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Breastfeeding Frequently Asked Questions

Breastfeeding Frequently Asked Questions

Why is it so important that babies are breastfed?
Infant Feeding: Breastfeeding FAQs

Breastfeeding is the normal and natural way to feed a baby, and is the way that humans have evolved over millions of years to feed their babies. Breastmilk is not just about food and drink. Breastfeeding helps to keep babies healthy, as it supplies all the nutrients baby needs and protects them from a vast range of conditions including allergies, illness, infections, obesity, diabetes, cancer, asthma, heart disease and Sudden Infant Death Syndrome (SIDS). Breastfeeding also protects mothers too, from conditions such breast and ovarian cancers and heart disease. Breastfeeding also supports the relationship between mother and baby, and has a protective effect on the mental health of both of them. Breastfeeding is important for our wider society too – it’s much better for the environment, saves lots of money and is protective of everyone’s general health and wellbeing. 

What’s the difference between formula and breastmilk?

Breast milk and formula are completely different. Breastmilk is tailor made for human babies and contains everything they need, including water, fat, protein, carbohydrate, minerals and vitamins. In addition, breastmilk contains other important ingredients that cannot be copied or manufactured, such as living cells, stem cells, white blood cells, immune factors, hormones, enzymes, growth factors, essential fatty acids, and antibodies, plus varying flavours. Breastmilk constantly changes to meet a baby’s unique needs, so varies from feed to feed and from day to day, providing just the right amount of everything that a baby needs with every breastfeed. Infant Formula is made from cow’s milk which has been processed to make it suitable for babies, and may also contain ingredients such as stabilisers, emulsifiers, soya protein, vegetable oils, inositol, antioxidants and fish oils. There are several brands of infant formula but they all contain very similar ingredients.

What is the current guidance on breastfeeding?

Because of all the scientific evidence on the importance of breastfeeding, it is widely agreed that breastfeeding should be supported, protected and promoted as the healthiest way to feed, for all mothers and babies. The public health recommendation around the world is that infants should be exclusively breastfed for the first six months - this means that babies are given only breastmilk. At around 6 months of age, when baby shows signs of developmental readiness, family foods can be introduced to baby, alongside continued breastfeeding. In the UK, it is recommended that babies are breastfed for at least 1 year. The World Health Organization recommends that breastfeeding should continue for up to two years of age or beyond.

How does breastfeeding work?

Every woman starts to produce breastmilk around half way through her pregnancy. After the mother gives birth and then delivers her placenta (the ‘afterbirth’), the process of making breastmilk continues. This happens for all women - whether they have a ‘normal’ or ‘assisted’ birth or a Caesarean section. When mother and baby have skin-to-skin, and when baby suckles at the breast, this stimulates a mother’s breastfeeding hormones, so she produces more breastmilk. If a baby latches effectively and is fed responsively, virtually every mother is able to make all the breastmilk a baby needs, and breastfeeding can continue for as long as the mother and baby wants.

How is breastmilk made?

Breastmilk is made and stored in the breasts, and because the ‘ingredients’ are taken a woman’s blood supply rather from the contents of her stomach, a breastfeeding mother doesn’t have to eat or avoid any particular foods to produce breastmilk or increase how much breastmilk she makes.

How much breastmilk does a woman make?

Because breastmilk is made by ‘supply-and-demand’, the more a baby breastfeeds the more milk a mother will make. So women can breastfeed twins or even triplets, and can start to breastfeed a new baby while continuing to breastfeed her toddler. It’s important to remember that humans are mammals, just like cats or dogs for example, so breastfeeding one or multiple babies is the ‘biological norm’ for humans.

Can a woman feed a baby with breastmilk and formula?

Many women ‘combine feed’– where they breastfeed their baby, or give them breastmilk, but give them formula too. Because breastmilk is so important to a mother and baby’s health and wellbeing, even small amounts given to baby are valuable, to protect both mother and baby from illness. But because breastmilk is made by ‘supply-and-demand’, the more a baby is given formula, the less milk a mother will make. Also, because formula doesn’t contain any ingredients that protect a baby’s health, babies are more likely to become unwell if fed on formula.

Also, some babies find it difficult to go back onto the breast once they’ve been given a bottle. This is because the way baby feeds from a bottle and a breast is entirely different, and the use of teats, and dummies, encourages baby to use a very shallow or ‘closed-mouth’ latch, which is unhelpful when getting breastfeeding started. So if parents want to use a bottle to feed baby but would like to continue breastfeeding too, it’s recommended that a bottle is only introduced when breastfeeding is fully established. How long it takes for a mother and baby to learn how to breastfeed together varies; for some it only takes a few days, but for others it may take a few weeks. So while mothers and their baby are honing their breastfeeding skills, it’s helpful to avoid using bottles, teats and dummies, to avoid confusion.

Can all women breastfeed?

Virtually every woman is physically able to breastfeed and can produce plenty of breastmilk for their baby, no matter what her body size and shape is. It’s only a very tiny percentage of women who physically cannot breastfeed or produce enough breastmilk, for example due to major breast surgery, certain medical conditions or a small number of medications. Virtually every baby is born able to breastfeed too - it’s only a very small number of babies who physically cannot breastfeed, for example due to a disability or illness.

Can women who have had breast implants or breast surgery breastfeed?

In general, women who have had breast implants or breast surgery can still go on to breastfeed their babies. However, it does depend on the techniques used during the breast surgery. If breast implants have been inserted, they’re usually located behind the existing breast tissue, so cause very little damage to the breastmilk-producing tissue of the breasts. Women who have had breast enlargement or reduction surgery may find it more challenging to breastfeed, if some of their milk producing tissues and ducts have been removed, their nipple re-located or their breast nerves damaged. Again, it depends on the type of surgical techniques used for how much this will affect breastfeeding. Generally, the longer ago the surgery occurred, the better the chances are that breastfeeding will still be possible, though some supplementation with expressed breastmilk or formula may be necessary.  

