What is breastfeeding?

Breastfeeding is a natural way to feed your baby. If you are able to breastfeed, it can provide your baby with all the nutrition they need during their first 6 months of life. It also helps to create a loving bond between you and your baby.

Not everyone is able to, or chooses to, breastfeed their baby. You can access support, no matter what decision you make about how you want to feed your baby.

The first milk your body makes after birth is called colostrum. It is rich in protein and antibodies, which newborns need to build their immunity. Breast milk changes over time to meet the needs of your baby.

What are the benefits of breastfeeding?

Any amount of breastfeeding can benefit you and your baby — even if it's only for a short time.

Benefits for your baby

Breastfeeding helps to:

• protect your baby against infections and develop their immune system
• prevent them from gaining too much weight
• lower their risk of developing leukaemia and diabetes
• protect against sudden unexplained death in infancy (SUDI)

Benefits for you

Breastfeeding:

• helps your recovery after birth and helps your uterus return to its pre-pregnancy size
• helps you to return to your pre-pregnancy weight
• may reduce your risk of breast and ovarian cancer
• helps prevent high blood pressure, type 2 diabetes, heart disease and stroke

Benefits for your family

Breastfeeding can also benefit your family as it is cheaper than formula feeding. It can also be more convenient.

How to get started with breastfeeding

You may want to let your baby find their own way to your breast using their natural instincts. This is called baby-led attachment, and is when you hold your baby towards your chest, and they attach by themselves.

You may choose to hold them in a position that helps your baby attach to your nipple (parent-led attachment). There are many ways you may choose to hold your baby to feed. Some positions that may be comfortable during breastfeeding are to:

• lie in a semi-reclined position, supported by pillows, while your baby is lying on your stomach, with their nose at the level of your nipple
• support your baby with your forearm while they lie across your lap
• put your baby on a pillow next to you, with their legs and feet tucked around your side

How to get a good attachment

1. Sit comfortably with your back and feet well supported.
2. Unwrap your baby and put them in a position that is comfortable for both of you.
3. Your baby's head, shoulders and back should be in a straight line, facing your body.
4. Their mouth and nose should be level with your nipple.
5. Gently stroke your baby's mouth with your nipple to encourage them to open their mouth.
6. As their mouth opens and their tongue comes forward, aim your nipple towards the roof of their mouth. Their mouth should be open wide with a part of your areola in their mouth, not just your nipple.
7. When your baby attaches and starts sucking, try to relax your shoulders. This will help your let-down reflex.

Watch this video from Raising Children Network on how to get a good attachment.

Think about how you feel when breastfeeding. Your baby's mouth should follow a sucking and swallowing pattern. It should not be painful when your baby sucks. If breastfeeding is continuously painful, speak to your doctor or midwife.

What are hunger cues?

Hunger or feeding cues are signs that your baby gives to show they're hungry and ready for a feed. They can also tell you if your baby is full and does not want a feed. Once you have established breastfeeding, you may want to follow your baby's cues rather than watching the clock and feeding to a schedule.

Early signs that your baby is ready to feed include:

• turning their head from side-to-side
• opening their mouths
• stirring or moving their body
• rooting (turning their head and opening their mouth when the side of their mouth is touched — this reflex helps them find your nipple and start feeding)

Other signs that your baby is hungry include:

• stretching
• fussing and making squeaking noises
• moving around and getting restless
• putting their hand in their mouth

If your baby has started crying and has become more agitated, this is a late hunger cue. You may find it difficult to calm them down before feeding.

If you are breastfeeding, you can try putting them on your breast to see if that calms them down. If they are still crying, or you are bottle feeding, you can:

• try skin-to-skin contact with either you or your partner
• walk around to help calm them
• place some milk on their lips
• gently stroke your baby's mouth

Follow your baby's lead when breastfeeding. Watch to see if they show that they want to keep sucking or have finished. They may come off your breast by themselves when they have finished feeding. Look for your baby's hunger cues to see if they're still hungry.

Tips for breastfeeding success

• Try to have skin-to-skin contact with your baby after birth.
• Learn the most comfortable position for attachment for you and your baby.
• Breastfeeding is a skill and takes time to learn.
• Being relaxed will help calm your baby too.
• Watch for your baby's hunger cues to know when they are ready to feed.

How will my breasts change during pregnancy?

