Breastfeeding: The Basics

The benefits of breastfeeding are numerous for both babies and mothers. The saying “breast is best” was coined by people who knew what they were talking about.  Human breast milk provides the baby with crucial nutrients and immune support while triggering hormonal shifts in mom that help the uterus recover, decrease bleeding, and fight postpartum depression. Breastfeeding also provides a profound bonding opportunity and can be emotionally nourishing for both mother and baby. For all these reasons, pediatricians recommend that women breastfeed for at least the first six months (if not the first year) of a child’s life. 

Though breastfeeding is ideal, it’s important to note that it is not always easy or feasible to establish, and that bottle-fed babies now have largely similar health outcomes. “Breast is best,” while true, has also made a lot of women unduly anxious when breastfeeding turns out to be a huge, time consuming, sometimes painful struggle, and so it’s good to remember that other, equally true saying: “fed is best.”

Many couples turn to formula or some combination of bottle and breast when babies struggle to latch or mothers struggle to produce an adequate milk supply (common when a baby is delivered by C-section) or experience other obstacles. Infections can also hamper efforts to breastfeed, as can modern work schedules, which necessitate pumping and often lead to breast milk feedings being supplemented with formula. 

Luckily, with partners working together and support from lactation consultants, most feeding problems can be resolved in a happy, healthy way.

Breastfeeding Glossary

Latch: The way that a baby attaches to the breast, with her mouth over the nipple and most of the areola. A good latch, which may take time to achieve, should not cause a mother any pain and allows for maximal milk flow.
Areola: The dark area of skin around the nipple. During pregnancy, the areolas will often darken, making them easier for the baby to find.
Colostrum: The first milk a mother produces. Colostrum is a concentrated, high-protein substance that is important for a baby’s nutrition, provides the first bacteria to populate a baby’s gut, and contains antibodies to fight infection.
Letdown: The release of milk through the milk ducts to the nipple for feeding. The letdown reflex is prompted by a release of the hormone oxytocin, which is usually triggered by the baby’s sucking at the breast.
Mastitis: Painful swelling of breast tissue associated with infection and clogged milk ducts. Mastitis makes breastfeeding very painful and the affected breasts are often sore, red, hard, and warm to the touch. It may be accompanied by fevers and chills.

Breastfeeding FAQs

I’m a dad. I don’t have breasts. What can I do to help?

There’s a lot that fathers can do to support their breastfeeding partners. Dads can help figure out how to use some of the breastfeeding aids mom uses, like pumps or nipple shields, or, should their partner explicitly ask, research breastfeeding tips. They can read up on breastmilk storage guidelines, and label and organize any extra milk. They can keep nursing areas stocked with snacks, nipple creams, and burp cloths, and keep pumps and bottles clean. They can take on diaper changes, or become the primary chef for a breastfeeding-friendly diet. They can even become directly involved in feeding by becoming an ad hoc nursing coach. Sometimes all moms need is another hand to make sure the baby is positioned right and latching. 

If breastfeeding is a struggle, it’s also important for partners to be understanding and calm. Breastfeeding can be a very personal act for new mothers, and it’s critical for partners to communicate understanding. You can’t understand everything she’s going through, but you can be there to listen. 

Is breastfeeding ever painful?

A nipple is a very sensitive part of the body, so it’s possible that a baby’s latch and sucking will cause pain, particularly in the beginning, as breastfeeding is becoming established. There are some conditions, like mastitis, clogged ducts, or chafing of the skin, that can make breastfeeding even more painful. Most of these issues, however, are temporary and clear up pretty quickly. Pain is not the norm, and any prolonged pain should be brought to the attention of a doctor and lactation consultant.

Can breastfeeding damage breasts?

Breasts will change during breastfeeding. It makes sense that they would. After all, the breasts are engorged with milk. After breastfeeding they may look slightly different, but the changes are completely superficial and rarely a medical concern. How a breast changes during breastfeeding will be different for each breast and each woman, depending on their genetics. But change does not equate to damage. It is not unusual for breasts to be larger while a new mother is breastfeeding (or for a new father to express pleasure in that).

When should breastfeeding start?

If possible, breastfeeding should be attempted within the first few hours of a baby’s life. The initial milk that a mother produces, called colostrum, is packed with the probiotics necessary to help a newborn’s system digest food, fight germs, and rid the body of meconium, and a first feeding soon after birth provides a healthy dose of it. The baby nurses on colostrum for the first few days, while the milk is coming in.

When should breastfeeding end?  

