HealthLink BC File #70, September 2011

Breastfeeding

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• Why should you breastfeed your baby?
• When should you breastfeed your baby?
• How do you know if your baby is getting enough breast milk?
• Does your baby need anything other than breast milk?
• What should you eat when you are breastfeeding?
• Is there anything you should not eat or drink?
• When should you get help with breastfeeding?

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Breast milk is the only food or drink your baby needs for the first 6 months. Health Canada recommends breastfeeding your baby until he/she is at least 2 years of age.

Why should you breastfeed your baby?

Breast milk is good for babies:

• It is the safest and healthiest food for babies.
• It is easy for your baby to digest.
• Breast milk and breastfeeding may help your baby's development � physical, emotional and intellectual.
• Breastfed babies have fewer infections, such as pneumonia, ear infections and diarrhea, than babies who are not breastfed.
• Breastfed babies are less likely to die from sudden infant death syndrome (SIDS).
• Breastfed babies have fewer illnesses and visits to the doctor or hospital.
• Breast milk may help prevent diabetes, leukemia (a type of cancer), and adolescent and adult obesity.

Breastfeeding is good for women:

• It helps mothers bond with their babies.
• It helps with healing after the baby's birth.
• It may help mothers return to their pre-pregnancy weight.
• It decreases a mother's risk of breast cancer, and it may also decrease the risk of ovarian cancer and diabetes.

When should you breastfeed your baby?

Babies should be breastfed or offered breast milk soon after birth � within the first hour if possible. The first milk is called colostrum, and it is perfect for your baby. It gives your baby important early nutrition and protection from infection.

Breastfeed when your baby shows signs of hunger. Keeping your newborn close and providing skin-to-skin contact will help with breastfeeding, bonding, and adjusting to the new environment. It will also help your baby's development.

Signs your baby feels hungry

• Your baby sucks her lips, tongue or hands.
• Your baby looks around with an open mouth, called rooting.
• Crying is a late sign of hunger.

Let your baby decide when to breastfeed and how long to breastfeed each time � not the time or the clock.

During the first few months, your baby will feed about 8 or more times in 24 hours (1 day). Your baby may feed more often at times. This is called cluster feeding and often happens in the evenings or during growth spurts at about 3 weeks, 6 weeks, 3 months and 6 months of age.

How do you know if your baby is getting enough breast milk?

• You can see and hear your baby sucking and swallowing.
• By day 4 to 6, your baby has 5 or more wet diapers a day.
• By day 5, your baby has loose or seedy yellow bowel movements at least 2-3 times a day. After 4-6 weeks, babies often have fewer bowel movements.
• By 2 weeks, your baby is at or above birth weight and growing well.
• Your breasts feel full before feedings and soft after feedings.

Signs your baby feels full

• Sucking and swallowing slows or stops.
• Your baby closes her mouth or pushes away from the breast after the feeding.
• Your baby is content or relaxed after feeding.

Does your baby need anything other than breast milk?

Most mothers can make more than enough milk for their babies. If you are worried about how your baby is breastfeeding or growing, contact your doctor, midwife, public health nurse, or lactation consultant.

Breastfed babies need a vitamin D supplement of 400 IU each day during the first year. Breastfed babies older than 1 year of age need 600 IU each day from foods and/or supplements.

At about 6 months, continue to breastfeed and start to feed your baby iron-rich solid foods. For more information, see HealthLink BC File #69c Baby's First Foods.

What should you eat when you are breastfeeding?

• Enjoy a variety of healthy foods in the amounts recommended by Eating Well with Canada's Food Guide.
• Many mothers who breastfeed need 2-3 extra servings of food each day, such as:
  • fruit and yogurt for a snack; or
  • an extra slice of toast at breakfast; and
  • an extra glass of milk at dinner.
• Drink plenty of fluids and choose water most often.
• Low fat milk is also a healthy choice and helps you get enough calcium and other nutrients you need.
• Take a multivitamin containing folic acid.

Breast milk is the best food for your baby even if you are not able to follow the food guide exactly every day.

Is there anything you should not eat or drink?

There are a few foods you should avoid or limit while breastfeeding your baby:

• Fish is an important source of omega-3 fats and good for your baby. Some fish are high in mercury, so limit the amount you eat. Instead, choose fish low in mercury such as salmon, sole, or shrimp. For more information, see HealthLink BC File #68m Healthy Eating: Choose Fish Low in Mercury.
• It is safe to enjoy coffee and tea but limit the amount of caffeine to 300 mg per day. This is 1-2 small (6 ounce or 175 mL) cups of coffee or about 6 small cups of tea. Caffeine is also found in some soft drinks or pop, sports drinks, over-the-counter medicines, and chocolate. Younger babies can be more sensitive to caffeine.
• It is best not to drink alcohol while breastfeeding. Alcohol may affect your baby's sleep and decrease the amount of milk you produce and the amount your baby has at feeding time.

When should you get help with breastfeeding?

Get help early if you have questions about breastfeeding your baby.

For more information, see Baby's Best Chance.

For help or advice, contact your doctor, midwife, public health nurse, or lactation consultant. You can also call 8-1-1 to speak with a nurse or pharmacist if you have the following concerns or any questions.

• You have pain when breastfeeding.
• Your nipples are sore, cracked, or bleeding.
• You are worried that your baby is not getting enough breast milk.
• Your baby does not have enough wet diapers each day.
• Your baby does not have at least 2-3 bowel movements each day from 4 days and up to 4-6 weeks of age.
• Your baby is not interested in feeding and often goes without feeding for 4-5 hours during the first few weeks after birth.

For more HealthLinkBC File topics, visit www.HealthLinkBC.ca/healthfiles/ or your local public health unit. Click on www.HealthLinkBC.ca or call 8-1-1 for non-emergency health information and services in B.C. For deaf and hearing-impaired assistance, call 7-1-1 in B.C. Translation services are available in more than 130 languages on request.