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Baby feeding mother milk 2018


CDC Releases 2018 Breastfeeding Report Card | CDC Online Newsroom

Nation meets over half of Healthy People 2020 breastfeeding goals

Press Release

For Immediate Release: Monday, August 20, 2018
Contact: Media Relations
(404) 639-3286

Of the approximately 4 million babies born in 2015,  most (83.2 percent) started out breastfeeding – but many stop earlier than recommended, according to the 2018 Breastfeeding Report Card released today by the Centers for Disease Control and Prevention (CDC).

Good nutrition starts with breastfeeding exclusively (only breast milk) for about the first six months of life, as recommended by the American Academy of Pediatrics’ Policy on Breastfeedingexternal icon. While nearly 6 in 10 (57.6 percent) infants are still breastfeeding at 6 months of age, only 1 in 4 are breastfeeding exclusively.

“We are pleased that most US babies start out breastfeeding and over half are still breastfeeding at 6 months of age,” said Ruth Petersen, MD, MPH, director of CDC’s Division of Nutrition, Physical Activity, and Obesity. “The more we support breastfeeding mothers, the more likely they will be able to reach their breastfeeding goals.”

Breastfeeding provides benefits for babies and mothers

Infants who are breastfed have reduced risks of asthma, obesity, type 2 diabetes, ear and respiratory infections, and sudden infant death syndrome (SIDS). Breastfeeding can also help lower a mother’s risk of hypertension, type 2 diabetes, and ovarian and breast cancer.

Highlights from the 2018 Breastfeeding Report Card show:

  • Among infants born in 2015, 4 out of 5 (83.2 percent) started out breastfeeding. This high percentage of babies who start out breastfeeding shows that most mothers want to breastfeed and are trying to do so.
  • Almost half (46.9 percent) were exclusively breastfeeding at 3 months.
  • Only one-third (35.9 percent) of infants were breastfeeding at 12 months.
  • Almost half (49 percent) of employers provide worksite lactation support programs.
  • Over 1 in 4 babies are born in facilities that provide recommended maternity care practices for breastfeeding mothers and their babies.

CDC researchers analyzed data on breastfeeding practices and support from 50 states, the District of Columbia (D.C.), Puerto Rico, Guam and the Virgin Islands. For the first time, the Breastfeeding Report Card includes data for Guam and the U.S. Virgin Islands.

Mothers and families benefit from breastfeeding support from all sectors

CDC’s recommendations for support to mothers include encouraging hospitals and health care staff to implement practices that support breastfeeding, including helping patients identify covered benefits, such as breast pumps and access to lactation consultants, to help support the mothers’ transition back to home, to school, and/or to work.

All sectors of society (family and friends, hospitals, health care offices/clinics, childcare facilities, community-based organizations, and workplaces) can play a role in improving the health of families by supporting breastfeeding. To reach their breastfeeding goals, mothers need worksite accommodations and continuity of care through consistent, collaborative and high-quality breastfeeding services. They need the support from their doctors, lactation consultants and counselors, and peer counselors.

The CDC Breastfeeding Report Card provides state-by-state data to help public health practitioners, health professionals, community members, childcare providers and family members work together to protect, promote and support breastfeeding.

For more information on CDC’s work on nutrition and breastfeeding, please visit www.cdc.gov/breastfeeding.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
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Breastfeeding Report Card | Breastfeeding

This year’s report highlights select breastfeeding support indicators that can help families reach their breastfeeding goals, including supportive maternity care practices, state paid family and medical leave laws, and early care and education (ECE) policies.

Evidence-based maternity care practices that support breastfeeding are critical in the first few hours and days to help mothers establish breastfeeding and reach their breastfeeding goals.5 Maternity care practices in the United States have improved slightly. National scores on CDC’s Maternity Practices in Infant Nutrition and Care (mPINC) survey increased from 79 in 2018 to 81 in 2020. Hospitals implementing the Baby-Friendly Hospital Initiative’s Ten Steps help ensure that mothers have the information, confidence, and skills necessary to successfully initiate and continue breastfeeding their babies, while reducing medically unnecessary formula supplementation. In 2021, over 1 in 4 babies were born in Baby-Friendly designated hospitals. Breastfeeding support in the maternity care setting continues to improve, but variations in care from state-to-state indicate that more work is needed.

Although a family’s breastfeeding journey usually begins in the hospital, supportive policies and access to continued, coordinated support in the community can help families continue breastfeeding. Once families leave their birthing setting, breastfeeding rates drop slowly but consistently, which suggests that families may need additional types of support that facilitate exclusive breastfeeding and a longer duration of breastfeeding.

Breastfeeding support is especially important for mothers taking leave from, and returning to, the workforce. The Surgeon General’s Call to Action to Support Breastfeeding (CTA) identified a lack of paid maternity leave as a significant barrier to breastfeeding, especially for employed mothers with lower incomes, who are also more likely to experience racial and ethnic disparities. 6 To reduce the impact of employment on breastfeeding disparities, the CTA calls for efforts to establish paid maternity leave for all employed mothers. Child care centers can also support breastfeeding for employed mothers; the CTA encourages states to adopt and enforce national standards that support breastfeeding mothers and caring for breastfed infants.

Two new support indicators related to employment are included in CDC’s 2022 Breastfeeding Report Card:

Paid family and medical leave (PFML) refers to partially or fully compensated time away from work for specific and generally significant family caregiving needs, such as the arrival of a new child or serious illness of a close family member, or an employee’s own serious medical needs. The PFML indicator identifies whether a state has enacted legislation to create a PFML insurance program, whether the program is currently paying benefits, and the number of weeks of paid parental leave benefits that can be claimed by eligible employees (for the care of a new child by birth, adoption, or foster care). As of May 2022, 12 states had enacted PFML insurance legislation. Eight state programs are currently paying benefits, and 4 have not yet begun paying benefits. Among states with enacted PFML insurance legislation, the number of weeks of paid parental leave benefits (i.e., that can be claimed for the arrival of a new child) available to eligible employees ranges from 5 to 12 weeks within a benefit year (Table 2).

The State ECE Licensing Breastfeeding Support Score indicates the extent to which a state’s licensing regulations for child care centers meet the Caring for our Children’s standard to support and encourage breastfeeding best practices.7 To fully meet the standard, a state’s ECE licensing regulations must provide comfortable accommodations (e.g., dedicated, private space; comfortable chair; electrical outlet) for mothers to express milk and/or breastfeed their children on-site and recommend feeding of breast milk by parents or caregivers during normal operating hours. State breastfeeding support scores range from 30 to 100. In 2021, 9 states had licensing regulations that fully aligned (score = 100) with the breastfeeding support standard, 37 states’ regulations partially aligned (score = 70), and 5 states’ regulations did not address the standard (score = 30) (Figure 2).

Breast milk and formula: what do they have in common?

1 Cribb VL et al. Contribution of inappropriate complementary foods to the salt intake of 8-month-old infants. Eur J Clin Nutr . 2012;66(1):104. - Cribb V.L. et al., "Effects of inappropriate complementary foods on salt intake in 8-month-old infants". Yur J Clean Nutr. 2012;66(1):104.

2 Lönnerdal B. Nutritional and physiologic significance of human milk proteins. Am J Clin Nutr . 2003;77(6):1537 S -1543 S - Lönnerdahl B. , "Biologically active proteins of breast milk". F Pediatrician Child Health. 2013;49 Suppl 1:1-7.

3 Savino F et al. Breast milk hormones and their protective effect on obesity. Int J Pediatric Endocrinol. 2009;2009:327505. - Savino F. et al., "What role do breast milk hormones play in protecting against obesity." Int J Pediatrician Endocrinol. 2009;2009:327505.

4 Hassiotou F, Hartmann PE. At the Dawn of a New Discovery: The Potential of Breast Milk Stem Cells. Adv Nutr . 2014;5(6):770-778. - Hassiot F, Hartmann PI, "On the threshold of a new discovery: the potential of breast milk stem cells." Adv Nutr. 2014;5(6):770-778.

5 Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl Immunology . - Hassiot F. et al. , "Infectious diseases of the mother and child stimulate a rapid leukocyte reaction in breast milk." Clean Transl Immunology. 2013;2(4):e3.

6 Pannaraj PS et al. Association Between Breast Milk Bacterial Communities and Establishment and Development of the Infant Gut Microbiome. JAMA Pediatr. 2017;171(7):647-654. - Pannaraj P.S. et al., "Bacterial communities in breast milk and their association with the emergence and development of the neonatal gut microbiome". JAMA pediatric. 2017;171(7):647-654.

7 Bode L. Human milk oligosaccharides: every baby needs a sugar mama.Glycobiology. 2012;22(9):1147-1162. - Bode L., "Oligosaccharides in breast milk: a sweet mother for every baby." Glycobiology (Glycobiology). 2012;22(9):1147-1162.

8 Deoni SC et al. Breastfeeding and early white matter development: A cross-sectional study. neuroimage. 2013;82:77-86. - Deoni S.S. et al., Breastfeeding and early white matter development: a cross-sectional study. Neuroimaging. 2013;82:77-86.

9 Birch E et al. Breast-feeding and optimal visual development. J Pediatr Ophthalmol Strabismus. 1993;30(1):33-38. - Birch, I. et al., "Breastfeeding and Optimum Vision Development." J Pediatrician Ophthalmol Strabismus. 1993;30(1):33-38.

10 Sánchez CL et al. The possible role of human milk nucleotides as sleep inducers. Nutr Neurosci . 2009;12(1):2-8. - Sanchez S.L. et al., "Nucleotides in breast milk may help the baby fall asleep." Nutr Neurosai. 2009;12(1):2-8.

11 Moukarzel S, Bode L. Human Milk Oligosaccharides and the Preterm Infant: A Journey in Sickness and in Health. Clin Perinatol. 2017;44(1):193-207. - Mukarzel S., Bode L., "Breast milk oligosaccharides and the full-term baby: a path to illness and health. " Klin Perinatol (Clinical perinatology). 2017;44(1):193-207.

12 Beck KL et al. Comparative Proteomics of Human and Macaque Milk Reveals Species-Specific Nutrition during Postnatal Development. J Proteome Res . 2015;14(5):2143-2157. - Beck K.L. et al., "Comparative proteomics of human and macaque milk demonstrates species-specific nutrition during postnatal development." G Proteome Res. 2015;14(5):2143-2157.

13 Michaelsen KF, Greer FR. Protein needs early in life and long-term health. Am J Clin Nutr . 2014;99(3):718 S -722 S . - Mikaelsen KF, Greer FR, Protein requirements early in life and long-term health. Am J Clean Nutr. 2014;99(3):718S-722S.

14 Howie PW et al. Positive effect of breastfeeding against infection. BMJ .1990;300(6716):11-16. — Howie PW, "Breastfeeding as a defense against infectious diseases." BMJ. 1990;300(6716):11-16.

15 Duijts L et al. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. Pediatrics , 2010;126(1): e 18-25. - Duitz L. et al., "Prolonged exclusive breastfeeding reduces the risk of infectious diseases in the first year of life." Pediatrix (Pediatrics). 2010;126(1):e18-25.

16 Ladomenou F et al. Protective effect of exclusive breastfeeding against infections during infancy: a prospective study. Arch Dis Child . 2010;95(12):1004-1008. - Ladomenu, F. et al., "The effect of exclusive breastfeeding on infection protection in infancy: a prospective study." Arch Dis Child. 2010;95(12):1004-1008.

17 Vennemann MM et al. Does breastfeeding reduce the risk of sudden infant death syndrome?. Pediatrics . 2009;123(3): e 406- e 410. - Wennemann M.M. et al., "Does Breastfeeding Reduce the Risk of Sudden Infant Death?" Pediatrix (Pediatrics). 2009;123(3):e406-e410.

18 Straub N et al. Economic impact of breast-feeding-associated improvements of childhood cognitive development, based on data from the ALSPAC. Br J Nutr . 2016;1-6. - Straub N. et al., "Economic Impact of Breastfeeding-Associated Child Cognitive Development (ALSPAC)". Br J Nutr . 2016;1-6.

19 Heikkilä K et al. Breast feeding and child behavior in the Millennium Cohort Study. Arch Dis Child . 2011;96(7):635-642 - Heikkila K. et al., Breastfeeding and Child Behavior in a Millennial Cohort Study. Arch Dis Child. 2011;96(7):635-642.

20 Singhal A et al. Infant nutrition and stereoacuity at age 4–6 y. Am J Clin Nutr , 2007;85(1):152-159. - Singhal A. et al., Nutrition in infancy and stereoscopic visual acuity at 4-6 years of age. Am F Clean Nutr. 2007;85(1):152-159.

21 Peres KG et al. Effect of breastfeeding on malocclusions: a systematic review and meta - analysis. Acta Paediatr . 2015;104(467):54-61. - Perez K.G. et al., "The impact of breastfeeding on malocclusion: a systematic review and meta-analysis". Akta Pediatr. 2015;104(S467):54-61.

22 Horta B et al. Long - term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta - analysis. Acta Paediatr . 2015;104(467):30-37. - Horta B.L. et al., "Long-term effects of breastfeeding and their impact on cholesterol, obesity, systolic blood pressure, and type 2 diabetes: a systematic review and meta-analysis." Akta Pediatr. 2015;104(S467):30-37.

23 Lund-Blix NA. Infant feeding in relation to islet autoimmunity and type 1 diabetes in genetically susceptible children: the MIDIA Study. Diabetes Care . 2015;38(2):257-263. - Lund-Blix N.A. et al., "Breastfeeding in the context of isolated autoimmunity and type 1 diabetes in genetically predisposed children: the MIDIA study ". Diabitis Care. 2015;38(2):257-263.

24 Amitay EL, Keinan-Boker L. Breastfeeding and Childhood Leukemia Incidence: A Meta-analysis and Systematic Review. JAMA Pediatr . 2015;169(6): e 151025. - Amitai I.L., Keinan-Boker L., "Breastfeeding and incidence of childhood leukemia: a meta-analysis and systematic review. " JAMA Pediatrician. 2015;169(6):e151025.

25 Bener A et al. Does continued breastfeeding reduce the risk for childhood leukemia and lymphomas? Minerva Pediatr. 2008;60(2):155-161. - Bener A. et al., "Does long-term breastfeeding reduce the risk of leukemia and lymphoma in a child?". Minerva Pediatric. 2008;60(2):155-161.

26 Dewey KG. Energy and protein requirements during lactation. Annu Rev Nutr . 1997;17:19-36. - Dewey K. J., "Energy and Protein Requirements During Lactation". Anna Rev Nutr. 1997 Jul;17(1):19-36.

27 Victoria CG et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490. - Victor S.J. et al., "Breastfeeding in the 21st century: epidemiology, mechanisms and long-term effects". Lancet (Lancet). 2016;387(10017):475-490.

28 Jordan SJ et al. Breastfeeding and Endometrial Cancer Risk: An Analysis From the Epidemiology of Endometrial Cancer Consortium. Obstet Gynecol . 2017;129(6):1059-1067. — Jordan S.J. et al., "Breastfeeding and the risk of endometrial cancer: an analysis of epidemiological data from the Endometrial Cancer Consortium". Obstet Ginecol (Obstetrics and Gynecology). 2017;129(6):1059-1067.

29 Li DP et al. Breastfeeding and ovarian cancer risk: a systematic review and meta-analysis of 40 epidemiological studies. Asian Pac J Cancer Prev . 2014;15(12):4829-4837. - Lee D.P. et al., "Breastfeeding and the risk of ovarian cancer: a systematic review and meta-analysis of 40 epidemiological studies." Asia Pas G Cancer Prev. 2014;15(12):4829-4837.

30 Peters SAE et al. Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300,000 Chinese Women. J Am Heart Assoc . 2017;6(6). - Peters S.A. et al., "Breastfeeding and Maternal Risk of Cardiovascular Disease: A Prospective Study of 300,000 Chinese Women". J Am Hart Assoc. 2017;6(6):e006081.

31 U.S. Department of Health & Human Services [Internet]. Surgeon General Breastfeeding factsheet ; 2011 Jan 20 — Department of Health and Human Services [Internet], Breastfeeding Facts from the Chief Medical Officer, January 20, 2011 [cited April 4, 2018]

32 Doan T et al. Breast-feeding increases sleep duration of new parents. J Perinat Neonatal Nurs . 2007;21(3):200-206. - Dawn T. et al., "Breastfeeding increases parental sleep duration. " G Perinat Neonatal Nurs. 2007;21(3):200-206.

