Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

What are the benefits of breast feeding?

Breast feeding has many benefits for your baby. Breast milk is rich in nutrients. It helps protect your baby against infections. It also helps prevent your baby from having allergies.

Breast feeding also has benefits for you. It's easy - you don't have to wash bottles or mix formula. It's cheaper than using formula. It helps your uterus contract back to normal size after having been stretched during pregnancy. Learning to breast feed takes a little time and some patience, but it's worth it. Breast feeding is an enriching experience that continues the special relationship with your infant.

Getting Started

How early should I start breast feeding my baby?

Breast feed your baby as early as possible after birth. With your free hand, put your thumb on top of your breast and your other fingers below. Don't touch your areola (the dark skin around your nipple). This is where you baby's lips will be. Tickle your baby's top lip with your nipple, move mouth away slightly, repeat until baby opens his or her mouth as big as a yawn. Pull baby towards you quickly, when your baby feels your nipple with his tongue his lips will close over the areola, both lips should be rolled outwards. As your baby nurses his jaw will move up and down, and you will hear low pitched swallowing noises, often following a suck, suck, pause rhythm.

How should I hold my baby while breast feeding?

There are many breast feeding positions. When begging to breast feed many woman have found it helpful to hold their babies in the cross cradle position. This allows mom to easily see both her breast and her baby's mouth. In the cross cradle position if mom is breastfeeding on the right side, baby's body is supported by mother's left arm; her left hand gently supports the baby's head. Mother's right hand is placed on the breast, allowing mom to position her breast to help baby latch on. Mom and baby are almost tummy-to-tummy; baby's head is tilted back slightly, and baby's body and legs are wrapped in around mom.

In any position, it is very important for mom to be comfortable, make sure your back is supported with pillows and bring baby to the breast, avoiding learning into baby. Other ways of holding your baby include the cradle, football and side lying position, and as you become more confident, you will find the ones you like best.

How often should I feed my baby?

Feed your baby as often as she wants to be fed. This will be about eight to 12 times in a 24-hour period. Your baby may take one or both breasts at each feeding; the important part is that she is satisfied.

Your baby is likely getting enough when she has six or more wet diapers a day, has frequent bowel movements and is gaining weight. How often your baby wants to feed may change over time as she goes through growth spurts. Growth spurts occur at about two and six weeks of age and again at about three and six months of age. Frequent feedings increases mom's milk supply and meets the demands of your growing baby.

What is the let-down reflex?

A few seconds to several minutes after you start breast feeding, you may feel a tingle in your breast and milk may start to drip from the breast not being used. These are signs that your milk has "let-down". This means your milk is ready to flow.
This let-down reflex makes breast feeding easier for your baby. Let-down may also occur if a feeding is overdue, if you hear your baby cry or even if you think about your baby.

Let-down can be forceful enough to cause your baby to cough. If this is a problem, you can express some of your milk by hand before a feeding to bring on the let-down reflex before you start breast feeding.

What if my nipples get sore?

At the beginning your nipples may be tender. The most important part of preventing sore nipples is a good latch. There are some things you can do to care for sore nipples:

	Make sure your baby is latched on properly
	Expressing some milk before feeding to relieve fullness will allow baby to latch on easier
	Express a bit of milk onto your nipples after feeding and let them air dry
	Off your baby the less sore of your nipples first; the baby's sucking may be less vigorous after the first few minutes
	Changing nursing positions may be helpful
	Wash your nipples daily with warm water; avoid using soap
	Breast feed often to prevent engorgement (overfullness of the breast). Engorgement can make it hard for your baby to latch on.

Don't limit the time you let your baby nurse. This doesn't prevent sore nipples; it just keeps the mild ducts from completely emptying. This can lead to swelling and pain. Applying crushed ice compresses before nursing can ease discomfort. Some women find that rubbing lanolin cream on their nipples is soothing. Call your doctor if you have a red, sore or painful area on your breast, if you have painful engorgement, if you have a fever or you feel achy. These may be signs of an infection.

How can I increase my milk supply?

If you think your baby needs more milk, increase the number of feedings a day. It's also important to get plenty of rest and eat right. Give your body time to catch up to your baby's demands. Increased feeding will stimulate your body to produce more milk.
Don't start giving your baby formula or cereal. Your baby doesn't need any solid foods until he or she is four to six months old. If you give formula or cereal to your baby, he or she may not want as much breast milk. This will decrease your milk supply.

What should I eat?

The main thing is to eat a well-balanced diet with plenty of calcium. This means eating fruits and vegetables, whole-grain cereals and breads, meats or beans, and milk and dairy foods like cheese. You'll need to get enough calories - about 500 more per day than usual-and you'll need to drink normal amounts of fluids.
A balanced diet that includes five servings of milk or dairy products each day will give you enough calcium. You can also get calcium from broccoli, canned fish (salmon, sardines, tuna or herring) sesame seeds, tofu and kale. Talk to your doctor about taking extra calcium if you don't think you're getting enough from your diet.

What should I avoid eating?

If you think a food you're eating bothers your baby, stop eating it. Caffeine and alcohol can get into your milk, so limit how much you drink. Drugs - even those you can buy without a prescription-can also get into your milk. Don't take anything without talking to your doctor first. Also avoid smoking. Smoking can cause you to make less milk.

Other resources

Along with your family doctor, there are others who can help you with your breastfeeding questions and concerns, i.e. public health nurses; lactation consultants; La Leche League; and breastfeeding hotlines in your area.

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Revised 2007 The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank.