BREASTFEEDING

We enthusiastically recommend breast feeding for our newborn patients beginning shortly after birth. The American Academy of Pediatrics recommends exclusive breast feeding for the first 4-6 months of an infant’s life. This means your baby needs no additional foods (except Vitamin D) or fluids (including water) unless medically indicated. Then a diet of solid baby foods along with breast feeding is recommended until one year of age. Many women choose to breast feed their child much longer than this. The World Health Organization recommends breast feeding for the first two years of a child’s life. 

Breast milk has many advantages over formula feeding. Some of these advantages include:

1. optimal nutrition. Breast milk provides the nutrients in the perfect amounts that your baby needs in order to grow optimally.
2. enhanced cognitive function of the child.
3. providing anti-infectious factors to the baby from the mother.
4. decreased inflammatory conditions in the infant such as asthma.
5. the establishment of a healthy intestinal microbiome in the child.
6. the establishment of strong emotional ties between the mother and infant which yields strong emotional health for the baby.
7. cost savings (as much as $6,000 per year).
8. ease and convenience of food preparation. 

 Breast milk is the most nutritionally complete food that is available for babies. We find that the composition of breast milk is WONDERFULLY COMPLEX! Besides the basic sugars, protein, fats and micro-nutrients that are specially designed for babies, breast milk is rich in anti-oxidants needed for eye health, rich in omega 3 fatty acids needed for healthy brain development, rich in MFGM (Milk Fat Globule Membrane) which helps support your baby’s cognitive development, rich in oligosaccarides (complex sugars) which are needed for the building of a healthy intestinal bacterial micro-flora, rich in Lactoferrin which ensures the infant’s absorption of iron from breast milk and protects against certain GI infections, and rich in nucleotides which helps build the immune system and promote cell growth. These nutrients are in the right concentrations and presented to the baby in the right form for maximum growth. 

Although the composition of infant formulas have come a long way since the time of PET milk and karo syrup, attempts to copy breast milk fall short. Simply put, breast milk is a natural food that is perfectly designed for your baby.

Breast milk contains several different anti-infectious factors which protect your child from infections. Breast fed babies are sick less often than formula fed babies. If infections do happen, they are generally milder than what they would have been if the baby was not breast fed. We routinely find that when a mother weans her baby, infections usually begin shortly thereafter.

Breast feeding also promotes closer emotional bonds between the mother and the baby. Most breast feeding mothers feel that they are giving their babies a part of themselves which helps develop more satisfying relationships. Successful infant bonding is an important factor in a mother developing an adequate breast milk supply.

There are other benefits of breast milk. It is readily available, pre-warmed and cheap. This makes middle of the night feedings easier and reduces financial stress. Infant formula can cost between $5,500 to $6,000 per year and more. 

At the time of birth, breast feeding helps the mother’s uterus contract so that less blood is lost. After birth mothers sometimes feel some mild discomfort in the lower abdomen when they feed their baby, which are the uterine contractions that breast feeding helps to stimulate. These contractions are normal. This sensation will lessen with time. 

Breast feeding utilizes about 800 calories per day of maternal nutrients, which helps a mother lose the weight that she have may have gained during the pregnancy. 

As we hope that you can see, the bottom line is this: breast feeding is the optimal way to feed your baby. The benefits to you and your baby are numerous! For these reasons, our clinic enthusiastically recommends breast feeding for all of our patients. For more information on breast feeding, please see our reading list in the back of this handbook. 

Initiation of Breast Feeding

The best time to initiate breastfeeding is within the first few minutes after birth when babies are typically alert. Most newborns will latch onto the breast soon after birth, and some may even display the “infant crawl,” instinctively moving toward the breast when placed on the mother's chest. This natural behavior, supported by instincts like rooting and nuzzling, fosters bonding with the mother and helps babies find nourishment. Skin-to-skin contact is beneficial during this time, helping regulate the baby’s temperature, heart rate, and breathing while stimulating the mother’s milk production.

Not all babies will perform the infant crawl, and various factors can affect breastfeeding initiation. Neonatal nurses play an important role in supporting these natural instincts and boosting a mother’s confidence in her breastfeeding efforts.

A few hours after birth, babies may enter a sleepy phase, feeding briefly before sleeping again. For the next two to three days, babies might be less receptive to breastfeeding, but this is normal and usually improves as their hunger increases after an initial weight loss.

Initially, breast milk is available in small amounts as colostrum. It’s normal for newborns to lose up to 10-12% of their body weight before gaining it back. This weight loss declines once the milk supply increases, typically by the third to fifth day. Early stimulation through skin-to-skin contact and frequent breastfeeding attempts can help enhance milk production and establish effective breastfeeding.

Signs indicating successful breastfeeding around the third to fifth day include: 

1. hearing the baby swallow
2. seeing milk in the corners of the baby’s mouth during feeding
3. experiencing leakage from the opposite breast at the start of breastfeeding sessions.

These signs of adequate breast milk supply should reassure mothers that breastfeeding is progressing well. 

Engorgement

Eventually, a mother’s breasts will feel heavy and tight as they fill with breast milk. If not drained adequately during these early days, engorgement can occur, which is common as milk production begins.

To manage engorgement, feed your baby frequently, ideally every 2 to 3 hours, to relieve fullness and establish milk supply. Ensure your baby is latching correctly—don’t worry if their nose touches your breast, they can breathe in this position. Before nursing, apply warm compresses or take a warm shower to stimulate milk flow and soften the breasts, aiding latching. After feeding, use cool compresses to reduce swelling and discomfort. Hand expressing, breast pumping, and massaging towards the nipple while feeding can also alleviate engorgement. Wear a supportive, non-underwire bra to prevent additional pressure on your breasts. If engorgement persists or is severe, seek medical advice at the hospital or at our office.

By the third or fourth day after birth, your breast milk should “come in,” and the baby will begin to regain lost weight. During this phase, babies may feed often due to hunger and thirst, sometimes exhibiting “marathon feedings.” or “cluster feedings.” Feed your baby on demand whenever they desire. To ensure successful breastfeeding, avoid using infant formula or bottles unless your baby loses more than 10-12% of their body weight. Supplementation with formula can cause infants to prefer bottles since formula is easier to obtain than breast milk in the first days of breastfeeding.

Bring your baby to our office on the third to fifth day of life so we can assess feeding adequacy, weight loss, feedings, jaundice, and signs of infection. We will advise on further follow-ups during this check-up.

For optimal nutrition, breastfed babies need vitamin D supplementation, as breast milk may not provide enough vitamin D3 needed for strong bones. The American Academy of Pediatrics recommends starting 400 IU (international units) of vitamin D3 daily within the first few days or weeks of life. This supplement is available over the counter. Fluoride supplementation, starting after six months, may also be necessary depending on your community’s water fluoride content. Consult us if your tap water lacks adequate fluoride, such as well water, to prevent tooth decay.