The global average duration of breastfeeding is three years. That’s quite a bit longer than most Americans feel comfortable with. But the fact is that the immunological benefits from breastfeeding — the ability for breastmilk to support a child’s immune system — last for the entire duration of breastfeeding. In a sense, there is no such thing as late breastfeeding. It’s up to each family to decide, based on what’s practical and comfortable to them, how long to maintain the nursing relationship. 

Is breastfeeding in public legal?

Yes. Absolutely. Breastfeeding in public is protected by law in all 50 states. But that doesn’t mean that there aren’t people who will be judgmental or overly interested. This can be particularly distressing for non-breastfeeding partners who want to protect the baby’s mother. Unfortunately there are few good ways to deal with those individuals who make breastfeeding in public a hassle. The best thing to do is think of the benefits the baby is receiving and ignore everyone else to the degree that that is possible. 

Is it normal for the non-breastfeeding partner to feel left out?

When a partner is breastfeeding, it’s completely normal to feel a bit like a third wheel. After all, breastfeeding mothers and their babies are nearly inseparable by design. A lot of bonding happens during nursing, and there’s not a lot of room for anyone else. But proactive partners can bond with the baby too, in their own ways. Skin-to-skin time is great for that, as are things like taking on extra diaper changes and other tasks that support both partner and baby. 

Is pumping breast milk and using bottles as good as breastfeeding? 

When it comes to the health of the child, there is really only one consistently cited concern: overfeeding. A baby at the breast needs to work a bit more for their meal, and babies who breastfeed have a tendency to get about half as much per feeding as those who receive a strong consistent milk flow from a bottle. This simply means that parents need to be conscientious about how much they are feeding their babies via a bottle and being sure to use a bottle with appropriate flow (i.e., one that is most similar to the breast). 

For mothers who are not experiencing issues with breastfeeding, pumping can be a more complicated option. After all, it requires more equipment, more cleaning of that equipment, more preparation, and more time. However, it does provide more freedom to be away from a child for extended periods to work, travel, or simply get away. Essentially, it all comes down to personal choice. 

Breastfeeding vs. Formula

The general consensus among pediatricians is that mothers who are able to breastfeed should do so for the first three months of a child’s life. However, that suggestion is complicated by the fact that there are a number of baby formulas on the market that market themselves as breast milk equivalents, or at least the next best thing. While these formulas are incredibly valuable for mothers who are unable to breastfeed, they do not benefit a child as much as breast milk. 

Unlike formula, breast milk builds and supports a child’s immune system, particularly in the first few weeks of life. While in utero, a baby receives many infection-fighting antibodies through the placenta. That process continues after the baby is born as the mother passes on additional antibodies to the baby through the colostrum. There is simply no way for formula manufacturers to reproduce the immune support in infant formula.  

Another important difference between breast milk and formula is that it provides a natural balance of fat and proteins that are the easiest for child to digest. It also provides bacteria to help populate the newborn’s digestive system and aid in extracting nutrients from food. Formula, on the other hand, isn’t quite up to the same task. Not only can it be a bit more difficult for babies to digest, there’s no evidence that probiotics added to formula can populate a child’s gut with good bugs the way breast milk does.

The Costs: Breastfeeding and Formula 

It’s also important to consider the cost. Formula can be incredibly expensive, particularly if parents are lured by top-shelf brands, which by law are nutritionally identical to bargain brands. That’s in addition to the cost of bottles and washing systems required to deliver the formula. 

While the most basic breastfeeding is free, there can be costs associated with complications like mastitis, chapped nipples, or low supply, as well as with a lactation consultant to help with any issues that arise. The cost also goes up if a mother pumps breast milk: the breast pumps, bottles, and bottle washing system, not to mention the time that goes into pumping and maintenance, do add up. And a nursing mom needs to eat more — about an extra 500 calories a day — so the grocery bill might also go up a notch. That said, the overall cost is still generally lower than formula when amortized over the length of breastfeeding, which can last up to three years. (Also check your insurance: many plans will cover pumps and equipment, or lactation consultants.)

So, breastfeeding likely ends up saving families money, in addition to giving babies a slew of health benefits. It’s important to note, though, that should a woman not be able to physically breastfeed, or experience complications in breastfeeding that cannot be resolved through lactation consultants, formula is a completely reasonable and healthy option. There should be no shame in switching to formula for any reason. It will not adversely affect the health of a baby; it just may not provide the additional benefits. 

“The benefits of breastmilk are so important that it should be a very high priority for a doctor and a family.”