33 Menella JA et al. Prenatal and postnatal flavor learning by human infants. Pediatrics . 2001;107(6): E 88. - Menella J.A. et al., Prenatal and Postnatal Taste and Smell Recognition in Children. Pediatrix (Pediatrics). 2001;107(6):e88.

34 Forestell CA, Mennella JA. Early determinants of fruit and vegetable acceptance. Pediatrics . 2007;120(6):1247-1254. - Forestell S.A., Mennella J.A., "The First Signs of Readiness to Taste Fruits and Vegetables." Pediatrix (Pediatrics). 2007;120(6):1247-1254.

Breastfeeding in the first month: what to expect

Not sure how to establish lactation and increase milk production? If you need help, support, or just want to know what to expect, read our first month breastfeeding advice

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The first weeks of breastfeeding are a very stressful period. If at times you feel like you can't handle it, know that you are not alone. Feeding your baby all day long is completely natural and helps produce breast milk, but can be quite tiring at times. Be patient, think about yourself and remember: after the first month, when milk production stabilizes, it will become easier.

How often should a baby be breastfed?

Babies are born with a small stomach that grows rapidly with increased milk production: in the first week it is no larger than an apricot, and after two weeks it is already the size of a large hen's egg. 1.2 Let the child eat as much as he wants and when he wants. This will help him quickly regain the weight lost after birth and grow and develop further.

“Be prepared to feed every two to three hours throughout the day. At night, the intervals between feedings can be longer: three to four or even five hours, says Cathy Garbin, a recognized international expert on breastfeeding. Some eat quickly and are satiated in 15 minutes, while others take an entire hour to feed. Do not compare your breastfeeding regimen with that of other mothers - it is very likely that there will be nothing in common between them.

At each feed, give your baby a full meal from one breast and then offer a second one, but don't worry if the baby doesn't take it. When the baby is full, he lets go of his chest and at the same time looks relaxed and satisfied - so much so that he can immediately fall asleep. The next time you feed, start on the other breast. You can monitor the order of the mammary glands during feeding using a special application.

Why does a child always ask for a breast?

The first month is usually the hardest time to breastfeed. But do not think that because the baby is constantly hungry and asks for a breast almost every 45 minutes, then you do not have enough milk.

In the first month, the baby needs to eat frequently to start and stimulate the mother's milk production. It lays the foundation for a stable milk supply in the future. 3

In addition, we must not forget that the child needs almost constant contact with his mother. The bright light and noise of the surrounding world at first frighten the baby, and only by clinging to his mother, he can calm down.

Sarah, mother of three from the UK, confirms: “Crying is not always a sign of hunger. Sometimes my kids just wanted me to be around and begged for breasts to calm them down. Use a sling. Place the cradle next to the bed. Don't look at the clock. Take advantage of every opportunity to relax. Forget about cleaning. Let those around you take care of you. And not three days, but six weeks at least! Hug your baby, enjoy the comfort - and trust your body."

Do I need to feed my baby on a schedule?

Your baby is still too young for a strict daily routine, so
forget about breastfeeding schedules and focus on his needs.

“Volumes have been written about how to feed a baby on a schedule, but babies don't read or understand books,” Cathy says. - All children are different. Some people can eat on a schedule, but most can't. Most often, over time, the child develops his own schedule.

Some mothers report that their babies are fine with scheduled feedings, but they are probably just the few babies who would eat every four hours anyway. Adults rarely eat and drink the same foods at the same time of day - so why do we expect this from toddlers?

Offer your baby the breast at the first sign of hunger. Crying is already the last stage, so be attentive to early signs: the baby licks his lips, opens his mouth, sucks his fist, turns his head with his mouth open - looking for the breast. 4

What is a "milk flush"?

At the beginning of each feed, a hungry baby actively suckles the nipple,
thereby stimulating the milk flow reflex - the movement of milk through the milk ducts. 5

“Nipple stimulation triggers the release of the hormone oxytocin,” Cathy explains. “Oxytocin circulates throughout the body and causes the muscles around the milk-producing glands to contract and the milk ducts to dilate. This stimulates the flow of milk.

If the flushing reflex fails, milk will not come out. This is a hormonal response, and under stress it may not work at all or work poorly. Therefore, it is so important that you feel comfortable and calm when feeding.

