HealthLink BC File #70, July 2009

Breastfeeding

• Why should I breastfeed my baby?
• When should I breastfeed my baby?
• How do I know if my baby is getting enough breast milk?
• Does my baby need anything other than breast milk?
• What should I eat when I am breastfeeding?
• Are there foods I should not eat?
• When should I get help with breastfeeding?

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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 help every part of your baby's development - physical, emotional and possibly intellectual.
• Breastfed babies have fewer infections, such as pneumonia, colds, ear infections and diarrhea, than babies who do not breastfeed.
• Breastfed babies have fewer illnesses and trips to the doctor or hospital, so family stress and medical costs are less.
• Breast milk can help prevent diabetes, cancer and childhood obesity.

Breastfeeding is good for women:

• It helps mothers bond with their babies.
• It helps with healing after the baby's birth.
• It decreases a mother's risk of breast cancer, ovarian cancer and diabetes.

Babies should be breastfed or offered breast milk soon after birth - within the first hour if possible.

Keeping your newborn close and giving skin-to-skin contact will help with breastfeeding, bonding and adjusting to the new environment. It will also help your baby's development.

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

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

• 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.
• Your baby is at or above birth weight by 2 weeks and growing well.
• Your breasts feel full before feedings and soft after feedings.

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.

Signs your baby feels full

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

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 and 200 IU each day for 1 year of age and older.

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.

• Enjoy a variety of healthy foods in the amounts recommended by Canada's Food Guide.
• Many mothers who breastfeed need 2 to 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.

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, and these should be limited. 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 cups of coffee or about 6 small cups of tea. Caffeine is also found in some soft drinks, 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. For more information see HealthLink BC File #38e: Fetal Alcohol Spectrum Disorder.

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 you are not making enough milk.
• You are worried that your baby is not getting enough milk from breastfeeding.
• Your baby does not have enough wet diapers each day.
• Your baby does not have at least 2-3 bowel movements each day after 4 days of age and up to the first 4-6 weeks
• Your baby is not interested in feeding and often goes without feeding for 4-5 hours during the first week.

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