy and hard.

• If this happens you should feed your baby often. Engorgement is less likely to happen if you feed your baby frequently when your baby wants to, day and night from birth.
• If feeding does not make your breasts feel any better, the midwives will show you how to express some milk from your breasts.
• After a few days your breasts will feel less full even though you are still making plenty of milk.

Sore nipples

Sore nipples are a problem for some new mothers. This usually happens because the baby is not attached to the breast properly. Breastfeeding should not be painful.

• Sometimes the nipple may be sore (or tingling) at the beginning of a feed for a few sucks but if the soreness lasts longer than this it means the baby is not on the breast properly.
• If you find your nipples are starting to get sore, ask your midwife to watch you feed and help you get the baby on properly each time you feed.
• If your baby continues to feed in a poor position, you may end up with cracked nipples, which can be very painful.

Breastfeeding a premature or sick baby

In neonatal intensive care units and special care nurseries, staff are aware of the importance of skin-to-skin contact and breast milk, and will encourage you to provide breastmilk for your baby.

You will need to start expressing milk as soon as possible after the birth of your baby, and to do this as often as your baby would feed (six to eight times a day at least).

In the first day or two you will only be able to express a small amount of milk (colostrum), and then your milk with ‘come in’, and the amount you can express will increase.

When your baby is strong enough to start sucking, the nursery staff will show you how to help and encourage your baby to feed from the breast.

Expressing milk and then trying to feed premature babies is hard work and often mothers are not able to manage to fully feed their baby.

Smoking

Cigarette smoking can decrease your milk supply and the chemicals in smoke can cause health problems for babies. For example, nicotine is absorbed into a mother’s bloodstream and passes into breast milk.

• If you cannot give up smoking try to cut down the amount you smoke.
• Do not smoke during a feed – apart from the harm of the smoke, there is a danger of hot ash burning your baby!
• Don’t let anyone smoke near your baby (this is called 'passive smoking') because your baby will be affected.

Quitting smoking means

• There are no tobacco poisons being passed to the baby through breast milk.
• You will produce more breast milk.
• Your baby will feed better.

If you do continue to smoke while breastfeeding, then it is better to smoke after you have fed rather than before or during a feed.

For more information on how to quit smoking, visit www.quitnow.gov.au, or contact Quitline on 13 7848.

Drinking alcohol

If you drink alcohol when you are breastfeeding some of the alcohol gets into your milk. The amount of alcohol in your breast milk will be almost the same as in your blood.

Therefore, it is best not to drink any alcohol while you are breastfeeding, but if you do want to have an alcoholic drink, make sure you do so after you breastfeed your baby. The occasional drink is not harmful. Drinking a lot or very often can be dangerous for the baby.

Breastfeeding help and support

Breastfeeding support and advice can be sought from other mothers and from a range of health professionals including midwives, baby health nurses, Australian Breastfeeding Association counsellors, lactation consultants and doctors.

Australian Breastfeeding Association (ABA)

The Australian Breastfeeding Association offers mother-to-mother support and encouragement to breastfeed. It also provides counselling from trained ABA counsellors, a newsletter, a library and other activities. ABA support is available in all states and territories of Australia.

The website www.breastfeeding.asn.au is an excellent source of useful hints and information. One feature is information for fathers. It provides an email counselling service and links to other breastfeeding sites.

• Pregnancy, Birth and Baby on 1800 882 436
• Breastfeeding Helpline - Australia 1800 686 2 686.
• Child and Family Health Services in your state or territory.
• Parent Helpline in your state or territory.