Breastfeeding for beginners

Why is breastmilk special?

Breastmilk is perfectly designed to nourish your baby and protect them against illness when they're at their most vulnerable in their early months. Breastmilk is very easy for your baby to digest, plus it's free and available whenever your baby wants it.

Feeding your baby only breastmilk in their first six months (exclusive breastfeeding) is particularly good for them. Exclusive breastfeeding gives your baby:

• Every nutrient they need to thrive and grow well.
• Hormones to help their body function well.
• Disease-fighting compounds that protect them against illness. Breastfed babies are much less likely than formula-fed babies to suffer from diarrhoea and vomiting, colds, chest infections such as bronchiolitis and pneumonia, and ear infections.
• Microbes that help their organs, gut, immune system and brain to develop.
  (Ballard and Morrow 2013, Bar et al 2016, Boucher et al 2017, NHS nd, NHS 2017a, Victora et al 2016)

Breastfeeding can also be a life-saver. Breastfed babies have a lower risk of childhood leukaemia (NHS 2017a, Victora et al 2016) and sudden infant death syndrome (SIDS) (NHS 2017a, The Lullaby Trust nd, Thompson et al 2017).

Formula milk has none of the unique ingredients that your breastmilk has (Ballard and Morrow 2013).

As well as the health benefits, exclusive breastfeeding can improve your baby's understanding and learning abilities (Bar et al 2016, Boucher et al 2017, Victora et al 2016).

If you have allergies in your family, breastfeeding may protect your baby for longer against eczema, although it's unlikely to prevent eczema altogether (Flohr et al 2011, Greer et al 2008, von Berg 2013).

Your baby loves the smell of your skin, and to feel your warmth and closeness when you hold them. When you breastfeed, you release the "love hormone" oxytocin (Welford 2011). All this helps you and your baby to develop a strong bond through breastfeeding (NHS nd). Your breastmilk adjusts to your baby's needs as they grow (Ballard and Morrow 2013, NHS 2017a). Being breastfed may help your baby to stay healthier when they're older too. Breastfed babies are less likely than formula-fed babies to be overweight or obese in adulthood, or to develop type 2 diabetes (NHS 2017a, Victora et al 2016).

Breastfeeding is good for you, too, and may help you to lose your baby weight, as long as you're eating healthily and keeping active (Neville et al 2014, NICE 2010). In the long term, it also protects you against:

• breast cancer and ovarian cancer
• being overweight or obese
• developing type 2 diabetes
• developing endometriosis
  (Bobrow et al 2013, Farland et al 2017, NHS 2017a , Victora et al 2016)

How easy is breastfeeding?

Breastfeeding is a skill you and your baby learn together. Neither of you has done it before, so it's normal to have to practise and persevere until you both get the hang of it.

Plenty of new mums find breastfeeding tough at first. If you're struggling, you're not alone. Talk to your community midwife, or ask to be referred to a breastfeeding specialist. A specialist can watch you feed your baby, and suggest ways to make breastfeeding easier and more comfortable.

The NCT, La Leche League and The Breastfeeding Network can help you find a skilled supporter in your area.

Your health visitor is also a great source of support and advice. She can put you in touch with local groups where you can meet other breastfeeding mums.

Encourage your partner to learn about breastfeeding too, so he's ready to give you lots of support and practical help.

Take a look at our solutions for common breastfeeding problems.

How do I start breastfeeding?

• Find a comfortable place before you start. Feeds can take anything from five minutes to more than an hour, so you may need to settle in for a while (Unicef 2016). Try different spots until you find what works for you.
• Hold your baby in a position that won't make your arms and back ache. Have cushions or pillows nearby to support you or your baby. Laid-back breastfeeding means your baby can rest on your body, while your hands are free to support them. Or try the cradle hold, which means cradling your baby across your chest, raised up on a cushion or pillow. It depends on what's most comfortable for you.
• If you have large breasts, you may find it more comfortable to lie on your side while feeding, or you may want to try holding your baby under your arm in a rugby ball position.
• Pay attention to how your breasts feel when your baby latches on. They should take in a big mouthful of breast, not just your nipple. If they're sucking just your nipple, it may hurt.
• If it hurts after your baby has latched on, give it 30 seconds or so to settle down. If it's still painful, gently break the suction by inserting your little finger between their gums and your nipple, and try again. Focus on how your baby's attachment feels, rather than how it looks. Once your baby latches on comfortably, they'll be able to do the rest.