It is important to consider the reasons why breast surgery took place too: for some women, they may have had implants due to problems with their breast development, which might mean there are underlying issues which will require them to have more support to breastfeed, before and after baby is born.  

For any pregnant women concerned about being able to breastfeed their baby or produce sufficient breastmilk, it’s a good idea to start collecting breastmilk towards the end of pregnancy, to stimulate supply and store some breastmilk so their baby can start life without the need for supplementation with formula.

How does expressing work?

Some women remove milk from their breasts by ‘expressing’, to collect and store it to use at another time, for example if they are going to be separated from their baby. Expressing breastmilk stimulates a mother’s breastfeeding hormones, so she produces more breastmilk, in a similar way to breastfeeding. Expressing breastmilk can be done by hand, or by using a hand operated or electric breastpump, and should not be uncomfortable, but it can be time consuming and some mothers don’t find expressing very easy to do.

Does breastfeeding hurt?

If baby is latched effectively to the breast during feeds, breastfeeding should be pain free. If breastfeeding is uncomfortable, it means that the mother needs support, information and guidance on how to latch her baby to the breast, from a health professional or a breastfeeding peer support volunteer.

Is breastfeeding difficult?

By the time women have their first baby, many of them have never seen breastfeeding, so quite a few new mothers find breastfeeding challenging at first. Many mothers find that no-one they know has breastfed at all or for any length of time, so they often feel that they have no friends or family to ask for help or show them how. Because of this, sometimes people around them give them well-meaning but incorrect advice about breastfeeding, which mothers find unhelpful, contradictory and confusing. However, with some support, information and guidance from a health professional or a breastfeeding peer support volunteer, most women find breastfeeding to be very rewarding, enjoyable and convenient, after mother and baby have learned the skill of breastfeeding together.

What happens when a woman stops breastfeeding?

When a woman stops breastfeeding, the amount of breastmilk she makes gradually gets less and less, because her breasts are not being stimulated to make more milk when baby feeds. It’s more comfortable and easier for the baby, the mother and her breasts if breastfeeding is stopped gradually, so everyone has time to adjust. After stopping breastfeeding, any breastmilk within the mothers breasts gets reabsorbed back into her body, although some women may feel that they need to express a little of their breastmilk occasionally to stay comfortable. After a woman has breastfed, it’s quite easy for her breasts to start producing breastmilk again in the future.

What are people’s attitudes towards breastfeeding in public?

Breastmilk is always ready, requires no preparation or sterilization and is always at the right temperature, so breastfeeding is the ideal way of feeding baby ‘out and about’. However some mothers can feel nervous at first about breastfeeding in public. Breastfeeding out and about happens all the time without any problems at all, but most of us don’t notice it because we’re not looking out for it and because it’s usually done so discreetly. Occasionally, you may hear about a breastfeeding mother getting a negative reaction for feeding in public – this happens very rarely though, in fact most women find it’s usually quite the opposite. Breastfeeding is the normal and natural way to feed a baby, and breastfeeding in public can help society to develop this view gradually over time.

Why do so many mothers bottle or formula feed their babies?

Most women in the UK start off breastfeeding, but nearly all of them stop breastfeeding before they want to. Some women bottle feed by choice, as they feel that it suits them better than breastfeeding. Lots of women formula or bottle feed because everyone around them did the same, so it feels like the ‘normal’ choice. Other women end up bottle feeding because they don’t get the support and information they need to enable them to start or carry on breastfeeding, so found it difficult, painful or embarrassing.

What support can women get?

Women have breastfeeding support from their health professional (eg their midwife or health visitor), or from a breastfeeding peer support volunteer from organisations and charities such as the NHS, The Breastfeeding Network, The National Childbirth Trust, The Association of Breastfeeding Mothers and La Leche League UK.

Who are breastfeeding peer support volunteers?

Breastfeeding Peer Supporters are mothers who have breastfed their babies and who have had training on breastfeeding and the support of mothers. They continue to receive support, supervision and further training as they support breastfeeding women in their community.

Why do people find it so hard to talk about breastfeeding?

The UK has some of the lowest breastfeeding rates in the world, because although most women start off breastfeeding, nearly all of them stop before they want to, because they don’t have the support they need to continue. This means that most babies are only breastfed for a short time, leaving many mothers feeling upset, frustrated, angry and guilty. It also means that more women have to turn to bottle feeding, which strengthens the bottle feeding culture and industry, and discourages other mothers from breastfeeding. Some people feel embarrassed to talk about breastfeeding too, because society sees women’s bodies in a different way. This all makes breastfeeding a very emotional subject in the UK, because so many parents experience real trauma from feeling that they weren’t able to breastfeed or that they had to stop breastfeeding before they wanted to, due to lack of support. This ‘shuts down’ conversations about breastfeeding, which adds to the practical, emotional and cultural barriers against breastfeeding. This is a great shame, as worldwide it is agreed that breastfeeding is essential in improving health, saving lives and reducing costs. So it is vital that we all talk about breastfeeding, and ask for more support from our whole society – our government, policy makers, communities and families - so that women feel supported and enabled to breastfeed, and are protected from commercial pressure.

Where can I find more information about breastfeeding?

Our other Infant Feeding Team web pages are an excellent source of information, easily found any time by searching online for “You and your baby Wolverhampton”.

A Teaching Trust of the University of Birmingham