“Studies show that each mother has a different rhythm of hot flashes during one feed,” Kathy continues, “Oxytocin is a short-acting hormone, it breaks down in just 30-40 seconds after formation. Milk begins to flow, the baby eats, the effect of oxytocin ends, but then a new rush of milk occurs, the baby continues to suckle the breast, and this process is repeated cyclically. That is why, during feeding, the child periodically stops and rests - this is how nature intended.

The flow of milk may be accompanied by a strong sensation of movement or tingling in the chest, although 21% of mothers, according to surveys, do not feel anything at all. 5 Cathy explains: “Many women only feel the first rush of milk. If you do not feel hot flashes, do not worry: since the child eats normally, most likely, you simply do not understand that they are.

How can you tell if your baby is getting enough milk?

Since it is impossible to track how much milk a baby eats while breastfeeding, mothers sometimes worry that the baby is malnourished. Trust your child and your body.

After a rush of milk, the baby usually begins to suckle more slowly. Some mothers clearly hear how the baby swallows, others do not notice it. But one way or another, the child himself will show when he is full - just watch carefully. Many babies make two or three approaches to the breast at one feeding. 6

“When a child has had enough, it is noticeable almost immediately: a kind of “milk intoxication” sets in. The baby is relaxed and makes it clear with his whole body that he is completely full, says Katie, “Diapers are another great way to assess whether the baby is getting enough milk. During this period, a breastfed baby should have at least five wet diapers a day and at least two portions of soft yellow stool, and often more. ”

From one month until weaning at six months of age, a baby's stool (if exclusively breastfed) should look the same every day: yellow, grainy, loose and watery.

When is the child's birth weight restored?

Most newborns lose weight in the first few days of life. This is normal and should not be cause for concern. As a rule, weight is reduced by 5-7%, although some may lose up to 10%. One way or another, by 10–14 days, almost all newborns regain their birth weight. In the first three to four months, the minimum expected weight gain is an average of 150 grams per week. But one week the child may gain weight faster, and the next slower, so it is necessary that the attending physician monitor the health and growth of the baby constantly. 7.8

At the slightest doubt or signs of dehydration, such as
dark urine, no stool for more than 24 hours, retraction of the fontanel (soft spot on the head), yellowing of the skin, drowsiness, lethargy, lack of appetite (ability to four to six hours without feeding), you should immediately consult a doctor. 7

What is "cluster feeding"?

When a baby asks for a breast very often for several hours, this is called cluster feeding. 6 The peak often occurs in the evening between 18:00 and 22:00, exactly when many babies are especially restless and need close contact with their mother. Most often, mothers complain about this in the period from two to nine weeks after childbirth. This is perfectly normal and common behavior as long as the baby is otherwise healthy, eating well, gaining weight normally, and appears content throughout the day. 9

Cluster feeding can be caused by a sharp jump in the development of the body - during this period the baby especially needs love, comfort and a sense of security. The growing brain of a child is so excited that it can be difficult for him to turn off, or it just scares the baby. 9 If a child is overworked, it is often difficult for him or her to calm down on his own and the help of adults is needed. And breastfeeding is the best way to calm the baby, because breast milk is not only food, but also pain reliever and a source of happiness hormones. 10

“Nobody told me about cluster feeding, so for the first 10 days I just went crazy with worry - I was sure that my milk was not enough for the baby,” recalls Camille, a mother from Australia, “It was a very difficult period . I was advised to pump and supplement until I finally contacted the Australian Breastfeeding Association. There they explained to me what was happening: it turned out that it was not about milk at all.

Remember, this is temporary. Try to prepare dinner for yourself in the afternoon, when the baby is fast asleep, so that in the evening, when he begins to often breastfeed, you have the opportunity to quickly warm up the food and have a snack. If you are not alone, arrange to carry and rock the baby in turns so that you have the opportunity to rest. If you have no one to turn to for help and you feel that your strength is leaving you, put the baby in the crib and rest for a few minutes, and then pick it up again.

Ask your partner, family and friends to help you with household chores, cooking and caring for older children if you have any. If possible, hire an au pair. Get as much rest as possible, eat well and drink plenty of water.