Is breastfeeding in public protected by the law?

Yes, you have the right to breastfeed in public places in England, Scotland and Wales (MA 2016). In Scotland, a specific law protects your right to breastfeed. In England and Wales, your right to feed in public is protected by equality law.

The rules differ slightly in Northern Ireland, but you have some protection under sex discrimination law (Betts and Russell 2017, DHSSPS 2013). Plans are in the pipeline to introduce a specific law giving women the right to breastfeed in public (Betts and Russell 2017).

It's normal to feel shy about breastfeeding in front of other people at first.

If you feel self-conscious, there are tops that allow you to breastfeed discreetly. Stretchy tops you can pull up or down work well. Wearing layers is helpful - a vest underneath that you can pull down, and a big, loose top you can pull up, creates a space for your baby to feed. This will give you plenty of privacy while keeping you and your baby comfortable.

If you prefer, you could use a breastfeeding cover, or drape a scarf or muslin over your shoulder and chest while you feed. Make sure your baby can breathe easily, though. It's ideal if you can keep eye contact with your baby, too.

Some larger shops have mum-and-baby rooms where you can sit and feed, and local councils also provide information about places where you are welcome to breastfeed.

Breastfeeding your baby when they're hungry is your first priority, so try not to feel self-conscious about doing what's best for them. You'll probably find you get plenty of supportive words and glances from passers-by.

What should I buy for breastfeeding?

Buy at least two or three breastfeeding or nursing bras. These bras have hooks or zips that you can undo easily for feeding your baby.

Your bras need to be a comfortable fit, and to open completely for feeding (NHS 2016a, NICE 2017). If the bra is tight-fitting it may press on your breasts and make you more prone to blocked ducts or mastitis (NHS 2016a).

Shopping with a newborn isn't easy, so you may want to buy a couple of nursing bras in late pregnancy. Some department stores have staff who are trained to fit nursing bras after 36 weeks.

You may find that your breasts leak a little sometimes. This is perfectly normal. If it bothers you, keep a supply of washable or disposable breast pads handy. You could wear a light-weight nursing bra for night-time, so you can use breast pads while you sleep.

If you're planning to express your breastmilk, you may want to buy a breast pump.

How long should I breastfeed for?

You can breastfeed for as long as you and your baby like (NHS 2017b). There's no need to stop once your baby has started solid foods. Your baby will benefit the most if you feed them until the end of their second year (Ballard and Morrow 2013, NHS 2017b, WHO 2017).

Continuing to breastfeed while introducing solid foods to your baby may help their immune system. They may be less likely to develop health conditions such as type 1 diabetes (Meijer et al 2017, Victora et al 2016).

Can I breastfeed after I go back to work?

You can continue to breastfeed if you're going back to work. If your workplace has a nursery, you may be able to visit your baby during the working day, and breastfeed them as usual (Marinelli et al 2013, MA 2017).

If, like most mums, you can't visit your baby during the day, you may want to express milk (Marinelli et al 2013). Or you may choose to breastfeed only when you are with your baby, and arrange for them to have formula milk during the day (MA 2017) (combination feeding).

Let your employer know in writing if you want to breastfeed after you return to work, so a risk assessment can be carried out (MA 2017). This is to make sure that your workplace is safe for a breastfeeding mum.

Working mums who are supported to carry on breastfeeding take less time off and are more likely to stay on in their job (Garvin et al 2013, Marinelli et al 2013). So it's good for your employer too.

Find out how to prepare yourself for breastfeeding.