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Breastfeeding

Breastfeeding is very important because it has health benefits for both mother and child. Exclusive breastfeeding is recommended for the first six months of life. While breastfeeding is a natural act, it is also a learned behavior. Mothers require active support for establishing and sustaining appropriate breastfeeding practices.

What is exclusive breastfeeding?
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Exclusive breastfeeding is recommended during the first 6 months of life, this means: "The baby only receives breastmilk without any additional foods or drinks, not even water". 
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Video - exclusive breastfeeding

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What are the benefits of breastfeeding?

It is recommended to exclusively breastfed your child during the first 6 months of life.  After 6 months of exclusive breastfeeding, it is recommended to continue breastfeeding to at least 24 months of age, in addition to complementary feeding. Breastfeeding has benefits for both mother and child.​

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  • Natural anti-conception method: helps to space children

  • Reduces the risk of cancer (breast + ovarian)

  • An easy and safe way of feeding:
    - Always available
    - Right temperature
    - Right amount
    - Hygienic

  • Good for the environment and saves money!

  • Helps with healing after childbirth (weight loss, uterus returning to normal, decrease post-delivery bleeding)

  • Increase hormones to support mental health (increases calm feeling and decreases chances of postpartum depression)

Benefits for mothers:

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  • Natural first food for babies:
    - 100% of the nutritional needs first 6 months
    - 50% of the nutritional needs 6-12 months
    - 30% of the nutritional needs 12-24 months

  • Breastmilk protects the baby against: infections and illnesses (such as diarrhea) and chronic disease when they are grown ups

  • Breastmilk helps to make babies smart, to recover quickly after illness, and to develop their senses

  • Breastfeeding helps to bond with the mother and to feel safe

  • Easy for the baby to digest

Benefits for babies:

Video - benefits of breastfeeding

Colostrum

It is important for a mother to start breastfeeding within the first hour of life, because then she produces a “yellowish” first milk called colostrum. 
 

  • Colostrum is ideal for the newborn because of:
    - The composition and quantity 
    - Colostrum rich in antibodies (which will help to prevent the baby from disease) 
    - Colostrum contains all the important nutrients that nourishes and protects a baby in the first few days of life
    - Feeding water or other liquids instead of colostrum deprives the child of a good start in life.

Video - colostrum

Breastfeeding positions

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There are several breastfeeding positions, in every position the baby should be held close in order to support them.
 

 

Below examples are provided:

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Breastfeeding positions Uganda.png

Video - breastfeeding positions & burgping

Attachment to the breast

When breastfeeding, it's important that the baby is well attached to the breast.

4 signs of good attachment are:

  1. The baby’s mouth is wide open 

  2. You can see more of the darker skin above the baby’s mouth than below

  3. The baby’s lower lip is turned outwards

  4. The baby’s chin is touching the mothers’ breast
     

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Attachment to the breast Uganda.png
Attachment to the breast Uganda.png

Video - things that are important when breastfeeding

How often should a mother breastfeed?

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Every baby is different, how much and how often your baby feeds will depend on your baby’s needs. Therefore, responsive feeding is very important. Responsive feeding is letting your baby decide when to breastfeed and for how long.  Your baby will show signs when they are hungry and when they are full. Do not worry about how long they breast feed or the time of day/night they feed. 
 

  • Signs that your baby is hungry include:
    - Baby bringing hands to their mouth
    - Making sucking motions or sounds
    - Rooting (turning head towards the person holding them and opening their mouth)
    - Putting tongue out
    - Sucking on hands
    - Baby cries (this is a late sign of hunger)
     

  • Signs to know your baby is full:
    - Sucking and swallowing slows or stops
    - Baby closes their mouth or pushes away from the breast
    - Baby is content or relaxed after feeding
     

However, there are some guidelines to see if breastfeeding is going well:

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  • First days:
    - The belly of a newborn is small, a baby does not need a lot of milk with each feeding to be full​
    - In the first days, a baby may want to eat as often as every 1 to 3 hours - babies need to eat regularly to help them get enough nutrition for growth and development
    - Frequent feeding helps increase the milk supply of the mother and helps the baby practice sucking and swallowing
     

  • First weeks and months:​
    - As the baby grows, their belly also grows - the baby will be able to drink more breast milk at each feeding​
    - An exclusive breastfed baby may want to eat on average about every 2 to 4 hours 
    - How often you feed the baby might change depending on the time of day, some feeding sessions may be long, and other short
    - In general, babies will generally take what they need at each feeding and stop eating when they are full
    - Your baby will breastfeed about 8 - 12 times in 24 hours
     