“My daughter slept a lot during the day, but from 23:00 to 5:00 the cluster feeding period began, which was very tiring,” recalls Jenal, a mother from the USA, “My husband tried his best to make life easier for me - washed, cleaned, cooked, changed diapers, let me sleep at every opportunity and never tired of assuring me that we were doing well.

If you are concerned about the frequency of breastfeeding, it is worth contacting a specialist. “Check with a lactation consultant or doctor to see if this is indicative of any problems,” recommends Cathy. “Resist the temptation to supplement your baby with formula (unless recommended by your doctor) until you find the cause. It may not be a matter of limited milk production at all - it may be that the child is inefficiently sucking it.

When will breastfeeding become easier?

This early stage is very special and does not last long. Although sometimes it seems that there will be no end to it, rest assured: it will get easier soon! By the end of the first month, breast milk production will stabilize, and the baby will become stronger and learn to suckle better. 2.3 Any problems with latch on will most likely be resolved by this time, and the body will be able to produce milk more efficiently, so inflammation and leakage of milk will begin to subside.

“The first four to six weeks are the hardest, but then things start to get better,” Cathy assures. It just needs to be experienced!”

The longer breastfeeding continues, the more benefits it brings, from saving on formula and improving sleep quality 11-13 to boosting your baby's immune system 14 and reducing your risk of certain cancers. 15

“When you feel like you're pushing yourself, try to go from feed to feed and day to day,” says Hannah, a British mom. “I was sure I wouldn’t make it to eight weeks. And now I have been breastfeeding for almost 17 weeks, and I dare say it is very easy.”

Read the resource Breastfeeding After the First Month: What to Expect

Readings

1 Naveed M et al. An autopsy study of relationship between perinatal stomach capacity and birth weight. Indian J Gastroenterol .1992;11(4):156-158. - Navid M. et al., Association between prenatal gastric volume and birth weight. Autopsy. Indian J Gastroenterol. 1992;11(4):156-158.

2 Neville MC et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation .Am J Clinl Nutr . 1988;48(6):1375-1386. at the beginning and at the peak of lactation." Am F Clean Nutr. 1988;48(6):1375-1386.

3 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet , Gynecol , & Neonatal Nurs . 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121.

4 Australian Breastfeeding Feeding cues ; 2017 Sep [ cited 2018 Feb ]. - Australian Breastfeeding Association [Internet], Feed Ready Signals; September 2017 [cited February 2018]

5 Kent JC et al. Response of breasts to different stimulation patterns of an electric breast pump. J Human Lact . 2003;19(2):179-186. - Kent J.S. et al., Breast Response to Different Types of Electric Breast Pump Stimulation. J Human Lact (Journal of the International Association of Lactation Consultants). 2003;19(2):179-186.

6) Kent JC et al . Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3):e387-95.

7 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p . - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." Seventh edition. Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2010. P. 1128.

8 World Health Organization. [Internet]. Child growth standards; 2018 [cited 2018 Feb] - World Health Organization. [Internet]. Child Growth Standards 2018 [cited February 2018].

9 Australian Breastfeeding Association . [ Internet ]. Cluster feeding and fussing babies ; Dec 2017 [ cited 2018 Feb ] - Australian Breastfeeding Association [Internet], Cluster Feeding and Screaming Babies; December 2017 [cited February 2018].

10 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206.- Moberg K, Prime DK, "Oxytocin effects on mother and child during breastfeeding". Infant. 2013;9(6):201-206.

11 U.S. Department of Health & Human Services [Internet]. Surgeon General Breastfeeding factsheet; 2011 Jan 20 [cited 2017 Feb] - Department of Health and Human Services [Internet], "Breastfeeding Facts from the Chief Medical Officer", Jan 20, 2011 [cited Feb 2017]

12 Kendall-Tackett K et al. The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. clinical lactation. 2011;1;2(2):22-26. - Kendall-Tuckett, K. et al., "Influence of feeding pattern on sleep duration, maternal well-being and the development of postpartum depression." Clinical Lactation. 2011;2(2):22-26.

13 Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breast Med . 2015;10(5):246-252. - Brown A., Harris W., "Night feedings and infant sleep in the first year of life and their association with feeding frequency, daytime supplementation, and infant weight." Brest Med (Breastfeeding Medicine). 2015;10(5):246-252.

14 Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk.

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