Changes in your hormone levels during pregnancy can change how your breasts look and feel.

Some of the first signs of pregnancy are breast and nipple tenderness. This is because even during the earliest stages of pregnancy, your breasts are getting ready to breastfeed.

Breasts and nipples change in size, colour and shape during pregnancy. These changes include:

• your breasts and nipples enlarging
• your nipples and areola (the skin surrounding the nipple) darkening
• veins in your breasts becoming more obvious
• your breasts feeling heavier and fuller

From the start of your second trimester, your breasts may start leaking colostrum. This is thick and yellow at first. As your pregnancy progresses, it will become almost colourless.

When does the first breastfeed happen?

Babies can begin feeding from your breast soon after they are born. Most maternity facilities support breastfeeding within one hour after birth. At birth, your baby's stomach is tiny, and they only need a small amount of milk.

Skin-to-skin contact between you and your baby is an important way to encourage early connection and bonding. It's also recommended by the World Health Organization for all premature and small babies.

What happens if my baby is in special care?

If your baby is unwell or needs special care, you may have to delay your first breastfeed. Speak with your doctors and midwife about your options soon after birth.

If your baby is expected to be born premature or unwell, your doctor or midwife may recommend expressing colostrum before giving birth. You may be able to express a few millilitres a day once they enter their third trimester. Colostrum is a good source of:

• growth factors
• immune factors
• important nutrients

Common issues with breastfeeding

Breastfeeding may come easily for some people, but it's also a learning process for you and your baby. You may initially experience nipple tenderness and engorgement (full breasts) until your breast milk supply matches your baby's demands.

Breastfeeding is a set of skills that both you and your baby learn together. Sometimes there are challenges when starting a breastfeeding journey. Many breastfeeding issues can be solved with the help of someone skilled in breastfeeding support.

Read more on common breastfeeding issues.

Common breastfeeding issues for your baby

A hungry baby

It can take a few days for your colostrum milk to become mature milk. During this time your newborn may be hungry and unsettled.

Frequent breastfeeding helps manage this and will also increase your supply. Your health team may also recommend that you express milk to increase your supply.

A sleepy baby

Labour and birth can be very tiring for you and your baby. It can take a few days for newborns to learn how to attach and feed from your breast. To help manage this, you may need to wake them to make sure they get the milk they need.

Cluster feeding

Babies often want to cluster feed when they go through growth spurts. Cluster feeding occurs when the baby wants many brief breastfeeds over a short period of time. This is normal and often happens in the first stages of breastfeeding and during periods of rapid growth.

Common breastfeeding issues for you

Breast engorgement — this is when your milk comes in and your breasts become larger and feel heavy. It's common at around 3 to 5 days after birth. You can relieve very full breasts by feeding your baby more often.

Sore, cracked nipples — this is usually a sign that your baby isn't attached correctly.

Flat or inverted nipples — this can make it difficult for your baby to attach. A lactation consultant can help with attachment.

Some people get mastitis — a common infection of the breast tissue. If you have mastitis, you will usually:

• feel unwell
• have flu-like symptoms
• have a sore, firm or red area on your breast

If you experience this, it's important to breastfeed as often as possible and promptly seek medical help.

Returning to work while breastfeeding

Breastfeeding can also be hard to manage while getting back to your usual daily routine. If you go back to work or start working while breastfeeding, ask your employer to support you by:

• providing a quiet place at work to express breast milk
• allowing you time to breastfeed or express — this is your legal right

The Australian Breastfeeding Association is a great resource for learning more about breastfeeding and returning to work.

Resources and support

For help with breastfeeding you can talk with:

• your midwife or child and family health nurse
• a registered lactation consultant
• the Australian Breastfeeding Association Breastfeeding Helpline: 1800 686 268 (1800 mum 2 mum). They also have an app.

The Royal Women's Hospital has resources to help you learn more about breastfeeding.

King Edward Memorial Hospital has videos on common breastfeeding challenges.

Languages other than English

• The NSW Health page on breastfeeding is available in other languages.
• Find breastfeeding resources translated into other languages on the Australian Breastfeeding Association website.

Information for Aboriginal and/or Torres Strait Islander peoples

• Learn more about breastfeeding with resources on the Australian Breastfeeding Association website.
• Find tips for breastfeeding on the NSW Government page 'Breastfeeding our Boori'.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.