  • 6 - 12 months:
    - The feeding pattern of a breastfed baby (how often and how long they feed) vary and will likely change and start eating more solid foods (complementary feeding)​
    - Continue to follow your baby's cues and breastfeed when you notice signs of hunger (responsive feeding)
    - At this age, breastmilk is still the most important source of nutrition, even after you start feeding your baby solids
    - When introducing solids try breastfeeding first before you offer solids
     

  • 12 - 24 months:
    - The number of times a day you breastfeed your child varies
    - Continue to follow your child's cues to decide when he or she is hungry and wants to breastfeed (responsive feeding)
     

How do you know if the baby is getting enough breastmilk?

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  • Signs that the baby is getting enough milk:
    - Their mouth looks moist  
    - The baby appears calm and relaxed during feeds 
    - The baby appears content and satisfied after most feeds 
    - The baby appears healthy and alert when awake 
    - The baby is gaining weight after the first two weeks – Note: babies lose some birth weight in the first two weeks

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Video - how often to breastfeed

Milk expression

A mother might want to express breastmilk when she is returning to work, planning a night out or to relieve pressure from the breasts. 
 

  • How to store expressed milk:
    - Store the milk in a covered container for a maximum of 8 hours in a cool place.
    - If you have a refrigerator, milk can be stored for 24 hours (remember to warm milk, to lukewarm, before feeding)
    - Frozen milk can be stored for 6 months to ensure freshness    , defrost frozen breastmilk in the fridge and use defrosted breastmilk immediately and throw away any used milk. 

    Note: Never refreeze or reuse defrosted breastmilk!

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Video - milk expression

Video - working mother and exclusive breastfeeding

Breastfeeding problems

A mother might experience breast- or nipple pain, however, there are several things a mother can do to relieve this pain. 

Video - breastfeeding problems

Note: a mother should see a health care provider when:

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  • If one or both breasts become painful, feel hot, hard, and tight.

  • In case of fever

  • When her nipples are swollen   

  • Pain when breastfeeding

  • Sore, cracked, or bleeding nipples

  • Worried baby is not getting enough breastmilk 

  • Worried baby does not have enough diapers or bowel movements each day

  • Baby not feeling well, looks pale or grey

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Breastmilk vs. formula- or animal milk

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vs.

Breastmilk:

  • Most safe, no risk of contamination

  • Contains antibodies from the mother (protects the child against illness and infections)

  • Contains all the essential nutrients for the baby in the first 6 months of life

  • Breastfed infants tend to accept the introduction of solid foods more readily than formula-fed infants – most likely a result of the infant’s exposure to a variety of flavors in the breastmilk from the mother’s diet

  • Continued breastfeeding in the second year of life protects the child against mortality and is an important nutrition source

  • Free of cost, always available, and natural

Formula milk:

  • Formula milk requires added water which can lead to contamination – increasing the risk of diarrhea in the child

  • Option when a mother is not able to express breastmilk because of medical reasons

  • Formula milk contains more protein but less essential vitamins, minerals, and fats that are needed for adequate growth and the development of babies and young children

  • Is expensive

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Breastmilk vs. animal milk

Animal milk:

  • Do not feed infant under the age of 6 months.

  • Animal milk and alternative milk (oat or vegetable protein milk) can cause harm to the baby under 6 months. 

  • May introduce animal milk or alternative milk to the child’s diet after the child is one year. At this time, the child’s body is developed enough to digest milk other than from their parents.

Sources:

  1. How Much and How Often to Breastfeed. (2020, 11 December). Centers for Disease Control and Prevention. https://www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/how-much-and-how-often.html

  2. Certa Nutritio. (2020, 1 April). GloCal Nutrition [Video]. YouTube. https://www.youtube.com/channel/UCvxwMjlLzZP_l3CvIWPZHCg

  3. Breastfeeding vs. Formula Feeding (for Parents) - Nemours KidsHealth. (2018, juni). The Nemours Foundation. https://kidshealth.org/en/parents/breast-bottle-feeding.html#:%7E:text=As%20a%20group%2C%20breastfed%20infants,minerals%20that%20a%20newborn%20requires.

  4. World Health Organization. (2010, 9 december). WHO | First Food First. https://www.who.int/nutrition/topics/world_breastfeeding_week/en/

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