—Dr. Jay Gordon

Fatherly Recommendation:
Bonding With Baby When You Can’t Breastfeed

When a mother breastfeeds, a father can often feel like his partner is receiving the lion’s share of the newborn bonding. And the truth is, that may be true, especially for fathers who are not proactive at getting in on the bonding game. But just because a newborn is spending a lot of time at their mother’s breast doesn’t mean dad can’t bond, too.

A great way for dads to bond, especially with newborns, is to do skin to skin. You may have heard this term back in the hospital when the baby was born. The concept is simple, but has tons of benefits. Basically you take off your shirt and hold baby to your chest, with nothing in between you. This skin-to-skin contact offers the closest approximation to breastfeeding that a dad can experience, and research has found that babies’ growth and intellectual development benefit from being held in this way.

Another way of bonding with the baby is by being as vocal as possible when on outings or spending time with the kid. A baby may not be able to know what you’re saying, but hearing your voice helps their development and helps them orient you as a dad. Be silly and reassuring, and know that they’re listening. 

Finally, look for a baby’s cues. When they show they want to interact, drop everything and give them your attention, even if it’s just for five minutes. Bonding during breastfeeding is often opportunistic, so keep your eyes peeled for chances to bond with baby, not to mention give your partner a break. 

Breastfeeding Tips for Partners

  • Maintain the breastfeeding area by keep snacks stocked, magazines fresh, and the area clean. If mom uses a pump, help keep it clean and (if electric) charged.
  • Run interference. If there are older children in the house, many breastfeeding mothers would prefer partners to keep them occupied while they focus on breastfeeding. 
  • Bring her water.
  • Take on additional baby changes to compensate for the extra work she’s doing feeding the child. 
  • Be ready to answer requests when she’s breastfeeding. You may feel like a butler, but she’ll thank you for it.
  • Also be ready to just listen. When breastfeeding gets difficult sometimes a mom simply needs to talk. No need to offer tips or solutions unless she asks for input.
  • If she’s pumping, prep and wash bottles and pumping equipment so she doesn’t have to.
  • Read the same breastfeeding books that she’s reading.
  • Be entertaining. As lovely as breastfeeding can be, it can also get boring. Partners can help out by reading aloud from favorite books or magazines or providing mom-approved distractions during breastfeeding. 
  • Take a nighttime feeding shift when milk is being pumped to give her some much-needed rest and give you bonding time with the baby. 
  • Answer your baby’s cries instead of alerting your breastfeeding partner. The crying may not be hunger-related. 
  • Subtly use your body to block gawkers if she is breastfeeding in public.
  • Be flexible and supportiveSome mothers may find breastfeeding to be difficult or painful. They may decide to stop or supplement with formula. Some mothers may opt to pump rather than breastfeed. Support their decision and avoid making them feel ashamed or guilty.

The Best Breastfeeding Gear

Women love the Spectra breast pump because it's quiet, comfortable, and, according to many breastfeeding moms, the best at maximizing output. This last piece is crucial: breast pumps don't draw milk as efficiently as babies, and lower output means not only less milk for the baby, but it can also send a signal to the mom's body that less milk is needed, which can reduce overall milk production.

Breastfeeding can be seriously uncomfortable, whether because of an over-eager infant, clogged ducts, a poor latch, mastitis, or some other strain. These pads can be used hot or cold to improve supply, prevent clogged ducts, help with weaning, and support letdown.

Breast pumps are notoriously loud, and the noise can be grating, making a mom feel like she’s been hooked up to a milking machine. These Bose noise-canceling headphones can ease the irritation of loud breast pumps by decreasing the din of the machine.

The title needs some work, granted, but this very readable tome is the authoritative manual to breastfeeding. It's published by the nonprofit La Leche League International, which supports breastfeeding families with its free support groups, phone consultations, and online resources.

Nipple shields provide a buffer between breast and baby, helping to ease the pain of nursing with chafed or cracked nipples.

Should mom prefer to cover up while nursing, this multipurpose cover might come in handy. It can be worn across the chest for some portable privacy, or double as a car seat cover.

This revolutionary pump is wireless, so moms can put it in their bras and go on with their day. It's noise-free and connects to an app that tracks output.

This wearable wireless pump has seven levels of suction to maximize comfort and output. It's silent and comes with an app that tracks volume and reminds you when you pumped last.

This breastfeeding pillow straps on so baby stays put during feedings and mom can walk around or have one hand free. It comes with a storage pouch, and like most breastfeeding pillows, reduces back and neck strain.

These recyclable milk storage bags screw right into most major pumps and bottles for mess-free milk transfer. They come pre-sterilized, can be frozen, and are easy to label.